Journal Cover
British Journal of Psychiatry
Journal Prestige (SJR): 2.844
Citation Impact (citeScore): 3
Number of Followers: 217  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0007-1250 - ISSN (Online) 1472-1465
Published by Cambridge University Press Homepage  [374 journals]
  • BJP volume 215 issue 3 Cover and Front matter
    • PubDate: 2019-09-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.177
      Issue No: Vol. 215, No. 3 (2019)
  • BJP volume 215 issue 3 Cover and Back matter
    • PubDate: 2019-09-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.178
      Issue No: Vol. 215, No. 3 (2019)
  • Promoting resilience in children and adolescents living with parental
           mental illness (CAPRI): children are key to identifying solutions
    • Authors: Kathryn M. Abel; Holly Hope, Annie Faulds, Matthias Pierce
      Pages: 513 - 515
      Abstract: The lives of Children and Adolescents with PaRental mental Illness (CAPRI) represent a public health priority. Identifying those at most risk within the risk subset is crucial to promote resilience for this group. The ability to develop child-centred interventions will underpin the success of evidence-based services and CAPRI themselves are key to unlocking current service barriers.Declaration interestNone.
      PubDate: 2019-09-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.118
      Issue No: Vol. 215, No. 3 (2019)
  • The Dyuta Sukta (Ode to the Dice): an account of gambling in the Rig Veda
           (1700–1100 BCE) – Psychiatry in sacred texts
    • Authors: Sanju George
      Pages: 515 - 515
      PubDate: 2019-09-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.172
      Issue No: Vol. 215, No. 3 (2019)
  • Sodium valproate in psychiatric practice: time for a change in perception
    • Authors: David Cunningham Owens
      Pages: 516 - 518
      Abstract: Sodium valproate and related preparations have recently undergone regulatory review following concern about effects on the unborn child and doctors' failure to communicate risk. The issues are wider. Valproate is overused in psychiatry based on the false perception that ‘ease’ of use equates to better safety than alternatives. Valproic acid can disrupt fundamental physiological processes, the consequences of which are poorly understood and little discussed in the psychiatric literature. Valproate may be useful in a small number of patients with bipolar disorder but current prescribing patterns are unjustified. Perception needs to change.Declaration of interestD.C.O. is psychiatric commissioner on the Commission on Human Medicines and a member of the European Medicines Agency's Scientific Advisory Group on Psychiatry. He chaired the European Medicines Agency's review of the psychiatric use of valproate in pregnancy and women of childbearing potential.
      PubDate: 2019-09-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.137
      Issue No: Vol. 215, No. 3 (2019)
  • Evidence for oestrogen sensitivity in perinatal depression:
           pharmacological sex hormone manipulation study
    • Authors: Divya Mehta; Monika Rex-Haffner, Helle Bach Søndergaard, Anja Pinborg, Elisabeth B. Binder, Vibe G. Frokjaer
      Pages: 519 - 527
      Abstract: BackgroundEnhanced sensitivity to oestrogen signalling may drive increased risk for depressive symptoms when exposed to peripartum sex-steroid hormone fluctuations.AimTesting if 116 pre-identified sex steroid-responsive transcripts that predicted perinatal depression (PND) translates to a pharmacological model of hormone-induced mood changes.MethodWe generated longitudinal, genome-wide gene-expression and DNA-methylation data from 60 women exposed to a gonadotrophin-releasing hormone agonist (GnRHa) or placebo. We used linear mixed-effect models to assess differences between baseline and follow-up for gene expression and DNA methylation in the biphasic ovarian response to GnRHa.ResultsOf the 116 PND-predictive transcripts, a significant (19%) overlap was observed with those differentially expressed post-GnRHa at both early and later follow-up, indicating sustained effects. Similarly, 49% of tested genes were differentially methylated post-GnRHa at the late follow-up. Within the GnRHa group, a large proportion of PND genes were significantly associated (gene expression; DNA methylation) with changes in depressive symptoms (28%; 66%), oestradiol levels (49%; 66%) and neocortex serotonin transporter binding (8%; 45%) between baseline and follow-up.ConclusionsOur data bridge clinical PND biomarkers with a pharmacological model of sex hormone-induced mood changes and directly relate oestrogen-induced biological changes with depressive symptoms and associated serotonin-signalling changes. Our data highlight that individual variations in molecular sensitivity to oestrogen associate with susceptibility to hormone-induced mood changes and hold promise for candidate biomarkers.Declaration of interestV.G.F. received honorarium for being a speaker for H. Lundbeck A/S. E.B.B. receives research funding from Böhringer Ingelheim to investigate FKBP5 as a potential drug target for depression.
