{"title":"Mental health for all: fostering healthy lifestyles.","authors":"Danuta Wasserman","doi":"10.1002/wps.21102","DOIUrl":"https://doi.org/10.1002/wps.21102","url":null,"abstract":"343 known, psychiatrists should be familiar with strategies known to improve coping, such as selfmanagement, mindfulness meditation, cognitive behavioural therapy, and supportive therapies. The burgeoning number of people needing psychiatric treatment because of the COVID19 pandemic has strained already in adequate mental health services. Access to mental health care has become more difficult, due to restrictive measures and the shortage of staff and other resources. Digital technologies have offered an immediate solution to continue delivering mental health treatment. Nevertheless, the lack of legal and ethical regulation, standardization and preparation has posed several challenges to the largescale application of telepsychiatry. Recognition of the opportunity to increase access to mental health care has led the WPA to develop global guidelines for telepsychiatry. Public health agencies’ commitment to increasing mental health awareness and selfhelp during the pandemic has also enhanced interest in other digital mental health interventions, such as those based on mobile apps, sensor data, social media, and virtual reality. The integration of these interventions into realworld clinical practice requires ongoing progress. Even as the pandemic fades, the psychological burdens of long COVID will create new needs for care. Furthermore, the easing of restrictions and the “return to the new normality” will require coping with new sourc es of stress. Governments, insurers and other funders should support increased re sourc es for mental health services, commen surate with the growth in demand for treat ment. Longerterm solutions, including a commitment to augmenting the mental health work force, are also needed. Our recommendations for action are the following:","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"343-344"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168156/pdf/WPS-22-343.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura M Hart, Anthony F Jorm, Catherine L Johnson, Lucy A Tully, Emma Austen, Karen Gregg, Amy J Morgan
{"title":"Mental health literacy for supporting children: the need for a new field of research and intervention.","authors":"Laura M Hart, Anthony F Jorm, Catherine L Johnson, Lucy A Tully, Emma Austen, Karen Gregg, Amy J Morgan","doi":"10.1002/wps.21099","DOIUrl":"https://doi.org/10.1002/wps.21099","url":null,"abstract":"World Psychiatry 22:2 June 2023 health collaborations; ii) developing mental health services tailored to address the trauma and other consequences of the Russian war; iii) providing medications and other resources to treat patients with mental health needs; iv) developing remote tele mental health ser vices, making treatment available for all; v) preparing to re build Ukrainian facilities, services, and education systems, so that Ukrain ians can benefit from the skills and resources of modern psychiatric practice; vi) establishing research programs, so that Ukrainians and people of other countries can learn from these circumstances and be better prepared, if such events occur in the future. World leaders in the mental health and general health fields should: a) support the process of bringing war crimes prosecutions before the War Crimes Tribunal in The Hague, and human rights violations before the European Court of Human Rights, as part of the recovery process for Ukraine’s collective trauma; b) recognize and address the special needs of children and young families (i.e., i) provide safety and security for all children, including shielding them from the atrocities of war, trafficking, and emotional and phys ical damage; ii) provide parent guidance and support for families who are displaced or facing the trauma of injury, war crimes, and death; iii) help children maintain contact with family members from whom they have been separated; iv) build online facilities to re establish supportive social networks for developing youth; v) sustain virtual Ukrainian schools, so that children who had to leave homeland can continue their intellectual and social development, while also giving them the tools and hopes for a future in Ukraine; vi) provide evidence based general interventions that give com fort and promote resilience, such as mindfulness training and ev i dence based single session interventions); c) never forget: the Rus sian war; the Ukrainian people; the threats to all of us; the need to promote healthy development, mental health, and peace. There is great power in unity. Now is the time to stand together. A strong way to support resilience and recovery is for medical and mental health professionals to speak in one voice supporting the end of this and other wars.","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"338-339"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168171/pdf/WPS-22-338.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9436372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Margreet Ten Have, Marlous Tuithof, Saskia van Dorsselaer, Frederiek Schouten, Annemarie I Luik, Ron de Graaf
