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British Journal of Psychiatry
Journal Prestige (SJR): 2.844
Citation Impact (citeScore): 3
Number of Followers: 278  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0007-1250 - ISSN (Online) 1472-1465
Published by Cambridge University Press Homepage  [400 journals]
  • Highlight of this Issue

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      Authors: Katherine Adlington
      PubDate: 2021-10-01T00:00:00.000Z
      DOI: 10.1192/bjp.2021.124
      Issue No: Vol. 219, No. 4 (2021)
       
  • BJP volume 219 issue 4 Cover and Front matter

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      PubDate: 2021-10-01T00:00:00.000Z
      DOI: 10.1192/bjp.2021.126
      Issue No: Vol. 219, No. 4 (2021)
       
  • BJP volume 219 issue 4 Cover and Back matter

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      PubDate: 2021-10-01T00:00:00.000Z
      DOI: 10.1192/bjp.2021.127
      Issue No: Vol. 219, No. 4 (2021)
       
  • The digital divide: amplifying health inequalities for people with severe
           mental illness in the time of COVID-19

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      Authors: Panagiotis Spanakis; Emily Peckham, Alice Mathers, David Shiers, Simon Gilbody
      Pages: 529 - 531
      Abstract: During COVID-19, health provision and information resources have been increasingly provided via digital means (e.g. websites, apps) and this will become a standard practice beyond the pandemic. People with severe mental illness face profound health inequalities (e.g. a >20-year mortality gap). Digital exclusion puts this population at risk of heightened or compounded inequalities. This has been referred to as the ‘digital divide’. For any new digital means introduced in clinical practice to augment healthcare service provision, issues of accessibility, acceptability and usability should be addressed by researchers and developers early in the design phase, and prior to full implementation, to prevent digital exclusion.
      PubDate: 2021-10-01T00:00:00.000Z
      DOI: 10.1192/bjp.2021.56
      Issue No: Vol. 219, No. 4 (2021)
       
  • Disambiguation of psychotherapy: a search for meaning

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      Authors: Giulio Castelpietra; Judit Simon, Mencía Ruiz Gutiérrez-Colosía, Sebastian Rosenberg, Luis Salvador-Carulla
      Pages: 532 - 537
      Abstract: This analysis identifies the significant problem of ambiguity, variation and vagueness in relation to the intervention described as ‘psychotherapy’. Its purpose is to raise international awareness of this problem and alternative solutions.
      PubDate: 2021-10-01T00:00:00.000Z
      DOI: 10.1192/bjp.2020.196
      Issue No: Vol. 219, No. 4 (2021)
       
  • Psychological interventions as an alternative and add-on to antidepressant
           medication to prevent depressive relapse: systematic review and
           meta-analysis

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      Authors: Josefien Johanna Froukje Breedvelt; Maria Elisabeth Brouwer, Mathias Harrer, Maria Semkovska, David Daniel Ebert, Pim Cuijpers, Claudi Louisa Hermina Bockting
      Pages: 538 - 545
      Abstract: BackgroundAfter remission, antidepressants are often taken long term to prevent depressive relapse or recurrence. Whether psychological interventions can be a viable alternative or addition to antidepressants remains unclear.AimsTo compare the effectiveness of psychological interventions as an alternative (including delivered when tapering antidepressants) or addition to antidepressants alone for preventing depressive relapse.MethodEmbase, PubMed, the Cochrane Library and PsycINFO were searched from inception until 13 October 2019. Randomised controlled trials (RCTs) with previously depressed patients in (partial) remission where preventive psychological interventions with or without antidepressants (including tapering) were compared with antidepressant control were included. Data were extracted independently from published trials. A random-effects meta-analysis on time to relapse (hazard ratio, HR) and risk of relapse (risk ratio, RR) at the last point of follow-up was conducted. PROSPERO ID: CRD42017055301.ResultsAmong 11 included trials (n = 1559), we did not observe an increased risk of relapse for participants receiving a psychological intervention while tapering antidepressants versus antidepressants alone (RR = 1.02, 95% CI 0.84–1.25; P = 0.85). Psychological interventions added to antidepressants significantly reduced the risk of relapse (RR = 0.85, 95% CI 0.74–0.97; P = 0.01) compared with antidepressants alone.ConclusionsThis study found no evidence to suggest that adding a psychological intervention to tapering increases the risk of relapse when compared with antidepressants alone. Adding a psychological intervention to antidepressant use reduces relapse risk significantly versus antidepressants alone. As neither strategy is routinely implemented these findings are relevant for patients, clinicians and guideline developers.
      PubDate: 2021-10-01T00:00:00.000Z
      DOI: 10.1192/bjp.2020.198
      Issue No: Vol. 219, No. 4 (2021)
       
