Rohit Shankar,Inder Sawhney,Samuel Tromans,Sujeet Jaydeokar,Mahesh Oodiyor,Rory Sheehan,Bhathika Perera,Amy Blake,Jana de Villers,Kiran Purandare,Jane McCarthy,Raja Anindya Sekhar Mukerjee,Richard A Laugharne,Angela Hassiotis,Andre Strydom,Regi Alexander,Ashok Roy
The NHS 2025 Health Plan aims for radical reform but overlooks people with intellectual disability. This editorial highlights critical omissions in policy, services, research and rights protections. Without intentional inclusion, digital and community shifts risk deepening inequality. True progress demands co-produced strategies to ensure equitable care for this vulnerable population.
{"title":"Fit for whose future? A critical omission of people with intellectual disability in the 2025 NHS 10 Year Health Plan for England.","authors":"Rohit Shankar,Inder Sawhney,Samuel Tromans,Sujeet Jaydeokar,Mahesh Oodiyor,Rory Sheehan,Bhathika Perera,Amy Blake,Jana de Villers,Kiran Purandare,Jane McCarthy,Raja Anindya Sekhar Mukerjee,Richard A Laugharne,Angela Hassiotis,Andre Strydom,Regi Alexander,Ashok Roy","doi":"10.1192/bjp.2025.10428","DOIUrl":"https://doi.org/10.1192/bjp.2025.10428","url":null,"abstract":"The NHS 2025 Health Plan aims for radical reform but overlooks people with intellectual disability. This editorial highlights critical omissions in policy, services, research and rights protections. Without intentional inclusion, digital and community shifts risk deepening inequality. True progress demands co-produced strategies to ensure equitable care for this vulnerable population.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"100 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Louise Hussey,Matthew Gittins,Anna Hedges,Kate Allsopp,Neharika Puligundla,Alan Barrett,Gill Szafranski,Prathiba Chitsabesan,Paul French
BACKGROUNDThe Resilience Hub was established to support people in need of psychological/psychosocial support following the 2017 Manchester Arena terrorist attack.AIMSTo use mental health screening measures over 3 years following the Arena event to examine the variation in symptoms reported by adults registered with the Hub, and whether this was associated with treatment access characteristics.METHODAdults engaging with Hub services were separated into eight cohorts depending on when they registered post-incident. Participants completed screening measures for symptoms of trauma, depression, generalised anxiety and work/social functioning. Baseline and follow-up scores over 3 years were compared among the eight admission groups. All types of appointment were recorded in terms of the number of minutes of clinical 'contact time' involved, to explore associations with time taken to register.RESULTSOverall, baseline screening scores increased as time to register post-event increased. Over the 3 years of follow-up, a decrease in scores was observed for all 4 screening measures, indicating improvement in mental well-being. Those taking longer to register had higher follow-up scores. However, they showed a slightly stronger decrease in average change of score per follow-up month. Mean contact time per month was greater (apart from the 18-months admission group) in individuals delaying registration. Increased contact time was associated with decreased follow-up screening scores for depression and anxiety.CONCLUSIONSPeople who registered earlier were less symptomatic, suggesting there may be a potential beneficial impact of early engagement with support services following traumatic events. All who registered showed improvement in symptoms, including those delaying registration, with increased contact time being beneficial. This reinforces the benefits of encouraging early and sustained engagement with services as soon as possible post-incident.
