BJPsych Bulletin最新文献

Aims and method: There is no consensus on core curriculum content for neuropsychiatry and behavioural neurology training and the breadth of topic coverage is poorly understood. Using a scoping review, we identified 23 unique syllabuses from Australia, Argentina, Chile, Mexico, New Zealand, South Africa, the USA and the UK, and one explicitly international in scope.

Results: Syllabuses addressed a wide range of neuropsychiatric conditions, encompassing not only overlapping psychiatric and neurological disorders, but also functional, behavioural and cognitive disorders. Training integrated knowledge from neuropsychology, philosophy, ethics and social sciences. Core elements included clinical assessment, intervention skills and case management in social and institutional settings. Neuropsychiatry and behavioural neurology training integrates a broad spectrum of knowledge and skills, is aimed at a range of professionals and is delivered as both specialist training and embedded components within core training.

Clinical implications: The core components of neuropsychiatry curricula identified in this study provide a foundation for institutions to develop or enhance their neuropsychiatry training programs.

Aims and method: Early Positive Approaches to Support (E-PAtS) is a co-produced group intervention supporting family carers of children (0-5 years) with additional developmental needs. This study compared online (n = 10) and in-person (n = 11) groups to investigate whether mode of delivery was associated with different outcomes. Participants were 98 family carers reporting on their mental well-being, self-efficacy, child symptoms and knowledge pre and post intervention. Generalised estimating equations compared outcomes between groups, controlling for group cluster effects.

Results: Mental well-being improved significantly across both groups (d = 0.47, 95% CI: 0.30, 0.63), as did an in-session measure concerning mechanisms of change (d = 1.28, 95% CI: 0.97, 1.59) and all other assessed outcomes. There were no significant differences in measured outcomes between online and in-person groups.

Clinical implications: Establishing the equivalence of in-person with online groups is an important first step for improving service reach and support access for families of children with additional developmental needs.

Patients find the term 'borderline personality disorder' offensive and, from a list of alternative labels, prefer 'emotional intensity disorder'. It is suggested that any term will take on a pejorative connotation if professional attitudes do not change as well; and that this requires an alteration in the environment in which professionals operate. This should not look so strongly to compulsion to prevent suicide, but should allow therapeutic relationships to flourish. Blaming clinicians for incidents when they have few choices is counterproductive. The problem reflects a systemic impatience with patients who get better slowly or not at all.

Aims and method: This study evaluated whether brief teaching sessions on transference-focused psychotherapy (TFP) could improve psychiatric trainees' attitudes and clinical confidence in managing patients with personality disorders. A mixed-methods design was used, combining pre- and post-training validated questionnaires with a focus group discussion. Two 4-h workshops covered TFP theory and techniques, and case discussions.

Results: Twenty-six participants completed paired questionnaires. Statistically significant improvements were observed in overall attitudes (Attitudes to Personality Disorder Questionnaire total score, P = 0.022) and enthusiasm towards patients with personality disorders (P = 0.003). Clinical confidence (Clinical Confidence with Personality Disorder Questionnaire) improved markedly (P < 0.001). Qualitative analysis identified high acceptability, valuing TFP concepts and enhanced emotional awareness, although participants desired more practical components.

Clinical implications: Even brief TFP training can positively influence trainees' attitudes and confidence in treating personality disorders. Incorporating TFP-informed training into psychiatric education may reduce clinician frustration and improve therapeutic engagement with this complex patient group.

Aims and method: To investigate associations between maternal ethnicity and involuntary mother and baby unit (MBU) admission, adjusting for potential confounding variables. Data from electronic records in a Scottish MBU (July 2012 to January 2024) were analysed with logistic regression.

Results: A total of 450 first admissions were analysed. The proportion of patients from Black, Asian, Mixed or other ethnic minorities who were admitted involuntarily (n = 8/48, 38%) was twice that of White British patients (n = 66/364, 18%) with White not British patients showing an intermediate proportion (n = 12/38, 32%). In the unadjusted model, being of Black, Asian, Mixed or other minority ethnicity was associated with involuntary admission (odds ratio 2.7, 95% CI 1.4-5.2; P = 0.002), as was being of White not British ethnicity (odds ratio 2.1, 95% CI 1.0-4.3; P = 0.04997). Association were attenuated after adjustment for potential confounders, including psychosis.

