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British Journal of Psychiatry
Journal Prestige (SJR): 2.844
Citation Impact (citeScore): 3
Number of Followers: 224  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0007-1250 - ISSN (Online) 1472-1465
Published by Cambridge University Press Homepage  [387 journals]
  • BJP volume 215 issue 6 Cover and Front matter
    • PubDate: 2019-12-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.221
      Issue No: Vol. 215, No. 6 (2019)
  • BJP volume 215 issue 6 Cover and Back matter
    • PubDate: 2019-12-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.222
      Issue No: Vol. 215, No. 6 (2019)
  • A possible role for sarcosine in the management of schizophrenia
    • Authors: David Curtis
      Pages: 697 - 698
      Abstract: Sarcosine, which is freely sold as a dietary supplement, has pharmacological activity to boost functioning of the glutamatergic N-methyl-d-aspartate receptor (NMDAR) and hence it is a biologically rational treatment for schizophrenia. The small number of studies carried out to date provide some evidence for its efficacy and psychiatrists could consider suggesting its use to their patients.
      PubDate: 2019-12-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.194
      Issue No: Vol. 215, No. 6 (2019)
  • Evolutionary biology: an essential basic science for the training of the
           next generation of psychiatrists
    • Authors: Riadh Abed; Agnes Ayton, Paul St John-Smith, Annie Swanepoel, Derek K. Tracy
      Pages: 699 - 701
      Abstract: Evolutionary science can serve as the high-level organising principle for understanding psychiatry. Evolutionary concepts generate new models and ideas for future psychiatric study, research, policy and therapy. The authors accordingly make the case for the inclusion of evolutionary biology in the postgraduate education of psychiatric trainees.
      PubDate: 2019-12-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.123
      Issue No: Vol. 215, No. 6 (2019)
  • Addiction care in crisis: evidence should drive progressive policy and
    • Authors: Kamaldeep S. Bhui; Peter Byrne, Diane Goslar, Julia Sinclair
      Pages: 702 - 703
      Abstract: Addictions are challenging health and social problems that need to be addressed to preserve and promote good mental health and ensure that individuals within society lead healthy and productive lives. Tackling addictions is complex and requires communities, public health, specialist services, and local and national government to act in unison and implement evidence-based interventions. This editorial raises systemic issues that need attention and proposes a range of systemic options.
      PubDate: 2019-12-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.158
      Issue No: Vol. 215, No. 6 (2019)
  • Lung cancer incidence in patients with schizophrenia: meta-analysis
    • Authors: Chuanjun Zhuo; Hongqing Zhuang, Xiangyang Gao, Patrick Todd Triplett
      Pages: 704 - 711
      Abstract: BackgroundLung cancer risk factors, like tobacco smoking, are highly prevalent in patients with schizophrenia. Whether these patients have a higher risk of lung cancer remains unknown.AimsWe aimed to investigate whether patients with schizophrenia have a higher incidence of lung cancer compared with general population, in a meta-analysis.MethodEligible studies were searched from PubMed and EMBASE databases to identify cases of lung cancer in patients with schizophrenia and the general population. This meta-analysis utilised the random-effects model and prediction interval was used to calculate the heterogeneity of these eligible studies. We assessed the quality of evidence with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.ResultsThere were 12 studies, totalling 496 265 patients, included in this meta-analysis. The data showed that the baseline schizophrenia diagnosis was not associated with any changes in lung cancer incidence in the overall population, with a standardised incidence ratio of 1.11 (95% CI 0.90–1.37; P = 0.31), although there was a significant heterogeneity among these studies (I2 = 94%). Moreover, there was also a substantial between-study variance with wide prediction interval values (0.47–2.64). The data were consistent for both males and females.ConclusionsUp-to-date evidence from epidemiological studies indicates the lack of certainty about the association between schizophrenia diagnosis and lung cancer incidence.