{"title":"Longitudinal changes in the mental health of those affected by the 2017 Manchester Arena attack: 3-year follow-up of adults seeking support from the Resilience Hub.","authors":"Louise Hussey,Matthew Gittins,Anna Hedges,Kate Allsopp,Neharika Puligundla,Alan Barrett,Gill Szafranski,Prathiba Chitsabesan,Paul French","doi":"10.1192/bjp.2025.10342","DOIUrl":"https://doi.org/10.1192/bjp.2025.10342","url":null,"abstract":"BACKGROUNDThe Resilience Hub was established to support people in need of psychological/psychosocial support following the 2017 Manchester Arena terrorist attack.AIMSTo use mental health screening measures over 3 years following the Arena event to examine the variation in symptoms reported by adults registered with the Hub, and whether this was associated with treatment access characteristics.METHODAdults engaging with Hub services were separated into eight cohorts depending on when they registered post-incident. Participants completed screening measures for symptoms of trauma, depression, generalised anxiety and work/social functioning. Baseline and follow-up scores over 3 years were compared among the eight admission groups. All types of appointment were recorded in terms of the number of minutes of clinical 'contact time' involved, to explore associations with time taken to register.RESULTSOverall, baseline screening scores increased as time to register post-event increased. Over the 3 years of follow-up, a decrease in scores was observed for all 4 screening measures, indicating improvement in mental well-being. Those taking longer to register had higher follow-up scores. However, they showed a slightly stronger decrease in average change of score per follow-up month. Mean contact time per month was greater (apart from the 18-months admission group) in individuals delaying registration. Increased contact time was associated with decreased follow-up screening scores for depression and anxiety.CONCLUSIONSPeople who registered earlier were less symptomatic, suggesting there may be a potential beneficial impact of early engagement with support services following traumatic events. All who registered showed improvement in symptoms, including those delaying registration, with increased contact time being beneficial. This reinforces the benefits of encouraging early and sustained engagement with services as soon as possible post-incident.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"41 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lysenko was a powerful Soviet pseudoscientist, whose theories cost millions of lives. He died 50 years ago, but his legacy is highly salient. Anti-science and ideology come together slowly, and UK pseudoscience has had unforeseen consequences. Pseudoscience must be challenged even when this has repercussions for those who speak up.
{"title":"Remembering Lysenko: when ideology and science meet","authors":"Rob Poole","doi":"10.1192/bjp.2025.10418","DOIUrl":"https://doi.org/10.1192/bjp.2025.10418","url":null,"abstract":"<p>Lysenko was a powerful Soviet pseudoscientist, whose theories cost millions of lives. He died 50 years ago, but his legacy is highly salient. Anti-science and ideology come together slowly, and UK pseudoscience has had unforeseen consequences. Pseudoscience must be challenged even when this has repercussions for those who speak up.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cody Varnish, Alice R. Phillips, Shailaja Tallam Laxman, Nina Maxwell, Sarah L. Halligan, Katherine S. Button
Background
Children in care who experience frequent placement changes face an increased risk of negative mental health outcomes. Emerging evidence suggests a bidirectional relationship, where placement instability can both predict and result from mental health difficulties. Understanding the strength and direction of this relationship is crucial for informing policy and practice, yet UK-based evidence remains unconsolidated.
Aims
To conduct the first systematic review and meta-analysis examining the relationship between placement instability and mental health in the UK care system.
Method
This review was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO; CRD42024493617). We searched five databases (up to August 2024) for peer-reviewed UK studies that included a care-experienced sample, measured placement (in)stability, measured mental health, and quantitatively examined the relationship between placement instability and mental health. A random-effects meta-analysis was conducted, and study quality was assessed using the Newcastle–Ottawa Scale.
Results
Fifteen studies (N = 6905) were included, with twelve studies (n = 5536) contributing to the meta-analysis. Children with unstable placements were more than twice as likely to experience mental health difficulties compared to those with stable placements (odds ratio 2.07, 95% CI 1.65–2.59). However, evidence on the causal direction of this relationship was limited.
Conclusion
Placement instability doubles the risk of mental health difficulties for care-experienced children, who already face elevated rates of mental disorders. Further research is urgently needed to clarify the bidirectional nature of this relationship and guide targeted intervention. Meanwhile, policymakers should prioritise collaborations between mental health services and local authorities to prevent the cycle of instability and mental health deterioration.
