World Psychiatry最新文献

{"title":"Activities and technologies: developing safer acute inpatient mental health care","authors":"Alan Simpson","doi":"10.1002/wps.20967","DOIUrl":"https://doi.org/10.1002/wps.20967","url":null,"abstract":"World Psychiatry 21:2 June 2022 provide a wide range of interventions. Vari­ ations among team practices suggest that it is hard to practice all elements or compo­ nents well, and that sometimes different components can compete, e.g., ensuring rapid response to new referrals vs. provid­ ing intensive care with frequent visits to current service users. Local adaptations are often necessary, and this may add to challenges in comparing complex inter­ ventions across sites and countries. Johnson et al’s overview describes a wide range of acute psychiatric care mod­ els used in various stages and contexts. For most of these models, there is a lack of research­based evidence, and achiev­ ing evidence for all these models may not be possible. However, a possible path may be to use research models currently under development for complex interventions to study individual elements of acute psychi­ atric care. If such research could identify which elements are critical for what types of clinical effect, these elements could be applied and studied within various models and contexts. One dilemma of the increasing special­ ization and differentiation in mental health services, including acute psychiatric care, is the increasing discontinuity of care for service users who need services through several phases of illness. Models with more generic or integrated teams may secure more continuity in the personal relation­ ships between the service user and the service provider. Efficiency requirements focus on management of disorders, but often leave little room for the interaction of providers with persons with these dis­ orders. We need to know more about which out­ comes are most important for service users and what elements of acute psychi­ atric care contribute to the various out­ comes. As a part of this, it is important to better understand how continuity of care and therapeutic relationships contribute to positive patient experiences and out­ comes in acute psychiatric care, and how these two critical elements may be pro­ vided.","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45680582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WPA Working Group on Medical Students: current initiatives and future priorities","authors":"Muhammad Waqar Azeem, Howard  Y. Liu, N. Imran, Bernardo Ng, Khalid Bazaid, Pronob K. Dalal, Mohan Issac, Afzal Javed","doi":"10.1002/wps.20980","DOIUrl":"https://doi.org/10.1002/wps.20980","url":null,"abstract":"World Psychiatry 21:2 June 2022 WPA public health mission to emphasize the importance of risk factors and to adopt evidence-based preventive and rehabilitative interventions. The WPA Working Group on IDD has participated this year in the initiative called Rehabilitation 2030, sponsored by the WHO Department of Noncommunicable Diseases, Disability, Violence, and Injury Prevention, aiming to develop a package of rehabilitative interventions along with specified resource requirements for their delivery. The overarching goal is the improved care of persons with IDD across the lifespan, with a particular emphasis on LMICs. Following on these ground-breaking approaches in classification and evidencebased interventions, the Working Group is now promoting a second paradigm shift aiming to include training on IDD within mainstream psychiatry, once again with a particular emphasis on LMICs. Three important arguments justify this call. First, when polled about their knowledge on the impact of IDD, many trainees in psychiatry recognize the disproportionately high burden of co-occurring mental disorders in persons with IDD. Second, when offered opportunities to interact with persons with IDD during rotations, many trainees in psychiatry regard such experiences as highly formative and inspiring. Third, and most important, psychiatry as a profession has the potential to improve significantly the care for persons with IDD. Furthermore, the gap in mental health services for persons with IDD is too significant to be compensated by an ad hoc reliance on individual providers and families, and their resilience is not limitless. Moreover, within the context of the COVID-19 pandemic, persons with IDD are facing the utmost intensification of inequities in term of underlying medical liabilities, inability to socially distance, increased infection and mortality risks, challenges to participate in telehealth services, and ensuing social isolation and adverse mental health outcomes. The Working Group and the WPA leadership invite Member Societies to work collectively to enhance efforts for the development of inclusive training models in the mental care of persons with IDD. The Working Group is ready to provide awareness raising, training, and research collaboration to promote and disseminate effective services and thereby improve the lives and outcomes for persons with IDD. For this purpose, the Working Group