BJPsych Open最新文献

{"title":"Stability in attention-deficit hyperactivity disorder prevalence: wishful illusion or complex reality?","authors":"Yasser Saeed Khan, Waleed Ahmed, Jigna Stott","doi":"10.1192/bjo.2026.11009","DOIUrl":"10.1192/bjo.2026.11009","url":null,"abstract":"<p><p>This editorial examines the current debate surrounding attention-deficit hyperactivity disorder prevalence, the perceived surge in diagnoses and the growing pressure on healthcare services. It discusses the wide methodological variation in recent studies, the limited pool of high-quality evidence and the challenges this creates when trying to understand true population rates. The article highlights the gap between stable epidemiological estimates and the marked rise in referrals, waiting lists, private assessments and prescribing. It explores how increased awareness, evolving diagnostic criteria and improved detection of previously unrecognised cases contribute to the overall picture, along with the role of social media and shifting societal attitudes. Implications for policy and clinical practice are outlined, emphasising the need for efficient clinical pathways, better-quality data and more comprehensive, multi-informant assessments.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e96"},"PeriodicalIF":3.5,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572566","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":"Mental health practitioners' experiences and practices in making decisions about onward care for patients presenting to emergency departments with self-harm or suicidal ideation: systematic review and meta-synthesis.","authors":"Mimi Suzuki, Alexandra E Bakou, James Dove, Rose McCabe","doi":"10.1192/bjo.2026.11007","DOIUrl":"10.1192/bjo.2026.11007","url":null,"abstract":"<p><strong>Background: </strong>Emergency department mental health practitioners (MHPs) decide onward care for individuals presenting with self-harm or suicidal ideation. However, their experiences and practices in making these decisions remain underexplored.</p><p><strong>Aims: </strong>To synthesise research on MHPs' experiences and practices in making decisions about onward care for patients presenting to emergency departments with self-harm or suicidal ideation.</p><p><strong>Method: </strong>We searched six databases (inception to July 2024) for empirical studies of MHPs making care decisions for self-harm or suicidal patients in emergency departments. We used a segregated mixed-methods design, applying narrative synthesis of quantitative data and thematic synthesis of qualitative data.</p><p><strong>Results: </strong>Eleven studies were included (one quantitative, one mixed-methods, nine qualitative). Narrative synthesis of quantitative data produced two themes: (a) subjective decision-making and variability among MHPs and (b) impact of the institutional mandate to discharge within 4 h on referral outcomes. Thematic synthesis of qualitative data generated five themes: (a) risk-centric culture is anti-therapeutic and shapes defensive practice, scepticism toward patients and burnout; (b) time and environmental pressures impact therapeutic potential of assessments; (c) 'battling' to access services: gatekeeping, cycles of repeat attendances affecting patient safety and staff moral injury; (d) strategies to facilitate access and extending care to overcome challenges in the emergency department and (e) potential for training to counter negative attitudes and stereotypes.</p><p><strong>Conclusions: </strong>Intersecting institutional, systemic and emotional pressures shape MHPs' practices, undermining assessment quality and access to care. System-level reforms and training should promote relational, compassionate care. Limited quantitative evidence restricted integration, and the review reflects high-income Western settings.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e95"},"PeriodicalIF":3.5,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572518","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":"Prevalence and related factors of anxiety symptoms in patients with major depressive disorder and a history of recent suicide attempts: cross-sectional study.","authors":"Quanfeng Zhu, Wenli Chen, Xiaoe Lang, Yali Zheng, Xiang-Yang Zhang","doi":"10.1192/bjo.2026.11000","DOIUrl":"10.1192/bjo.2026.11000","url":null,"abstract":"<p><strong>Background: </strong>Patients with major depressive disorder (MDD) are known to be at a heightened risk of suicide. Research indicates that comorbid anxiety may further elevate this risk. However, studies specifically examining the prevalence of anxiety and its associated factors among patients with MDD and history of a recent suicide attempt (RSA) remain limited.</p><p><strong>Aims: </strong>To investigate the prevalence of anxiety and the factors associated with its severity in patients with MDD.</p><p><strong>Method: </strong>A total of 1718 patients with MDD were included. Hypothesis testing and binary logistic regression were employed to examine differences in anxiety severity and clinical factors between patients with and without an RSA, as well as the association between anxiety severity and RSA. Subsequently, patients with MDD were categorised into three subgroups based on anxiety severity. One-way analysis of variance and multivariate logistic regression were then conducted to identify factors associated with anxiety symptoms.