BJPsych Open最新文献

{"title":"Causes of death and mortality patterns in clozapine-treated patients: 17-year retrospective cohort study.","authors":"Mar Alonso-Garcia, David Seabright, Guluno Malik Achakzai, Amina Ali, Rajeev Krishnadas, Rudolf N Cardinal, Christoper Jenkins, Celso Arango, Emilio Fernandez-Egea","doi":"10.1192/bjo.2026.12069","DOIUrl":"10.1192/bjo.2026.12069","url":null,"abstract":"<p><strong>Background: </strong>Clozapine reduces overall mortality and suicide risk in schizophrenia, but the specific causes and clinical contexts of death among clozapine-treated patients remain less well characterised.</p><p><strong>Aims: </strong>We aimed to characterise causes of death in clozapine-treated patients within a defined UK catchment area over 17 years (2009-2025); compare features across predefined mortality clusters (suicide, expected, unexpected); compare unexpected death cases with a clozapine-treated comparison cohort alive in 2019 and examine temporal mortality patterns.</p><p><strong>Method: </strong>We conducted a retrospective, descriptive cohort study of all deaths among clozapine-treated patients within a UK mental health National Health Service Trust between 1 January 2009 and 31 December 2025. Deaths were classified into suicide, expected and non-intentional unexpected, using a previously established framework. Variables were compared across clusters and between unexpected death cases and a clozapine-treated comparison cohort alive in 2019.</p><p><strong>Results: </strong>Of 87 deaths, 11 (12.6%) were suicides, 29 (33.3%) were expected and 47 (54.0%) were non-intentional unexpected. Malignancy was the most common cause (21/87, 24.1%), followed by cardiovascular (13/87, 14.9%) and respiratory or infective causes (9/87, 10.3%). Age differed across clusters (<i>p</i> = 0.005), with suicides at younger ages. Compared with the 2019 cohort, patients who died unexpectedly were older (55.0 <i>v</i>. 48.6 years, <i>p</i> = 0.006) and more likely to smoke (75.0 <i>v</i>. 34.6%, <i>p</i> < 0.001). Annual mortality peaked in 2021 and was not fully explained by direct COVID-19 deaths.</p><p><strong>Conclusions: </strong>Mortality in clozapine-treated patients arises across diverse clinical contexts, with more than half classified as non-intentional unexpected. Findings support sustained physical health monitoring, closer attention to smoking and other modifiable risks, and continuity of care.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 5","pages":"e213"},"PeriodicalIF":4.0,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700730","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":"Language-Related Differences in Prenatal Depression Screening Uptake in the USA Midwest, 2019-2024.","authors":"Amanda Luff, Akaninyene Noah, Emily Malloy, Ravi Mishra, Veronica Fitzpatrick, Anne Rivelli","doi":"10.1192/bjo.2026.12074","DOIUrl":"10.1192/bjo.2026.12074","url":null,"abstract":"<p><p>Prenatal depression is a substantial contributor to maternal morbidity, and screening is an entry point to psychiatric assessment and treatment during pregnancy. Following updated guidelines and quality metrics for prenatal depression screening, we evaluated whether screening uptake differed by preferred language within a large USA healthcare system. We used electronic health record data to identify a retrospective cohort of deliveries at or beyond 20 weeks gestation in 2019-2024. We used logistic regression with a language×year interaction to estimate the adjusted marginal probabilities of screening by language preference. Among 92 063 pregnancies (77 828 individuals), screening increased substantially over time, but increases differed across language groups (<i>p</i> < 0.001). In 2019, screening probabilities were similar (English 0.50, Spanish 0.51, another language 0.46). By 2024, probabilities diverged (English 0.82, Spanish 0.72, another language 0.65). Unequal screening uptake can systematically underidentify prenatal depression among patients with non-English-language preference, with implications for equitable access to psychiatric care.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 5","pages":"e208"},"PeriodicalIF":4.0,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677088","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":"Cancer-related mortality among individuals with schizophrenia: systematic review and meta-analysis of cohort studies.","authors":"Seyyed Muhammad Mahdi Mahdavinoor, Aghil Mollaei, Arash Golzar, Saeed Kargar-Soleimanabad, Amir-Hassan Bordbari, Melika Amiri, Mohammad Hosein Rafiee, Leila Seddigh","doi":"10.1192/bjo.2026.12068","DOIUrl":"10.1192/bjo.2026.12068","url":null,"abstract":"<p><strong>Background: </strong>Individuals with schizophrenia have shown distinct cancer incidence patterns.