is developing an open access handbook focusing on global aspects of the psychiatry of IDD, with authorship from both LMICs and high-income countries. In parallel, the Working Group is developing online educational materials summarizing the key aspects of psychiatric care in people with IDD. These resources will be accessible through the WPA educational portal in 2022. The WPA Working Group on IDD encourages systematic exposure to and experience in this area for all psychiatrists, so that they can adjust treatments for cooccurring mental disorders and avoid diagnostic o","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46104992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No service is an island: towards an ecosystem approach to mental health service evaluation","authors":"A. Rosen, L. Salvador-Carulla","doi":"10.1002/wps.20963","DOIUrl":"https://doi.org/10.1002/wps.20963","url":null,"abstract":"","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44531394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repurposing fluvoxamine, and other psychiatric medications, for COVID‐19 and other conditions","authors":"E. Lenze, A. Reiersen, P. Santosh","doi":"10.1002/wps.20983","DOIUrl":"https://doi.org/10.1002/wps.20983","url":null,"abstract":"regarding the efficacy of various treatments. But this study also shows an important role for psychiatrists in managing, and supervising, the long-term neuropsychiatric effects of COVID-19.","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"21 1","pages":"314 - 315"},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43415290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From inter‐brain connectivity to inter‐personal psychiatry","authors":"G. Dumas","doi":"10.1002/wps.20987","DOIUrl":"https://doi.org/10.1002/wps.20987","url":null,"abstract":"","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48987654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute psychiatric care: the need for contextual understanding and tailored solutions","authors":"Kuruthukulangara S. Jacob","doi":"10.1002/wps.20964","DOIUrl":"https://doi.org/10.1002/wps.20964","url":null,"abstract":"World Psychiatry 21:2 June 2022 care system has been used to estimate the optimal workforce in full time equivalents in acute wards and acute day care in the Basque Country (Spain), and the relative technical efficiency of service provision in catchment areas, including both acute and non­acute services. Impact analysis is another key compo­ nent of the evaluation in mental health care. This should not be limited to end­point re­ sults on individuals. Major attention should be paid to the process of implementation and the analysis of the readiness, usability, adoption and penetration of a new service in real world environments. The empha­ sis on fidelity should be balanced with the need for adaptation to local con texts. Additional mention should be made of the role of international networks in pro­ moting new models of care and imple­ mentation. Relevant examples are the Crisis Now/Recovery International glob­ ally growing network of facilities, which provides welcoming, peer­partnership and firmly community­based service fa­ cilities, not backed as yet by published rigorous research; the I­CIRCLE consor­ tium, that promotes community models in urban environments; and the EUCOM model of community care in Eu rope. The broader bio­psycho­socio­cultural innovations have evolved with an empha­ sis on complexity science, co­design with lived experience and family expertise, hu­ man rights facilitation and community­ based recovery approaches. Attempts to fragment and undo cost­effective commu­ nity­based reforms are often accompanied by demands for ever­more hospital beds. These hospital­centric views should no long ­ er prevail over responsive, wholistic ecosys­ tems, integrating community and hospital components. Transforming acute mental health care towards community models exceeds men­ tal health systems, heralding broader reform of general acute health care and support systems towards community care. To keep on­track with previous advances, the eval­ uation of the mental health sector acute care should adopt a health care ecosystem perspective, including systematic assess­ ment of the service delivery systems, their impact on processes, outcomes, workforce, and especially service users and families, val ­ orizing lived experiences.","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46270311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WPA Working Group on Public Mental Health: objectives and recommended actions","authors":"J. Campion, A. Javed","doi":"10.1002/wps.20981","DOIUrl":"https://doi.org/10.1002/wps.20981","url":null,"abstract":"Mental disorder is reported to account for almost a third of global disease burden as measured by years lived with disability (YLDs). On the other hand, mental wellbeing results in broad positive impacts. Effective public mental health interventions exist to treat mental disorder, prevent associated impacts, prevent mental disorder from arising, and promote mental