British Journal of Psychiatry最新文献

{"title":"Investing in mental health: a path to economic growth through psychological therapies.","authors":"Roger Muñoz-Navarro, Rob Saunders, Joshua E J Buckman, Paloma Ruiz-Rodríguez, César González-Blanch, Leonardo A Medrano, Juan Antonio Moriana, Antonio Cano-Vindel","doi":"10.1192/bjp.2024.70","DOIUrl":"https://doi.org/10.1192/bjp.2024.70","url":null,"abstract":"","PeriodicalId":9259,"journal":{"name":"British Journal of Psychiatry","volume":"225 4","pages":"460-461"},"PeriodicalIF":8.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood trauma and differential response to long-term psychoanalytic versus cognitive-behavioural therapy for chronic depression in adults.","authors":"Lina Krakau, Mareike Ernst, Martin Hautzinger, Manfred E Beutel, Marianne Leuzinger-Bohleber","doi":"10.1192/bjp.2024.112","DOIUrl":"10.1192/bjp.2024.112","url":null,"abstract":"<p><strong>Background: </strong>Childhood trauma is a major risk factor for chronic depression. It has been suggested that adults with chronic depression who have experienced childhood trauma may require long-term treatment owing to a breakdown of basic trust and related difficulties in developing a productive therapeutic relationship.</p><p><strong>Aims: </strong>As empirical studies have been preliminary and scarce, we studied the effects of psychoanalytic therapy (PAT) versus cognitive-behavioural therapy (CBT) for chronic depression in adults with a history of childhood trauma. In this subgroup, we expected a greater symptom reduction in PAT compared with CBT.</p><p><strong>Method: </strong>In a large trial of long-term psychotherapies for chronic depression (LAC-Study; Clinical Trial Register ISRCTN91956346), 210 adults received open-ended CBT or PAT in an out-patient setting and were examined yearly over 5 years on the Beck Depression Inventory - II (BDI-II). Based on a linear mixed model approach, we tested participant-reported childhood trauma based on the Childhood Trauma Questionnaire (CTQ) as a predictor and moderator of treatment outcome. CTQ subscales were examined exploratively.</p><p><strong>Results: </strong>Depressive symptoms decreased over time (<i>b</i> = -4.55, s.e. = 0.90, 95% CI -6.32 to -2.81, <i>T</i> = -5.08; <i>P</i> < 0.001). A significant three-way interaction between childhood trauma, time and therapy group (<i>b</i> = -0.05, s.e. = 0.02, 95% CI -0.09 to -0.01, <i>T</i> = -2.42; <i>P</i> = 0.016) indicated that participants with childhood trauma profited especially well from PATs.</p><p><strong>Conclusions: </strong>Our results indicate differential benefits from PAT compared with CBT among adults with chronic depression and a history of childhood trauma. The results have important implications for differential indication and policy.</p>","PeriodicalId":9259,"journal":{"name":"British Journal of Psychiatry","volume":" ","pages":"446-453"},"PeriodicalIF":8.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Winifred Holtby (1898-1935): a mental hospital visit, early 1930s - Psychiatry in literature.","authors":"Andrew J Larner","doi":"10.1192/bjp.2024.44","DOIUrl":"https://doi.org/10.1192/bjp.2024.44","url":null,"abstract":"","PeriodicalId":9259,"journal":{"name":"British Journal of Psychiatry","volume":"225 3","pages":"400"},"PeriodicalIF":8.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomised controlled trial of the short-term effects of osmotic-release oral system methylphenidate on symptoms and behavioural outcomes in young male prisoners with attention deficit hyperactivity disorder (ADHD): CIAO-II study: commentary, Asherson et al.","authors":"Philip Asherson, Andrew Forrester, Lena Johansson, Lindsay Thomson","doi":"10.1192/bjp.2024.60","DOIUrl":"https://doi.org/10.1192/bjp.2024.60","url":null,"abstract":"","PeriodicalId":9259,"journal":{"name":"British Journal of Psychiatry","volume":"225 3","pages":"412-413"},"PeriodicalIF":8.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LSD-assisted therapy in patients with anxiety: open-label prospective 12-month follow-up.","authors":"Friederike Holze, Peter Gasser, Felix Müller, Manuel Strebel, Matthias E Liechti","doi":"10.1192/bjp.2024.99","DOIUrl":"10.1192/bjp.2024.99","url":null,"abstract":"<p><strong>Background: </strong>Anxiety disorders are a major public health burden with limited treatment options.</p><p><strong>Aims: </strong>We investigated the long-term safety and efficacy of lysergic acid diethylamide (LSD)-assisted therapy in patients with anxiety with or without life-threatening illness.