  • Neural effects of antidepressant medication and psychological treatments:
           a quantitative synthesis across three meta-analyses

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      Authors: Camilla L. Nord; Lisa Feldman Barrett, Kristen A. Lindquist, Yina Ma, Lindsey Marwood, Ajay B. Satpute, Tim Dalgleish
      Pages: 546 - 550
      Abstract: BackgroundInfluential theories predict that antidepressant medication and psychological therapies evoke distinct neural changes.AimsTo test the convergence and divergence of antidepressant- and psychotherapy-evoked neural changes, and their overlap with the brain's affect network.MethodWe employed a quantitative synthesis of three meta-analyses (n = 4206). First, we assessed the common and distinct neural changes evoked by antidepressant medication and psychotherapy, by contrasting two comparable meta-analyses reporting the neural effects of these treatments. Both meta-analyses included patients with affective disorders, including major depressive disorder, generalised anxiety disorder and panic disorder. The majority were assessed using negative-valence tasks during neuroimaging. Next, we assessed whether the neural changes evoked by antidepressants and psychotherapy overlapped with the brain's affect network, using data from a third meta-analysis of affect-based neural activation.ResultsNeural changes from psychotherapy and antidepressant medication did not significantly converge on any region. Antidepressants evoked neural changes in the amygdala, whereas psychotherapy evoked anatomically distinct changes in the medial prefrontal cortex. Both psychotherapy- and antidepressant-related changes separately converged on regions of the affect network.ConclusionsThis supports the notion of treatment-specific brain effects of antidepressants and psychotherapy. Both treatments induce changes in the affect network, but our results suggest that their effects on affect processing occur via distinct proximal neurocognitive mechanisms of action.
      PubDate: 2021-10-01T00:00:00.000Z
      DOI: 10.1192/bjp.2021.16
      Issue No: Vol. 219, No. 4 (2021)
       
  • Time use and mental health in UK adults during an 11-week COVID-19
           lockdown: a panel analysis

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      Authors: Feifei Bu; Andrew Steptoe, Hei Wan Mak, Daisy Fancourt
      Pages: 551 - 556
      Abstract: BackgroundThere is currently major concern about the impact of the global COVID-19 outbreak on mental health. But it remains unclear how individual behaviours could exacerbate or protect against adverse changes in mental health.AimsTo examine the associations between specific activities (or time use) and mental health and well-being among people during the COVID-19 pandemic.MethodData were from the UCL COVID-19 Social Study, a panel study collecting data weekly during the COVID-19 pandemic. The analytical sample consisted of 55 204 adults living in the UK who were followed up for the 11-week strict lockdown period from 21 March to 31 May 2020. Data were analysed using fixed-effects and Arellano–Bond models.ResultsChanges in time spent on a range of activities were associated with changes in mental health and well-being. After controlling for bidirectionality, behaviours involving outdoor activities such as gardening and exercising predicted subsequent improvements in mental health and well-being, whereas increased time spent following news about COVID-19 predicted declines in mental health and well-being.ConclusionsThese results are relevant to the formulation of guidance for people obliged to spend extended periods in isolation during health emergencies and may help the public to maintain well-being during future lockdowns and pandemics.
      PubDate: 2021-10-01T00:00:00.000Z
      DOI: 10.1192/bjp.2021.44
      Issue No: Vol. 219, No. 4 (2021)
       
  • Network structure of ICD-11 adjustment disorder: a cross-cultural
           comparison of three African countries