      PubDate: 2019-09-01T00:00:00.000Z
      DOI: 10.1192/bjp.2018.234
      Issue No: Vol. 215, No. 3 (2019)
  • De+Melancholia+...+De+Coitu+and+Chaucer+–+Psychiatry+in+history&rft.title=British+Journal+of+Psychiatry&rft.issn=0007-1250&">Ishaq Ibn Imran ... Constantine the African, De Melancholia ... De Coitu
           and Chaucer – Psychiatry in history
    • Authors: Greg Wilkinson
      Pages: 527 - 527
      PubDate: 2019-09-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.169
      Issue No: Vol. 215, No. 3 (2019)
  • High- versus low-intensity interventions for perinatal depression
           delivered by non-specialist primary maternal care providers in Nigeria:
           cluster randomised controlled trial (the EXPONATE trial)
    • Authors: Oye Gureje; Bibilola D. Oladeji, Alan A. Montgomery, Ricardo Araya, Toyin Bello, Dan Chisholm, Danielle Groleau, Laurence J. Kirmayer, Lola Kola, Lydia B. Olley, Wei Tan, Phyllis Zelkowitz
      Pages: 528 - 535
      Abstract: BackgroundContextually appropriate interventions delivered by primary maternal care providers (PMCPs) might be effective in reducing the treatment gap for perinatal depression.AimTo compare high-intensity treatment (HIT) with low-intensity treatment (LIT) for perinatal depression.MethodCluster randomised clinical trial, conducted in Ibadan, Nigeria between 18 June 2013 and 11 December 2015 in 29 maternal care clinics allocated by computed-generated random sequence (15 HIT; 14 LIT). Interventions were delivered individually to antenatal women with DSM-IV (1994) major depression by trained PMCPs. LIT consisted of the basic psychosocial treatment specifications in the World Health Organization Mental Health Gap Action Programme – Intervention Guide. HIT comprised LIT plus eight weekly problem-solving therapy sessions with possible additional sessions determined by scores on the Edinburgh Postnatal Depression Scale (EPDS). The primary outcome was remission of depression at 6 months postpartum (EPDS < 6).ResultsThere were 686 participants; 452 and 234 in HIT and LIT arms, respectively, with both groups similar at baseline. Follow-up assessments, completed on 85%, showed remission rates of 70% with HIT and 66% with LIT: risk difference 4% (95% CI −4.1%, 12.0%), adjusted odds ratio 1.12 (95% CI 0.73, 1.72). HIT was more effective for severe depression (odds ratio 2.29; 95% CI 1.01, 5.20; P = 0.047) and resulted in a higher rate of exclusive breastfeeding. Infant outcomes, cost-effectiveness and adverse events were similar.ConclusionsExcept among severely depressed perinatal women, we found no strong evidence to recommend high-intensity in preference to low-intensity psychological intervention in routine primary maternal care.Declaration of interestsNone.
      PubDate: 2019-09-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.4
      Issue No: Vol. 215, No. 3 (2019)
  • Aiding the diagnosis of dissociative identity disorder: pattern
           recognition study of brain biomarkers
    • Authors: Antje A. T. S. Reinders; Andre F. Marquand, Yolanda R. Schlumpf, Sima Chalavi, Eline M. Vissia, Ellert R. S. Nijenhuis, Paola Dazzan, Lutz Jäncke, Dick J. Veltman
      Pages: 536 - 544
      Abstract: BackgroundA diagnosis of dissociative identity disorder (DID) is controversial and prone to under- and misdiagnosis. From the moment of seeking treatment for symptoms to the time of an accurate diagnosis of DID individuals received an average of four prior other diagnoses and spent 7 years, with reports of up to 12 years, in mental health services.AimTo investigate whether data-driven pattern recognition methodologies applied to structural brain images can provide biomarkers to aid DID diagnosis.MethodStructural brain images of 75 participants were included: 32 female individuals with DID and 43 matched healthy controls. Individuals with DID were recruited from psychiatry and psychotherapy out-patient clinics. Probabilistic pattern classifiers were trained to discriminate cohorts based on measures of brain morphology.ResultsThe pattern classifiers were able to accurately discriminate between individuals with DID and healthy controls with high sensitivity (72%) and specificity (74%) on the basis of brain structure. These findings provide evidence for a biological basis for distinguishing between DID-affected and healthy individuals.ConclusionsWe propose a pattern of neuroimaging biomarkers that could be used to inform the identification of individuals with DID from healthy controls at the individual level. This is important and clinically relevant because the DID diagnosis is controversial and individuals with DID are often misdiagnosed. Ultimately, the application of pattern recognition methodologies could prevent unnecessary suffering of individuals with DID because of an earlier accurate diagnosis, which will facilitate faster and targeted interventions.Declaration of interestThe authors declare no competing financial interests.