Clinical implications: We identified racial inequalities in a perinatal mental health setting. The drivers of these differences are likely multifactorial.

This study examines the representation of psychotic disorders in Spanish punk music over three decades, analysing 5647 songs from 177 bands. Content related to psychotic disorders appeared in 2.28% of the corpus, divided into songs with psychosis as a central theme and those using psychopathological terms incidentally. Schizophrenia and paranoia were the most referenced diagnoses, although frequently applied in ways that lacked clinical accuracy. Thematic analysis revealed two main dimensions: a clinical-therapeutic one, typically negative in tone, centred on symptoms, suffering, treatments, hospital admission and substance use; and a social dimension, highlighting stigma, rejection, loneliness and incomprehension. Although many songs linked psychosis to violence and crime, others framed it as a source of wisdom, freedom or creativity. Overall, punk music offers a complex and polarised discourse on mental illness, reflecting societal perceptions that oscillate between empathy and the reinforcement of stereotypes.

Aims and method: We aimed to quantify attention-deficit hyperactivity disorder (ADHD) and autism assessment requests, and explore correlations with public interest and COVID-19 restrictions. We collected data on referrals to adult ADHD or autism services, Google searches for 'autism' or 'ADHD', birth gender ratios, ADHD prescriptions in England and COVID-19 restriction measures in four countries.

Results: ADHD assessment demand tripled from July 2020 to January 2023, with Google searches for ADHD rising in parallel. Autism referrals and searches saw smaller, similarly timed rises. Female referrals outstripped males. ADHD prescriptions rose particularly in those aged 30-34 years. Google searches for ADHD unexpectedly rose from July 2020 in four countries, correlating with sustained intensity of national COVID-19 restrictions.

Clinical implications: Public interest may have driven demand for ADHD assessments, with COVID-19 restrictions encouraging social media use facilitated by easy electronic information access. The public has decided that ADHD is important, independent of professional views. It is now critical that a consensus is reached to determine who benefits most from an ADHD diagnosis and medication.

Bessel van der Kolk's book The Body Keeps the Score has maintained exceptional cultural and clinical influence since its publication in 2014, remaining a best-seller and shaping public discourse on trauma. Its central claims - that trauma causes lasting neurobiological damage and that body-based treatments are uniquely effective - have been widely embraced but seldom subjected to systematic critical evaluation in peer-reviewed literature. This commentary synthesises the evidentiary basis for these claims as a counterweight to an influential narrative. It situates these findings within broader discussions of neuroscience framing, cultural appeal and evidence-based communication, underscoring the need for rigorous, balanced engagement with widely disseminated mental health narratives.

Little has been written regarding the experience of training in medicine with a diagnosis of a personality disorder. The stigma of personality disorders, evidenced even within psychiatry, potentially marginalises affected students and resident doctors. This article provides a first-hand account of the lead author's (E.M.) lived experience of being a medical student with a diagnosis of emotionally unstable personality disorder (EUPD). Challenges that have been faced include a lack of understanding, limited literature about medical students and doctors with personality disorders, and derogatory attitudes. Despite this, the positive aspects of the diagnosis are recognised, through enhanced resilience and heightened emotional sensitivity, which can benefit patients.

Aims and method: Restraints in mental health in-patient settings can negatively affect recovery. This study aimed to examine the prevalence and associated factors of restraint use. A retrospective cohort study was conducted in a rural NHS mental health trust in the UK, covering all adult in-patients from July 2020 to July 2021.

Results: The prevalence of restraint was 34%. Factors associated with restraint included age 18-25 or ≥65 years, female gender, disability, long-term sickness benefits, detention under the Mental Health Act, frequent admissions and a diagnosis of depressive or severe mental illness. Statistically significant associations were found for age ≥65 years (odds ratio 3.920), Section 2 detention (odds ratio 5.72), more than ten previous admissions (odds ratio 5.672) and depressive disorders (odds ratio 3.478).

Clinical implications: Restraint use remains common and is linked to identifiable risk factors. These findings support the need for targeted interventions to reduce restraint, particularly for high-risk patient groups.