</p><p><strong>Aims: </strong>We aimed to assess whether their cancer-related mortality differs from the general population overall, by gender and by specific cancer types.</p><p><strong>Method: </strong>We systematically searched Scopus, Web of Science, PsycINFO, PubMed and Embase, up to December 2025. Each record was independently screened by two reviewers, and data were independently extracted by two investigators. Two authors assessed the quality of the included articles with the Newcastle-Ottawa Scale. Analyses were conducted using Stata version 16; between-study heterogeneity was evaluated with Cochran's <i>Q</i>-statistic and the <i>I</i>²-statistic, and potential sources of heterogeneity were further examined through exploratory meta-regression.</p><p><strong>Results: </strong>Meta-analysis of cohort studies showed that individuals with schizophrenia had a 55% higher risk of cancer-related death than the general population (standardised mortality ratio (SMR) 1.55; 95% CI 1.16-2.07). In gender-stratified analyses, SMRs for all cancers combined were 1.37 (95% CI 1.01-1.87) in men and 1.43 (95% CI 1.15-1.79) in women. Site-specific SMRs were 1.77 (95% CI 1.17-2.68) for breast, 2.40 (95% CI 2.35-2.45) for respiratory, 1.54 (95% CI 1.35-1.76) for gastrointestinal, 2.32 (95% CI 0.72-7.45) for haematologic, 4.43 (95% CI 0.71-27.62) for skin and soft tissue, 3.03 (95% CI 1.96-4.69) for urogenital and 1.01 (95% CI: 0.36-2.83) for other cancers, although precision varied considerably across cancer sites.</p><p><strong>Conclusions: </strong>Schizophrenia was associated with substantially elevated cancer-related mortality compared with the general population. These findings underscore the need for earlier cancer detection and guideline-concordant, integrated physical and mental healthcare for this high-risk group.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 5","pages":"e206"},"PeriodicalIF":4.0,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677066","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":"Patient experiences of coercion in mental healthcare: systematic review and metasummary of qualitative studies from 1991 to 2025.","authors":"Olav Nyttingnes, Tonje Lossius Husum, Solveig Helene Høymork Kjus, Tiina Överlund, Jorun Rugkasa","doi":"10.1192/bjo.2026.12067","DOIUrl":"10.1192/bjo.2026.12067","url":null,"abstract":"<p><strong>Background: </strong>Questions have been raised whether the patient organisations assessments of coercion - often critical - captures the breadth of patient experiences of coercion. Existing systematic reviews have not captured the full scope of reported experiences, necessitating a more comprehensive approach.</p><p><strong>Aims: </strong>To identify the existing body of qualitative studies reporting patients' experiences of coercion; map study distribution over time, regions, and type of coercion; and synthesise broad categories of reported experiences.</p><p><strong>Method: </strong>The review protocol was preregistered (PROSPERO identifier CRD42021248744). We searched 12 databases (MEDLINE, Embase, APA PsycINFO, CINAHL, Web of Science, Sociological Abstracts, Scopus, ASSIA, Norart, SveMed+, OpenGrey.eu and Google Scholar) for qualitative studies published from 1 January 1991 to 3 June 2025. Peer-reviewed studies and approved doctoral theses were included. We used EPPI-Reviewer for screening, data extraction and coding. Study quality was assessed with a modified Critical Appraisal Skills Programme tool.</p><p><strong>Results: </strong>We included 291 studies, 18 of them from low-and middle-income countries. The most studied coercive practices were involuntary admissions, coercive measures and community treatment orders. Quality concerns included limited author reflexivity and lack of involvement of experts by experience. At least one negative experience was reported in 279 of the studies, while mixed and positive experiences appeared in 166 and 167, respectively.</p><p><strong>Conclusions: </strong>A large body of qualitative research reporting patient experiences of coercion exists, with a near-universal presence of negative experiences. Improved patient involvement in research, and more studies from low-and middle-income countries and on involuntary medication are needed.