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      Authors: Yafit Levin; Rahel Bachem, Thanos Karatzias, Mark Shevlin, Andreas Maercker, Menachem Ben-Ezra
      Pages: 557 - 564
      Abstract: BackgroundAdjustment disorder is one of the most widespread mental disorders worldwide. In ICD-11, adjustment disorder is characterised by two main symptom clusters: preoccupation with the stressor and failure to adapt. A network analytic approach has been applied to most ICD-11 stress-related disorders. However, no study to date has explored the relationship between symptoms of adjustment disorder using network analysis.AimsWe aimed to explore the network structure of adjustment disorder symptoms and whether its structure replicates across questionnaire versions and samples.MethodA network analysis was conducted on adjustment disorder symptoms as assessed by the Adjustment Disorder–New Module (ADNM-8) and an ultra-brief version (ADNM-4) using data from 2524 participants in Nigeria (n = 1006), Kenya (n = 1018) and Ghana (n = 500).ResultsThere were extensive connections between items across all samples in both ADNM versions. Results highlight that preoccupation symptoms seem to be more prominent in terms of edges strengths (i.e. connections) and had the highest centrality in all networks across samples and ADNM versions. Comparisons of network structure invariance revealed one difference between Nigeria and Ghana in both ADNM versions. Importantly, the ADNM-8 global strength was similar in all networks whereas in the ADNM-4 Kenya had a higher global strength score compared with NigeriaConclusionsResults provide evidence of the coherence of adjustment disorder in ICD-11 as assessed by the ADNM questionnaire. The prominence of preoccupation symptoms in adjustment disorder highlights a possible therapeutic target to alleviate distress. There is a need to further replicate the network structure of adjustment disorder in non-African samples.
      PubDate: 2021-10-01T00:00:00.000Z
      DOI: 10.1192/bjp.2021.46
      Issue No: Vol. 219, No. 4 (2021)
       
  • Psychiatry and the Bhagavad Gita – Psychiatry in sacred texts

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      Authors: Aarti Datta
      Pages: 564 - 564
      PubDate: 2021-10-01T00:00:00.000Z
      DOI: 10.1192/bjp.2021.83
      Issue No: Vol. 219, No. 4 (2021)
       
  • Cultural research deconstructs the psychosocial construct ‘expressed
           emotion’

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      Authors: Alison M. Heru
      Pages: 565 - 568
      Abstract: Expressed emotion (EE) is a highly researched psychosocial construct. Cultural research challenges the assumption that high family criticism is a universal determinant of poor outcome, especially for chronic illness. The concept of warmth, an original component of EE, was dropped owing to the complexity of its measurement. Warmth has now been resurrected as an important predictor of good patient outcome. Cultural scrutiny and appropriate adaptation of any psychosocial construct is necessary before its acceptance into the medical lexicon of healthcare.
      PubDate: 2021-10-01T00:00:00.000Z
      DOI: 10.1192/bjp.2020.148
      Issue No: Vol. 219, No. 4 (2021)
       
  • Light at the end of the tunnel: a front-line clinician's personal
           narrative on COVID-19 and mental illness – Reflection

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      Authors: Venkat Ramesh
      Pages: 568 - 568
      PubDate: 2021-10-01T00:00:00.000Z
      DOI: 10.1192/bjp.2021.84
      Issue No: Vol. 219, No. 4 (2021)
       
  • William Hogarth's depiction of Bedlam – psychiatry in pictures

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      Authors: R. H. S. Mindham
      Pages: 569 - 569
      PubDate: 2021-10-01T00:00:00.000Z
      DOI: 10.1192/bjp.2021.85
      Issue No: Vol. 219, No. 4 (2021)
       
  • ‘Disarticulation’ and ‘What we call depression’
           – Poems

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      Authors: Nicola Healey
      Pages: 570 - 571
      PubDate: 2021-10-01T00:00:00.000Z
      DOI: 10.1192/bjp.2021.26
      Issue No: Vol. 219, No. 4 (2021)
       
  • Kaleidoscope

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      Authors: Derek K. Tracy; Dan W. Joyce, Dawn N. Albertson, Sukhwinder S. Shergill
      Pages: 573 - 574
      PubDate: 2021-10-01T00:00:00.000Z
      DOI: 10.1192/bjp.2021.125
      Issue No: Vol. 219, No. 4 (2021)
       
 
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