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Bridging the gap: national virtual education programme for professionals caring for adults with intellectual and developmental disabilities at the time of COVID-19. 缩小差距:在 COVID-19 会议期间为照顾智力和发育障碍成人的专业人员提供国家虚拟教育计划。
IF 3.9 3区 医学
BJPsych Open Pub Date : 2024-07-25 DOI: 10.1192/bjo.2024.67
Anupam Thakur, Nicole Bobbette, Victoria Bond, Angela Gonzales, Johanna Lake, Gill Lefkowitz, Nadia Mia, Ullanda Niel, Sanjeev Sockalingam, Erica Streisslberger, Kendra Thomson, Tiziana Volpe, Yona Lunsky
{"title":"Bridging the gap: national virtual education programme for professionals caring for adults with intellectual and developmental disabilities at the time of COVID-19.","authors":"Anupam Thakur, Nicole Bobbette, Victoria Bond, Angela Gonzales, Johanna Lake, Gill Lefkowitz, Nadia Mia, Ullanda Niel, Sanjeev Sockalingam, Erica Streisslberger, Kendra Thomson, Tiziana Volpe, Yona Lunsky","doi":"10.1192/bjo.2024.67","DOIUrl":"https://doi.org/10.1192/bjo.2024.67","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic significantly impacted the mental health of adults with intellectual and developmental disabilities (IDD). During this period of uncertainty and need for up-to-date information, various virtual training programmes demonstrated the role of tele-mentoring programmes.</p><p><strong>Aim: </strong>The aim of this paper is to describe the educational evaluation of the National Extension for Community Healthcare Outcomes - Adults with Intellectual and Developmental Disabilities (ECHO-AIDD), a programme for service providers working with adults with IDD during COVID-19.</p><p><strong>Method: </strong>The programme consisted of six sessions, conducted weekly, over two cycles. Each session included didactic teaching by hub team members, COVID-19 news updates, wellness check-ins and a brief mindfulness activity, followed by a 30 to 45 min case-based discussion. The hub structure had an inter-professional approach to team expertise. Those with lived experience were an integral part of the content experts' hub. Pre-, post- and follow-up evaluation data were collected.</p><p><strong>Results: </strong>Care providers from health and social care sectors (<i>n</i> = 230) participated in the programme. High levels of engagement and satisfaction were reported. Self-efficacy ratings improved from pre- to post-, and were maintained at 8-week follow-up; improvement from pre- to post- was significant (<i>P</i> < 0.0001).</p><p><strong>Conclusion: </strong>Exposure to National ECHO-AIDD educational intervention led to improvement in perceived competencies. This study also shows the valuable role of people with lived experience in fostering adaptive expertise in learners. The outreach and scalability support the feasibility of building a national virtual community of practice for IDD service providers. Future studies should focus on studying the impact of these programmes on the health outcomes of people with IDD.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757084","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}
引用次数: 0
Reflections on working as and supervising trial therapists on trials of psychosocial interventions. 在社会心理干预试验中担任和监督试验治疗师的思考。
IF 3.9 3区 医学
BJPsych Open Pub Date : 2024-07-25 DOI: 10.1192/bjo.2024.709
Katherine Berry, Joanne Ellis, Daniel Pratt, Gillian Haddock
{"title":"Reflections on working as and supervising trial therapists on trials of psychosocial interventions.","authors":"Katherine Berry, Joanne Ellis, Daniel Pratt, Gillian Haddock","doi":"10.1192/bjo.2024.709","DOIUrl":"https://doi.org/10.1192/bjo.2024.709","url":null,"abstract":"<p><p>This editorial provides an overview of the challenges and benefits of working as and supervising trial therapists from the perspective of investigators and trial therapists. Key differences between trial therapy and standard care are considered, with recommendations for best practice.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757085","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}
