BMJ Mental Health

ImportanceAI-enabled features may improve the effectiveness of routine mental health care, yet large-scale real-world evidence remains limited. ObjectiveTo evaluate whether access to AI-enabled continuous care features embedded within routine psychotherapy delivery is associated with improved treatment engagement and clinical outcomes under real-world conditions. DesignPreregistered cluster-level, matched, quasi-experimental study using a real-world rollout of AI-enabled continuous care featur...

BackgroundAdolescents experiencing psychiatric emergencies often require intensive intervention to avoid hospital admission and support their transition into education, employment, or training (EET). Intensive Community Care Services (ICCS) offer a potential alternative to inpatient care. This pilot study aimed to assess the feasibility of conducting a randomised controlled trial (RCT) to evaluate the effectiveness of ICCS compared to treatment as usual (TAU) in reducing time to start or return ...

Suicide prevention requires risk identification, appropriate intervention, and follow-up. Traditional risk identification relies on patient self-reporting, support network reporting, or face-to-face screening with validated instruments or history and physical exam. In the last decade, statistical risk models have been studied and more recently deployed to augment clinical judgment. Models have generally been found to be low precision or problematic at scale due to low incidence. Few have been te...

ObjectiveTo explain discrepant findings for fluoxetines efficacy in three influential network meta-analyses (NMAs) of treatments for pediatric depression, which led to conflicting clinical recommendations. DesignCritical appraisal and re-analysis of three published NMAs. Data sourcesNMAs published in two Lancet journals and in Cochrane, together with the trial datasets reported therein. Data synthesisWe compared efficacy estimates for fluoxetine versus placebo across NMAs. We identified and a...

ObjectiveTo investigate the association between newly developed type 2 diabetes (T2D) and incident psychopharmacological treatment and psychiatric hospital contact. MethodsWe identified all individuals from the Central- and Northern Denmark Regions with newly developed T2D (defined by the first HbA1c measurement >6.5%) from 2000-2016 and up to five age and sex matched individuals without T2D (controls). Those having received psychopharmacological treatment or having had a psychiatric hospital c...

IntroductionAntipsychotic medications are used to treat individuals with severe mental illness (SMI), but are associated with rapid weight gain and several physical and mental risk factors. Early, proactive weight management is necessary to pre-empt these risk factors. The aim was to understand and explain how, why, for whom, and in what contexts non-pharmacological interventions can help to manage antipsychotic-induced weight gain. MethodsRealist review to identify contextual factors and under...

ImportanceDepression is a major cause of disability worldwide, motivating substantial interest in psilocybin as a potential treatment. ObjectiveTo conduct a systematic review and meta-analysis of psilocybins impact on depressive symptoms and provide a living open data resource. Data SourcesPubMed, Embase, Scopus, Web of Science, and PsycINFO retrieved by a systematic search up to July 1, 2025. Study SelectionWe included randomized controlled trials of psilocybin or psilocybin-assisted therapy...

Research QuestionTo what extent do undisclosed financial conflicts of interest (COIs) exist among physician-authors in high-impact US-based psychiatry journals? Study DesignCross-sectional ObjectivesThe study aimed to assess the prevalence and magnitude of undisclosed financial COIs within high-impact US-based psychiatry journals. The primary research question was determining the extent and distribution of financial COIs among physician-authors in these journals. DesignThis investigation anal...

ImportanceDespite increasingly widespread use of artificial intelligence-driven ambient scribes in medicine, the extent to which they may impact clinician practice is not well-studied. ObjectiveTo characterize differences in documentation and treatment of psychiatric symptoms in primary care outpatient notes generated using ambient scribes. DesignCase-control electronic health records SettingPrimary care annual visit notes from the Massachusetts General and Brigham and Womens Hospital systems...

BackgroundPoor quality in research reporting is a persistent issue that has hindered the advancement of scientific knowledge across all health science disciplines. Similarly, the progress of evidence-based practice has been hampered, as the replication of interventions is often impeded by the incomplete reporting of implementation details. ObjectiveTo map how reports of psychological interventions describe implementation at both the whole intervention level and the level of recipients behaviour...

