BJPsych Open最新文献

Background: Crime has significant impact on older victims. High rates of anxiety and depression may be associated with crimes.

Aims: This paper aims to evaluate the cost-effectiveness of a victim improvement package (VIP) for the reduction of continued symptoms of depression or anxiety in older victims of community crime, from the societal perspective, in a three-step, parallel-group, single-blind randomised controlled trial.

Method: Participants (N = 131) were randomised to receive either the VIP intervention in addition to treatment as usual (TAU) (n = 65), or to TAU alone (n = 66). Service resource use was collected using the Client Service Receipt Inventory and health-related quality-of-life data via the EQ-5D-5L instrument at 3 months post-crime (baseline), 6 months post-crime (post-intervention) and 9 months post-crime (follow-up).

Results: The mean cost of the VIP intervention was estimated at £1330 per participant in the intervention arm. The mean difference in costs between the VIP and TAU arms over the 6-month trial duration was -£881 (95% CI: -£5947 to £4186). The mean difference in quality-adjusted life-years (QALYs) was -0.011 (95% CI: -0.042 to 0.020).

Conclusions: The addition of VIP to TAU for older victims of community crime generated a lower mean point estimate for costs, and failed to improve quality of life compared with TAU alone. While this places VIP in the south-west quadrant of the cost-effectiveness plane, the magnitude and significance of the QALY difference do not justify declaring VIP cost-effective or TAU not cost-effective. Future research is needed to identify the most cost-effective intervention.

Background: Students, due to their specific academic and psychosocial conditions, are at higher risk of suicide compared with the general population, and suicide is one of the leading causes of death among students worldwide.

Aims: To investigate the prevalence of suicidal ideation and suicide attempts among Iranian university students.

Method: A systematic search was conducted in international and national databases, including Scopus, Web of Science, PsycINFO, PubMed and Magiran, up to February 2025. Title and abstract screening was performed by a single reviewer. Two reviewers independently undertook full-text screening (study selection) and data extraction. Data were analysed using Stata 16. The heterogeneity of studies was tested with Cochran's Q and quantified with the I² statistic. To explore the sources of heterogeneity, we performed sensitivity analyses and meta-regression. The protocol was registered in the International Registration of Systematic Reviews (no. CRD42023471340).

Results: We included 28 studies in this research. The pooled prevalence of suicidal ideation, 12-month suicide attempts and lifetime suicide attempts among Iranian students was 17% (95% CI: 13-21%), 3% (95% CI: 2-4%) and 8% (95% CI: 6-10%), respectively, with substantial heterogeneity (I² = 94.85, 91.16 and 93.46%, respectively).

Conclusions: This study highlights the high prevalence of suicidal ideation and suicide attempts among Iranian university students, underscoring the need for effective preventive strategies and further research.

Background: Memory deficits are among the key risk factors in mental health problems, and are associated with dysfunctional cognitive factors.

Aims: The present study explored the relations between dysfunctional attitudes, rumination and mind-wandering, and emotional and non-emotional memory, respectively, aiming to inform the mechanism underlying the negative association of these cognitive factors with memory.

Method: A total of 123 undergraduate university students completed self-report measurements, including Dysfunctional Attitude Scale Form A, Rumination Responses Scale, Mind Wandering Frequency Scale and the Center for Epidemiological Studies Depression Scale. Additionally, they were invited to participate in an experiment consisting of two tasks (n = 111 completed the task for emotional memory and n = 110 for non-emotional memory). Pearson correlation analysis and a linear regression model examined the relationship between cognitive factors and memory performance.

Results: Based on correlational analyses, rumination, dysfunctional attitudes and depression are negatively correlated with the accuracy of negative emotional face memory (emotional memory, all P<0.05). The regression models suggest that dysfunctional attitude significantly predicts the accuracy of negative face memory (β = -0.205, P = 0.037). Digit memory accuracy (non-emotional memory) was associated with rumination and mind-wandering (all P<0.05), in which rumination was the significant predictor of accuracy (β = -0.231, P = 0.021).

Conclusions: The study indicated that dysfunctional attitudes are related mostly to negative emotional memories, and that rumination is mostly associated with non-emotional memories. Dysfunctional attitude and rumination represent potential treatment targets for emotional and non-emotional memory deficits, respectively, related to psychopathology.