背景：经常更换安置的儿童面临负面心理健康结果的风险增加。新出现的证据表明存在一种双向关系，即安置不稳定既可以预测心理健康问题，也可以导致心理健康问题。了解这种关系的强度和方向对于为政策和实践提供信息至关重要，但基于英国的证据仍未得到巩固。目的对英国护理系统中安置不稳定性与心理健康之间的关系进行首次系统回顾和荟萃分析。方法本综述已在国际前瞻性系统综述注册（PROSPERO; CRD42024493617）上前瞻性注册。我们检索了五个数据库（截至2024年8月），以获取同行评议的英国研究，其中包括有护理经验的样本、测量的安置稳定性、测量的心理健康，并定量检查了安置不稳定性与心理健康之间的关系。进行随机效应荟萃分析，并使用纽卡斯尔-渥太华量表评估研究质量。结果纳入15项研究（N = 6905），其中12项研究（N = 5536）参与meta分析。安置不稳定的儿童出现心理健康问题的可能性是安置稳定儿童的两倍多（优势比2.07,95% CI 1.65-2.59）。然而，关于这种关系的因果方向的证据是有限的。结论安置不稳定使接受过照料的儿童出现心理健康问题的风险增加一倍，这些儿童本来就面临着较高的精神障碍发生率。迫切需要进一步的研究来阐明这种关系的双向性质，并指导有针对性的干预。与此同时，政策制定者应优先考虑精神卫生服务机构与地方当局之间的合作，以防止不稳定和精神卫生恶化的循环。
{"title":"The relationship between placement instability and mental health among care-experienced children and young people: UK systematic review and meta-analysis","authors":"Cody Varnish, Alice R. Phillips, Shailaja Tallam Laxman, Nina Maxwell, Sarah L. Halligan, Katherine S. Button","doi":"10.1192/bjp.2025.10375","DOIUrl":"https://doi.org/10.1192/bjp.2025.10375","url":null,"abstract":"<span>Background</span><p>Children in care who experience frequent placement changes face an increased risk of negative mental health outcomes. Emerging evidence suggests a bidirectional relationship, where placement instability can both predict and result from mental health difficulties. Understanding the strength and direction of this relationship is crucial for informing policy and practice, yet UK-based evidence remains unconsolidated.</p><span>Aims</span><p>To conduct the first systematic review and meta-analysis examining the relationship between placement instability and mental health in the UK care system.</p><span>Method</span><p>This review was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO; CRD42024493617). We searched five databases (up to August 2024) for peer-reviewed UK studies that included a care-experienced sample, measured placement (in)stability, measured mental health, and quantitatively examined the relationship between placement instability and mental health. A random-effects meta-analysis was conducted, and study quality was assessed using the Newcastle–Ottawa Scale.</p><span>Results</span><p>Fifteen studies (<span>N</span> = 6905) were included, with twelve studies (<span>n</span> = 5536) contributing to the meta-analysis. Children with unstable placements were more than twice as likely to experience mental health difficulties compared to those with stable placements (odds ratio 2.07, 95% CI 1.65–2.59). However, evidence on the causal direction of this relationship was limited.</p><span>Conclusion</span><p>Placement instability doubles the risk of mental health difficulties for care-experienced children, who already face elevated rates of mental disorders. Further research is urgently needed to clarify the bidirectional nature of this relationship and guide targeted intervention. Meanwhile, policymakers should prioritise collaborations between mental health services and local authorities to prevent the cycle of instability and mental health deterioration.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Attitudes towards mental health professionals in social media: infodemiology study: commentary, Shahbaz et al.","authors":"Aized Raza Shahbaz,Marta Corti,Ben Gray","doi":"10.1192/bjp.2025.10416","DOIUrl":"https://doi.org/10.1192/bjp.2025.10416","url":null,"abstract":"","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"85 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
André Kerber,Caroline Macina,Ludwig Ohse,Leonie Kampe,Oliver Busch,Michael Rentrop,Christine Knaevelsrud,Johannes Wrege,Susanne Hörz-Sagstetter
BACKGROUNDDecades of research on the dimensional nature of personality disorder have led to the replacement of categorical personality disorder diagnoses by a dimensional assessment of personality disorder severity (PDS) in ICD-11, which essentially corresponds to personality functioning in the alternative DSM-5 model for personality disorders. Besides advancing the focus in the diagnosis of PD on impairments in self- and interpersonal functioning, this shift also urges clinicians and researchers worldwide to get familiar with new diagnostic approaches.AIMSThis study investigated which PDS dimensions among different assessment methods and conceptualisations have the most predictive value for overall PDS.METHODUsing semi-structured interviews and self-reports of personality functioning, personality organisation and personality structure in clinical samples of different settings in Switzerland and Germany (n = 534), we calculated a latent general factor for PDS (g-PDS) by applying a correlated trait correlated (method - 1) model (CTC(M-1)).RESULTSOur results showed that four interview-assessed PDS dimensions: defence mechanisms, desire and capacity for closeness, sense of self, and comprehension and appreciation of others' experiences and motivations account for 91.1% of variance of g-PDS, with a combination of either two of these four dimensions already explaining between 81.8 and 91.3%. Regarding self-reports, the dimensions depth and duration of connections, self-perception, object perception and attachment capacity to internal objects predicted 61.3% of the variance of a latent interview-based score, with all investigated self-reported dimensions together adding up to 65.2% variance explanation.CONCLUSIONSTaken together, our data suggest that focusing on specific dimensions, such as intimacy and identity, in time-limited settings might be viable in determining PDS efficiently.