BackgroundThere is considerable interest in developing novel psychological interventions for eating disorders targeting characteristics potentially serving as maintaining factors in eating disorder pathology. An estimated 94% of patients with an eating disorder report a dominant internal voice commenting on weight and self-worth, often referred to as the eating disorder voice . The experience of a more dominating eating disorder voice has been linked to longer illness duration. Within psychoti...

BackgroundThe ability for digital mental health interventions (DMHI) to reduce mental health disparities relies on recruitment of research participants with diverse sociodemographic and self-identity characteristics. Despite its importance, sociodemographic reporting in research is often limited, and the state of reporting practices in DMHI research in particular has not been comprehensively reviewed. ObjectivesTo characterize the state of sociodemographic data reported in randomized controlled...

BackgroundThe effectiveness of Digital Cognitive Behavioural Therapy (dCBT) smartphone applications for reducing depressive symptoms in adolescents remain unclear. MethodsAn online three-arm, parallel-group randomised controlled trial evaluated the effectiveness of a CBT smartphone application (ClearlyMe(R)) for reducing depressive symptoms in adolescents with outcomes assessed at baseline, post intervention (primary endpoint: 6-weeks post baseline) and follow-up (secondary endpoint: 4-months p...

This study surveyed researchers to assess the contents and funding success of federal grant applications for research into therapeutic applications of psychedelics in the United States. The author emailed an anonymous survey to the corresponding authors of the 50 most-cited articles on psychedelics published after 2000 and disseminated it via Twitter. Ten researchers responded, reporting on 24 grant submissions for psilocybin, ibogaine, LSD, MDMA, and other psychedelics, all to the National Inst...

BackgroundDepression and anxiety are highly prevalent conditions in the US. Despite the availability of suitable therapeutic options, limited access to high quality psychiatrists represents a major barrier to treatment. Although telepsychiatry has the potential to improve access to psychiatrists, treatment efficacy in the telepsychiatry model remains unclear. ObjectivesOur primary objective was to determine whether there was a clinically meaningful change in one of two validated outcome measure...

BackgroundAdults with intellectual disabilities who display behaviours that challenge (BtC) are more prone to poor health. This study seeks to evidence the long-term health outcomes for this population. MethodsWe conducted a longitudinal cohort study of adults with intellectual disabilities aged 18+ years in England using data from Clinical Practice Research Datalink Aurum (01/2003-12/2023) linked to Hospital Episode Statistics and Office for National Statistics. Main outcome measures were Annu...

Depressive disorders remain a leading cause of health-related burden globally. Patients often suffer with symptoms throughout their lifetime, and rates of remission have been estimated to be as high as 66%. Clinicians typically favour the use of scales monitoring quantity and severity of depressive symptoms to evaluate response to treatment and determine whether patients have entered remission. However, given the complexity of the disorders and the subjective nature of mental health, research in...

Even before the pandemic, the treatment gaps in depression care were substantial, with issues ranging from rates of depression detection and intervention to a lack of follow-up after treatment initiation and access to secondary care services. The COVID-19 pandemic, which has had major effects on global healthcare systems, is almost certain to have impacted the MDD care pathway, though it is unclear what changes have manifested and what opportunities have arisen in response to COVID-19. The exten...

BackgroundFollowing the COVID-19 pandemic, computer-based self-help platforms for eating disorders (EDs) became increasingly prevalent as a tool to effectively prevent and treat ED symptoms and related behaviours. This systematic review explored the clinical effectiveness of computer-based self-help platforms for EDs. MethodsFrom inception to the 31st of May 2024, a systematic search of Ovid MEDLINE, Embase, Global Health, and APA PsycInfo was conducted. This systematic review followed the Pref...

BackgroundAccurate recognition and recording of intellectual disability in those who are admitted to general hospitals is necessary for making reasonable adjustments, ensuring equitable access, and monitoring quality of care. In this study we determined the rate of recording of intellectual disability in those with the condition who were admitted to hospital, and factors associated with the condition being unrecorded. Methods and FindingsRetrospective cohort study using two linked datasets of r...