BJPsych Open最新文献

{"title":"Psychological cost of Hong Kong's zero-COVID policy: three-wave repeated cross-sectional study of pandemic fatigue, pandemic fear and emotional well-being from peak pandemic to living-with-COVID policy shift.","authors":"Sam S S Lau, Jason W L Fong, Marco C H Cheng","doi":"10.1192/bjo.2025.18","DOIUrl":"10.1192/bjo.2025.18","url":null,"abstract":"<p><strong>Background: </strong>Hong Kong's 3-year dynamic zero-COVID policy has caused prolonged exposure to stringent, pervasive anti-epidemic measures, which poses additional stressors on emotional well-being through pandemic fatigue, beyond the incumbent fear of the pandemic.</p><p><strong>Aims: </strong>To investigate how major policy shifts in the zero-COVID strategy have corresponded with changing relationships between emotional well-being, pandemic fatigue from policy adherence, and pandemic fear, following the pandemic peak to a living-with-COVID policy.</p><p><strong>Method: </strong>A three-wave repeated cross-sectional study (<i>N</i> = 2266) was conducted on the Chinese working-age population (18-64 years) during the peak outbreak (Wave 1), and subsequent policy shifts towards a living-with-COVID policy during the initial relaxation (Wave 2) and full relaxation (Wave 3) of anti-epidemic measures from March 2022 to March 2023. Non-parametric tests, consisting of robust analysis of covariance tests and quantile regression analysis, were performed.</p><p><strong>Results: </strong>The severity of all measures was lowered after Wave 1; however, extreme pandemic fears reported in Wave 2 (<i>n</i> = 38, 7.7%) were associated with worse emotional well-being than the pandemic peak (Wave 1), which then subsided in Wave 3. Pandemic fatigue posed greater negative emotional well-being in Wave 1, whereas pandemic fear was the dominant predictor in Waves 2 and 3.</p><p><strong>Conclusions: </strong>Pandemic fatigue and pandemic fear together robustly highlight the psychological cost of prolonged pandemic responses, expanding on a framework for monitoring and minimising the unintended mental health ramifications of anti-epidemic policies.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e68"},"PeriodicalIF":3.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691019","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":"Efficacy and safety of behavioural activation on depression in people with co-occurring non-communicable diseases: systematic review and meta-analysis.","authors":"Engida Yisma, Kuda Muyambi, Sandra Walsh, Shwikar Othman, Richard Gray, Kuan Liung Tan, Mary Steen, Martin Jones","doi":"10.1192/bjo.2024.870","DOIUrl":"10.1192/bjo.2024.870","url":null,"abstract":"<p><strong>Background: </strong>People with non-communicable diseases (NCDs) have a higher prevalence of comorbid depression than the general population. While previous research has shown that behavioural activation is effective for general depression, its efficacy and safety in treating depression associated with NCDs remains unclear.</p><p><strong>Aims: </strong>To compare the efficacy and safety of behavioural activation against comparators in reducing depression symptoms in people with NCDs.</p><p><strong>Method: </strong>We searched six databases from inception until 30 March 2023 (updated 23 September 2024) for randomised controlled trials (RCTs) comparing behavioural activation with comparators for depression in people with NCDs. Risk of bias was assessed using the Cochrane Collaboration's 'risk-of-bias 2 tool'. We calculated a random-effects, inverse-variance weighting meta-analysis.</p><p><strong>Results: </strong>Of the 21 386 initial studies, 12 RCTs (with 2144 patients) comparing behavioural activation with any comparator on treatment outcomes for depression with comorbid NCD met the inclusion criteria. Six studies rated as low risk of bias. For short-term follow-ups (up to 6 months), meta-analysis showed behavioural activation had little effect on depression symptom improvement in people with NCDs (Hedges' <i>g</i> = -0.24; 95% CI, -0.62 to 0.15), compared to comparators, with high heterogeneity (<i>I</i>² = 91.91%). Of the 12 included studies, three RCTs provided data on adverse events occurring during the trial.</p><p><strong>Conclusions: </strong>Evidence from this systematic review is not sufficient to draw clear conclusions about the efficacy and safety of behavioural activation for reducing depression symptoms in people with NCDs. Future reviews need to include more high-quality, well-designed RCTs to better understand the potential benefits of behavioural activation for comorbid depression.