BJPsych Open最新文献

{"title":"Enhanced treatment outcomes for schizophrenia through combined long-acting injectable antipsychotic medications and home visits: retrospective cohort study.","authors":"Hiroyuki Harada, Shigemasa Katayama, Tadafumi Kato","doi":"10.1192/bjo.2025.10809","DOIUrl":"10.1192/bjo.2025.10809","url":null,"abstract":"<p><strong>Background: </strong>Long-acting injectable antipsychotic medications (LAIs) are more beneficial than oral medications for people with schizophrenia. However, some individuals are unable to visit out-patient clinics due to their symptoms, resulting in missed monthly LAI injections and subsequent relapse. Home visits for administration of LAIs could potentially reduce treatment failure, but there are no comparative studies on their effectiveness.</p><p><strong>Aims: </strong>This study aims to evaluate whether home visit administration of LAIs, compared with the out-patient clinic, reduces treatment failure for those with schizophrenia.</p><p><strong>Method: </strong>We conducted a retrospective cohort study using electronic medical records from Seijin Hospital. Patients diagnosed with schizophrenia and treated with LAIs during hospitalisation between 1 April 2020 and 31 March 2023 were included. Following discharge, patients were followed for 1 year, either under home visits or out-patient clinic visits. The primary outcome was defined as treatment failure, including psychiatric rehospitalisation, discontinuation of treatment or death. Multivariate Cox proportional hazards regression analysis was performed to evaluate treatment failure risks.</p><p><strong>Results: </strong>A total of 125 patients in the home visit group and 117 in the out-patient group were included. During the follow-up period, home visits significantly reduced the risk of treatment failure (hazard ratio 0.62, 95% CI 0.40-0.97). However, having two or more psychiatric hospitalisations (hazard ratio 2.32, 95% CI 1.28-4.37) and living alone following discharge (hazard ratio 1.77, 95% CI 1.07-2.86) were associated with significantly increased risk of treatment failure.</p><p><strong>Conclusions: </strong>Home visits, compared with out-patient clinic care, significantly reduce treatment failure in individuals with schizophrenia undergoing LAI treatment.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e183"},"PeriodicalIF":3.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854414","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":"Retrospective chart review of cases of steroid-responsive catatonia: exploring a potential autoimmune aetiology.","authors":"Rifat Serav Ilhan, Jonathan P Rogers, Kazım Cihan Can, Berker Duman, Burçin Çolak, Meram Can Saka, Seyda Erdoğan, Rezzak Yilmaz, Canan Yucesan, Mine Araz, Güle Çınar, Sena Ünal, Özlem Doğan, Emine Uslu, Thomas A Pollak","doi":"10.1192/bjo.2025.10806","DOIUrl":"10.1192/bjo.2025.10806","url":null,"abstract":"<p><strong>Background: </strong>Catatonia, a neuropsychiatric syndrome, can be associated with inflammatory conditions of the central nervous system.</p><p><strong>Aims: </strong>To explore steroid-responsive catatonia with possible autoimmune origins.</p><p><strong>Method: </strong>A retrospective investigation was conducted of clinical and paraclinical features, including imagining, serum, and cerebrospinal fluid findings in ten patients presenting with subacute onset catatonia and treated with steroid pulse therapy between January 2022 and January 2024.</p><p><strong>Results: </strong>A retrospective chart review identified ten patients (of a total of 56) with steroid-responsive subacute onset catatonia. Catatonia types varied. All patients were positive for delirium and psychotic symptoms. Imaging and cerebrospinal fluid results indicated non-specific signs of central nervous system inflammation. Intravenous 1 g methylprednisolone pulse therapy resulted in complete remission in all patients. Autoantibodies for limbic and paraneoplastic encephalitis were negative for all patients. None of the patients fulfilled the criteria for definite autoimmune encephalitis or autoantibody-negative probable autoimmune encephalitis.</p><p><strong>Conclusions: </strong>Diagnosis of autoimmune catatonia is challenging without autoantibody markers, but steroid responsiveness, combined with clinical and paraclinical features, may suggest an autoimmune mechanism.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e182"},"PeriodicalIF":3.