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 5","pages":"e205"},"PeriodicalIF":4.0,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677054","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":"Integrated mental health treatment and employment services for refugees with PTSD: randomised controlled trial.","authors":"Maja Bruhn, Henriette Laugesen Attardo, Hinuga Sandahl, Lene Falgaard Eplov, Carsten Hjorthøj, Jessica Carlsson","doi":"10.1192/bjo.2026.12070","DOIUrl":"10.1192/bjo.2026.12070","url":null,"abstract":"<p><strong>Background: </strong>Post-migration stressors can exacerbate post-traumatic stress disorder (PTSD) and reduce treatment effectiveness among refugees. Evidence for integrated care models in high-income settings remains limited.</p><p><strong>Aims: </strong>To compare treatment as usual (TAU) with an add-on integrated care intervention for unemployed refugees with PTSD.</p><p><strong>Method: </strong>We conducted a two-arm, parallel-group superiority trial with 1:1 randomisation to TAU or TAU with an add-on integrated care intervention, delivered at a specialised out-patient clinic in Denmark (ClinicalTrials.gov NCT04244864). TAU included sessions with a psychologist and physician over 8-12 months. The integrated care intervention also included structured collaboration with employment services. The primary outcome was functioning, using the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS) interview. Secondary outcomes included symptoms, quality of life and post-migration stressors. Analyses followed the intention-to-treat principle, using analysis of covariance and linear regression with multiple imputations.</p><p><strong>Results: </strong>The study included 195 patients in treatment from 2020 to 2025. No difference was observed in WHODAS score between groups pre- to post-treatment (mean difference 0.30, 95% CI -2.40 to 3.00; <i>P</i> = 0.825). Similarly, no differences were found for secondary or exploratory outcomes, and overall change was limited. However, the integrated care group had a lower rate of early dropout (<i>P</i> = 0.042) and higher level of treatment satisfaction (<i>P</i> = 0.035).</p><p><strong>Conclusions: </strong>Integrated care was feasible but not superior to TAU in improving outcomes for refugees with longstanding symptoms and unemployment. Future research should examine how the timing and intensity of integrated care interventions influence outcomes, including earlier implementation and adequate support for refugees with longstanding and complex needs.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 5","pages":"e207"},"PeriodicalIF":4.0,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673034","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":"Multidimensional moderators of treatment trajectories in people with schizophrenia at high risk of relapse: findings from a real-world lower middle-income country cohort.","authors":"Retha Smit, Hilmar Luckhoff, Lebogang Phahladira, Sanja Kilian, Robin Emsley, Laila Asmal","doi":"10.1192/bjo.2026.12061","DOIUrl":"10.1192/bjo.2026.12061","url":null,"abstract":"<p><strong>Background: </strong>While treatment non-adherence is a well-established relapse risk factor, broader contributors require investigation. Studying chronic, high-risk schizophrenia cohorts in real-world lower middle-income country (LMIC) settingsremains methodologically challenging.</p><p><strong>Aims: </strong>To explore multidimensional factors moderating treatment trajectories in individuals with chronic schizophrenia at high risk of relapse, comparing relapsers and non-relapsers in a real-world LMIC setting.</p><p><strong>Method: </strong>In this 12-month prospective naturalistic study, 56 clinically stable adults with chronic schizophrenia (≥2 relapses within 3 years), receiving long-acting injectable and/or oral antipsychotics were followed up monthly. Relapse was defined as worsening psychotic symptoms requiring re-hospitalisation. Linear mixed-effects models examined trajectories of Positive and Negative Syndrome Scale (PANSS) total and factor domains (positive, negative and disorganised) and tested group*time*moderator interactions for neurological soft signs (NSS), quality of life (QOL), aberrant salience, anxiety, resilience, self-esteem, social adversity and childhood trauma.