</p><p><strong>Results: </strong>Anxiety severity was identified as an independent correlate of RSA. Compared with patients with anxiety, patients with MDD and significant or severe anxiety had a 2.9-fold and 11.8-fold increased risk of RSA, respectively. Furthermore, Hamilton Rating Scale for Depression score, Positive and Negative Syndrome Scale positive subscale score, and thyroid function indices (free triiodothyronine and thyroid-stimulating hormone levels) were also determined to be independent correlates of anxiety severity.</p><p><strong>Conclusions: </strong>Anxiety is associated with risk of RSA in patients with MDD, and depressive symptoms, positive psychotic symptoms and thyroid function may be related factors for severity of anxiety.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e97"},"PeriodicalIF":3.5,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572488","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":"When forensic psychiatry clashes with jurisdiction: nemesis and challenges of a patient suffering from glioblastoma.","authors":"Ambra D'Imperio, Didier Delessert, Marcello Ienca, Georg Starke","doi":"10.1192/bjo.2026.11022","DOIUrl":"10.1192/bjo.2026.11022","url":null,"abstract":"<p><p>This case study explores the interaction of brain pathology, criminal behaviour and art in forensic psychiatry through the case of a 68-year-old man exhibiting neuropsychiatric symptoms and delusions. His progressive cognitive and emotional deterioration led to aggressive behaviour, threats towards colleagues and family and allegations of violent and sexual assault. After months of his refusing treatment, magnetic resonance imaging revealed a grade IV glioblastoma. Despite the terminal diagnosis, he was placed in a forensic acute psychiatric unit while under prosecutorial investigation, because his actions remained criminally relevant. In this restrictive setting, he turned to drawing as his primary coping strategy. His artwork offered both an outlet for suffering and a means of transcending a situation characterised by severe illness, legal deprivation of liberty and existential despair. The case illustrates the benefit of creative expression when medical and legal circumstances appear intractable. It also raises ethical and forensic concerns, including impaired culpability due to amygdala and prefrontal damage, refusal of care, thoughts of physician-assisted suicide and the attribution of legal responsibility.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 2","pages":"e94"},"PeriodicalIF":3.5,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147519970","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":"Long-term segregation in mental health hospitals: qualitative study of its impact and human rights implications.","authors":"Kathryn Fradley, Alina Haines-Delmont","doi":"10.1192/bjo.2026.10996","DOIUrl":"10.1192/bjo.2026.10996","url":null,"abstract":"<p><strong>Background: </strong>Long-term segregation (LTS) is used in mental health hospitals in England to manage individuals perceived to pose a sustained risk of harm to others. Increasing evidence indicates that LTS causes significant psychological and physical harm and may breach international human rights standards. The HOPE(S) programme (2022-2025) was introduced nationally to reduce, and ultimately end, the use of LTS for autistic people, individuals with learning disabilities and children and young people.</p><p><strong>Aims: </strong>To explore the experiences of LTS from different perspectives and to examine its impact through a human rights lens.</p><p><strong>Method: </strong>Qualitative data were collected from 73 participants, including people with lived experience of LTS, family members, HOPE(S) practitioners, clinical staff, commissioners and regulators. Reflexive thematic analysis was conducted as part of a wider, mixed-methods evaluation of the HOPE(S) programme.</p><p><strong>Results: </strong>LTS was described by most participants as harmful, dehumanising and lacking in therapeutic value. Four interrelated themes emerged: (a) dehumanisation and erosion of personhood; (b) safeguarding and systemic failure; (c) psychological and relational harm; and (d) loss of hope and systemic inertia. These experiences reflected breaches of the Convention on the Rights of Persons with Disabilities, and of the Convention on the Rights of the Child.</p><p><strong>Conclusions: </strong>LTS is not a therapeutic intervention and is associated with profound psychological harm and human rights violations. Systemic reform and implementation of rights-based, trauma-informed alternatives, such as the HOPE(S) model, are urgently required to safeguard well-being and dignity in mental healthcare.