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854426","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":"An overview of antipsychotic drug prescribing trends (initiation/prevalence) in UK primary care from 1995 to 2018: analysis of electronic health records from over 790 general practices.","authors":"Siti Watiqah Samsuddin, Claudia Cooper, Joseph Hayes, Juan Carlos Bazo-Alvarez, Patricia Schartau, Irene Petersen","doi":"10.1192/bjo.2025.10815","DOIUrl":"10.1192/bjo.2025.10815","url":null,"abstract":"<p><strong>Background: </strong>Initially prescribed for schizophrenia and psychosis, antipsychotics are increasingly prescribed for other indications. Since the late 1990s, prescribing shifted from first-generation to second-generation antipsychotics.</p><p><strong>Aims: </strong>To examine overall initiation and prevalence of antipsychotic drug prescribing in UK primary care from 1995 to 2018, stratified by gender.</p><p><strong>Method: </strong>Cohort studies using UK anonymised electronic primary care data from IQVIA Medical Research Data, including over 790 general practices and registered individuals aged 18-99 years.</p><p><strong>Results: </strong>Antipsychotic drug initiation was stable in the late 1990s, at 6-7/1000 person-years at risk (PYAR) in men and 9-11/1000 PYAR in women. From 2001, initiation declined, stabilising from 2005 onward at 4/1000 PYAR in men and 4-5/1000 PYAR in women. Prevalence remained consistent from 1995 to 2018: 12/1000 in men and 14/1000 in women by 2018. Initiation and prevalence were higher in women than men, but increased with age in both genders: (18-39 <i>v</i>. 80-99 years; incidence rate ratio (IRR) 4.85, 95% CI 4.75-4.95 in men; IRR 5.90, 95% CI 5.78-6.02 in women; prevalence rate ratio (PRR) 2.22, 95% CI 2.19-2.25 in men; PRR 4.28, 95% CI 4.24-4.33 in women). Initiation and prevalence were greater in individuals with greater socioeconomic deprivation (Townsend score of 5 <i>v</i>. 1; IRR 2.69, 95% CI 2.64-2.75 in men; IRR 2.19, 95% CI 2.15-2.24 in women; PRR 3.87, 95% CI 3.82-3.92 in men; PRR 2.80, 95% CI 2.77-2.83 in women).</p><p><strong>Conclusions: </strong>Antipsychotic drug initiation decreased after 2001, stabilising from 2005 onward. Prevalence remained relatively consistent throughout the study period. Women had higher initiation and prevalence than men. However, both genders showed increased prescribing with age and socioeconomic deprivation.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e180"},"PeriodicalIF":3.5,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854412","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":"<i>BJPsych Open</i>: celebrating 10 years of publishing excellence: a decade in review.","authors":"Kenneth R Kaufman","doi":"10.1192/bjo.2025.10773","DOIUrl":"10.1192/bjo.2025.10773","url":null,"abstract":"<p><p>In celebrating the 10th anniversary of <i>BJPsych Open</i>, this editorial review serves as a personal reflection and an overview of the birth, growth, expansion and excellence of the Journal as well as an introduction to the <i>BJPsych Open</i> 10th Anniversary Thematic Series. Specific emphasis is placed on changes and advances in productivity, the editorial board, publishing, thematic series, topical articles and focus on ethics. Further, articles of importance to our stakeholders are noted (top cited/downloaded, highlighted articles, articles of the month). The remit and vision for <i>BJPsych Open</i> remains unchanged: a general psychiatric journal with high-quality, methodologically rigorous and relevant publications, with relevance to the advancement of clinical care, patient outcomes, the scientific literature, research and policy. The Journal's continued quality, growth and international recognition speak to its place in scientific literature, to the RCPsych mission to disseminate knowledge and to its bright future. As Editor-in-Chief, I note the debt of gratitude owed to an exemplary multidisciplinary team and the honour and privilege of serving in this role.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e179"},"PeriodicalIF":3.