{"title":"Prevalence and trends of common mental disorders from 2007-2009 to 2019-2022: results from the Netherlands Mental Health Survey and Incidence Studies (NEMESIS), including comparison of prevalence rates before vs. during the COVID-19 pandemic.","authors":"Margreet Ten Have, Marlous Tuithof, Saskia van Dorsselaer, Frederiek Schouten, Annemarie I Luik, Ron de Graaf","doi":"10.1002/wps.21087","DOIUrl":"https://doi.org/10.1002/wps.21087","url":null,"abstract":"<p><p>Up-to-date information on the prevalence and trends of common mental disorders is relevant to health care policy and planning, owing to the high burden associated with these disorders. In the first wave of the third Netherlands Mental Health Survey and Incidence Study (NEMESIS-3), a nationally representative sample was interviewed face-to-face from November 2019 to March 2022 (6,194 subjects; 1,576 interviewed before and 4,618 during the COVID-19 pandemic; age range: 18-75 years). A slightly modified version of the Composite International Diagnostic Interview 3.0 was used to assess DSM-IV and DSM-5 diagnoses. Trends in 12-month prevalence rates of DSM-IV mental disorders were examined by comparing these rates between NEMESIS-3 and NEMESIS-2 (6,646 subjects; age range: 18-64 years; interviewed from November 2007 to July 2009). Lifetime DSM-5 prevalence estimates in NEMESIS-3 were 28.6% for anxiety disorders, 27.6% for mood disorders, 16.7% for substance use disorders, and 3.6% for attention-deficit/hyperactivity disorder. Over the last 12 months, prevalence rates were 15.2%, 9.8%, 7.1%, and 3.2%, respectively. No differences in 12-month prevalence rates before vs. during the COVID-19 pandemic were found (26.7% pre-pandemic vs. 25.7% during the pandemic), even after controlling for differences in socio-demographic characteristics of the respondents interviewed in these two periods. This was the case for all four disorder categories. From 2007-2009 to 2019-2022, the 12-month prevalence rate of any DSM-IV disorder significantly increased from 17.4% to 26.1%. A stronger increase in prevalence was found for students, younger adults (18-34 years) and city dwellers. These data suggest that the prevalence of mental disorders has increased in the past decade, but this is not explained by the COVID-19 pandemic. The already high mental disorder risk of young adults has particularly further increased in recent years.</p>","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"275-285"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168151/pdf/WPS-22-275.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10299631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Falk Leichsenring, Allan Abbass, Nikolas Heim, John R Keefe, Steve Kisely, Patrick Luyten, Sven Rabung, Christiane Steinert
{"title":"The status of psychodynamic psychotherapy as an empirically supported treatment for common mental disorders - an umbrella review based on updated criteria.","authors":"Falk Leichsenring, Allan Abbass, Nikolas Heim, John R Keefe, Steve Kisely, Patrick Luyten, Sven Rabung, Christiane Steinert","doi":"10.1002/wps.21104","DOIUrl":"10.1002/wps.21104","url":null,"abstract":"<p><p>To assess the current status of psychodynamic therapy (PDT) as an empirically supported treatment (EST), we carried out a pre-registered systematic umbrella review addressing the evidence for PDT in common mental disorders in adults, based on an updated model for ESTs. Following this model, we focused on meta-analyses of randomized controlled trials (RCTs) published in the past two years to assess efficacy. In addition, we reviewed the evidence on effectiveness, cost-effectiveness and mechanisms of change. Meta-analyses were evaluated by at least two raters using the proposed updated criteria, i.e. effect sizes, risk of bias, inconsistency, indirectness, imprecision, publication bias, treatment fidelity, and their quality as well as that of primary studies. To assess the quality of evidence we applied the GRADE system. A systematic search identified recent meta-analyses on the efficacy of PDT in depressive, anxiety, personality and somatic symptom disorders. High quality evidence in depressive and somatic symptom disorders and moderate quality evidence in anxiety and personality disorders showed that PDT is superior to (inactive and active) control conditions in reducing target symptoms with clinically meaningful effect sizes. Moderate quality evidence suggests that PDT is as efficacious as other active therapies in these disorders. The benefits of PDT outweigh its costs and harms. Furthermore, evidence was found for long-term effects, improving functioning, effectiveness, cost-effectiveness and mechanisms of change in the aforementioned disorders. Some limitations in specific research areas exist, such as risk of bias and imprecision, which are, however, comparable to those of other evidence-based psychotherapies. Thus, according to the updated EST model, PDT proved to be an empirically-supported treatment for common mental disorders. Of the three options for recommendation provided by the updated model (i.e., \"very strong\", \"strong\" or \"weak\"), the new EST criteria suggest that a strong recommendation for treating the aforementioned mental disorders with PDT is the most appropriate option. In conclusion, PDT represents an evidence-based psychotherapy. This is clinically important since no single therapeutic approach fits all psychiatric patients, as shown by the limited success rates across all evidence-based treatments.</p>","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"286-304"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168167/pdf/WPS-22-286.