      PubDate: 2019-12-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.23
      Issue No: Vol. 215, No. 6 (2019)
  • Effect of lifestyle, medication and ethnicity on cardiometabolic risk in
           the year following the first episode of psychosis: prospective cohort
    • Authors: Fiona Gaughran; Daniel Stahl, Dominic Stringer, David Hopkins, Zerrin Atakan, Kathryn Greenwood, Anita Patel, Shubulade Smith, Poonam Gardner-Sood, John Lally, Margaret Heslin, Brendon Stubbs, Stefania Bonaccorso, Anna Kolliakou, Oliver Howes, David Taylor, Marta Di Forti, Anthony S. David, Robin M. Murray, Khalida Ismail
      Pages: 712 - 719
      Abstract: BackgroundThe first episode of psychosis is a critical period in the emergence of cardiometabolic risk.AimsWe set out to explore the influence of individual and lifestyle factors on cardiometabolic outcomes in early psychosis.MethodThis was a prospective cohort study of 293 UK adults presenting with first-episode psychosis investigating the influence of sociodemographics, lifestyle (physical activity, sedentary behaviour, nutrition, smoking, alcohol, substance use) and medication on cardiometabolic outcomes over the following 12 months.ResultsRates of obesity and glucose dysregulation rose from 17.8% and 12%, respectively, at baseline to 23.7% and 23.7% at 1 year. Little change was seen over time in the 76.8% tobacco smoking rate or the quarter who were sedentary for over 10 h daily. We found no association between lifestyle at baseline or type of antipsychotic medication prescribed with either baseline or 1-year cardiometabolic outcomes. Median haemoglobin A1c (HbA1c) rose by 3.3 mmol/mol in participants from Black and minority ethnic (BME) groups, with little change observed in their White counterparts. At 12 months, one-third of those with BME heritage exceeded the threshold for prediabetes (HbA1c >39 mmol/mol).ConclusionsUnhealthy lifestyle choices are prevalent in early psychosis and cardiometabolic risk worsens over the next year, creating an important window for prevention. We found no evidence, however, that preventative strategies should be preferentially directed based on lifestyle habits. Further work is needed to determine whether clinical strategies should allow for differential patterns of emergence of cardiometabolic risk in people of different ethnicities.
      PubDate: 2019-12-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.159
      Issue No: Vol. 215, No. 6 (2019)
  • Impact of secondary care financial incentives on the quality of physical
           healthcare for people with psychosis: a longitudinal controlled study
    • Authors: Mike J. Crawford; Daniel Huddart, Eleanor Craig, Krysia Zalewska, Alan Quirk, David Shiers, Geraldine Strathdee, Stephen J. Cooper
      Pages: 720 - 725
      Abstract: BackgroundConcerns have repeatedly been expressed about the quality of physical healthcare that people with psychosis receive.AimsTo examine whether the introduction of a financial incentive for secondary care services led to improvements in the quality of physical healthcare for people with psychosis.MethodLongitudinal data were collected over an 8-year period on the quality of physical healthcare that people with psychosis received from 56 trusts in England before and after the introduction of the financial incentive. Control data were also collected from six health boards in Wales where a financial incentive was not introduced. We calculated the proportion of patients whose clinical records indicated that they had been screened for seven key aspects of physical health and whether they were offered interventions for problems identified during screening.ResultsData from 17 947 people collected prior to (2011 and 2013) and following (2017) the introduction of the financial incentive in 2014 showed that the proportion of patients who received high-quality physical healthcare in England rose from 12.85% to 31.65% (difference 18.80, 95% CI 17.37–20.21). The proportion of patients who received high-quality physical healthcare in Wales during this period rose from 8.40% to 13.96% (difference 5.56, 95% CI 1.33–10.10).ConclusionsThe results of this study suggest that financial incentives for secondary care mental health services are associated with marked improvements in the quality of care that patients receive. Further research is needed to examine their impact on aspects of care that are not incentivised.
      PubDate: 2019-12-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.162
      Issue No: Vol. 215, No. 6 (2019)
  • Margery Kempe: puerperal psychosis, mysticism and the first autobiography
           in English – psychiatry in history
    • Authors: Greg Wilkinson
      Pages: 725 - 725
      PubDate: 2019-12-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.212
      Issue No: Vol. 215, No. 6 (2019)
  • Urbanicity and risk of first-episode psychosis: incidence study in Brazil
    • Authors: Cristina Marta Del-Ben; Rosana Shuhama, Camila Marcelino Loureiro, Taciana Cristina Carvalho Ragazzi, Daniela Perocco Zanatta, Silvia Helena Galo Tenan, Jair Lício Ferreira Santos, Paulo Louzada-Junior, Antonio Carlos dos Santos, Craig Morgan, Paulo Rossi Menezes
      Pages: 726 - 729
      Abstract: We estimated the incidence of first-episode psychosis over a 3-year period in a Brazilian catchment area comprising the region's main city, Ribeirão Preto (1 425 306 persons-years at risk), and 25 other municipalities with a total of 1 646 556 persons-years at risk. The incidence rates were estimated and adjusted by gender and age, using the direct standardisation method to the world population as reference. The incidence of psychosis was higher in the younger groups, men, and among Black and minority ethnic Brazilians. Psychosis incidence was lower in Ribeirão Preto (16.69/100 000 person-years at risk; 95% CI 15.68–17.70) compared with the average incidence in the remaining municipalities (21.25/100 000 person-years at risk; 95% CI 20.20–22.31), which have lower population density, suggesting a distinct role for urbanicity in the incidence of first-episode psychosis in low- and middle-income countries.