      PubDate: 2019-09-01T00:00:00.000Z
      DOI: 10.1192/bjp.2018.255
      Issue No: Vol. 215, No. 3 (2019)
  • Resting-state neural network disturbances that underpin the emergence of
           emotional symptoms in adolescent girls: resting-state fMRI study
    • Authors: Gin S. Malhi; Pritha Das, Tim Outhred, Richard A. Bryant, Vince Calhoun
      Pages: 545 - 551
      Abstract: BackgroundSubsyndromal emotional symptoms in adolescence may represent precursors for full-blown emotional disorders in early adulthood. Understanding the neurobiological mechanisms that drive this development is essential for prevention.AimsSelf-referential processing and emotion regulation are remodelled substantively during adolescence, therefore this study examined integration of key neural networks involved in these processes.MethodAt baseline, clinical and resting-state functional magnetic resonance imaging data were collected for 88 adolescent girls (mean age 15 years), and 71 of these girls underwent repeat clinical assessment after 2 years. These 71 girls were then partitioned into two groups depending on the presence (ES+) or absence (ES−) of emotional symptoms, and differences in dynamic functional network connectivity were determined and correlated with clinical variables.ResultsThe two groups displayed a differential pattern of functional connectivity involving the left lateral prefrontal network (LPFN). Specifically, in the ES+ group this network displayed positive coupling with the right LPFN but negative coupling with the default mode network, and the inverse of this pattern was found in the ES− group. Furthermore, the coupling strengths between left and right LPFN at the irst time point predicted follow-up depression and state anxiety scores.ConclusionsOur findings suggest that in adolescent girls, emotional symptoms may emerge as a result of impaired integration between networks involved in self-referential information processing and approach-avoidance behaviours. These impairments can compromise the pursuit of important goals and have an impact on emotion processing and finally may lead to the development of emotional disorders, such as anxiety and depression in adulthood.Declaration of interestNone.
      PubDate: 2019-09-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.10
      Issue No: Vol. 215, No. 3 (2019)
  • Neurocognitive functioning in community youth with suicidal ideation:
           gender and pubertal effects
    • Authors: Ran Barzilay; Monica E. Calkins, Tyler M. Moore, Rhonda C. Boyd, Jason D. Jones, Tami D. Benton, Maria A. Oquendo, Ruben C. Gur, Raquel E. Gur
      Pages: 552 - 558
      Abstract: BackgroundAlthough there are extensive data on clinical psychopathology in youth with suicidal ideation, data are lacking regarding their neurocognitive function.AimsTo characterise the cognitive profile of youth with suicidal ideation in a community sample and evaluate gender differences and pubertal status effects.MethodParticipants (N = 6151, age 11–21 years, 54.9% females) from the Philadelphia Neurodevelopmental Cohort, a non-help-seeking community sample, underwent detailed clinical evaluation. Cognitive phenotyping included executive functioning, episodic memory, complex reasoning and social cognitive functioning. We compared participants with suicidal ideation (N = 672) and without suicidal ideation (N = 5479). Regression models were employed to evaluate differences in cognitive performance and functional level, with gender and pubertal status as independent variables. Models controlled for lifetime depression or general psychopathology, and for covariates including age and socioeconomic status.ResultsYouth with suicidal ideation showed greater psychopathology, poorer level of function but better overall neurocognitive performance. Greater functional impairment was observed in females with suicidal ideation (suicidal ideation × gender interaction, t = 3.091, P = 0.002). Greater neurocognition was associated with suicidal ideation post-puberty (suicidal ideation × puberty interaction, t = 3.057, P = 0.002). Exploratory analyses of specific neurocognitive domains showed that suicidal ideation-associated cognitive superiority was more prominent in post-pubertal males compared with females (Cohen's d = 0.32 and d = 0.11, respectively) across all cognitive domains.ConclusionsSuicidal ideation was associated with poorer functioning yet better cognitive performance, especially in post-pubertal males, as measured by a comprehensive cognitive battery. Findings point to gender and pubertal-status specificity in the relationship between suicidal ideation, cognition and function in youth.Declaration of interestR.B. serves on the scientific board and reports stock ownership in ‘Taliaz Health’, with no conflict of interest relevant to this work. M.A.O. receives royalties for the commercial use of the Columbia-Suicide Severity Rating Scale from the Research Foundation for Mental Hygiene. Her family owns stock in Bristol-Myers Squibb. All other authors declare no potential conflict of interest.