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evolutionary psychiatry: foundations, progress and challenges.","authors":"Randolph M Nesse","doi":"10.1002/wps.21072","DOIUrl":"10.1002/wps.21072","url":null,"abstract":"<p><p>Evolutionary biology provides a crucial foundation for medicine and behavioral science that has been missing from psychiatry. Its absence helps to explain slow progress; its advent promises major advances. Instead of offering a new kind of treatment, evolutionary psychiatry provides a scientific foundation useful for all kinds of treatment. It expands the search for causes from mechanistic explanations for disease in some individuals to evolutionary explanations for traits that make all members of a species vulnerable to disease. For instance, capacities for symptoms such as pain, cough, anxiety and low mood are universal because they are useful in certain situations. Failing to recognize the utility of anxiety and low mood is at the root of many problems in psychiatry. Determining if an emotion is normal and if it is useful requires understanding an individual's life situation. Conducting a review of social systems, parallel to the review of systems in the rest of medicine, can help achieve that understanding. Coping with substance abuse is advanced by acknowledging how substances available in modern environments hijack chemically mediated learning mechanisms. Understanding why eating spirals out of control in modern environments is aided by recognizing the motivations for caloric restriction and how it arouses famine protection mechanisms that induce binge eating. Finally, explaining the persistence of alleles that cause serious mental disorders requires evolutionary explanations of why some systems are intrinsically vulnerable to failure. The thrill of finding functions for apparent diseases is evolutionary psychiatry's greatest strength and weakness. Recognizing bad feelings as evolved adaptations corrects psychiatry's pervasive mistake of viewing all symptoms as if they were disease manifestations. However, viewing diseases such as panic disorder, melancholia and schizophrenia as if they are adaptations is an equally serious mistake in evolutionary psychiatry. Progress will come from framing and testing specific hypotheses about why natural selection left us vulnerable to mental disorders. The efforts of many people over many years will be needed before we will know if evolutionary biology can provide a new paradigm for understanding and treating mental disorders.</p>","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"177-202"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168175/pdf/WPS-22-177.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9436375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Biomarkers in psychiatric disorders: status quo, impediments and facilitators.","authors":"Michael Berk","doi":"10.1002/wps.21071","DOIUrl":"https://doi.org/10.1002/wps.21071","url":null,"abstract":"World Psychiatry 22:2 June 2023 forces have pushed us to a genetic sweet spot regarding a cer tain trait that does not tail off gradually but, with relatively minor changes in the allele distribution, suddenly transforms into dis order. Many psychological traits may need to stay within narrow bounds to enable adaptive social interaction, so small variations may yield cliff edge disorder vulnerability. Emergent properties of specific allele combinations may exist for other unexpected reasons. For example, a recent study found that certain combinations of positively selected alleles yield ing cognitive advantage increased risk for autism spectrum dis order. Moreover, beyond alleles, at the trait level, there can be dysfunction causing combinations of individually selected posi tive traits (e.g., certain combinations of individually selected per sonality traits can yield personality disorders such as psychopa thy). All of this goes to show that it is not dimensionality per se but the way selective processes operated on various elements on a dimension that determines normality and disorder. Evolutionary psychiatry’s role thus transcends the current dis pute over psychiatry’s nosological future. Whichever proposal triumphs, psychiatry’s status as a medical discipline requires distinguishing normal variation from mental disorder, which rests on understanding human psychobiological design. Symp tom networks, extremes on symptom dimensions, and intense brain circuitry activations can be normal or abnormal depend ing on context. These proposals, whatever their merits, rearrange the symptomatic deck chairs on our nosological Titanic without addressing the root problem: i.e., that DSM psychiatric nosology is sinking due to lack of attention to the evolved nature of human normality, yielding invalid normal/disorder demarcations. Only evolutionary psychiatry provides a scientifically defensible answer to the fundamental nosological normal/disorder “demar cation” problem. Because the way people are biologically designed does not always fit social values and ideals, evolutionary psychiatry treads on potentially controversial ground. There is a tension between social idealizations – what we want to believe about ourselves and demand of our society’s members – versus the scientific reality of human nature. M. Foucault correctly observed that a society’s view of human nature tends to be distorted and permeated by its values and biases, rationalizing its efforts at social control. If psychiatry is to make scientific progress, it must understand the truth of human nature that lies beyond cultural preconceptions as a basis for valid diagnostic concepts that support psychiatric science. The promise of evolutionary psychiatry is that it is the one subdiscipline of psychiatry devoted to realizing this foundational goal.","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"174-176"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168162/pdf/WPS-22-174.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9436369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The promise of evolutionary psychiatry.","authors":"Jerome C Wakefield","doi":"10.1002/wps.21070","DOIUrl":"https://doi.org/10.1002/wps.21070","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"173-174"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168155/pdf/WPS-22-173.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"WPA education initiatives in the triennium 2020-2023.","authors":"Roger M K Ng","doi":"10.1002/wps.21107","DOIUrl":"https://doi.org/10.1002/wps.21107","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"22 2","pages":"346-347"},"PeriodicalIF":73.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168174/pdf/WPS-22-346.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}