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833967","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":"Hamilton Rating Scale for Anxiety: exploring validity with robust measures of classical theory parameters and a rating scale model in university students.","authors":"Md Dilshad Manzar, Faizan Z Kashoo, Mohammed Salahuddin, Dejene Nureye, Habtamu Acho Addo, Seithikurippu R Pandi-Perumal, Amir H Pakpour, Ahmed S Bahammam","doi":"10.1192/bjo.2025.10055","DOIUrl":"10.1192/bjo.2025.10055","url":null,"abstract":"<p><strong>Background: </strong>No research has assessed Hamilton Rating Scale for Anxiety (HRSA) psychometric properties in Ethiopian university students, using item response theory (IRT) and classical theory.</p><p><strong>Aims: </strong>This study aimed to assess psychometric properties of the English HRSA in Ethiopian students, using IRT and classical theory.</p><p><strong>Method: </strong>University students (<i>N</i> = 370, age 21.44 ± 2.30 years) in Ethiopia participated in a cross-sectional study. Participants completed a self-reported measure of anxiety, a sociodemographics tool and interviewer-administered HRSA.</p><p><strong>Results: </strong>Confirmatory factor analysis (CFA) favoured a one-factor structure because fit indices for the one-factor model; and two distinct two-factor models were similar, but high interfactor correlations violated discriminant validity criteria in two-factor models. This one-factor structure showed structural invariance as evidenced by multi-group CFA across gender groups. No ceiling/floor effects were seen for the HRSA total scores. Infit and outfit mean square values for all the items were within the acceptable range (0.6-1.4). Four threshold estimates (<i>τ</i>i1, <i>τ</i>i2, <i>τ</i>i3 and <i>τ</i>i4) for each item were ordered as expected. Differential item functions showed item-level measurement invariance for all the 14 HRSA items across gender for both uniform and non-uniform estimates. McDonald's <i>ω</i> and Cronbach's <i>α</i> for the HRSA tool were both 0.88. The convergent validity of the interviewer-administered HRSA with self-reported anxiety subscale of the 21-item Depression, Anxiety and Stress Scale was weak to moderate.</p><p><strong>Conclusions: </strong>The findings favour the validity of a one-factor structure of the HRSA with adequate item properties (classical and rating scale model), convergent validity, reliability and measurement invariance (structural and item level) across gender groups in Ethiopian university students.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e176"},"PeriodicalIF":3.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820515","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 hyperadrenergic state in hypertension is associated with depressive symptoms and impaired stress-modulated vasomotor responses: evidence for chronic stress as a common aetiology for a hypertension/depression phenotype.","authors":"Bushra Farukh, Luca Faconti, Ryan J McNally, Calum D Moulton, Allan H Young, Phil J Chowienczyk","doi":"10.1192/bjo.2025.64","DOIUrl":"10.1192/bjo.2025.64","url":null,"abstract":"<p><strong>Background: </strong>Noradrenergic activation in the central and peripheral nervous systems is a putative mechanism explaining the link between hypertension and affective disorders.</p><p><strong>Aims: </strong>We investigated whether these stress-sensitive comorbidities may be dependent on basal noradrenergic activity and whether vascular responses to centrally acting stimuli vary according to noradrenergic activity.</p><p><strong>Method: </strong>We examined the relation of affective disorders and stress-mediated vascular responses to plasma concentrations of normetanephrine, a measure of noradrenergic activity, in subjects with primary hypertension (<i>n</i> = 100, mean ± s.d. age 43 ± 11 years, 54% male). The questionnaires Patient Health Questionnaire-9 (PHQ-9), 16-item Quick Inventory of Depressive Symptomatology-Self Report (QIDSSR-16) and Generalized Anxiety Disorder-7 (GAD-7) were used for evaluation of symptoms of depression and anxiety. Forearm blood flow (strain gauge plethysmography) was used to assess vascular responses to mental stress and to device-guided breathing (DGB), interventions that respectively increase or decrease noradrenergic activity in the prefrontal cortex and locus coeruleus.</p><p><strong>Results: </strong>Low mood and high anxiety were two- to threefold higher for hypertensive subjects in the highest compared with the lowest normetanephrine tertiles (each <i>P</i> < 0.005). Forearm vasodilator responses to mental stress and vasoconstrictor responses to DGB were attenuated in those with high compared with low normetanephrine (28.3 ± 21% <i>v</i>. 