引用次数: 0
Concurrent self-administered transcranial direct current stimulation and attention bias modification training in binge eating disorder: feasibility randomised sham-controlled trial. 同时自控经颅直流电刺激和注意力偏差修正训练治疗暴饮暴食症:可行性随机假对照试验。
IF 3.9 3区 医学
BJPsych Open Pub Date : 2024-06-06 DOI: 10.1192/bjo.2024.54
Michaela Flynn, Iain C Campbell, Ulrike Schmidt
{"title":"Concurrent self-administered transcranial direct current stimulation and attention bias modification training in binge eating disorder: feasibility randomised sham-controlled trial.","authors":"Michaela Flynn, Iain C Campbell, Ulrike Schmidt","doi":"10.1192/bjo.2024.54","DOIUrl":"10.1192/bjo.2024.54","url":null,"abstract":"<p><strong>Background: </strong>Binge eating disorder (BED) is a common and disabling condition, typically presenting with multiple psychiatric and obesity-related comorbidities. Evidence-based treatments are either resource-intensive (psychotherapies) or have side-effects (medications): these achieve remission in around 50% of cases. Novel treatments are needed.</p><p><strong>Aims: </strong>This randomised sham-controlled trial aimed to assess feasibility, acceptability and preliminary efficacy of at-home, self-administered transcranial direct current stimulation (tDCS) and attention bias modification training (ABMT) in adults with binge eating disorder.</p><p><strong>Method: </strong>Eighty-two participants with binge eating disorder were randomly allocated to real tDCS with ABMT, sham tDCS with ABMT, ABMT only or waitlist control. Intervention groups received ten sessions of their allocated treatment over 2-3 weeks. tDCS (2 mA, 20 min) was self-administered using a bilateral (anode right/cathode left) montage targeting the dorsolateral prefrontal cortex. Outcomes were assessed at baseline, post-treatment and 6-week follow-up.</p><p><strong>Results: </strong>Prespecified feasibility criteria (recruitment ≥80 participants and retention rate ≥75%) were exceeded, and treatment completion rates were high (98.7%). All interventions reduced binge eating episodes, eating disorder symptoms and related psychopathology between baseline and follow-up, relative to waitlist control (medium-to-large between-group effect sizes for change scores). Small-to-medium effect sizes for change scores favoured real tDCS with ABMT versus comparators, suggesting the verum intervention produces superior outcomes.</p><p><strong>Conclusions: </strong>At-home, self-administered tDCS with ABMT is feasible and acceptable, and preliminary data on efficacy are promising. This approach could be a useful and scalable alternative or adjunct to established treatments for binge eating disorder. Confirmatory trials can, and should, be pursued.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260772","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}
引用次数: 0
Perspectives on competency-based feedback for training non-specialists to deliver psychological interventions: multi-site qualitative study of the EQUIP competency-based approach. 基于能力的反馈对培训非专业人员进行心理干预的观点:对基于能力的 EQUIP 方法的多站点定性研究。
IF 3.9 3区 医学
BJPsych Open Pub Date : 2024-06-03 DOI: 10.1192/bjo.2024.37
Abdelrhman Elnasseh, Varun S Mehta, Gergana Manolova, Gloria A Pedersen, Shannon Golden, Liyam Eloul, Frezgi Gebrekristos, Pamela Y Collins, Teresia Mutavi, Anne W Mbwayo, Muthoni Mathai, Tessa Concepcion, Rozane El Masri, Frederik Steen, Jerome T Galea, Carmen Contreras, Josephine Akellot, Rosco Kasujja, Samuel Wasereka, Byamah Brian Mutamba, Wietse A Tol, Mansurat Raji, Sacha Moufarrej, Alison Schafer, Brandon A Kohrt