</p><p><strong>Results: </strong>Twenty-three participants (41%) relapsed; overall attrition was 59%, with 21% of discontinuations relapsing. Most relapses (87%) involved non-adherence and substance misuse. No group*time interaction effects were found for PANSS domains. Poorer overall QOL (<i>F</i>(4, 31 = 4.0), <i>p</i> = 0.009) was associated with worse negative symptom trajectory in the relapse group, while more pronounced NSS was associated with worse positive symptom trajectory in the non-relapse group (<i>F</i>(2, 23 = 8.4), <i>p</i> = 0.002).</p><p><strong>Conclusions: </strong>Conducting longitudinal research in chronic, high-risk schizophrenia populations in LMICs is challenging. Although exploratory and hypothesis-generating, QOL and NSS may represent clinically meaningful moderators of treatment course and potential targets for intervention and future research.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 4","pages":"e204"},"PeriodicalIF":4.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629459","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":"Family harmony, emotion-management skills, problematic social media use and individual social responsibility: testing a serial mediation model.","authors":"Mustafa Ercengiz, Samet Makas, Suat Polat, Nurullah Şahin, Murat Yıldırım","doi":"10.1192/bjo.2026.12058","DOIUrl":"10.1192/bjo.2026.12058","url":null,"abstract":"<p><strong>Background: </strong>Family harmony, emotion-management skills, problematic social media use and individual social responsibility are relevant to young adults' psychosocial functioning, but evidence on their interrelations remains limited, particularly in Turkish samples.</p><p><strong>Aims: </strong>This study examined whether emotion-management skills and problematic or dysregulated social media use statistically mediated the association between family harmony and individual social responsibility among Turkish young adults.</p><p><strong>Method: </strong>A cross-sectional online survey was completed by 854 participants (64.1% female) using the Individual Social Responsibility Scale, Family Harmony Scale, Emotion-Management Skills Scale and the Bergen Social Media Addiction Scale, interpreted here as an indicator of problematic or dysregulated social media use symptoms.</p><p><strong>Results: </strong>Family harmony showed a significant total association with individual social responsibility (<i>B</i> = 0.77, 95% CI 0.64 to 0.89) and remained directly associated after the mediators were included (<i>B</i> = 0.60, 95% CI 0.47 to 0.72). The total indirect effect was significant (<i>B</i> = 0.17, 95% CI 0.13 to 0.22), including specific indirect associations through emotion-management skills (<i>B</i> = 0.11, 95% CI 0.07 to 0.15), problematic social media use (<i>B</i> = 0.04, 95% CI 0.02 to 0.06) and their serial pathway (<i>B</i> = 0.03, 95% CI 0.01 to 0.04).</p><p><strong>Conclusions: </strong>Family harmony was associated with individual social responsibility directly and through emotion-related and digital-behavioural correlates. Because the data are cross-sectional, findings should be interpreted as associative rather than causal.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 4","pages":"e203"},"PeriodicalIF":4.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629454","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 prescribing in UK primary care during the COVID-19 pandemic: national interrupted time-series analysis.","authors":"Amanj Kurdi, Abdullah Alrahmani, Saher Bakar, Chris Johnson, Brian Godman","doi":"10.1192/bjo.2026.12054","DOIUrl":"10.1192/bjo.2026.12054","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic disrupted healthcare delivery and coincided with increased psychological distress worldwide. In the UK, restrictions on healthcare access, rapid adoption of remote consultations and pressures on mental health services may have influenced prescribing of psychotropic medications. However, evidence comparing prescribing trends across the four UK nations during the pandemic remains limited.</p><p><strong>Aims: </strong>To examine trends in community prescribing of psychotropic medicines across England, Scotland, Wales and Northern Ireland before and during the COVID-19 pandemic.</p><p><strong>Method: </strong>We conducted a repeated cross-sectional study of national Prescription Cost Analysis data-sets covering March 2019 to March 2023. Monthly utilisation of antidepressants, anxiolytics/hypnotics, antipsychotics and antidementia medicines was measured, using two indicators: number of items dispensed per 1000 inhabitants and defined daily doses per 1000 inhabitants per day. Interrupted time-series regression was applied to assess changes in prescribing levels and trends associated with the first (March 2020) and second (November 2020) UK national lockdowns.