</p><p><strong>Method: </strong>This study was an <i>a priori</i>-planned long-term follow-up of an investigator-initiated, two-centre trial that used a double-blind, placebo-controlled, two-period, random-order, crossover design with two sessions with either oral LSD (200 μg) or placebo per period. Participants (<i>n</i> = 39) were followed up 1 year after the end-of-study visit to assess symptoms of anxiety, depression and long-term effects of psychedelics using Spielberger's State-Trait Anxiety Inventory-Global (STAI-G), the Beck Depression Inventory (BDI), the Persisting Effects Questionnaire and measures of personality traits using the NEO<b>-</b>Five-Factor Inventory.</p><p><strong>Results: </strong>Participants reported a sustained reduction of STAI-G scores compared with baseline (least square means (95% CI) = -21.6 (-32.7, -10.4), <i>d</i> = 1.04, <i>P</i> < 0.001, for those who received LSD in the first period (94 weeks after the last LSD treatment) and -16.5 (-26.2, -6.8), <i>d</i> = 1.02, <i>P</i> < 0.05, for those who received LSD in the second period (68 weeks after the last LSD treatment)). Similar effects were observed for comorbid depression with change from baseline BDI scores of -8.1 (-13.2, -3.1), <i>d</i> = 0.71, <i>P</i> < 0.01, and -8.9 (-12.9, -4.9), <i>d</i> = 1.21, <i>P</i> < 0.01, for the LSD-first and placebo-first groups, respectively. Personality trait neuroticism decreased (<i>P</i> < 0.0001) and trait extraversion increased (<i>P</i> < 0.01) compared with study inclusion. Individuals attributed positive long-term effects to the psychedelic experience.</p><p><strong>Conclusions: </strong>Patients reported sustained long-term effects of LSD-assisted therapy for anxiety.</p>","PeriodicalId":9259,"journal":{"name":"British Journal of Psychiatry","volume":" ","pages":"362-370"},"PeriodicalIF":8.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards a unified theory of the aetiology of schizophrenia: commentary, Shergill et al.","authors":"Sukhwinder S Shergill, Kyrillos M Meshreky","doi":"10.1192/bjp.2024.107","DOIUrl":"10.1192/bjp.2024.107","url":null,"abstract":"","PeriodicalId":9259,"journal":{"name":"British Journal of Psychiatry","volume":" ","pages":"416-417"},"PeriodicalIF":8.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between a selective 5-HT₄ receptor agonist and incidence of major depressive disorder: emulated target trial.","authors":"Angharad N de Cates, Catherine J Harmer, Paul J Harrison, Philip J Cowen, Anton Emmanuel, Simon Travis, Susannah E Murphy, Maxime Taquet","doi":"10.1192/bjp.2024.97","DOIUrl":"10.1192/bjp.2024.97","url":null,"abstract":"<p><strong>Background: </strong>The serotonin 4 receptor (5-HT₄R) is a promising target for the treatment of depression. Highly selective 5-HT₄R agonists, such as prucalopride, have antidepressant-like and procognitive effects in preclinical models, but their clinical effects are not yet established.</p><p><strong>Aims: </strong>To determine whether prucalopride (a 5-HT₄R agonist and licensed treatment for constipation) is associated with reduced incidence of depression in individuals with no past history of mental illness, compared with anti-constipation agents with no effect on the central nervous system.</p><p><strong>Method: </strong>Using anonymised routinely collected data from a large-scale USA electronic health records network, we conducted an emulated target trial comparing depression incidence over 1 year in individuals without prior diagnoses of major mental illness, who initiated treatment with prucalopride versus two alternative anti-constipation agents that act by different mechanisms (linaclotide and lubiprostone). Cohorts were matched for 121 covariates capturing sociodemographic factors, and historical and/or concurrent comorbidities and medications. The primary outcome was a first diagnosis of major depressive disorder (ICD-10 code F32) within 1 year of the index date. Robustness of the results to changes in model and population specification was tested. Secondary outcomes included a first diagnosis of six other neuropsychiatric disorders.</p><p><strong>Results: </strong>Treatment with prucalopride was associated with significantly lower incidence of depression in the following year compared with linaclotide (hazard ratio 0.87, 95% CI 0.76-0.99; <i>P</i> = 0.038; <i>n</i> = 8572 in each matched cohort) and lubiprostone (hazard ratio 0.79, 95% CI 0.69-0.91; <i>P</i> < 0.001; <i>n</i> = 8281). Significantly lower risks of all mood disorders and psychosis were also observed. Results were similar across robustness analyses.