{"title":"Perspectives on competency-based feedback for training non-specialists to deliver psychological interventions: multi-site qualitative study of the EQUIP competency-based approach.","authors":"Abdelrhman Elnasseh, Varun S Mehta, Gergana Manolova, Gloria A Pedersen, Shannon Golden, Liyam Eloul, Frezgi Gebrekristos, Pamela Y Collins, Teresia Mutavi, Anne W Mbwayo, Muthoni Mathai, Tessa Concepcion, Rozane El Masri, Frederik Steen, Jerome T Galea, Carmen Contreras, Josephine Akellot, Rosco Kasujja, Samuel Wasereka, Byamah Brian Mutamba, Wietse A Tol, Mansurat Raji, Sacha Moufarrej, Alison Schafer, Brandon A Kohrt","doi":"10.1192/bjo.2024.37","DOIUrl":"10.1192/bjo.2024.37","url":null,"abstract":"<p><strong>Background: </strong>The use of feedback to address gaps and reinforce skills is a key component of successful competency-based mental health and psychosocial support intervention training approaches. Competency-based feedback during training and supervision for personnel delivering psychological interventions is vital for safe and effective care.</p><p><strong>Aims: </strong>For non-specialists trained in low-resource settings, there is a lack of standardised feedback systems. This study explores perspectives on competency-based feedback, using structured role-plays that are featured on the Ensuring Quality in Psychosocial and Mental Health Care (EQUIP) platform developed by the World Health Organization and United Nations Children's Fund.</p><p><strong>Method: </strong>Qualitative data were collected from supervisors, trainers and trainees from multiple EQUIP training sites (Ethiopia, Kenya, Lebanon, Peru and Uganda), from 18 key informant interviews and five focus group discussions (<i>N</i> = 41 participants). Qualitative analysis was conducted in Dedoose, using a codebook with deductively and inductively developed themes.</p><p><strong>Results: </strong>Four main themes demonstrated how a competency-based structure enhanced the feedback process: (a) competency-based feedback was personalised and goal-specific, (b) competency-based feedback supported a feedback loop, (c) competency-based feedback supported a comfortable and objective feedback environment, and (d) competency-based feedback created greater opportunities for flexibility in training and supervision.</p><p><strong>Conclusions: </strong>A better understanding of the role of feedback supports the implementation of competency-based training that is systematic and effective for trainers and supervisors, which ultimately benefits the learning process for trainees.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199304","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}
引用次数: 0
Childhood adversity and mental health admission patterns prior to young person suicide (CHASE): a case-control 36 year linked hospital data study, Scotland UK 1981-2017. 1981-2017年英国苏格兰青少年自杀前的童年逆境和心理健康入院模式(CHASE):一项为期36年的病例对照关联医院数据研究。
IF 3.9 3区 医学
BJPsych Open Pub Date : 2024-06-03 DOI: 10.1192/bjo.2024.69
Nadine Dougall, Jan Savinc, Margaret Maxwell, Thanos Karatzias, Rory C O'Connor, Brian Williams, Ann John, Helen Cheyne, Claire Fyvie, Jonathan I Bisson, Carina Hibberd, Susan Abbott-Smith, Liz Nolan, Jennifer Murray
{"title":"Childhood adversity and mental health admission patterns prior to young person suicide (CHASE): a case-control 36 year linked hospital data study, Scotland UK 1981-2017.","authors":"Nadine Dougall, Jan Savinc, Margaret Maxwell, Thanos Karatzias, Rory C O'Connor, Brian Williams, Ann John, Helen Cheyne, Claire Fyvie, Jonathan I Bisson, Carina Hibberd, Susan Abbott-Smith, Liz Nolan, Jennifer Murray","doi":"10.1192/bjo.2024.69","DOIUrl":"10.1192/bjo.2024.69","url":null,"abstract":"<p><strong>Background: </strong>Childhood adversity is associated with increased later mental health problems and suicidal behaviour. Opportunities for earlier healthcare identification and intervention are needed.</p><p><strong>Aim: </strong>To determine associations between hospital admissions for childhood adversity and mental health in children who later die by suicide.</p><p><strong>Method: </strong>Population-based longitudinal case-control study. Scottish in-patient general and psychiatric records were summarised for individuals born 1981 or later who died by suicide between 1991 and 2017 (cases), and matched controls (1:10), for childhood adversity and mental health (broadly defined as psychiatric diagnoses and general hospital admissions for self-harm and substance use).