Understanding the psychological impact of identifying carrier status on young adults: A qualitative study exploring peer reactions.

The benefits and harms of identifying carriers in childhood have long been debated with European Guidelines advising against this practice. Yet over a thousand carriers are identified via newborn bloodspot screening per year in the United Kingdom alone. One of the concerns about identification is the impact it has on an individual's identity. This, in part, will be determined by how parents and peers view carriers, particularly during young adulthood. To address the paucity of research looking at how carriers are perceived by peers, this study sought to explore the views of young adults, who themselves are not carriers, toward carriers. As the narratives around COVID-19 increased, the salience of the term "carrier", the impact of such narratives on perceptions, was also explored. Twenty-five 18-25 year olds participated in a diary-interview study in the United Kingdom during 2021 to explore their perceptions of carriers via hypothetical scenarios. Data were analyzed using thematic analysis. Interviewees believed carriers would experience stigma-including societal and self-stigma. This was because people used existing illness beliefs to make sense of carrier status about which they had low levels of understanding. Interviewees believed carriers would experience challenges in familial and romantic relationships due to others' judgments. They also believed parents of carriers would experience a burden around making reproductive decisions, with clear views on what society would view as acceptable choices. Importantly interviewees felt knowledge of ones' own carrier status conferred complex communication challenges within relationships. These findings suggest an urgent need for more research and support for young adults entering a key stage in life for identity formation who have knowledge of their carrier status. The results suggest that support targeted toward the carrier regarding navigating complex communication and targeted more broadly to avoid stigma based on misunderstanding should be researched and developed.

New guidance for self-harm: an opportunity not to be missed.

In this editorial we, as members of the 2022 NICE Guideline Committee, highlight and discuss what, in our view, are the key guideline recommendations (generated through evidence synthesis and consensus) for mental health professionals when caring for people after self-harm, and we consider some of the implementation challenges.

Are Black Caribbean patients more likely to receive an incorrect diagnosis of very-late-onset schizophrenia-like psychosis than their white British counterparts?

OBJECTIVE: Increased rates of schizophrenia and schizophrenia-like psychoses are repeatedly reported within migrant populations. The authors investigated whether some or all of an observed increase in service contact rates for very-late-onset schizophrenia-like psychosis in older black people of Caribbean origin could be explained by underdiagnosis of affective psychosis. METHODS: The case-notes of 47 patients with very-late-onset schizophrenia-like psychosis were rated with a 44-point psychopathology checklist. RESULTS: Black Caribbean patients with very-late-onset schizophrenia-like psychosis were younger and more likely to be male than their white British counterparts. Although there were some differences in symptoms between the groups, these did not reach levels of statistical significance. CONCLUSION: Further studies will be required to establish the diagnostic stability and outcome of very-late-onset schizophrenia-like psychosis in older black Caribbean migrants.