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e70"},"PeriodicalIF":3.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691017","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":"Variations between, and within, jurisdictions in the use of community treatment orders and other compulsory community treatment: study of 402 060 people across four Australian states.","authors":"Steve Kisely, Claudia Bull, Tessa Zirnsak, Vrinda Edan, Morgan Gould, Sharon Lawn, Edwina Light, Chris Maylea, Giles Newton-Howes, Christopher James Ryan, Penelope Weller, Lisa Brophy","doi":"10.1192/bjo.2025.23","DOIUrl":"10.1192/bjo.2025.23","url":null,"abstract":"<p><strong>Background: </strong>The use of compulsory community treatment (CCT) in Australia is some of the highest worldwide despite limited evidence of effectiveness. Even within Australia, use varies widely across jurisdictions despite general similarities in legislation and health services. However, there is much less information on whether variation occurs within the same jurisdiction.</p><p><strong>Aims: </strong>To measure variations in the use of CCT in a standardised way across the following four Australian jurisdictions: Queensland, South Australia, New South Wales (NSW) and Victoria. We also investigated associated sociodemographic variables.</p><p><strong>Methods: </strong>We used aggregated administrative data from the Australian Institute of Health and Welfare.</p><p><strong>Results: </strong>There were data on 402 060 individuals who were in contact with specialist mental health services, of whom 51 351 (12.8%) were receiving CCT. Percentages varied from 8% in NSW to 17.6% in South Australia. There were also wide variations within jurisdictions. In NSW, prevalence ranged from 2% to 13%, in Victoria from 6% to 24%, in Queensland from 11% to 25% and in South Australia from 6% to 36%. People in contact with services who were male, single and aged between 25 and 44 years old were significantly more likely to be subject to CCT, as were people living in metropolitan areas or those born outside Oceania.</p><p><strong>Conclusions: </strong>There are marked variations in the use of CCT both within and between Australian jurisdictions. It is unclear how much of this variation is determined by clinical need and these findings may be of relevance to jurisdictions with similar clinician-initiated orders.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e57"},"PeriodicalIF":3.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673294","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":"Suicide-related stigma and its relationship with help-seeking, mental health, suicidality and grief: scoping review.","authors":"Jessica M Wyllie, Kathryn A Robb, David Sandford, Marianne E Etherson, Nadia Belkadi, Rory C O'Connor","doi":"10.1192/bjo.2024.857","DOIUrl":"10.1192/bjo.2024.857","url":null,"abstract":"<p><strong>Background: </strong>Suicide-related stigma (i.e. negative attitudes towards people with suicidal thoughts and/or behaviours as well as those bereaved by suicide) is a potential risk factor for suicide and mental health problems. To date, there has been no scoping review investigating the association between suicide-related stigma and mental health, help-seeking, suicide and grief across several groups affected by suicide.</p><p><strong>Aims: </strong>To determine the nature of the relationship between suicide-related stigma and mental health, help-seeking, grief (as a result of suicide bereavement) and suicide risk.</p><p><strong>Method: </strong>This review was registered with PROSPERO (CRD42022327093). Five databases (Web of Science, APA PsycInfo, Embase, ASSIA and PubMed) were searched, with the final update in May 2024. Studies were included if they were published in English between 2000 and 2024 and assessed both suicide-related stigma AND one of the following: suicide, suicidal thoughts or suicidal behaviours, help-seeking, grief or other mental health variables. Following screening of 14 994 studies, 100 eligible studies were identified. Following data charting, cross-checking was conducted to ensure no relevant findings were missed.</p><p><strong>Results: </strong>Findings across the studies were mixed. However, most commonly, suicide-related stigma was associated with higher levels of suicide risk, poor mental health, lowered help-seeking and grief-related difficulties. A model of suicide-related stigma has been developed to display the directionality of these associations.</p><p><strong>Conclusions: </strong>This review emphasises the importance of reducing the stigma associated with suicide and suicidal behaviour to improve outcomes for individuals affected by suicide. It also identifies gaps in our knowledge as well as providing suggestions for future research.