</p><p><strong>Conclusions: </strong>These findings support preclinical data and suggest a role for 5-HT₄R agonists as novel agents in the prevention of major depression. These findings should stimulate randomised controlled trials to confirm if these agents can serve as a novel class of antidepressant within a clinical setting.</p>","PeriodicalId":9259,"journal":{"name":"British Journal of Psychiatry","volume":" ","pages":"371-378"},"PeriodicalIF":8.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7616487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality associated with clozapine: what is the evidence?","authors":"Emilio Fernandez-Egea, Robert J Flanagan, David Taylor, Fiona Gaughran, Stephen M Lawrie, Christopher Jenkins, Shubulade Smith, Oliver D Howes, James H MacCabe","doi":"10.1192/bjp.2024.88","DOIUrl":"10.1192/bjp.2024.88","url":null,"abstract":"<p><p>While clozapine has risks, relative risk of fatality is overestimated. The UK pharmacovigilance programme is efficient, but comparisons with other drugs can mislead because of reporting variations. Clozapine actually lowers mortality, partly by reducing schizophrenia-related suicides, but preventable deaths still occur. Clozapine should be used earlier and more widely, but there should be better monitoring and better management of toxicity.</p>","PeriodicalId":9259,"journal":{"name":"British Journal of Psychiatry","volume":" ","pages":"357-359"},"PeriodicalIF":8.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential unintended consequences of Mental Health Act reforms in England and Wales on people with intellectual disability and/or autism: commentary, author response, Tromans et al.","authors":"Samuel Tromans, Indermeet Sawhney, Rohit Shankar","doi":"10.1192/bjp.2024.58","DOIUrl":"https://doi.org/10.1192/bjp.2024.58","url":null,"abstract":"","PeriodicalId":9259,"journal":{"name":"British Journal of Psychiatry","volume":"225 3","pages":"414-415"},"PeriodicalIF":8.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of nature on the mental health and well-being of children and adolescents: meta-review.","authors":"Tessa Lomax, Joseph Butler, Andrea Cipriani, Ilina Singh","doi":"10.1192/bjp.2024.109","DOIUrl":"10.1192/bjp.2024.109","url":null,"abstract":"<p><strong>Background: </strong>Urbanisation is taking place worldwide and rates of mental illness are rising. There has been increasing interest in 'nature' and how it may benefit mental health and well-being.</p><p><strong>Aims: </strong>To understand how the literature defines nature; what the characteristics of the nature intervention are; what mental health and well-being outcomes are being measured; and what the evidence shows, in regard to how nature affects the mental health and well-being of children and adolescents.</p><p><strong>Method: </strong>A meta-review was conducted, searching three databases for relevant primary and secondary studies, using key search terms including 'nature' and 'mental health' and 'mental well-being'. Inclusion criteria included published English-language studies on the child and adolescent population. Authors identified the highest quality evidence from studies meeting the inclusion criteria. Data were extracted and analysed using descriptive content analysis.</p><p><strong>Results: </strong>Sixteen systematic reviews, two scoping reviews and five good quality cohort studies were included. 'Nature' was conceptualised along a continuum (the 'nature research framework') into three categories: a human-designed environment with natural elements; a human-designed natural environment; and a natural environment. The nature 'intervention' falls into three areas (the 'nature intervention framework'): access, exposure and engagement with nature, with quantity and quality of nature relevant to all areas. Mental health and well-being outcomes fit along a continuum, with 'disorder' at one end and 'well-being' at the other. Nature appears to have a beneficial effect, but we cannot be certain of this.</p><p><strong>Conclusions: </strong>Nature appears to have a beneficial effect on mental health and well-being of children and adolescents. Evidence is lacking on clinical populations, ethnically diverse populations and populations in low- and middle-income countries. Our results should be interpreted considering the limitations of the included studies and confidence in findings.</p>","PeriodicalId":9259,"journal":{"name":"British Journal of Psychiatry","volume":" ","pages":"401-409"},"PeriodicalIF":8.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}