{"title":"Determining essential dimensions for the clinical approximation of personality disorder severity: multi-method study.","authors":"André Kerber,Caroline Macina,Ludwig Ohse,Leonie Kampe,Oliver Busch,Michael Rentrop,Christine Knaevelsrud,Johannes Wrege,Susanne Hörz-Sagstetter","doi":"10.1192/bjp.2025.10347","DOIUrl":"https://doi.org/10.1192/bjp.2025.10347","url":null,"abstract":"BACKGROUNDDecades of research on the dimensional nature of personality disorder have led to the replacement of categorical personality disorder diagnoses by a dimensional assessment of personality disorder severity (PDS) in ICD-11, which essentially corresponds to personality functioning in the alternative DSM-5 model for personality disorders. Besides advancing the focus in the diagnosis of PD on impairments in self- and interpersonal functioning, this shift also urges clinicians and researchers worldwide to get familiar with new diagnostic approaches.AIMSThis study investigated which PDS dimensions among different assessment methods and conceptualisations have the most predictive value for overall PDS.METHODUsing semi-structured interviews and self-reports of personality functioning, personality organisation and personality structure in clinical samples of different settings in Switzerland and Germany (n = 534), we calculated a latent general factor for PDS (g-PDS) by applying a correlated trait correlated (method - 1) model (CTC(M-1)).RESULTSOur results showed that four interview-assessed PDS dimensions: defence mechanisms, desire and capacity for closeness, sense of self, and comprehension and appreciation of others' experiences and motivations account for 91.1% of variance of g-PDS, with a combination of either two of these four dimensions already explaining between 81.8 and 91.3%. Regarding self-reports, the dimensions depth and duration of connections, self-perception, object perception and attachment capacity to internal objects predicted 61.3% of the variance of a latent interview-based score, with all investigated self-reported dimensions together adding up to 65.2% variance explanation.CONCLUSIONSTaken together, our data suggest that focusing on specific dimensions, such as intimacy and identity, in time-limited settings might be viable in determining PDS efficiently.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"58 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUNDAlcohol use disorder (AUD) increases the likelihood of suicide attempts. The characteristics of AUD that increase suicide attempt risk remain unclear.AIMSTo identify factors associated with a history of suicide attempts and with suicidal acts occurring within a 2-year follow-up in patients with AUD.METHODThis multicentre, prospective cohort study included patients with AUD within 1 week of admission to in-patient care for alcohol withdrawal management. Sociodemographic and clinical data were collected during a face-to-face clinician interview at baseline. Follow-up telephone interviews were conducted up to 24 months post-inclusion to assess the primary end-point: the occurrence of a suicidal act (suicide attempt or completed suicide). To identify factors associated with past suicide attempts, Student's t-tests, chi-squared tests and logistic regression were performed. Univariate survival analyses and a multivariate Cox model were computed to identify predictors of suicidal acts occurring during the follow-up period.RESULTSOf the 779 patients included in the study, 337 (43.3%) had a history of suicide attempts. This was significantly associated with a history of major depressive disorder, female gender and higher levels of suicidal ideation and hopelessness. Regarding the prospective analysis, suicidal acts occurred in 90 (11.5%) patients. A history of severe alcohol withdrawal symptoms, defined as delirium tremens or seizures (adjusted hazard ratio (aHR) 2.38, 95% CI 1.38-4.10, P = 0.002), and a history of suicide attempts (aHR 1.84, 95% CI 1.14-2.99, P = 0.013), were associated with higher occurrence of suicidal acts, while living alone (0.47, 95% CI 0.28-0.78, P = 0.004) was a protective factor.CONCLUSIONSWhile a history of suicide attempts is a well-established risk factor for future suicidal acts, a history of severe alcohol withdrawal symptoms emerges as an even stronger predictor. Further studies are necessary to generalise this finding and use it to identify patients at higher risk of suicidal acts.