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e60"},"PeriodicalIF":3.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673290","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":"Psychometric validation of the Bangla Digital Addiction Scale for Teenagers and its associated factors among adolescents: MeLiSA study.","authors":"Firoj Al-Mamun, Mohammed A Mamun, Moneerah Mohammad ALmerab, Johurul Islam, David Gozal, Mohammad Muhit","doi":"10.1192/bjo.2025.10","DOIUrl":"10.1192/bjo.2025.10","url":null,"abstract":"<p><strong>Background: </strong>Digital addiction among adolescents is an escalating concern with profound psychological implications, yet validated tools to measure it and studies exploring its relationship remain limited.</p><p><strong>Aims: </strong>To validate the Bangla Digital Addiction Scale for Teenagers (Bangla DAST) and identify factors of digital addiction among Bangladeshi adolescents.</p><p><strong>Methods: </strong>Using a two-stage stratified cluster sampling method, data from 1496 adolescents in Bangladesh were collected and analysed using non-parametric tests, Spearman correlations and multiple regression models.</p><p><strong>Results: </strong>The two-factor structure, encompassing attachment to digital devices (Factor 1) and compulsive use in different places (Factor 2) was supported by confirmatory factor analysis (comparative fit index 0.97, Tucker-Lewis index 0.95, root mean square error of approximation 0.06 [90% CI: 0.056-0.07] and standardised root mean square residual 0.048). McDonald's omega was 0.81 for the total scale, 0.77 for Factor 1 and 0.63 for Factor 2. Convergent validity was supported by significant associations between digital addiction and psychological symptoms. Factors of digital addiction included age (<i>b</i> = 0.517, <i>P</i> = 0.020), academic grade (<i>b</i> = 0.737, <i>P</i> = 0.021), depression (<i>b</i> = 0.334, <i>P</i> < 0.001), anxiety (<i>b</i> = 0.400, <i>P</i> < 0.001) and insomnia (<i>b</i> = 0.504, <i>P</i> < 0.001). In contrast, female gender (<i>b</i> = -1.250, <i>P</i> = 0.001), not sleeping alone (<i>b</i> = -0.846, <i>P</i> = 0.029) and reduced smartphone usage (<i>b</i> = -1.895, <i>P</i> < 0.001) were associated with lower digital addiction scores. The model accounted for 23.1% of the variance in digital addiction.</p><p><strong>Conclusions: </strong>The Bangla DAST appears to be a psychometrically valid and reliable tool and can be used for further studies assessing digital addiction among Bangladeshi adolescents. The study highlights the need for targeted preventive measures, particularly focusing on at-risk groups.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e55"},"PeriodicalIF":3.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662234","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":"Modifiable unhealthy lifestyle behaviours in subclinical manifestations of attention-deficit hyperactivity disorder: what are the first empirical results and putative clinical implications?","authors":"Kristin Annawald, Thomas Meyer","doi":"10.1192/bjo.2024.837","DOIUrl":"10.1192/bjo.2024.837","url":null,"abstract":"<p><p>Attention-deficit hyperactivity disorder (ADHD) is one of the most common mental disorders in adolescents, and a full syndrome diagnosis requires a combination of persistent symptoms. In a multicentre cross-sectional study from Italy using a non-clinical sample from a secondary school comprising 440 adolescents, published in this issue of BJPsych Open, Gostoli et al examined whether unhealthy lifestyle habits are linked to both clinical manifestation of ADHD and subclinical symptomatology. In line with the literature, the authors demonstrate an association between clinical ADHD diagnosis, unhealthy lifestyle behaviours and psychosocial impairments. Modifiable, adverse lifestyle behaviours are also prevalent in subclinical ADHD manifestations. This observation may be important for child and adolescent psychiatry when considering targeted health promotion approaches that delay or prevent progression from subclinical to clinical ADHD. In this article, we discuss from a clinical perspective the putative relevance of addressing subclinical ADHD symptoms in the context of the existing literature.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e66"},"PeriodicalIF":3.