</p><p><strong>Results: </strong>Records were extracted for 2477 'cases' and 24 777 'controls'; 2106 cases (85%) and 13 589 controls (55%) had lifespan hospitalisations. Mean age at death was 23.7; 75.9% were male. Maltreatment or violence-related childhood adversity codes were recorded for 7.6% cases aged 10-17 (160/2106) versus 2.7% controls (371/13 589), odds ratio = 2.9 (95% CI, 2.4-3.6); mental health-related admissions were recorded for 21.7% cases (458/2106), versus 4.1% controls (560/13 589), odds ratio = 6.5 (95% CI, 5.7-7.4); 80% of mental health admissions were in general hospitals. Using conditional logistic models, we found a dose-response effect of mental health admissions <18y, with highest adjusted odds ratio (aOR) for three or more mental health admissions: aOR<sub>male</sub> = 8.17 (95% CI, 5.02-13.29), aOR<sub>female</sub> = 15.08 (95% CI, 8.07-28.17). We estimated that each type of childhood adversity multiplied odds of suicide by aOR<sub>male</sub> = 1.90 (95% CI, 1.64-2.21), aOR<sub>female</sub> = 2.65 (95% CI, 1.94-3.62), and each mental health admission by aOR<sub>male</sub> = 2.06 (95% CI, 1.81-2.34), aOR<sub>female</sub> = 1.78 (95% CI, 1.50-2.10).</p><p><strong>Conclusions: </strong>Our lifespan study found that experiencing childhood adversity (primarily maltreatment or violence-related admissions) or mental health admissions increased odds of young person suicide, with highest odds for those experiencing both. Healthcare practitioners should identify and flag potential 'at-risk' adolescents to prevent future suicidal acts, especially those in general hospitals.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199302","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}
引用次数: 0
Involvement of propranolol in suicides: cross-sectional study using coroner-reported data. 普萘洛尔与自杀的关系:利用验尸官报告数据进行的横断面研究。
IF 3.9 3区 医学
BJPsych Open Pub Date : 2024-06-03 DOI: 10.1192/bjo.2024.714
Hayley C Gorton, Charlotte Archer, Thikra Algahtani, Faraz Mughal, Caroline S Copeland
{"title":"Involvement of propranolol in suicides: cross-sectional study using coroner-reported data.","authors":"Hayley C Gorton, Charlotte Archer, Thikra Algahtani, Faraz Mughal, Caroline S Copeland","doi":"10.1192/bjo.2024.714","DOIUrl":"10.1192/bjo.2024.714","url":null,"abstract":"<p><strong>Background: </strong>Propranolol is a beta-blocker medication indicated mostly for heart rhythm conditions and for physical symptoms of anxiety. Prescriptions for propranolol in the UK have increased since 2008. Recently, there have been concerns about the involvement of propranolol in intentional poisonings, but such deaths are not routinely reported. Therefore, use of coroner-reported and toxicology data enables unique investigation into the scale of involvement of propranolol in suicide.</p><p><strong>Aims: </strong>To describe the extent to which propranolol is involved in suicides, including patterns over time and characteristics of people whose suicide involved propranolol compared with other suicides.</p><p><strong>Method: </strong>Data were derived from the National Programme on Substance Use Mortality (NPSUM). All suicides and deaths of undetermined intent between 2010 and 2021 in England, Wales and Northern Ireland were extracted, and a subset was identified where propranolol was involved in death.</p><p><strong>Results: </strong>There were 4473 suicides of which 297 (6.6%) involved propranolol, with the proportion involving propranolol nearly quadrupling during the study period (3.4% <i>v</i>. 12.3%). Compared with all other suicides, a greater proportion of propranolol suicides were in women (56.6% <i>v</i>. 37.1%) and in people with diagnoses of depression (39.1% <i>v</i>. 27.1%) and anxiety (22.2% <i>v</i>. 8.6%). When suicide involved propranolol, an antidepressant was detected at post-mortem in 81.8% of deaths, most commonly a selective serotonin reuptake inhibitor (SSRIs) (51.5%), and most often citalopram (24.6%).</p><p><strong>Conclusions: </strong>A small number, but increasing proportion, of suicides reported to the NPSUM involve propranolol. Vigilance to the combined toxicity profile of medicines used alongside propranolol may be pertinent.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199372","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}
