BJPsych Bulletin最新文献

To provide a useful contextual backdrop to an exhibition at the Royal College of Psychiatrists this summer, we used a question and answer format to summarise the thoughts of its curator, Gavin Miller. Gavin has chosen 12 books published by Penguin between 1949 and 1975 to illuminate the relationship between psychiatrists, psychologists, psychotherapists and the British media. He reflects on the opportunities and pitfalls that come with the association, the motivations of previous writers and provides practical advice for any media psychiatrists considering such a role in the future. The exhibition is open to visitors to the College building in London.

Many people experiencing mental ill health are trapped in cycles of worsening social exclusion. Individual Placement and Support (IPS) is being implemented to support those with mental ill health into employment. However, this intervention does not address the many challenges faced by those who are more vulnerable and is less effective for those with more severe clinical presentations. Although National Health Service (NHS) guidance suggests broader support is needed, there is little clarity over what this should look like. We discuss one model, drawing on years of experience facilitating user-led services at Lambeth Vocational Services, implementing a genuinely person-centred, trust-based approach to facilitate social inclusion.

Comprehend, Cope and Connect (CCC) is a trauma-informed, transdiagnostic and evidence-based psychological intervention for mental health crises that can be applied cross-culturally. CCC has been implemented in acute and crisis mental health settings across the South of England and in services elsewhere in the UK. More recently, it has been taken up and adapted for specialist community settings, including perinatal services, addiction services and primary care settings. A continuously growing evidence base indicates that CCC could be the next step towards solving the national problem of mental health crises. It is now time for CCC to be piloted and researched nationally.

Aims and method: The medical workforce in psychiatry is increasingly diverse, but not necessarily in its senior leadership in the UK's National Health Service (NHS). We aimed to describe the characteristics of psychiatrists with board-level responsibility in mental health trusts in England in 2024, comparing the current picture with that of 2016 and 2020, using publicly available data.

Results: The proportion of medical directors who are female has not changed, so women remain underrepresented, while the proportion who are international medical graduates has increased substantially, so they are no longer underrepresented. Although fewer in number, intellectual disability psychiatrists are underrepresented.

Clinical implications: Greater attention will need to be paid to developing female medical leaders if representative leadership is to be achieved.

Aims and method: Previous meta-analysis of the efficacy of mobile phone applications (mHealth apps) for depression has several limitations, including high risk of bias and heterogeneity in effect sizes across studies, and gaps in understanding of variability in treatment outcomes. We aimed to provide more reliable and clinically relevant findings by conducting a systematic literature search on PubMed, Embase and PsycInfo, focusing on newer studies with minimal risk of bias.

Results: Analysing 17 randomised controlled trials (n = 2821) published between 2020 and 2025, we found a pooled standardised mean difference (s.m.d.) of -0.46 (95% CI -0.64 to -0.28; P < 0.001) relative to the control groups, which indicates a significant reduction in depressive symptoms. Subgroup analyses confirmed efficacy in both adolescents (s.m.d. = -0.42) and adults (s.m.d. = -0.49). Despite evidence of publication bias, 70% of the studies had a low risk of bias, supporting the robustness and reliability of these findings.

Clinical implications: The results underscore the clinical relevance of mHealth apps as scalable and accessible tools for bridging gaps in mental healthcare. Their effectiveness across age groups highlights their potential for broad implementation, with future research needed to refine personalisation, engagement strategies and methodological rigour.

Aims and method: To investigate the impact of the widespread availability and use of the semi-synthetic cannabinoid hexahydrocannabinol (HHC) on hospital admissions owing to psychosis. Medical records of patients admitted for psychotic illness to University Hospital Galway were examined to assess HHC or other illicit drug use before admission.

Results: Of the 214 total admissions for psychotic illness, 28 admissions (13.1%) were preceded by use of HHC, nine of whom used only HHC. Sixteen (34%) admissions of first-episode psychosis were preceded by HHC use, with seven of these using only HHC.

Clinical implications: Clinicians should explicitly enquire about the use of HHC in patients presenting with first-episode and relapse of psychotic illness. Sufficient evidence has now accumulated from research of a link between HHC and psychosis. Such psychoses appear to be more prominent in young people with early-phase psychosis, and highlights the need for authorities to change legislation to avoid further harm.

Aims and method: Non-pharmacological interventions (NPIs) are recognised for their potential in treating dementia symptoms. However, little is known about the extent of their use. In this study, we conducted structured interviews with people with dementia and their family caregivers (n = 50), professional caregivers (n = 42) and dementia care coordinators (n = 42) on the use of 14 NPIs.

Results: Cognitive stimulation/training, physical activity and occupational therapy were implemented by most participants, whereas neurofeedback, drama therapy and phototherapy were rarely used. Most NPIs were carried out weekly. People with dementia and their caregivers reported using significantly fewer NPIs than other participants (P < 0.001). Participants perceived effects for, on average, 90.3% (s.d. = 31.3%) of the NPIs that they used.

Clinical implications: Providing targeted support and funding might help to increase the use of NPIs by family caregivers as well as in institutional care settings.

The Mental Health Act perpetuates the harmful and misguided detention of individuals with personality disorders. The outdated practice lacks ethical, legal or clinical justification. Coercion is mistaken for care, and detention often exacerbates distress, retraumatises patients and increases suicide risk. Despite its promises, the new Mental Health Bill fails to address these systemic failures, continuing the cycle of risk-driven, defensive psychiatry. It is time to abandon compulsory detention for this patient group, redirect resources toward evidence-based, relational interventions, and move toward a capacity-based, trauma-informed legal framework that aligns with contemporary psychiatric understanding of these conditions and fundamental human rights.

Child and youth mental health is an international public health and research priority. We are an interdisciplinary and cross-sectoral network of UK-based early career researchers (ECRs) with an interest in child and youth mental health research. In this paper, we reflect on ongoing challenges and areas for growth, offering recommendations for key stakeholders in our field, including researchers, institutions and funders. We present a vision from an ECR perspective of what future child and youth mental health research could look like and we explore how the research infrastructure can support ECRs and the wider research field in making this vision a reality. We focus specifically on: (a) embracing complexity; (b) centring diverse voices; and (c) facilitating sustainable research environments and funding systems. We present recommendations for all key partners to consider alongside their local contexts and communities to actively and collaboratively drive progress and transformative change.