wellbeing and resilience. However, only a minority of those with mental disorder receive treatment, with far lower coverage in lowand middle-income countries (LMICs). There is even less coverage of interventions to prevent associated impacts of mental disorder, and negligible coverage of interventions to prevent mental disorder, or promote mental well-being and resilience. This implementation gap represents a breach of the right to health, and results in population-scale suffering and associated economic costs. The gap has further widened during the COVID-19 pandemic. The United Nations (UN) Sustainable Developmental Goals have set a target of universal coverage by 2030 which includes treatment and prevention of mental disorder and promotion of mental well-being. The most recent World Health Organization (WHO) Mental Health Atlas highlighted that “global targets can be reached in 2030 only if there is a collective global commitment over the next 10 years across Member States to make massive investments and expanded efforts at the country level relating to mental health policies, laws, programmes and services”. Public mental health involves a population approach to improve coverage, outcomes and coordination of interventions to treat mental disorder, prevent associated impacts, prevent mental disorder from arising, and promote mental well-being and resilience. This aims to support efficient, equitable and sustainable reduction in mental disorder, promotion of population mental well-being, and achievement of the UN Sustainable Developmental Goals target of universal coverage by 2030. The WPA Action Plan 2020-2023 promotes public mental health as a guiding principle. A Working Group on Public Mental Health has been then established, including experts such as J. Allan, F.K. Baingana, J. Campion, Y. Huang, A. Javed, N. Lamb, S. Levin, C. Lund, M. Marmot, S. Saxena, T. Schulze, E. Sorel, H. Tu, P. Udomratn, and M. van Ommeren (observer). The Working Group highlighted that public mental health is not well defined or understood, with some languages having no terms for it. This contributes to lack of action on relevant issues. The Group agreed upon the definition outlined above, which is reported on the Group webpage of the WPA website (www.wpanet.org/publicmental-health) and in a recent publication. The main objective of the Working Group is to improve implementation of public mental health interventions in four ways. The first is to raise awareness, value, acceptance and prioritization of this area in national health policies. The second is to promote national assessments of public mental heal","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41996450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ICD‐11 is now officially in effect","authors":"P. Pezzella","doi":"10.1002/wps.20982","DOIUrl":"https://doi.org/10.1002/wps.20982","url":null,"abstract":"331 rative advocacy and leadership; b) public mental health practice; c) public mental health train ing and improving population knowledge; d) improving coverage of public mental health interventions through settings-based approaches, integrated approaches, digital technology, maximizing existing resources, and focus on highreturn interventions; e) a rights approach, legislation and regulation; f) public mental health research, including that focused on implementation.","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41953066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intimate partner violence and mental health: lessons from the COVID‐19 pandemic","authors":"L. Howard, Claire A. Wilson, P. Chandra","doi":"10.1002/wps.20976","DOIUrl":"https://doi.org/10.1002/wps.20976","url":null,"abstract":"311 ship between trauma exposure and onset of other psychiatric disorders, there are several mechanisms that can be considered, and these arguably function in an interactive manner. One key potential mechanism is the impact of PTSD on the capacity to down-regulate emotional distress. It is well documented that PTSD involves impaired emotion regulation, and it is possible that this impairment predisposes people to develop new psychiatric disorders or worsens others. The capacity to regulate emotions in PTSD can be related to the well-documented deficits in executive functioning. Deficient working memory and attentional capacity can limit the extent to which one can regulate emotions, which can result in greater risk for mental health problems. Moreover, avoidance is a key symptom of PTSD, and this can trigger a cascade of strategies that can be maladaptive. Avoidance can involve situations or thoughts and memories related to the traumatic experience. This tendency can generalize to more pervasive avoidance of social networks, emotional states, and activities that promote good mental health. This can lead to a worsening of depression, anxiety and other psychiatric conditions. Another common form of avoidance for people with PTSD is self-medicating with prescription or non-prescription substances to numb the distress that is experienced along with traumatic memories. This behaviour can