World Psychiatry最新文献

{"title":"Patterns and correlates of patient-reported helpfulness of treatment for common mental and substance use disorders in the WHO World Mental Health Surveys.","authors":"Ronald C Kessler, Alan E Kazdin, Sergio Aguilar-Gaxiola, Ali Al-Hamzawi, Jordi Alonso, Yasmin A Altwaijri, Laura H Andrade, Corina Benjet, Chrianna Bharat, Guilherme Borges, Ronny Bruffaerts, Brendan Bunting, José Miguel Caldas de Almeida, Graça Cardoso, Wai Tat Chiu, Alfredo Cía, Marius Ciutan, Louisa Degenhardt, Giovanni de Girolamo, Peter de Jonge, Ymkje Anna de Vries, Silvia Florescu, Oye Gureje, Josep Maria Haro, Meredith G Harris, Chiyi Hu, Aimee N Karam, Elie G Karam, Georges Karam, Norito Kawakami, Andrzej Kiejna, Viviane Kovess-Masfety, Sing Lee, Victor Makanjuola, John J McGrath, Maria Elena Medina-Mora, Jacek Moskalewicz, Fernando Navarro-Mateu, Andrew A Nierenberg, Daisuke Nishi, Akin Ojagbemi, Bibilola D Oladeji, Siobhan O'Neill, José Posada-Villa, Victor Puac-Polanco, Charlene Rapsey, Ayelet Meron Ruscio, Nancy A Sampson, Kate M Scott, Tim Slade, Juan Carlos Stagnaro, Dan J Stein, Hisateru Tachimori, Margreet Ten Have, Yolanda Torres, Maria Carmen Viana, Daniel V Vigo, David R Williams, Bogdan Wojtyniak, Miguel Xavier, Zahari Zarkov, Hannah N Ziobrowski","doi":"10.1002/wps.20971","DOIUrl":"10.1002/wps.20971","url":null,"abstract":"<p><p>Patient-reported helpfulness of treatment is an important indicator of quality in patient-centered care. We examined its pathways and predictors among respondents to household surveys who reported ever receiving treatment for major depression, generalized anxiety disorder, social phobia, specific phobia, post-traumatic stress disorder, bipolar disorder, or alcohol use disorder. Data came from 30 community epidemiological surveys - 17 in high-income countries (HICs) and 13 in low- and middle-income countries (LMICs) - carried out as part of the World Health Organization (WHO)'s World Mental Health (WMH) Surveys. Respondents were asked whether treatment of each disorder was ever helpful and, if so, the number of professionals seen before receiving helpful treatment. Across all surveys and diagnostic categories, 26.1% of patients (N=10,035) reported being helped by the very first professional they saw. Persisting to a second professional after a first unhelpful treatment brought the cumulative probability of receiving helpful treatment to 51.2%. If patients persisted with up through eight professionals, the cumulative probability rose to 90.6%. However, only an estimated 22.8% of patients would have persisted in seeing these many professionals after repeatedly receiving treatments they considered not helpful. Although the proportion of individuals with disorders who sought treatment was higher and they were more persistent in HICs than LMICs, proportional helpfulness among treated cases was no different between HICs and LMICs. A wide range of predictors of perceived treatment helpfulness were found, some of them consistent across diagnostic categories and others unique to specific disorders. These results provide novel information about patient evaluations of treatment across diagnoses and countries varying in income level, and suggest that a critical issue in improving the quality of care for mental disorders should be fostering persistence in professional help-seeking if earlier treatments are not helpful.</p>","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":"272-286"},"PeriodicalIF":60.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9077614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45958830","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":"Reasons why people may refuse COVID‐19 vaccination (and what can be done about it)","authors":"M. Hornsey","doi":"10.1002/wps.20990","DOIUrl":"https://doi.org/10.1002/wps.20990","url":null,"abstract":"","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"21 1","pages":"217 - 218"},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44037982","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":"Oral and long‐acting antipsychotics for relapse prevention in schizophrenia‐spectrum disorders: a network meta‐analysis of 92 randomized trials including 22,645 participants","authors":"G. Ostuzzi, F. Bertolini, F. Tedeschi, Giovanni Vita, P. Brambilla, L. Fabro, C. Gastaldon, D. Papola, M. Purgato, Guido Nosari, C. Del Giovane, C. Correll, C. Barbui","doi":"10.1002/wps.20972","DOIUrl":"https://doi.org/10.1002/wps.20972","url":null,"abstract":"According to current evidence and guidelines, continued antipsychotic treatment is key for preventing relapse in people with schizophrenia‐spectrum disorders, but evidence‐based recommendations for the choice