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 2","pages":"e93"},"PeriodicalIF":3.5,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147519989","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":"Measurement properties of the Supporting Voice Hearers Measure (SVHM): new scale to evaluate mental health workers' beliefs, attitudes, confidence and behaviours related to working with voice hearers.","authors":"Justin Newton Scanlan, Anne Honey, Lyndal Sherwin, Haylee Zink, Karen Wells, Glenda Jessup, Nicola Hancock","doi":"10.1192/bjo.2026.11005","DOIUrl":"10.1192/bjo.2026.11005","url":null,"abstract":"<p><strong>Background: </strong>Supporting voice hearers to explore and make meaning of their voice-hearing experiences can be helpful, but many mental health workers lack confidence or do not feel they have the skills required to do this. Although more is needed, some resources and training are available to assist workers in this area. To date, there are no suitable measures to evaluate the impact of these resources and training. Therefore, Supporting Voice Hearers Measure (SVHM) was developed. SVHM is a 23-item scale designed to evaluate mental health workers' beliefs, attitudes, confidence and behaviours related to working with voice hearers.</p><p><strong>Aims: </strong>To describe the development and testing of the SVHM.</p><p><strong>Method: </strong>Measurement properties explored included rating scale validity, unidimensionality, reliability, construct validity and person-fit statistics. Additionally, evaluations of concurrent validity, responsiveness and time taken to complete SVHM were completed.</p><p><strong>Results: </strong>A total of 548 completions of SVHM were included in the analysis. One item was interfering with measurement precision and was subsequently removed. The resultant 22-item measure demonstrated generally good measurement properties according to the quality criteria set. It demonstrated good concurrent reliability with confidence in working with voice hearers (<i>r</i> = 0.49, <i>p</i> < 0.001), strong responsiveness and evidence of feasibility, with a median time for completion of 3 min 39 s.</p><p><strong>Conclusions: </strong>These results suggest that SVHM is a promising measure of mental health workers' beliefs, attitudes, confidence and behaviours related to working with voice hearers. Future research should explore how changes in mental health workers' beliefs, attitudes, confidence and behaviours impact the experiences and outcomes achieved by the voice hearers they are working with.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 2","pages":"e92"},"PeriodicalIF":3.5,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147519979","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":"Advances in the study of non-suicidal self-injury in adolescents and emerging adults: integrating the <i>BJPsych Open</i> thematic series.","authors":"Theodore A Petti, Kathryn R Cullen","doi":"10.1192/bjo.2026.10998","DOIUrl":"10.1192/bjo.2026.10998","url":null,"abstract":"<p><p>The <i>BJPsych Open</i> thematic series is devoted to recent advances in the study of non-suicidal self-injury (NSSI) in youth. Together, this body of work reveals new insights that, if replicated, could be translated into clinical practice, enhancing our abilities to understand and treat young people presenting with NSSI.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 2","pages":"e91"},"PeriodicalIF":3.5,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147519935","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":"Preconception mental health and developmental vulnerability at school entry: population-based cohort study.","authors":"Naomi N Phagau, Paramdeep Kaur, Amanda S Nitschke, Helena Abreu do Valle, Michael R Law, Martin Guhn, Tim F Oberlander, Gillian E Hanley","doi":"10.1192/bjo.2026.11001","DOIUrl":"10.1192/bjo.2026.11001","url":null,"abstract":"<p><strong>Background: </strong>Perinatal depression and/or anxiety (depression-anxiety) have been associated with developmental disruptions. Less attention has been paid to preconception mental health, which could also contribute to adverse outcomes.</p><p><strong>Aims: </strong>To examine whether preconception mental health is associated with developmental vulnerability in children who were either exposed or unexposed to prenatal depression.</p><p><strong>Method: </strong>A population-based, retrospective cohort including 130 631 births to 108 340 pregnant people from British Columbia (Canada) between 1 January 2001 and 31 December 2012, with child development data in the form of the Early Development Instrument (EDI). Logistic regression using cluster-robust standard errors was used to compare the odds of vulnerability on EDI domains.</p><p><strong>Results: </strong>Children born to pregnant people in all groups with depression-anxiety preconception history were more likely to be considered vulnerable on all developmental domains, except for communication skills and general knowledge, than those without prenatal depression and no preconception depression-anxiety. After adjusting for confounders, effect size was largest for children born to a person with prenatal depression who had persistent depression-anxiety before they conceived on the domains of physical health and well-being (adjusted odds ratio 1.73 [95% CI: 1.56-1.92]). Children born to people with prenatal depression but no preconception depression-anxiety were probably more vulnerable on social competence and emotional maturity domains than those without prenatal depression and no preconception depression-anxiety.