引用次数: 0
Efficacy and safety of a mineral and vitamin treatment on symptoms of antenatal depression: 12-week fully blinded randomised placebo-controlled trial (NUTRIMUM). 矿物质和维生素治疗产前抑郁症状的有效性和安全性:为期 12 周的完全盲法随机安慰剂对照试验(NUTRIMUM)。
IF 3.9 3区 医学
BJPsych Open Pub Date : 2024-06-03 DOI: 10.1192/bjo.2024.706
Hayley A Bradley, Elena Moltchanova, Roger T Mulder, Lesley Dixon, Jacki Henderson, Julia J Rucklidge
{"title":"Efficacy and safety of a mineral and vitamin treatment on symptoms of antenatal depression: 12-week fully blinded randomised placebo-controlled trial (NUTRIMUM).","authors":"Hayley A Bradley, Elena Moltchanova, Roger T Mulder, Lesley Dixon, Jacki Henderson, Julia J Rucklidge","doi":"10.1192/bjo.2024.706","DOIUrl":"10.1192/bjo.2024.706","url":null,"abstract":"<p><strong>Background: </strong>Broad-spectrum micronutrients (minerals and vitamins) have shown benefit for treatment of depressive symptoms.</p><p><strong>Aims: </strong>To determine whether additional micronutrients reduce symptoms of antenatal depression.</p><p><strong>Method: </strong>Eighty-eight medication-free pregnant women at 12-24 weeks gestation, who scored ≥13 on the Edinburgh Postnatal Depression Scale (EPDS), were randomised 1:1 to micronutrients or active placebo (containing iodine and riboflavin), for 12 weeks. Micronutrient doses were generally between recommended dietary allowance and tolerable upper level. Primary outcomes (EPDS and Clinical Global Impression - Improvement Scale (CGI-I)) were analysed with constrained longitudinal data analysis.</p><p><strong>Results: </strong>Seventeen (19%) women dropped out, with no group differences, and four (4.5%) gave birth before trial completion. Both groups improved on the EPDS, with no group differences (<i>P</i> = 0.1018); 77.3% taking micronutrients and 72.7% taking placebos were considered recovered. However, the micronutrient group demonstrated significantly greater improvement, based on CGI-I clinician ratings, over time (<i>P</i> = 0.0196). The micronutrient group had significantly greater improvement on sleep and global assessment of functioning, and were more likely to identify themselves as 'much' to 'very much' improved (68.8%) compared with placebo (38.5%) (odds ratio 3.52, <i>P</i> = 0.011; number needed to treat: 3). There were no significant group differences on treatment-emergent adverse events, including suicidal ideation. Homocysteine decreased significantly more in the micronutrient group. Presence of personality difficulties, history of psychiatric medication use and higher social support tended to increase micronutrient response compared with placebo.</p><p><strong>Conclusions: </strong>This study highlights the benefits of active monitoring on antenatal depression, with added efficacy for overall functioning when taking micronutrients, with no evidence of harm. Trial replication with larger samples and clinically diagnosed depression are needed.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199368","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}
引用次数: 0
Cost-utility analysis of Social Stories™ for children with autism spectrum disorder in mainstream primary schools: results from a randomised controlled trial. 针对主流小学自闭症谱系障碍儿童的 Social Stories™ 成本效用分析:随机对照试验结果。
IF 3.9 3区 医学
BJPsych Open Pub Date : 2024-06-03 DOI: 10.1192/bjo.2024.47
Han-I Wang, Kerry Bell, Jane Blackwell, Charlie Welch, Laura Mandefield, Judith Watson, Emma Standley, Dean McMillan, Simon Gilbody, Barry Wright, Catherine Hewitt, Steve Parrott