      PubDate: 2019-12-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.110
      Issue No: Vol. 215, No. 6 (2019)
  • Long-term effects of prenatal exposure to earthquake on adult
    • Authors: Chao Guo; Ping He, Xinming Song, Xiaoying Zheng
      Pages: 730 - 735
      Abstract: BackgroundMaternal exposure to major stressors during pregnancy has been found to increase the risk of neurodevelopmental, cognitive and psychiatric disorders in the offspring. However, the association between prenatal exposure to earthquake and the risk of adult schizophrenia has yet to be examined.AimsTo explore the potential long-term effects of prenatal exposure to maternal stress on the risk of schizophrenia in adulthood, using the Great Tangshan Earthquake in 1976 as a natural experiment.MethodWe obtained data from the Second China National Sample Survey on Disability, and analysed 94 410 Chinese individuals born between 1975 and 1979. We obtained difference-in-differences estimates of the earthquake effects on schizophrenia by exploiting temporal variation in the timing of earthquake exposure across four birth cohorts born between 1975 and 1979, along with geographical variation in earthquake severity at the prefecture level. Schizophrenia was ascertained by psychiatrists using the ICD-10 classification. Earthquake severity was measured by seismic intensity.ResultsEarthquake cohort who experienced prenatal exposure to felt earthquake had higher risk of schizophrenia (odds ratio, 3.38; 95% CI 1.43–8.00) compared with the unexposed reference cohort. After specifying the timing of exposure by the trimester of pregnancy, prenatal exposure to felt earthquake during the first trimester of pregnancy increased the risk of adulthood schizophrenia significantly (odds ratio, 7.45; 95% CI 2.83–19.59).ConclusionsPrenatal (particularly early pregnancy) exposure to maternal stress after a major disaster substantially affects the mental health of Chinese adults.
      PubDate: 2019-12-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.114
      Issue No: Vol. 215, No. 6 (2019)
  • A population-based study of the frequency and predictors of induced
           abortion among women with schizophrenia
    • Authors: Hilary K. Brown; Cindy-Lee Dennis, Paul Kurdyak, Simone N. Vigod
      Pages: 736 - 743
      Abstract: BackgroundInduced abortion is an indicator of access to, and quality of reproductive healthcare, but rates are relatively unknown in women with schizophrenia.AimsWe examined whether women with schizophrenia experience increased induced abortion compared with those without schizophrenia, and identified factors associated with induced abortion risk.MethodIn a population-based, repeated cross-sectional study (2011–2013), we compared women with and without schizophrenia in Ontario, Canada on rates of induced abortions per 1000 women and per 1000 live births. We then followed a longitudinal cohort of women with schizophrenia aged 15–44 years (n = 11 149) from 2011, using modified Poisson regression to identify risk factors for induced abortion.ResultsWomen with schizophrenia had higher abortion rates than those without schizophrenia in all years (15.5–17.5 v. 12.8–13.6 per 1000 women; largest rate ratio, 1.33; 95% CI 1.16–1.54). They also had higher abortion ratios (592–736 v. 321–341 per 1000 live births; largest rate ratio, 2.25; 95% CI 1.96–2.59). Younger age (
      PubDate: 2019-12-01T00:00:00.000Z
      DOI: 10.1192/bjp.2018.262
      Issue No: Vol. 215, No. 6 (2019)
  • Unsystematic review shows neither that early intervention in psychosis is
           cost-effective nor cost-minimising
    • Authors: Andrew Amos
      Pages: 744 - 744
      PubDate: 2019-12-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.223
      Issue No: Vol. 215, No. 6 (2019)
  • Author's reply
    • Authors: David Aceituno
      Pages: 744 - 745
      PubDate: 2019-12-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.224
      Issue No: Vol. 215, No. 6 (2019)
  • Kaleidoscope
    • Authors: Derek K. Tracy; Dan W. Joyce, Sukhwinder S. Shergill, Dawn N. Albertson
      Pages: 747 - 748
      PubDate: 2019-12-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.239
      Issue No: Vol. 215, No. 6 (2019)
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