背景：酒精使用障碍（AUD）增加了自杀企图的可能性。AUD增加自杀企图风险的特征尚不清楚。目的：确定AUD患者在2年随访期间发生自杀企图史和自杀行为的相关因素。方法：这项多中心、前瞻性队列研究纳入了入院1周内接受酒精戒断治疗的AUD患者。社会人口学和临床数据是在基线时面对面的临床医生访谈中收集的。随访电话访谈持续至纳入后24个月，以评估主要终点：自杀行为（自杀未遂或自杀完成）的发生。为了确定与过去自杀企图相关的因素，进行了学生t检验、卡方检验和逻辑回归。通过单因素生存分析和多因素Cox模型来确定随访期间自杀行为的预测因素。结果纳入研究的779例患者中，337例（43.3%）有自杀未遂史。这与重度抑郁症病史、女性、更高水平的自杀意念和绝望感有显著关联。在前瞻性分析中，有90例（11.5%）患者发生自杀行为。重度酒精戒断症状史，定义为震颤谵妄或癫痫发作（校正危险比（aHR） 2.38, 95% CI 1.38-4.10, P = 0.002）和自杀未遂史（aHR 1.84, 95% CI 1.14-2.99, P = 0.013）与自杀行为发生率较高相关，而独居（0.47,95% CI 0.28-0.78, P = 0.004）是一个保护因素。结论：虽然自杀未遂史是未来自杀行为的一个公认的风险因素，但严重的酒精戒断症状史是一个更强的预测因素。需要进一步的研究来推广这一发现，并利用它来识别自杀行为风险较高的患者。
{"title":"Severe alcohol withdrawal symptoms and the risk of suicidal acts in patients treated for alcohol use disorder.","authors":"Clément Vansteene,Caroline Dubertret,Henri-Jean Aubin,Philippe Batel,Daphnée Poupon,Philip Gorwood","doi":"10.1192/bjp.2025.10386","DOIUrl":"https://doi.org/10.1192/bjp.2025.10386","url":null,"abstract":"BACKGROUNDAlcohol use disorder (AUD) increases the likelihood of suicide attempts. The characteristics of AUD that increase suicide attempt risk remain unclear.AIMSTo identify factors associated with a history of suicide attempts and with suicidal acts occurring within a 2-year follow-up in patients with AUD.METHODThis multicentre, prospective cohort study included patients with AUD within 1 week of admission to in-patient care for alcohol withdrawal management. Sociodemographic and clinical data were collected during a face-to-face clinician interview at baseline. Follow-up telephone interviews were conducted up to 24 months post-inclusion to assess the primary end-point: the occurrence of a suicidal act (suicide attempt or completed suicide). To identify factors associated with past suicide attempts, Student's t-tests, chi-squared tests and logistic regression were performed. Univariate survival analyses and a multivariate Cox model were computed to identify predictors of suicidal acts occurring during the follow-up period.RESULTSOf the 779 patients included in the study, 337 (43.3%) had a history of suicide attempts. This was significantly associated with a history of major depressive disorder, female gender and higher levels of suicidal ideation and hopelessness. Regarding the prospective analysis, suicidal acts occurred in 90 (11.5%) patients. A history of severe alcohol withdrawal symptoms, defined as delirium tremens or seizures (adjusted hazard ratio (aHR) 2.38, 95% CI 1.38-4.10, P = 0.002), and a history of suicide attempts (aHR 1.84, 95% CI 1.14-2.99, P = 0.013), were associated with higher occurrence of suicidal acts, while living alone (0.47, 95% CI 0.28-0.78, P = 0.004) was a protective factor.CONCLUSIONSWhile a history of suicide attempts is a well-established risk factor for future suicidal acts, a history of severe alcohol withdrawal symptoms emerges as an even stronger predictor. Further studies are necessary to generalise this finding and use it to identify patients at higher risk of suicidal acts.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"1 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tamara Williams,Isabella Barclay,Rhys Bevan-Jones,Lucy A Livingston,Sharifah Shameem Agha,Tamsin Ford,Ann John,Kapil Sayal,Anita Thapar,Joanna Martin
BACKGROUNDAttention-deficit/hyperactivity disorder (ADHD) is more commonly missed or diagnosed later in females than in males. One explanation is that diagnostic criteria have been informed by research primarily based on male samples and may not adequately capture the female presentation of ADHD.AIMSThis study used a qualitative approach to better understand female ADHD in childhood, from the perspective of young women and non-binary adults with ADHD.METHODTwelve young adults (10 women and 2 non-binary individuals assigned female at birth, aged 18-25 years) with ADHD were interviewed to describe their lived experiences of ADHD throughout childhood. Interviews were transcribed verbatim and qualitatively analysed using the framework method, a codebook approach to thematic analysis.RESULTSParticipants reported experiencing a range of ADHD symptoms, some of which are not included in current diagnostic criteria. Four core themes were identified: (a) socially oriented and internalised symptoms, (b) social impacts, (c) masking and compensation and (d) the importance of context. Theme one describes how girls with ADHD may experience symptoms as more socially oriented (e.g. losing track of thoughts in a conversation), non-disruptive (e.g. doodling) and internalised (e.g. feeling frustrated) than those described by current diagnostic criteria. Theme two highlights the importance of social impacts of ADHD on friends, home and school. Theme three describes the desire to 'fit in' socially, behaviours and strategies used to mask symptoms and associated unfavourable consequences. Theme four highlights variability in symptoms across different environmental contexts.CONCLUSIONSThis study suggests that the presentation of ADHD symptoms in girls may be socially oriented, internalised and especially influenced by the social context. Also, female ADHD symptoms may be less visible due to scaffolding, masking and context. Future research should consider whether current ADHD diagnostic criteria require adjustment, to aid earlier recognition and diagnosis of ADHD in children and young people, especially in females.
