The British Journal of Psychiatry最新文献

Internationally, drug- and alcohol-related morbidity is at its highest recorded levels yet these modifiable risk factors often remain overlooked within systems of healthcare delivery and research. We seek to reaffirm the ongoing commitment of BJPsych to publishing and promoting drug and alcohol research and encourage submission of high-quality articles.

Eating disorders, particularly anorexia nervosa and bulimia nervosa, are significant global health challenges.

This study analyses historical trends and forecasts future patterns of eating disorders among young adults aged 15–29 years using machine learning techniques.

Global data on anorexia nervosa and bulimia nervosa from the Global Burden of Disease study 2021 spanning 1990 to 2021 were analysed, examining incidence, prevalence and disability-adjusted life years (DALYs) across age groups, sociodemographic index (SDI) levels and regions. Eight machine-learning models were employed to forecast trends from 2022 to 2050.

Bulimia nervosa showed more pronounced increases compared to anorexia nervosa across all metrics. The 15–19 age group had the highest incidence rates, while the 20–24 age group showed the highest prevalence and DALY rates. Low SDI regions experienced substantial increases, with bulimia nervosa prevalence rising by 179.05%. East Asia demonstrated the most significant rise in age-standardised rates. The Prophet model best forecast anorexia nervosa trends, while ARIMA performed best for bulimia nervosa. Projections indicate continued increases through 2050 for both disorders.

The global burden of eating disorders among young adults is projected to increase significantly by 2050, with bulimia nervosa showing more rapid growth than anorexia nervosa. Substantial variations exist across age groups, SDI levels and regions. These findings highlight the urgent need for enhanced prevention programmes targeting high-risk age groups, strengthened healthcare capacity in rapidly developing regions and evidence-based policy interventions to address the growing global burden of eating disorders.

Benzodiazepine receptor agonists (BZRAs), including benzodiazepines and Z-drugs, are frequently prescribed during pregnancy but their long-term neurodevelopmental safety remains uncertain.

To investigate whether prenatal BZRA exposure is associated with an increased long-term risk of neurodevelopmental disorders (LNDDs) in offspring.

This nationwide, population-based cohort study used Korean National Health Insurance Service data on all live births from 2011 to 2014, followed until 2023. Prenatal BZRA exposure was defined as maternal prescriptions during pregnancy. Propensity score matching (1:10) was applied to balance covariates. Sensitivity analyses in the full cohort evaluated exposure intensity (0, 1–6, 7–29 and ≥30 cumulative days), drug class (benzodiazepines versus Z-drugs), trimester of exposure and discordant sibling comparisons with mother fixed effects.

Among 1 553 505 eligible births, 5949 BZRA-exposed and 55 015 matched unexposed children were analysed. LNDD incidence was 13.9% in the exposed group versus 11.4% in the unexposed (odds ratio 1.25, 95% CI: 1.16, 1.35). In the full cohort, risks increased with exposure intensity: 1–6 days (odds ratio 1.16, 95% CI: 1.05–1.28), 7–29 days (odds ratio 1.19, 95% CI: 1.04–1.36) and ≥30 days (odds ratio 1.18, 95% CI: 1.01–1.38). By trimester, risks were higher with second- (odds ratio 1.30, 95% CI: 1.07–1.59) and third-trimester (odds ratio 1.27, 95% CI: 1.09–1.48) exposure. Class-specific analyses showed stronger associations for benzodiazepines only (odds ratio 1.19, 95% CI: 1.15–1.23) than for Z-drugs only (odds ratio 1.06, 95% CI: 1.04–1.08). In a discordant sibling analysis including 2572 children this association persisted (odds ratio 1.29, 95% CI: 1.05–1.60), indicating that neither familial nor genetic confounding fully explains the observed effects.

Prenatal BZRA exposure was associated with increased long-term risks of LNDDs in offspring, with evidence of dose–response and class-specific effects, and persistence in sibling analyses.

Cue-reactivity responses in addictive behaviours are triggered by cues associated with the addictive activity itself. Although such cues may depict the rewarding aspects of the behaviour, responses may also generalise to more distal cues that do not directly convey this content.

To examine cue reactivity to distal cues (i.e. devices displaying starting or log-in screens of internet applications) in a diagnostically validated sample of individuals with specific problematic usage of the internet (PUIs) and determine whether laboratory-measured cue reactivity predicts real-life behavioural engagement and temptation experiences, in addition to differences across PUI stages and cue types.

In this preregistered study, data were collected from October 2021 to 31 August 2024 from individuals with non-problematic (n = 268), risky (n = 135) and pathological (n = 133) engagement in specific internet activities (gaming, buying and/or shopping, pornography use and social networking). Participants were aged 18–65 years (mean age 26.12 years, s.d. 6.79), and 44.6% were female. A cue-reactivity paradigm with distal cues showing target and non-target internet activities was used. A within–between participants design was used, with repeated measures analyses of variance. Correlations between laboratory cue-reactivity measures and measures from a 14-day end-of-day assessment in the natural environment are reported.

Heightened cue reactivity (arousal, urge and/or craving) was observed in individuals with risky and pathological use compared with those with non-problematic use across all levels of the paradigm. Individuals with pathological use showed elevated levels of urge and craving, along with generalised responses to stimuli showing starting and/or log-in screens not related to their specific (addictive) behaviour. These effects were consistent across different types of PUI and were associated with engagement in the behaviour and temptation experiences in naturalistic settings.

These findings indicate that cue reactivity and craving are central aspects of PUIs. Although different devices may elicit different types of action, our results highlight the challenges of regulating behaviour in environments saturated with unavoidable triggers, such as internet content and devices.

Suicides in children and young people are a major public health concern. Prevention of Future Death (PFD) reports are an underutilised resource detailing coroners’ concerns which, if actioned, are believed to be able to prevent future deaths. Research has investigated common themes for suicide during 2021 and 2022 but there are no published studies that thematically analyse these reports for children alone.

To identify key themes raised by coroners from PFD reports published between 2015 and 2023 for children who have died by suicide.

PFD reports for suicides in children were downloaded from the Courts and Tribunals Judiciary website. Descriptive statistics were collated from reports. Reports (n = 37) were analysed using inductive content analysis to determine primary and sub-themes using QSR NVIVO 14 Qualitative Analysis software.

Reports came from 30 coroners’ areas, with most reports being sent to government departments and NHS Trusts/Clinical Commissioning Groups. The qualitative analysis resulted in six primary themes being identified: service provision, staffing and resourcing, communication, multiple services involved in care, accessing services and access to harmful content and environment. Furthermore, 23 sub-themes were identified such as standard operating procedures/processes not being followed or being inadequate, a lack of specialist services and a disconnect between integrated services. A quarter of reports were on children diagnosed with autism, and there were specific issues highlighted in concerns relating to services and staffing for children with neurodiverse conditions.

The key findings from this report highlight themes raised by coroners relating to deaths of children by suicide. This included themes around service provision, staffing and resourcing of mental health services and communication between services and families. Children with neurodiversity, including autism, appear to be of particular concern.