{"title":"Cost-utility analysis of Social Stories™ for children with autism spectrum disorder in mainstream primary schools: results from a randomised controlled trial.","authors":"Han-I Wang, Kerry Bell, Jane Blackwell, Charlie Welch, Laura Mandefield, Judith Watson, Emma Standley, Dean McMillan, Simon Gilbody, Barry Wright, Catherine Hewitt, Steve Parrott","doi":"10.1192/bjo.2024.47","DOIUrl":"10.1192/bjo.2024.47","url":null,"abstract":"<p><strong>Background: </strong>One in 57 children are diagnosed with autism in the UK, and the estimated cost for supporting these children in education is substantial. Social Stories™ is a promising and widely used intervention for supporting children with autism in schools and families. It is believed that Social Stories™ can provide meaningful social information to children that can improve social understanding and may reduce anxiety. However, no economic evaluation of Social Stories has been conducted.</p><p><strong>Aims: </strong>To assess the cost-effectiveness of Social Stories through Autism Spectrum Social Stories in Schools Trial 2, a multi-site, pragmatic, cluster-randomised controlled trial.</p><p><strong>Method: </strong>Children with autism who were aged 4-11 years were recruited and randomised (<i>N</i> = 249). Costs measured from the societal perspective and quality-adjusted life-years (QALYs) measured by the EQ-5D-Y-3L proxy were collected at baseline and at 6-month follow-up for primary analysis. The incremental cost-effectiveness ratio was calculated, and the uncertainty around incremental cost-effectiveness ratios was captured by non-parametric bootstrapping. Sensitivity analyses were performed to evaluate the robustness of the primary findings.</p><p><strong>Results: </strong>Social Stories is likely to result in a small cost savings (-£191 per child, 95% CI -767.7 to 337.7) and maintain similar QALY improvements compared with usual care. The probability of Social Stories being a preferred option is 75% if society is willing to pay £20 000 per QALY gained. The sensitivity analysis results aligned with the main study outcomes.</p><p><strong>Conclusions: </strong>Compared with usual care, Social Stories did not lead to an increase in costs and maintained similar QALY improvements for primary-aged children with autism.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199344","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}
引用次数: 0
Bridging the gap from medical to psychological safety assessment: consensus study in a digital mental health context. 缩小医疗安全评估与心理安全评估之间的差距:数字心理健康背景下的共识研究。
IF 3.9 3区 医学
BJPsych Open Pub Date : 2024-06-03 DOI: 10.1192/bjo.2024.713
Rayan Taher, Palak Bhanushali, Stephanie Allan, Mario Alvarez-Jimenez, Heather Bolton, Laura Dennison, Brian E Wallace, Heather D Hadjistavropoulos, Charlotte L Hall, Amy Hardy, Alasdair L Henry, Sam Lane, Tess Maguire, Adam Moreton, Talar R Moukhtarian, Elvira Perez Vallejos, Sukhi Shergill, Daniel Stahl, Graham R Thew, Ladislav Timulak, David van den Berg, Noemi Viganò, Ben Wensley Stock, Katherine S Young, Jenny Yiend
{"title":"Bridging the gap from medical to psychological safety assessment: consensus study in a digital mental health context.","authors":"Rayan Taher, Palak Bhanushali, Stephanie Allan, Mario Alvarez-Jimenez, Heather Bolton, Laura Dennison, Brian E Wallace, Heather D Hadjistavropoulos, Charlotte L Hall, Amy Hardy, Alasdair L Henry, Sam Lane, Tess Maguire, Adam Moreton, Talar R Moukhtarian, Elvira Perez Vallejos, Sukhi Shergill, Daniel Stahl, Graham R Thew, Ladislav Timulak, David van den Berg, Noemi Viganò, Ben Wensley Stock, Katherine S Young, Jenny Yiend","doi":"10.1192/bjo.2024.713","DOIUrl":"10.1192/bjo.2024.713","url":null,"abstract":"<p><strong>Background: </strong>Digital Mental Health Interventions (DMHIs) that meet the definition of a medical device are regulated by the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK. The MHRA uses procedures that were originally developed for pharmaceuticals to assess the safety of DMHIs. There is recognition that this may not be ideal, as is evident by an ongoing consultation for reform led by the MHRA and the National Institute for Health and Care Excellence.