{"title":"Reflections on the manifestation of attention-deficit hyperactivity disorder in girls from young adults with lived experiences: a qualitative study.","authors":"Tamara Williams,Isabella Barclay,Rhys Bevan-Jones,Lucy A Livingston,Sharifah Shameem Agha,Tamsin Ford,Ann John,Kapil Sayal,Anita Thapar,Joanna Martin","doi":"10.1192/bjp.2025.10376","DOIUrl":"https://doi.org/10.1192/bjp.2025.10376","url":null,"abstract":"BACKGROUNDAttention-deficit/hyperactivity disorder (ADHD) is more commonly missed or diagnosed later in females than in males. One explanation is that diagnostic criteria have been informed by research primarily based on male samples and may not adequately capture the female presentation of ADHD.AIMSThis study used a qualitative approach to better understand female ADHD in childhood, from the perspective of young women and non-binary adults with ADHD.METHODTwelve young adults (10 women and 2 non-binary individuals assigned female at birth, aged 18-25 years) with ADHD were interviewed to describe their lived experiences of ADHD throughout childhood. Interviews were transcribed verbatim and qualitatively analysed using the framework method, a codebook approach to thematic analysis.RESULTSParticipants reported experiencing a range of ADHD symptoms, some of which are not included in current diagnostic criteria. Four core themes were identified: (a) socially oriented and internalised symptoms, (b) social impacts, (c) masking and compensation and (d) the importance of context. Theme one describes how girls with ADHD may experience symptoms as more socially oriented (e.g. losing track of thoughts in a conversation), non-disruptive (e.g. doodling) and internalised (e.g. feeling frustrated) than those described by current diagnostic criteria. Theme two highlights the importance of social impacts of ADHD on friends, home and school. Theme three describes the desire to 'fit in' socially, behaviours and strategies used to mask symptoms and associated unfavourable consequences. Theme four highlights variability in symptoms across different environmental contexts.CONCLUSIONSThis study suggests that the presentation of ADHD symptoms in girls may be socially oriented, internalised and especially influenced by the social context. Also, female ADHD symptoms may be less visible due to scaffolding, masking and context. Future research should consider whether current ADHD diagnostic criteria require adjustment, to aid earlier recognition and diagnosis of ADHD in children and young people, especially in females.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"1 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUNDThe risk factors for post-traumatic stress disorder (PTSD) in children and adolescents following mass violence incidents, such as terrorist attacks, remain incompletely understood. In the aftermath of the 14 July 2016, terrorist attack in Nice, France, a dedicated paediatric consultation centre was established at the Children's University Hospital, the Nice Pediatric Psychotrauma Center (NPPC).AIMSThis 2-year longitudinal study aims to identify and understand the influence of pre-trauma, trauma-related and post-trauma risk factors associated with the development of PTSD in children and adolescents following the 2016 terrorist attack in Nice.METHODParticipants under 18 years of age at the time of the attack were recruited from the NPPC over 2 years, between 21 November 2017 and 22 November 2019. Assessments included semi-structured diagnostic interviews with children and/or parents, standardised clinical questionnaires for both parents and children and cognitive tests exclusively for children.RESULTSTwo hundred and seventy-one children (mean age 8.10 years; 48.7% female) directly impacted by the terrorist attack, were assessed. Pre-traumatic factors (age, gender assigned at birth and cognitive functioning) failed to predict PTSD. Two trauma-related factors, subjective fear intensity and lifetime number of traumatic events emerged as significant predictors. Concerning post-trauma factors, maternal symptoms (anxiety, depression and PTSD), child somatic symptoms and comorbid DSM-5 diagnoses played a crucial role in child PTSD. The final regression model demonstrated an 84% accuracy in predicting PTSD in children and adolescents (χ2[3] = 2.4, P < 0.001).CONCLUSIONSThese findings highlight the importance of assessing specific risk factors for PTSD in children and adolescents to deliver specialised and targeted care to young people and their parents following a terrorist attack.