47.1 ± 30% increases for mental stress and 3.7 ± 21% <i>v</i>. 18.6 ± 15% decreases for DGB for highest versus lowest tertiles of normetanephrine, each <i>P</i> ≤ 0.01).</p><p><strong>Conclusions: </strong>A hyperadrenergic state in hypertension is associated with mood disturbance and impaired stress-modulated vasomotor responses. This association may be mediated by chronic stress impinging on pathways regulating central arousal and peripheral sympathetic nerve activity.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e175"},"PeriodicalIF":3.5,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815701","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":"Adaptations to implementation frameworks for minority ethnic groups to improve health equity: systematic scoping review.","authors":"Emma Mckenzie, Phoebe Barnett, Georgie Parker, Stephen Pilling","doi":"10.1192/bjo.2025.10075","DOIUrl":"10.1192/bjo.2025.10075","url":null,"abstract":"<p><strong>Background: </strong>There are critical gaps within implementation science concerning health equity, particularly for minoritised ethnic groups. Implementation framework adaptations are important to facilitate health equity, which is especially relevant for psychiatry due to ethnic inequities in mental health; however, the range of potential adaptations has yet to be synthesised.</p><p><strong>Aims: </strong>This systematic scoping review aimed to identify and map the characteristics of adaptations to implementation frameworks for minority ethnic groups to improve health equity.</p><p><strong>Method: </strong>Bibliographic searches of the MEDLINE, Embase, PsycINFO and CINAHL databases were conducted, spanning the period from 2004 to February 2024 for descriptions of implementation frameworks adapted for minority ethnic groups. The characteristics of those meeting the criteria were narratively synthesised.</p><p><strong>Results: </strong>Of the 2947 papers screened, six met the eligibility criteria. Three different types of implementation frameworks were adapted across the six papers: evaluation, process and determinant frameworks. Most of the adaptations were made by expanding the original framework, and by integrating it with another model, theory or framework with an equity focus. The adaptations primarily focused on putting equity at the forefront of all stages of implementation from intervention selection to implementation sustainability. No studies measured the effectiveness of the adapted framework.</p><p><strong>Conclusions: </strong>The findings demonstrate that implementation frameworks are modifiable, and different elements can be adapted according to the implementation framework type. This review provides a starting point for how researchers and healthcare providers can adapt existing implementation frameworks to promote health equity for minoritised groups across a range of healthcare settings.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e173"},"PeriodicalIF":3.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798126","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":"Sustainable financing for mental health and noncommunicable diseases: what's at stake?","authors":"Dan Chisholm, David Watkins, Jumana Qamruddin","doi":"10.1192/bjo.2025.10800","DOIUrl":"10.1192/bjo.2025.10800","url":null,"abstract":"<p><p>Informed by an international dialogue on sustainable financing for noncommunicable diseases and mental health in 2024, this Editorial explores some of the key financing issues to be addressed in September 2025 at the United Nations General Assembly high-level meeting on noncommunicable diseases and mental health, including those relating to domestic resource mobilisation, external assistance and health financing reforms.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e174"},"PeriodicalIF":3.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798127","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":"Resilience among refugee mothers: scoping review of promotion and hindrance factors.","authors":"Francesca Zecchinato, Ingi Iusmen, Dawn-Marie Walker, Pia Riggirozzi, Ken Brackstone","doi":"10.1192/bjo.2025.10781","DOIUrl":"10.1192/bjo.2025.10781","url":null,"abstract":"<p><strong>Background: </strong>Refugee mothers represent a significant proportion of the migrant population worldwide. Their resilience has important implications for their health and the positive adjustment of their family units. However, refugee mothers have received little attention in research.