</p><p><strong>Aims: </strong>The aim of this study was to generate an experts' consensus on how the medical regulatory method used for assessing safety could best be adapted for DMHIs.</p><p><strong>Method: </strong>An online Delphi study containing three rounds was conducted with an international panel of 20 experts with experience/knowledge in the field of UK digital mental health.</p><p><strong>Results: </strong>Sixty-four items were generated, of which 41 achieved consensus (64%). Consensus emerged around ten recommendations, falling into five main themes: Enhancing the quality of adverse events data in DMHIs; Re-defining serious adverse events for DMHIs; Reassessing short-term symptom deterioration in psychological interventions as a therapeutic risk; Maximising the benefit of the Yellow Card Scheme; and Developing a harmonised approach for assessing the safety of psychological interventions in general.</p><p><strong>Conclusion: </strong>The implementation of the recommendations provided by this consensus could improve the assessment of safety of DMHIs, making them more effective in detecting and mitigating risk.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199298","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}
引用次数: 0
Investigating changes in student mental health and help-seeking behaviour after the introduction of new well-being support services at a UK university. 调查英国一所大学引入新的幸福支持服务后学生心理健康和求助行为的变化。
IF 3.9 3区 医学
BJPsych Open Pub Date : 2024-05-27 DOI: 10.1192/bjo.2024.711
Jacks Bennett, Claire M A Haworth, Judi Kidger, Jon Heron, Myles-Jay Linton, David Gunnell
{"title":"Investigating changes in student mental health and help-seeking behaviour after the introduction of new well-being support services at a UK university.","authors":"Jacks Bennett, Claire M A Haworth, Judi Kidger, Jon Heron, Myles-Jay Linton, David Gunnell","doi":"10.1192/bjo.2024.711","DOIUrl":"10.1192/bjo.2024.711","url":null,"abstract":"<p><strong>Background: </strong>Growing numbers of students now seek mental health support from their higher education providers. In response, a number of universities have invested in non-clinical well-being services, but there have been few evaluations of these. This research addresses a critical gap in the existing literature.</p><p><strong>Aims: </strong>This study examined the impact of introducing non-clinical well-being advisers on student mental health and help-seeking behaviour at a large UK university.</p><p><strong>Method: </strong>Survey data collected pre-post service introduction in 2018 (<i>n</i> = 5562) and 2019 (<i>n</i> = 2637) measured prevalence of depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7), and low mental well-being (Warwick-Edinburgh Mental Wellbeing Scale), alongside student support-seeking behaviour. Logistic regression models investigated changes in outcome measures. Administrative data (2014-2020) were used to investigate corresponding trends in antidepressant prescribing at the onsite health service, student counselling referrals and course withdrawal rates.</p><p><strong>Results: </strong>Adjusted models suggested reductions in students' levels of anxiety (odds ratio 0.86, 95% CI 0.77-0.96) and low well-being (odds ratio 0.84, 95% CI 0.75-0.94) in 2019, but not depression symptoms (odds ratio 1.05, 95% CI 0.93-1.17). Statistical evidence showed reduced student counselling referrals, with antidepressant prescribing and course withdrawal rates levelling off. Student perception of the availability and accessibility of university support improved.</p><p><strong>Conclusions: </strong>Our findings suggest a non-clinical well-being service model may improve student perception of support, influence overall levels of anxiety and low well-being, and reduce clinical need. The current study was only able to examine changes over the short term, and a longer follow-up is needed.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155105","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}
引用次数: 0
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