背景：大规模暴力事件（如恐怖袭击）后儿童和青少年创伤后应激障碍（PTSD）的危险因素尚未完全了解。2016年7月14日法国尼斯发生恐怖袭击事件后，在尼斯儿童大学医院儿童精神创伤中心（NPPC）设立了专门的儿科咨询中心。目的：这项为期2年的纵向研究旨在识别和了解2016年尼斯恐怖袭击后儿童和青少年创伤前、创伤相关和创伤后风险因素对PTSD发展的影响。方法在2017年11月21日至2019年11月22日期间，从NPPC招募了攻击发生时未满18岁的参与者。评估包括对儿童和/或父母进行半结构化诊断访谈，对父母和儿童进行标准化临床问卷调查，以及专门对儿童进行认知测试。结果共评估了271名受恐怖袭击直接影响的儿童，平均年龄8.10岁，其中女性48.7%。创伤前因素（年龄、出生时的性别和认知功能）无法预测PTSD。两个与创伤相关的因素，主观恐惧强度和一生中创伤事件的数量成为显著的预测因子。在创伤后因素中，母亲症状（焦虑、抑郁和PTSD）、儿童躯体症状和共病DSM-5诊断在儿童PTSD中起着至关重要的作用。最终回归模型预测儿童和青少年PTSD的准确率为84% （χ2[3] = 2.4, P < 0.001）。这些发现强调了评估儿童和青少年创伤后应激障碍特定风险因素的重要性，以便在恐怖袭击后为年轻人及其父母提供专门和有针对性的护理。
{"title":"Risk factors associated with PTSD in a paediatric population exposed to the 14 July 2016, Nice terrorist attack: results from a 2-year longitudinal study.","authors":"Morgane Gindt,Philippe Auby,Philippe Robert,Radia Zeghari,Nicolas Bodeau,Florence Askenazy,Arnaud Fernandez","doi":"10.1192/bjp.2025.10378","DOIUrl":"https://doi.org/10.1192/bjp.2025.10378","url":null,"abstract":"BACKGROUNDThe risk factors for post-traumatic stress disorder (PTSD) in children and adolescents following mass violence incidents, such as terrorist attacks, remain incompletely understood. In the aftermath of the 14 July 2016, terrorist attack in Nice, France, a dedicated paediatric consultation centre was established at the Children's University Hospital, the Nice Pediatric Psychotrauma Center (NPPC).AIMSThis 2-year longitudinal study aims to identify and understand the influence of pre-trauma, trauma-related and post-trauma risk factors associated with the development of PTSD in children and adolescents following the 2016 terrorist attack in Nice.METHODParticipants under 18 years of age at the time of the attack were recruited from the NPPC over 2 years, between 21 November 2017 and 22 November 2019. Assessments included semi-structured diagnostic interviews with children and/or parents, standardised clinical questionnaires for both parents and children and cognitive tests exclusively for children.RESULTSTwo hundred and seventy-one children (mean age 8.10 years; 48.7% female) directly impacted by the terrorist attack, were assessed. Pre-traumatic factors (age, gender assigned at birth and cognitive functioning) failed to predict PTSD. Two trauma-related factors, subjective fear intensity and lifetime number of traumatic events emerged as significant predictors. Concerning post-trauma factors, maternal symptoms (anxiety, depression and PTSD), child somatic symptoms and comorbid DSM-5 diagnoses played a crucial role in child PTSD. The final regression model demonstrated an 84% accuracy in predicting PTSD in children and adolescents (χ2[3] = 2.4, P < 0.001).CONCLUSIONSThese findings highlight the importance of assessing specific risk factors for PTSD in children and adolescents to deliver specialised and targeted care to young people and their parents following a terrorist attack.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"88 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexandra Perkins,Julia Michalek,Lisa Dikomitis,Sukhi Shergill,Isabelle Mareschal
BACKGROUNDRefugees and asylum seekers often experience trauma, leading to high rates of post-traumatic stress disorder (PTSD). However, the extent to which trauma and PTSD impacts social functioning, such as social relationships or engaging with community activities in new environments, remains unclear.AIMSThis systematic review aims to identify key areas of social functioning influenced by trauma and PTSD, with additional analyses stratified by trauma type.METHODA comprehensive search of five databases, grey literature sources, and reference lists was conducted in February 2025. Included papers explored the impact of trauma or PTSD