not only lead to substance abuse, which has been documented in longitudinal studies of PTSD, but also facilitate other psychiatric problems, because issues may not be addressed in a constructive manner. Avoidance tendencies can also result in not seeking help from mental health services, which can impede early intervention or adequate treatment for other psychiatric disorders. The DSM-5 explicitly recognizes the presence of harmful behaviors in PTSD, including such risk-taking behaviors as dangerous driving, severe alcohol use, and self-harm. These reactions are conceptualized as a result of the extreme arousal and the difficulties in impulse control that can be experienced by people with PTSD. These behaviors can lead to a range of events and habits triggering repetitive cycles of exposure to trauma. This can compound the sensitization that has been reported in PTSD, in which the condition results in neural sensitivity to threats and stressors in one’s environment, such that the person is more reactive to these events. One of the strongest transdiagnostic predictors of risk for mental health problems is represented by maladaptive or catastrophic appraisals about oneself or the environment. A key feature of PTSD is the tendency to engage in catastrophic appraisals after the traumatic experience, and these appraisals can generalize to many aspects of a person’s life, such as one’s selfesteem, trust in others, fears of negative evaluations, germs, or self-blame. These cognitive tendencies are major risk factors for an array of psychiatric conditions, including anxiety, ","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"31 10","pages":"311 - 313"},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41331499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of the WPA Action Plan 2020‐2023: an update","authors":"A. Javed","doi":"10.1002/wps.20978","DOIUrl":"https://doi.org/10.1002/wps.20978","url":null,"abstract":"The year 2021 has been another tough one for us all. Uncertainty about the COVID situation, restrictions about travel, and difficulties in getting connected have been the major issues that have affected our professional work and personal lives during that year. The WPA has also struggled coping with these limitations. However, that period has given us some motivation and new insight to work under difficult circumstances and to continue with the implementation of our Action Plan 20202023. The WPA Executive Committee and Standing Committees, along with the Secretariat staff, remained committed to fulfil their responsibilities. The WPA’s drive to encourage and inspire learning among colleagues and trainees around the world led to offering more online educational activities during 2021. We were delighted to organize, support and promote several new educational modules, courses, teaching sessions and online programmes. The accelerated development of the WPA education portal and learning management system (LMS) has promoted the launch of new education and training modules to support our young professionals, especially for the emergency response measures during the pandemic period. The first of these modules supports psychiatrists in using e-mental health tools. The portal also gives ready access to WPA’s existing training materials available in several languages. Available programmes also include ICD-11 and Yoga courses, free webinars on Early Intervention in Psychosis, updates in Psychopharmacology and courses on Telepsychiatry, Psychotherapy and Child and Adolescent Psychiatry. We continued with our projects outlined in the Action Plan. Various Working Groups offered a number of activities in ar eas of training, research and clinical updates. The Working Groups on Co-morbidity in Mental Illnesses, Early Intervention in Psychosis, Public Mental Health, and Promotion of Psychiatry among Medical Students highlighted their contributions in various activities. I am pleased that we also completed some unfinished projects started in the previous triennium. The WPA Scientific Sections likewise supported the scientific work of the Association in an inspiring way. Since the start of the network of WPA Collaborating Centres in 2016, these centres are providing practical advice on teaching, policy, research and clinical activities in psychiatry worldwide. During 2021, the network, now including eight sites, supported the implementation of the WPA’s strategic plan to build a global alliance for better mental health. In addition to the pandemic, unfortunately, we saw many adversities in 2021 in several parts of the world. Following WPA’s mission to help and support our membership during disasters, we established an Advisory Committee for Responses to Emergencies (ACRE), that brought together the leaders of the larger Member Societies to facilitate practical and concrete aid to Member Societies in need. This work continued mobilizing and fostering education, in for","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"21 1","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41392342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}