</p><p><strong>Results: </strong>Psychotropic prescribing increased across most medicine classes during the study period. Antidepressant utilisation increased by 24.6% across the UK, representing the largest rise among psychotropic medicines. Antipsychotic prescribing increased by 2.7%; anxiolytic/hypnotic prescribing showed modest overall change (2.7%), but this varied between nations, increasing in Scotland (7.3%) and Northern Ireland (7.4%), and declining in Wales (-9.5%). Antidementia medicines increased modestly overall (9.3%), with variation between countries. Interrupted time-series analyses indicated that most changes occurred gradually rather than abrupt shifts following lockdowns.</p><p><strong>Conclusions: </strong>Psychotropic prescribing increased during the COVID-19 period, but largely reflected continuation of pre-existing trends rather than immediate effects of lockdown restrictions.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 4","pages":"e201"},"PeriodicalIF":4.0,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13419623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Medical Student's Attitudes to Electroconvulsive Therapy (ECT) - CORRIGENDUM.","authors":"Isabelle Schlegel, Georgia Wylie, Julie Langan Martin","doi":"10.1192/bjo.2026.12082","DOIUrl":"https://doi.org/10.1192/bjo.2026.12082","url":null,"abstract":"","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 4","pages":"e202"},"PeriodicalIF":4.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for the MyPREPED trial: hybrid type 2 effectiveness-implementation trial of a peer-delivered digital self-management tool (MyBRANCHES) for young people in Australia transitioning from early intervention in psychosis services.","authors":"Alyssa Milton, Ellie Brown, Urska Arnautovska, Priya Vaughan, Caroline Gao, Mary Lou Chatterton, Elizabeth Stratton, Nicola Hancock, Justin Chapman, Ravi Iyer, Simran Singh, Saahil Malhotra, Sam Batara, Symphony Chakma, Deanna De Cicco, Hadley Lindsay, Anthony Harris, Dan Siskind, Nicola Warren, Cate McHugh, Peter McArdle, Darren Phung, Jim Cook, Andrew Thompson, Nick Glozier","doi":"10.1192/bjo.2026.12056","DOIUrl":"10.1192/bjo.2026.12056","url":null,"abstract":"<p><strong>Background: </strong>Peer-supported self-management at discharge from early intervention in psychosis services (EIPS) has received limited attention. The MyPREPED (My Personal Recovery Plan for Early Discharge) trial will evaluate a co-designed, digital and paper-based, peer-delivered recovery and self-management focused intervention, tailored for young people exiting EIPS.</p><p><strong>Aims: </strong>This protocol describes a hybrid type 2 effectiveness-implementation trial designed to assess MyPREPED's impact, feasibility, real-world implementation and cost-utility.</p><p><strong>Method: </strong>This multi-site, mixed-method, two-arm (1:1), parallel-group, randomised controlled trial (MyPREPED versus treatment as usual) trial will be delivered across eight Australian EIPS that deliver ultra-high risk and/or first-episode psychosis streams, using a hybrid type 2 implementation-effectiveness design. Eligible participants are young people aged 16 years and over within 6 months of planned discharge from EIPS. Peer coaches will deliver up to ten sessions of using a self-management plan (modules: discharge, recovery, well-being, relapse prevention, goal-setting, service navigation). Co-primary outcomes include (a) mental health recovery (Recovery Assessment Scale - Domains and Stages; effectiveness outcome) and (b) feasibility (Feasibility of Implementation Measure; implementation outcome). Secondary outcomes assess broader effectiveness domains (mental health quality of life, clinical and functional outcomes) and other implementation outcomes. A cost-utility analysis will estimate incremental costs and quality-adjusted life-years associated with MyPREPED, alongside a secondary cost-effectiveness analysis. Analyses will follow intention-to-treat principles, using mixed-effects models.</p><p><strong>Conclusions: </strong>This study will provide the first rigorous test of a co-designed, peer-delivered recovery and self-management focused intervention specifically targeting EIPS discharge.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 4","pages":"e200"},"PeriodicalIF":4.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13419609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590379","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}