of the individual antipsychotic for maintenance treatment are lacking. Although oral antipsychotics are often prescribed first line for practical reasons, long‐acting injectable antipsychotics (LAIs) are a valuable resource to tackle adherence issues since the earliest phase of disease. Medline, EMBASE, PsycINFO, CENTRAL and CINAHL databases and online registers were searched to identify randomized controlled trials comparing LAIs or oral antipsychotics head‐to‐head or against placebo, published until June 2021. Relative risks and standardized mean differences were pooled using random‐effects pairwise and network meta‐analysis. The primary outcomes were relapse and dropout due to adverse events. We used the Cochrane Risk of Bias tool to assess study quality, and the CINeMA approach to assess the confidence of pooled estimates. Of 100 eligible trials, 92 (N=22,645) provided usable data for meta‐analyses. Regarding relapse prevention, the vast majority of the 31 included treatments outperformed placebo. Compared to placebo, “high” confidence in the results was found for (in descending order of effect magnitude) amisulpride‐oral (OS), olanzapine‐OS, aripiprazole‐LAI, olanzapine‐LAI, aripiprazole‐OS, paliperidone‐OS, and ziprasidone‐OS. “Moderate” confidence in the results was found for paliperidone‐LAI 1‐monthly, iloperidone‐OS, fluphenazine‐OS, brexpiprazole‐OS, paliperidone‐LAI 1‐monthly, asenapine‐OS, haloperidol‐OS, quetiapine‐OS, cariprazine‐OS, and lurasidone‐OS. Regarding tolerability, none of the antipsychotics was significantly worse than placebo, but confidence was poor, with only aripiprazole (both LAI and OS) showing “moderate” confidence levels. Based on these findings, olanzapine, aripiprazole and paliperidone are the best choices for the maintenance treatment of schizophrenia‐spectrum disorders, considering that both LAI and oral formulations of these antipsychotics are among the best‐performing treatments and have the highest confidence of evidence for relapse prevention. This finding is of particular relevance for low‐ and middle‐income countries and constrained‐resource settings, where few medications may be selected. Results from this network meta‐analysis can inform clinical guidelines and national and international drug regulation policies.","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":"47199809","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 “Meet the WPA Council” Panel at the 21st World Congress of Psychiatry","authors":"A. Okasha","doi":"10.1002/wps.20957","DOIUrl":"https://doi.org/10.1002/wps.20957","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":"44067894","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 need for a rights‐based approach to acute models of care","authors":"G. Newton-Howes, Sarah E. Gordon","doi":"10.1002/wps.20965","DOIUrl":"https://doi.org/10.1002/wps.20965","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":"48181144","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 alliance construct in psychotherapies: from evolution to revolution in theory and research","authors":"J. Muran","doi":"10.1002/wps.20973","DOIUrl":"https://doi.org/10.1002/wps.20973","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":"43503565","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":"Post‐traumatic stress disorder as moderator of other mental health conditions","authors":"R. Bryant","doi":"10.1002/wps.20975","DOIUrl":"https://doi.org/10.1002/wps.20975","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":"45485083","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":"Effectiveness of currently available psychotherapies for post‐traumatic stress disorder and future directions","authors":"S. Norman","doi":"10.1002/wps.20974","DOIUrl":"https://doi.org/10.1002/wps.20974","url":null,"abstract":"Post-traumatic stress disorder (PTSD) entered the DSM just over 40 years ago. Since then, there have been more than 300 completed randomized controlled trials (RCTs) of therapies for this condition, about two thirds of which have included one or more psychotherapies. It is therefore not surprising that there is a robust evidence base of effective psychotherapies for PTSD. Trauma-focused psychotherapies, in which processing memories and emotions related to the traumatic event is a primary focus throughout the treatment, have emerged as the most effective. Meta-analyses generally show large effect sizes for PTSD symptom reduction and high rates of loss of diagnosis or remission for these treatments. Among trauma-focused psychotherapies, prolonged exposure (PE) therapy, cognitive processing therapy (CPT), cognitive therapy, and eye movement desensitization and reprocessing stand out as having the