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662229","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":"Fluctuations in dispensed out-patient psychotropic medication prescriptions during the COVID-19 pandemic in The Netherlands.","authors":"Damian A Visser, Daphne S Everaerd, Hannah Ellerbroek, Janneke R Zinkstok, Indira Tendolkar, Femke Atsma, Arnt F A Schellekens","doi":"10.1192/bjo.2024.867","DOIUrl":"10.1192/bjo.2024.867","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic and lockdowns had a significant impact on mental well-being and (mental) healthcare systems globally.</p><p><strong>Aims: </strong>To describe trends and dynamics of out-patient prescribing of psychotropic medications during the COVID-19 pandemic in The Netherlands.</p><p><strong>Method: </strong>Dispensed psychotropic medication prescriptions during the COVID-19 pandemic from March 2020 to March 2022 were retrieved from national registry data. Numbers of total and incident dispensed prescriptions and defined daily doses (DDDs) were identified for six medication groups. Overall pandemic-related changes in prescribing trends were analysed using interrupted time-series analyses. Lockdown-related prescribing dynamics were described using monthly risk ratios.</p><p><strong>Results: </strong>No overall pandemic-related changes in prescribing were detected, except for alcohol addiction medication, for which a pre-pandemic decline in total dispensed prescriptions and DDDs levelled off during the pandemic: +10 prescriptions per week (95% CI 7-11, <i>P</i> ≤ 0.001) and +111 DDDs per week (95% CI 56-165, <i>P</i> = 0.001). Monthly prescribing dynamics showed transient increases in all medication groups during the second and third lockdown periods. There were decreases in dispensed incident antidepressant and opioid addiction medication prescriptions during the first lockdown (average risk ratios: 0.87 and 0.88 respectively), and DDDs of dispensed incident and total attention-deficit hyperactivity disorder medication prescriptions and incident benzodiazepine prescriptions were elevated from the end of the second lockdown (average risk ratios: 1.40, 1.12 and 1.17, respectively).</p><p><strong>Conclusions: </strong>These findings raise concerns regarding possible over- and under-prescribing during the pandemic. Further understanding of specific factors driving these changes is necessary to help prepare for future mental health(care) challenges.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e64"},"PeriodicalIF":3.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662215","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 among Chinese university students during COVID-19: 28-month, ten-wave longitudinal study.","authors":"Wendy Wen Li, Daniel Miller, Christopher Rouen, Fang Yang, Huizhen Yu","doi":"10.1192/bjo.2024.869","DOIUrl":"10.1192/bjo.2024.869","url":null,"abstract":"<p><strong>Background: </strong>The cumulative effects of long-term exposure to pandemic-related stressors and the severity of social restrictions may have been important determinants of mental distress in the time of COVID-19.</p><p><strong>Aim: </strong>This study aimed to investigate mental health among a cohort of Chinese university students over a 28-month period, focusing on the effects of lockdown type.</p><p><strong>Methods: </strong>Depression, anxiety, stress and fear of COVID-19 infection were measured ten times among 188 Chinese students (females 77.7%, mean_age = 19.8, s.d._age = 0.97), every 3 months: from prior to the emergence of COVID-19 in November 2019 (T1) to March 2022 (T10).</p><p><strong>Results: </strong>Initially depression, anxiety and stress dipped from T1 to T2, followed by a sudden increase at T3 and a slow upward rise over the remainder of the study period (T3 to T10). When locked down at university, participants showed greater mental distress compared with both home lockdown (<i>d</i> = 0.35-0.48) and a no-lockdown comparison period (<i>d</i> = 0.28-0.40). Conversely, home lockdown was associated with less anxiety and stress (<i>d</i> = 0.19 and 0.21, respectively), but not with depression (<i>d</i> = 0.13) compared with a no-lockdown period.</p><p><strong>Conclusions: </strong>This study highlights the cumulative effects of exposure to COVID-19 stressors over time. It also suggests that the way in which a lockdown is carried out can impact the well-being of those involved. Some forms of lockdown appear to pose a greater threat to mental health than others.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e56"},"PeriodicalIF":3.