New paper led by Maite Arribas and myself. We used electronic health records to explore the duration, first presentation, time course and transdiagnosticity of prodromes to depression (UMD), bipolar disorder (BMD) and psychosis (PSY) in secondary care 🧵⬇️

CBD: anti-psychotic or pro-psychotic? https://t.co/3S3N6ugmrW via @Rational_Psych

Taking part in research is good! Well done to the PAX-D team and of course to the participants who make clinical research possible I think the rate-limiting step is not the willingness of patients to participate but unnecessary bureaucratic hurdles we place before them

Management of #psychotic symptoms occurring during #ADHD #pharmacological treatment, in The Lancet Psychiatry. No evidence of a causal role of ADHD medication. Important to screen for individual vulnerability. https://t.co/NQZqdZt1m4

Dr Benjamin Perry is preparing PsyMetRiC, a digital tool to predict the risk of young people with psychosis developing physical health problems, for approval for use by clinicians: https://t.co/UABYg4UiLE @LES_UniBham @UoB_SoP @benjmnperry @unibirm_CMH @UoBhealthsci @HubMetPsych

• Around 50% of mental illnesses begin by age 11 • Mental health conditions account for 13% of the global burden of disease For #WorldMentalHealthDay, we asked experts from the Department of Psychiatry to share one fact everyone should know.

🧠 5-HT2ARs are the most highly expressed serotonin receptor in human cortex. They are also the main target of all classical psychedelics. So what happens to 5-HT2ARs in depression? Moncrieff et al. declined to look at this in their popular umbrella review. Now we have…👇

Really pleased to see our paper written about in @Mental_Elf by @HollyAlexFraser https://t.co/0cP55ETv6L @JoeBarnby @RPatelDr @koutsouleris

Do you want to do a PhD with us at @KingsIoPPN, on a project exploring the paranoid effects of THC? Read more and apply here (project ID NS-MH2026_45) :

My colleagues and I at the @KingsIoPPN wrote a little blog about out upcoming project! https://t.co/emUgHcP6Vh

Progression of Transdiagnostic Stages From Childhood to Young Adulthood | Adolescent Medicine | JAMA Psychiatry | JAMA Network Great paper led by Prof Ratheesh on the critical diagnostic model of clinical staging: avenue to clinical utility and validity

11/ Full study here:

10/ Bottom line: The mini-CAARMS can help make risk assessment feasible at scale, but it should complement, not replace, the full CAARMS when screening.

9/ One other thing to note: we are still collecting follow-up data so we do not know whether those false negatives on the mini-CAARMS are truly at risk for psychosis.

8/ One solution? Front-load with the mini-CAARMS: If someone screens negative → proceed with full CAARMS. If positive → consider still administering the full CAARMS if there’s clinical concern.

7/ This has important implications: The mini-CAARMS is highly scalable and efficient. But if used alone as a screener, risk of under-detection exists.

6/ But here’s the catch: specificity was 100%: no false positives. That sounds great, but as a screening tool, it means some true at-risk individuals may be missed (lower NPV, ~82%).

5/ We even tested an even shorter, ultra-mini-CAARMS (12 items). Performance was still excellent, with κ = 0.90 and sensitivity ~94%.

4/ Results: κ = 0.90 (agreement with full CAARMS) C-index = 0.93 Sensitivity: 95.6% Specificity: 100% Balanced accuracy: 97.8% PPV: 100% NPV: 86.3% In other words: shorter and highly accurate.

3/ We developed and validated the mini-CAARMS, a 23-item version, using cross-validated LASSO regression.

2/ The full CAARMS has 60 items and takes significant time and training to administer. This limits its scalability in real-world clinical settings, especially in low-resource services.