</p><p><strong>Aims: </strong>This review provides an overview of factors that may promote or hinder resilience among refugee mothers and a foundation for identifying potential targets for clinical and policy interventions.</p><p><strong>Method: </strong>A scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) reporting guidelines, using pre-defined criteria and a relevant search strategy on four databases: Web of Science Core Collection, APA PsycINFO, Ovid Medline, and Ovid Embase Classic+Embase. Study characteristics and data on resilience promotion and hindrance factors were extracted, and results were narratively synthesised.</p><p><strong>Results: </strong>Five articles met our inclusion criteria. Four studies described resilience promotion factors, and two studies described resilience hindrance factors. External (social or instrumental, community or professional, economic, and cultural) and internal (individual or psychological, and spiritual or religious) resilience resources were perceived as important for building resilience among refugee mothers.</p><p><strong>Conclusions: </strong>The most recurrent resilience promotion factors related to possessing strong social networks and instrumental support, while the most recurrent resilience hindrance factors related to community and professional stressors, such as accessing healthcare. These findings serve as a first step towards identifying potential clinical and policy intervention targets to strengthen resilience in refugee mothers - a vulnerable and currently under-studied population. This review can provide a guide for policymakers, health professionals, refugee charities and local communities in prioritising the efforts to address refugee mothers' needs.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e172"},"PeriodicalIF":3.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793427","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":"Factors associated with drug-drug interactions involving citalopram in the UK Biobank.","authors":"Benjamin Laplace, Win Lee Edwin Wong, Marco Menchetti, Diana De Ronchi, Paolo Fusar-Poli, Giuseppe Fanelli, Alessandro Serretti, Cathryn M Lewis, Chiara Fabbri","doi":"10.1192/bjo.2025.10060","DOIUrl":"10.1192/bjo.2025.10060","url":null,"abstract":"<p><strong>Background: </strong>Adults with mood and/or anxiety disorders have increased risks of comorbidities, chronic treatments and polypharmacy, increasing the risk of drug-drug interactions (DDIs) with antidepressants.</p><p><strong>Aims: </strong>To use primary care records from the UK Biobank to assess DDIs with citalopram, the most widely prescribed antidepressant in UK primary care.</p><p><strong>Method: </strong>We classified drugs with pharmacokinetic or pharmacodynamic DDIs with citalopram, then identified prescription windows for these drugs that overlapped with citalopram prescriptions in UK Biobank participants with primary care records. We tested for associations of DDI status (yes/no) with sociodemographic and clinical characteristics and with cytochrome 2C19 activity, using univariate tests, then fitted multivariable models for variables that reached Bonferroni-corrected significance.</p><p><strong>Results: </strong>In UK Biobank primary care data, 25 508 participants received citalopram prescription(s), among which 11 941 (46.8%) had at least one DDI, with an average of 1.96 interacting drugs. The drugs most commonly involved were proton pump inhibitors (40% of co-prescription instances). Individuals with DDIs were more often female and older, had more severe and less treatment-responsive depression, and had higher rates of psychiatric and physical disorders. In the multivariable models, treatment resistance and markers of severity (e.g. history of suicidal and self-harm behaviours) were strongly associated with DDIs, as well as comorbidity with cardiovascular disorders. Cytochrome 2C19 activity was not associated with the occurrence of DDIs.</p><p><strong>Conclusions: </strong>The high frequency of DDIs with citalopram in fragile groups confirms the need for careful consideration before prescribing and periodic re-evaluation.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e166"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759118","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}