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662224","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 trial of a brief theory-based online intervention to reduce self-harm.","authors":"Chris Keyworth, Jessica Z Leather, Leah Quinlivan, Rory C O'Connor, Christopher J Armitage","doi":"10.1192/bjo.2025.2","DOIUrl":"10.1192/bjo.2025.2","url":null,"abstract":"<p><strong>Background: </strong>Forming 'if-then' plans has been shown to reduce self-harm among people admitted to hospital following an episode of self-harm.</p><p><strong>Aims: </strong>To explore whether the same intervention, delivered online, could prevent future self-harm among a large community sample who had previously self-harmed.</p><p><strong>Method: </strong>UK adults were recruited to a randomised controlled trial and received either an intervention to reduce self-harm or one to reduce sedentariness (control group). Randomisation was stratified to ensure both groups were representative of the UK population. There were three primary outcomes: non-suicidal self-injury (NSSI), suicidal ideation and suicide attempts, assessed at baseline and 6 months post-intervention.</p><p><strong>Results: </strong>Participants (1040) were randomised to the intervention (<i>n</i> = 520) or control (<i>n</i> = 520) group. The vast majority of people formed implementation intentions in both the experimental (<i>n</i> = 459 (88.3%)) and control (<i>n</i> = 520 (100%)) condition. Overall, the intervention did not significantly reduce the frequency of NSSI, suicidal ideation or suicide attempts. Among people who had self-harmed in the past week at follow-up, mixed analysis of covariance revealed a significant interaction between time and condition for reflective motivation, <i>F</i>(1,102) = 7.08, <i>P</i> < 0.01, <i>p</i>_n² = 0.07, such that significantly lower levels of reflective motivation were reported at follow-up in the control condition, <i>t</i>(57) = 2.42, <i>P</i> = 0.02.</p><p><strong>Conclusions: </strong>This web-based intervention has limited utility for reducing self-reported self-harm or suicidal ideation in adults with a history of self-harm. Further work is needed to improve the effectiveness of brief interventions for self-harm aimed at adults living in the community and to understand the conditions under which the intervention may or may not be effective.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e63"},"PeriodicalIF":3.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655759","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 voices not heard: thematic analysis of asylum seekers' explanatory models of mental illness as elicited by the Cultural Formulation Interview.","authors":"Lukas Claus, Mario Braakman, Meryam Schouler-Ocak, Laura Van de Vliet, Bernard Sabbe, Seline van den Ameele","doi":"10.1192/bjo.2024.866","DOIUrl":"10.1192/bjo.2024.866","url":null,"abstract":"<p><strong>Background: </strong>Asylum seekers have difficulty gaining access to mental healthcare. Lack of understanding of asylum seekers' mental illness explanatory models appears to be an important barrier. Gaining a better understanding of these explanatory models is crucial for ensuring the inclusion of asylum seekers in healthcare services. The Cultural Formulation Interview (CFI) might help to explore asylum seekers' explanatory models of mental illness.</p><p><strong>Aims: </strong>To analyse asylum seekers' explanatory models as elicited by the CFI.</p><p><strong>Methods: </strong>The CFI and its first supplementary module were carried out with asylum seekers with mental health problems. Transcriptions of the interviews underwent reflexive thematic analysis within a social constructivist framework.</p><p><strong>Results: </strong>In the analysis of 25 illness narratives, three major themes characterising asylum seekers' explanatory models were identified: a burden of the past, a disenabling current reality, and a personal position and individual experience.</p><p><strong>Conclusions: </strong>The interplay among pre-, peri- and post-migration experiences, having a continuous impact on asylum seekers' mental health, was highlighted by the themes 'a burden of the past', and 'a disenabling current reality'. The theme 'a personal position and individual experience' revealed how the CFI enables self-determination in clinical encounters by embracing uncertainty and questioning the medicalisation of distress. The analysis characterises asylum seekers' symptoms as a personal idiom of distress within socio-relational contexts. The CFI provides a clinically useful framework for exploring asylum seekers' explanatory models and fostering dynamic understanding.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e62"},"PeriodicalIF":3.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655937","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}