Background: Dissociative identity disorder (DID) manifests with distinct trauma-avoidant and trauma-related identity states. Overtly conscious trauma-related knowledge processing is identity state-dependent. Previous research on covertly subconscious knowledge processing in DID lacks subject-specific trauma-related stimuli.

Aims: Our controlled functional magnetic resonance imaging (fMRI) study explored neural and behavioural differences of overt and covert knowledge processing of individualised self-relevant words in DID.

Method: Behavioural data were gathered while 56 participants underwent task-based fMRI: 14 with DID, 14 DID simulators and a paired control group of 14 healthy controls and 14 participants with post-traumatic stress disorder. Individuals with DID and simulators participated in a trauma-avoidant and a trauma-related identity state. Reaction times and brain activation following overtly and covertly presented individualised words were statistically analysed.

Results: Behavioural analyses showed a main effect of consciousness (P < 0.001). Post hoc between-group pairwise comparisons revealed slower reaction times for individuals with DID compared with simulating (P < 0.05) and paired controls (P < 0.05). Neural data analyses showed increased brain activation in frontal and parietal regions within the diagnosed DID group, especially during overt processing. Between-group comparisons mostly showed less pronounced activation in frontal, occipital and temporal areas.

Conclusions: The present study showed increased cognitive control during overt self-relevant knowledge processing in the trauma-avoidant identity state of DID, in line with previous research. The slower reaction times and increased frontoparietal activation shown in individuals with diagnosed DID, as compared with both control groups, support the notion of cognitive avoidance of trauma-related information in DID and further reinforce the authenticity of DID experiences.

Background: The COVID-19 pandemic disrupted daily social interactions, potentially affecting mental health. Understanding the risk of depressive and anxiety symptoms is essential for guiding mental health strategies during future crises.

Aims: To explore how social networks influenced mental health outcomes during the pandemic and how these relationships changed over time.

Method: Data from the Omtanke2020 study, a prospective cohort study of Swedish adults, were analysed using structural equation modelling (N = 10 918). Surveys at baseline and follow-up at 6 and 12 months assessed social networks, including structural components (e.g. relationship status, frequency of social contact) and perceived components (e.g. emotional support from family, feeling safe at home). Cross-lagged panel modelling was used to observe changes over time in the associations between social network indicators and depressive and anxiety symptoms.

Results: Stronger perceived social support - specifically closeness to family, perceived warmth or love from others and increased societal cohesion - were negatively correlated with depressive and anxiety symptoms across all time points (β coefficients = -0.14 to -0.23, all P < 0.001). Social network variables consistently predicted mental health outcomes, with effect sizes remaining relatively stable over time (β coefficient = -0.17 at baseline, β coefficient = -0.21 at 1-year follow-up).

Conclusions: This study highlights the protective role of the social network - namely perceived social support - in combatting depressive and anxiety symptoms during the COVID-19 pandemic. Interventions that strengthen close interpersonal ties and community cohesion may help mitigate mental health impacts during future public health crises.

Background: The Maudsley 3-item visual analogue scale (M3VAS) was developed as a novel and intuitive patient-reported measure for depression, focusing on core symptoms and suicidality.

Aims: To evaluate the longitudinal validity of M3VAS for capturing symptom change over time.

Method: Both M3VAS and the Patient Health Questionnaire (PHQ-9, as reference standard) were administered in an observational study (RHAPSODY, no. NCT04939818) at weeks 0, 2 and 4 to both depressed patients (n = 50) and matched controls (n = 24). We serially tested factor structure, internal consistency and convergence (correlation) over time, assessing responsiveness by both correlation of change in score and effect of time across scales (analysis of variance and effect size).

Results: M3VAS exhibited strong factor loadings and high item interrelatedness (Cronbach's alpha 0.78-0.83) at all time points. Total scores correlated strongly with PHQ-9 at each time point (r > 0.8, P < 0.001). Correlation of score change over the study period (r = 0.65, P < 0.001) also confirmed responsiveness. In the depressed group, an effect of time on score was seen for both M3VAS (F = 4.942, P = 0.010) and PHQ-9 (F = 12.505, P < 0.001), with standard response mean (Cohen's d) of 0.58 and 0.74, respectively. No effect of time was seen in the control group.

Conclusions: Following previous cross-sectional validation against the Quick Inventory of Depressive Symptomatology-Self-report, this present study demonstrated appropriate longitudinal measurement properties for M3VAS as a measure of depression, including responsiveness. Evaluating the ability of M3VAS to discern responses with a variety of treatments is a key future goal.