strongest evidence, because they have been studied the most, by investigators different from those who developed the treatments, and with the broadest variety of populations and comorbidities. All involve manualized protocols usually completed in about 12 sessions, most often delivered weekly. While there have been few direct comparisons of psychotherapies and pharmacotherapies for PTSD, a meta-analysis that compared effect sizes across studies found larger effects for psychotherapies (g=1.14) than medications (g=0.42). There is also evidence that PTSD can be treated effectively with nontrauma-focused psychotherapies, which generally aim to improve specific skills, but effect sizes are generally smaller than for trauma-focused psychotherapies. The availability of effective treatments has fundamentally shifted our view of PTSD from a chronic condition that we can at best hope to manage, to a condition from which it is possible to recover. While this is tremendously good news, there is still a great deal of work left to do. Not everyone with PTSD is willing or able to engage in a trauma-focused psychotherapy; dropout from PTSD treatment remains high (this is true across PTSD treatment types, in part because a hallmark symptom of PTSD is avoidance); and a number of people who engage in these treatments remain partial responders or non-responders. Ongoing work to further improve the effectiveness of psychotherapies for PTSD can be divided broadly into two categories: a) research to improve engagement in and outcomes of existing trauma-focused psychotherapies, and b) research to develop and evaluate novel psychotherapies. A delivery adaptation that is promising in terms of improving engagement in existing psychotherapies is massed treatment, that is, psychotherapy sessions offered on consecutive days or multiple times per week. This format allows patients to complete treatment in 2-4 weeks, rather than in 3-4 months as is usually the case with weekly sessions. Field studies and a small number of RCTs show treatment completion rates upward of 85%, with effectiven","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":"48810551","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":"Subjectivity, psychosis and the science of psychiatry","authors":"Louis Sass","doi":"10.1002/wps.20986","DOIUrl":"https://doi.org/10.1002/wps.20986","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":"49127611","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":"DSM‐5‐TR: overview of what’s new and what’s changed","authors":"M. First, Lamyaa Yousif, D. Clarke, Philip S. Wang, N. Gogtay, P. Appelbaum","doi":"10.1002/wps.20989","DOIUrl":"https://doi.org/10.1002/wps.20989","url":null,"abstract":"World Psychiatry 21:2 June 2022 Understanding the factors discussed above helps make sense of what, for many scientists and health professionals, is one of the most exasperating and difficult-to-understand features of the vaccination debate: facts are not enough. Merely repeating evidence has been a notoriously ineffective way of shifting attitudes among those who self-identify as anti-vaccination. One reason for this is that people do not always behave like cognitive scientists, weighing up evidence before reaching a conclusion. Frequently, we behave more like cognitive lawyers, selectively exposing ourselves, critiquing, and remembering evidence that reinforces a conclusion that feels “right” for us. Successful communication requires deep listening and an attentiveness to the fears, worldviews and ideologies that might be motivating COVID-19 refusal. Persuasion attempts that are responsive to these underlying “attitude roots” are more likely to be successful than those that sail above them with an exclusive focus on facts and data. Finally, mental health professionals recognize as much as anyone the importance of communication that is non-stigmatizing and inclusive. Although the public face of the anti-vaccination movement sometimes seems strident and unworthy of empathy, community members who align with those views are frequently characterized by anxiety and uncertainty. There is the potential for negative feedback loops, where the vaccine hesitant feel misunderstood and stigmatized, reinforcing their worldview that the system is corrupted and lacking in humanity. Feeling socially isolated, vaccine refusers may be driven toward the online communities and misinformation echo chambers that reinforce their fears. Respectful and inclusive communication is not just the “nice” thing to do; on a pragmatic level, it is a pre-requisite for enabling positive change.","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":"51240798","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}