on social functioning in adult displaced populations post-migration, within the last 30 years. Studies' risk of bias was assessed using the Mixed Methods Appraisal Tool and the Authority, Accuracy, Coverage, Objectivity, Date, Significance checklist. Data were extracted on associations between trauma, PTSD and social functioning outcomes.RESULTSOf the studies, encompassing 15 394 participants, 38 met the inclusion criteria. Our analysis indicated that trauma and PTSD have an impact on multiple domains of social functioning, including post-migration living difficulties, everyday functioning, acculturation and integration, social relationships, and employment and education. War-related trauma predominantly affected psychosocial functioning and integration, whereas interpersonal trauma had a greater impact on social relationships. While most findings indicated a negative influence of trauma and PTSD on these areas, some evidence suggested the potential for post-traumatic growth.CONCLUSIONSThe findings underscore the challenges displaced groups face, alongside the possibility of post-traumatic growth. Future research should focus on identifying factors that facilitate positive adaptation, informing interventions to support social integration in these vulnerable groups.
{"title":"The impact of trauma and PTSD on social functioning in refugees and asylum seekers post-migration: systematic review.","authors":"Alexandra Perkins,Julia Michalek,Lisa Dikomitis,Sukhi Shergill,Isabelle Mareschal","doi":"10.1192/bjp.2025.10385","DOIUrl":"https://doi.org/10.1192/bjp.2025.10385","url":null,"abstract":"BACKGROUNDRefugees and asylum seekers often experience trauma, leading to high rates of post-traumatic stress disorder (PTSD). However, the extent to which trauma and PTSD impacts social functioning, such as social relationships or engaging with community activities in new environments, remains unclear.AIMSThis systematic review aims to identify key areas of social functioning influenced by trauma and PTSD, with additional analyses stratified by trauma type.METHODA comprehensive search of five databases, grey literature sources, and reference lists was conducted in February 2025. Included papers explored the impact of trauma or PTSD on social functioning in adult displaced populations post-migration, within the last 30 years. Studies' risk of bias was assessed using the Mixed Methods Appraisal Tool and the Authority, Accuracy, Coverage, Objectivity, Date, Significance checklist. Data were extracted on associations between trauma, PTSD and social functioning outcomes.RESULTSOf the studies, encompassing 15 394 participants, 38 met the inclusion criteria. Our analysis indicated that trauma and PTSD have an impact on multiple domains of social functioning, including post-migration living difficulties, everyday functioning, acculturation and integration, social relationships, and employment and education. War-related trauma predominantly affected psychosocial functioning and integration, whereas interpersonal trauma had a greater impact on social relationships. While most findings indicated a negative influence of trauma and PTSD on these areas, some evidence suggested the potential for post-traumatic growth.CONCLUSIONSThe findings underscore the challenges displaced groups face, alongside the possibility of post-traumatic growth. Future research should focus on identifying factors that facilitate positive adaptation, informing interventions to support social integration in these vulnerable groups.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"22 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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