Background: Research on gender-based violence has shown the influence of Dark Tetrad personality traits (i.e. Machiavellianism, narcissism, psychopathy and sadism) on the development and perpetuation of sexist attitudes and cognitions that justify or condone harmful behaviours.

Aims: This study explored the potential mediating role of empathy in the relationship between the Dark Tetrad personality traits and support for vindictive rape, as a form of revenge for the perceived violation of traditional sexual norms.

Method: A sample of 1548 adult individuals from the general community (67.3% female, age range 18-83 years) completed the Dark Triad Dirty Dozen, the Short Sadistic Impulse Scale, the Basic Empathy Scale and the Vindictive Rape Attitude Questionnaire.

Results: The results showed that empathy partially mediated the relationship between sadism and attitudes supportive of vindictive rape, while a full mediation of empathy was found in the association between Machiavellianism, psychopathy and attitudes supportive of vindictive rape. Conversely, no significant association between empathy or vindictive rape and narcissism was observed.

Conclusions: Empathy plays an important role in mitigating the effects of Dark Tetrad personality traits on support for vindictive rape. Given the global prevalence of violence against women, these findings are discussed in the context of a social climate that may reinforce the perpetuation of gender inequalities and sex-based stereotypes that are at the root of the acceptance of violence.

Background: Studies have consistently found that up to 20% of people with anorexia nervosa experience a persistent illness, resulting in considerable psychosocial impairment, morbidity and mortality. This has been variously termed severe and enduring anorexia nervosa or longstanding anorexia nervosa (L-AN). Conflicting findings have hindered progress in distinguishing the nosological features of individuals with persistent illness.

Aims: This study aims to investigate the putative defining features of individuals reporting symptoms of L-AN, including consideration of their treatment trajectory.

Method: This cross-sectional study, drawing from a mixed-methods design, utilised a sample of symptomatic individuals who reported experiencing eating disorder treatment (n = 208). Several qualitative and quantitative data strands (a-c) were embedded within a single, self-report questionnaire measuring eating disorder severity and treatment experiences. Between-group comparisons were used to compare those of shorter (<3 years) and longer (>7 years) duration of illness.

Results: No between-group differences were found in measures of severity, including body mass index (kg/m²), eating disorder symptom scores, psychological distress or perceived health-related quality of life. However, those with L-AN had a significantly higher number of mental and physical health comorbidities, longer treatment delay, greater number of episodes of treatment and poorer subjective ratings of their treatment experiences.

Conclusions: Delineating L-AN by severity may be inappropriate; anorexia nervosa of any duration is a severe illness. This study suggests that treatments, or lack thereof, may have an inadvertent impact on duration of illness. Future focus needs to be on reconceptualising L-AN and its treatments. Treatment refinements informed by lived experience are proposed.

Background: An increasing number of children and adolescents are prescribed second-generation antipsychotic medications, which may lead to cardiometabolic or other physical health impairments. It is unknown whether lifestyle interventions can prevent or manage these adverse effects.

Aims: To evaluate the effectiveness of lifestyle interventions for preventing or managing cardiometabolic risks and other adverse physical health outcomes in this population.

Method: Four bibliographic databases were searched up to February 2024. Randomised controlled trials reporting a physical health outcome of children or adolescents (aged 6-17 years) taking antipsychotics and participating in a lifestyle intervention compared with treatment as usual (TAU) were eligible for inclusion. The Cochrane Risk of Bias 2 tool was used to assess risk of bias. Data were synthesised via a random-effects meta-analysis and narrative synthesis.

Results: Four studies with a total of 370 participants were included. Most (75%) had a high risk of bias. Lifestyle interventions resulted in moderate but statistically non-significant reductions in participants' body mass index (standard mean difference -0.70, 95% CI: -1.70 to 0.31) compared with TAU. Some studies reported improvements in other physical health outcomes favouring the intervention, although findings were inconsistent and varied across different measures. Reporting of secondary indicators of physical health, including participant or family health behaviours, was limited.

Conclusions: The effectiveness of lifestyle interventions for preventing or managing the cardiometabolic risk and other adverse physical health outcomes in this population is unclear due to the limited number of available trials, small samples and high risk of bias. Larger trials are needed.