      PubDate: 2019-09-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.55
      Issue No: Vol. 215, No. 3 (2019)
  • Childhood adversity and adolescent psychopathology: evidence for mediation
           in a national longitudinal cohort study
    • Authors: Niamh Dhondt; Colm Healy, Mary Clarke, Mary Cannon
      Pages: 559 - 564
      Abstract: BackgroundChildhood adversity is a well-established risk factor for psychopathology; however, many who experience adversity do not go on to develop psychopathology. Poor self-concept and poor parental support are known risk factors for adolescent psychopathology, which may account for some of this mechanism.AimsTo investigate candidate mediators in the relationship between childhood adversity and psychopathology.MethodWe used data from the age 9 and 13 waves of the child-cohort of the Growing Up in Ireland study. We undertook mediation analysis by path decomposition of the relationship between childhood adversity and psychopathology (internalising and externalising problems) at age 13 and persistent psychopathology. Candidate mediators were self-concept, parent–child relationship and hobby participation at age 9.ResultsChildhood adversity was reported by 28.2% of participants, and was significantly associated with internalising and externalising problems. Parent–child conflict mediated the relationship between childhood adversity and both age 13 and persistent psychopathology, accounting for 52.4% of the relationship between childhood adversity and persistent externalising problems (indirect odds ratio, 1.30; 95% CI 1.19–1.43) and 19.2% for persistent internalising problems (indirect odds ratio, 1.24; 95% CI 1.15–1.34). There was a small mediating effect of self-concept. Hobby participation and positive parent–child relationship did not mediate these relationships.ConclusionsParent–child conflict explains almost half the relationship between childhood adversity and persisting externalising problems in adolescence, and a fifth of the relationship with persisting internalising problems. This suggests parent–child conflict is a good target for interventions in childhood to prevent adolescent psychopathology.Declaration of interestNone.
      PubDate: 2019-09-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.108
      Issue No: Vol. 215, No. 3 (2019)
  • Prevalence of mental health problems in schools: poverty and other risk
           factors among 28 000 adolescents in England
    • Authors: Jessica Deighton; Suzet Tanya Lereya, Polly Casey, Praveetha Patalay, Neil Humphrey, Miranda Wolpert
      Pages: 565 - 567
      Abstract: Current mental health provision for children is based on estimates of one in ten children experiencing mental health problems. This study analyses a large-scale community-based dataset of 28 160 adolescents to explore school-based prevalence of mental health problems and characteristics that predict increased odds of experiencing them. Findings indicate the scale of mental health problems in England is much higher than previous estimates, with two in five young people scoring above thresholds for emotional problems, conduct problems or hyperactivity. Gender, deprivation, child in need status, ethnicity and age were all associated with increased odds of experiencing mental health difficulties.Declarations of interestNone.
      PubDate: 2019-09-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.19
      Issue No: Vol. 215, No. 3 (2019)
  • Neurometabolic approach to treatment-resistant depression
    • Authors: Edward H. Reynolds
      Pages: 568 - 568
      PubDate: 2019-09-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.170
      Issue No: Vol. 215, No. 3 (2019)
  • Authors’ reply
    • Authors: Mourad Wahba; Soraia Sousa, Stuart Watson, Rebecca Strawbridge, Allan H. Young, Anne Lingford-Hughes
      Pages: 568 - 569
      PubDate: 2019-09-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.171
      Issue No: Vol. 215, No. 3 (2019)
  • Kaleidoscope
    • Authors: Derek K. Tracy; Dan W. Joyce, Dawn N. Albertson, Sukhwinder S. Shergill
      Pages: 571 - 572
      PubDate: 2019-09-01T00:00:00.000Z
      DOI: 10.1192/bjp.2019.189
      Issue No: Vol. 215, No. 3 (2019)
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