</p><p><strong>Conclusions: </strong>Preconception mental health is associated with child development, even after accounting for depression in pregnancy. We hypothesise that it is picking up on different experiences of mental illness through the life course and represents slightly different fetal exposures.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 2","pages":"e90"},"PeriodicalIF":3.5,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497645","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":"Psychotropic medication use and bone loss in men: longitudinal study.","authors":"D Kavindi Weerasinghe, Amanda L Stuart, Julie A Pasco, Mohammadreza Mohebbi, Jason M Hodge, Rasika M Samarasinghe, Lana J Williams","doi":"10.1192/bjo.2026.10985","DOIUrl":"10.1192/bjo.2026.10985","url":null,"abstract":"<p><strong>Background: </strong>Psychotropic medication use has been shown to be associated with decreased bone mineral density (BMD) and quality, and increased fracture risk. Less is known about psychotropic use and associated bone loss over time.</p><p><strong>Aims: </strong>To determine the association between psychotropic medication use and bone loss in men.</p><p><strong>Method: </strong>Data from 940 men (aged ≥20 years) participating in the Geelong Osteoporosis Study were used in this longitudinal study. BMD (g/cm²) at the spine and hip were measured with dual-energy X-ray absorptiometry at baseline, and 5 and 15 years post-baseline. Body mass index (BMI) was calculated, lifestyle factors and medication use was self-reported, and socioeconomic status was determined. Mood and anxiety disorders were identified through a clinical interview. Multivariable linear regression was used to determine the associations.</p><p><strong>Results: </strong>Over the study period (median 13.2 years), psychotropic use was associated with change in BMD at the spine (unadjusted mean difference -0.063 g/cm², 95% CI -0.096 to -0.031, <i>p</i> < 0.001) and hip (-0.038 g/cm², 95% CI -0.059 to -0.017, <i>p</i> < 0.001). BMI was identified as an effect modifier. Psychotropic use was associated with spine and hip bone loss at the 25th (adjusted mean difference -0.077g/cm² (95% CI -0.122 to -0.033); and -0.058 g/cm² (95% CI -0.084 to -0.032), respectively) and 50th percentile (adjusted mean difference -0.053 g/cm² (95% CI -0.089 to -0.018) and -0.038 g/cm² (95% CI -0.059 to -0.017), respectively), but not the 75th percentile of BMI (<i>p</i> = 0.121 and <i>p</i> = 0.106, respectively).</p><p><strong>Conclusions: </strong>Psychotropic use was associated with bone loss in non-obese men, highlighting the need for regular monitoring and preventive strategies to protect bone health.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 2","pages":"e89"},"PeriodicalIF":3.5,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430708","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":"Mental health support for British Bangladeshi youth: multi-stakeholder qualitative study of priorities and preferences.","authors":"Ishrat Shahnaz, Hannah Kate Lewis, Kelly Rose-Clarke, Daniel Michelson, Petra C Gronholm, Erica Cini","doi":"10.1192/bjo.2026.10999","DOIUrl":"10.1192/bjo.2026.10999","url":null,"abstract":"<p><strong>Background: </strong>Despite young British Bangladeshis experiencing a higher prevalence of mental health problems than the White British population, they are comparatively underrepresented in mental health research and fewer access services.</p><p><strong>Aims: </strong>This study aimed to identify priorities and preferences for mental health support among young British Bangladeshis, as well as strategies to enhance the cultural appropriateness and accessibility of services.</p><p><strong>Method: </strong>A qualitative study was conducted in London and Leicester, with participants recruited through voluntary and community organisations. In-depth interviews were held with young people with lived experience of mental health problems (<i>n</i> = 12), their family members (<i>n</i> = 7) and Bangladeshi community workers from voluntary sector organisations (<i>n</i> = 7). Data were analysed using thematic framework analysis.</p><p><strong>Results: </strong>Participants' priorities for mental health support included reducing stigma, raising awareness, and addressing intergenerational and identity-related stressors. Preferences centred on culturally and linguistically appropriate care delivered by therapists familiar with Bangladeshi values in trusted community settings. Suggested strategies for improving existing services included enhancing access by providing support in trusted community spaces, building trust through the involvement of culturally aware professionals, and involving families and community leaders to reduce stigma and promote open discussion around youth mental health.</p><p><strong>Conclusions: </strong>This study identifies a need for culturally tailored, linguistically accessible and community-rooted mental health support for British Bangladeshi youth. Representatives from these communities should be actively involved in the development of future programmes and policies, ensuring that support is both relevant and sustainable.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 2","pages":"e86"},"PeriodicalIF":3.5,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389347","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}