Asia‐Pacific Psychiatry最新文献

{"title":"A century of Morita therapy: What has and has not changed","authors":"Mitsuhiro Nakamura MD, MPH,&nbsp;Hidehito Niimura MD, PhD,&nbsp;Kenji Kitanishi MD, PhD","doi":"10.1111/appy.12511","DOIUrl":"10.1111/appy.12511","url":null,"abstract":"<p>We review the history of Morita therapy (MT), which has existed for over 100 years, and examine what has changed over that period and what has not. Classic MT, which was dependent on a highly strict therapeutic approach, gradually lost its pre-eminence, but at the same time, the fundamental theory of MT was refined. This theory came to be applied to current outpatient MT and adapted to inpatient MT. As MT was refined, a standard training system for therapists was established, adaptations to modern conditions were made and expanded, and comparisons to and dialogs with other psychotherapeutic concepts such as mindfulness became possible. To better evaluate MT, further work should be conducted on its effectiveness of from a clinical epidemiological perspective.</p>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"15 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2022-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/appy.12511","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9319541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An international medical education perspective on training in child and adolescent psychiatry","authors":"Branko Aleksic MD, PhD,&nbsp;Hideki Kasuya MD, PhD","doi":"10.1111/appy.12509","DOIUrl":"10.1111/appy.12509","url":null,"abstract":"Martine Stecher Nielsen and colleagues' article ( 2021) in the Asia Pacific Psychiatry, which is the official journal of the Pacific Rim College of Psychiatrists and the Asian Federation of Psychiatric Associations, compared the status of child and adolescent psychiatry training programs and the workforce in child and adolescent mental health services in three geographical regions, namely South East Europe, the Middle East, and the Far East, to identify similar problems, highlight success stories, and to make recommendations for future regional studies. The study (Stecher-Nielsen et al., 2021) used data from the World Psychiatric Association, Child and Adolescent Psychiatry Section's regional projects including data from 44 countries. The study (Stecher-Nielsen et al., 2021) is extremely important, because it shows there is an urgent need for more qualified child and adolescent psychiatrists and allied professionals in a very large group of countries in South East Europe, the Middle East, and the Far East, with great differences in religion, culture, and economy. The aforementioned lack of qualified child and adolescent psychiatrists and allied professionals may result in various problems, which, in turn can lead to delayed identification, diagnosis, and treatment of child and adolescent mental disorders that can have lifelong consequences, due to the temporally regulated modifications brain undergoes during this neurodevelopmental period (Kieling et al., 2011). This (Skokauskas et al., 2019) is in line with the United Nations' Sustainable Development Goals (United Nations, 2015), adopted in 2015, which contributed to the greater recognition of both the current global mental health epidemic, and the urgent need for countries to allocate more resources. Martine Stecher Nielsen and colleagues (2021) in their article suggested, among other things that the future increase of the child and adolescent mental health workforce size, would inevitably mandate the implementation of other strategies such as advocating for child and adolescent psychiatry or child and adolescent mental health as a focus for both undergraduate and postgraduate trainees to ensure the long term expansion of training positions. This is very salient observation considering recent advances in genetics of childhood neurodevelopmental disorders, such as attention deficit hyperactivity disorder, autism spectrum disorder and intellectual disability (Parenti et al., 2020). Specifically, rare variants frequently affect protein function directly, providing a promising chance to discover the molecular mechanisms of neurodevelopmental disorders, such as autism spectrum disorder (Sanders et al., 2019). Various functional studies, using disease models such as induced pluripotent stem cells and genome-edited animals, with deleterious rare variants have been done to clarify the mechanism of pathogenesis and facilitate novel drug discovery. The aforementioned is conceptually in line with the Rese","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2022-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39637847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An international medical education perspective on training in child and adolescent psychiatry","authors":"Paul Robertson","doi":"10.1111/appy.12508","DOIUrl":"10.1111/appy.12508","url":null,"abstract":"&lt;p&gt;I write this commentary from Australia in the Asia-Pacific region. The work of the World Psychiatric Association (WPA) Consortium of Academic Child and Adolescent Psychiatrists (CAP) in undertaking such international comparison is immense. Collaboration allows us to learn from each other and find better ways of doing things. International comparison also supports CAP advocacy allowing benchmarking against comparable countries. An effective approach in Australia where CAP numbers are less than comparable European countries (RANZCP, &lt;span&gt;2019&lt;/span&gt;).&lt;/p&gt;&lt;p&gt;In this study the CAP profession almost universally reports a large ‘treatment gap’ between available CAP resources and community need, even in wealthy countries. Not surprisingly it shows wealthier countries have more CAP resources than less wealthy countries; not just number of CAP but also access to a CAP training program, national training guidelines, a broader range of training rotations and guidance from a National Child and Adolescent Mental Health Policy. But the connection between a countries wealth and CAP resources is far from universal. Collaborative approaches examining this variation will help us understand the enablers and barriers to greater CAP resources in all countries.&lt;/p&gt;&lt;p&gt;The study asks CAP about the perceived need for more CAP and CAMH professionals. Almost universally such a need is reported. Understandably it focuses on CAP. However, CAP do not work in isolation and what care they provide is determined by the system of care in which they work and how tasks are allocated between the various professions; both within specialist CAMH services (if available) and between primary and specialist care. The relative cost of training and employing various professionals is relevant with CAP being expensive to train and employ. A future challenge is looking at a broader multidisciplinary comparison of the CAMH workforce and the system of care they work in.&lt;/p&gt;&lt;p&gt;Modern CAMH place CAP in a role of clinical leadership, delivering direct and indirect consultation to other professionals, and oversight of care delivery by others. Defining the professional capabilities of the modern CAP guides what CAP training should include in curriculum and workplace training experiences provided.&lt;/p&gt;&lt;p&gt;The study asks about professional structures supporting CAP including the presence of a National Society, CAP Journal and availability of University CAP Academic Departments. It explores if CAP is a recognized specialty or subspecialty and the interface with general psychiatry. Such structures support the CAP profession, however distilling which and how such professional structures enable the profession requires further exploration. International collaboration is required to better understand what works best. The study demonstrates general psychiatrists deliver a lot of CAP care even in the presence of a CAP workforce. Clearly their training in CAP is important. In Australia debate exists on the bal","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2022-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/87/APPY-14-0.PMC9285939.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39816178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Piloting online training in the Pacific-Ophelia project for child and adolescent mental health","authors":"Odille Chang BSc, MBBS,&nbsp;Brigid Ryan MPH,&nbsp;Elaine Liebetrau MBBS,&nbsp;Paul Robertson BSS","doi":"10.1111/appy.12510","DOIUrl":"10.1111/appy.12510","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In June 2020, St Vincent's Mental Health, Fiji National University, and the Royal Australian and New Zealand College of Psychiatrists, Faculty of Child and Adolescent Psychiatry collaborated to deliver online, specialized child and adolescent mental health (CAMH) training to Pacific-based healthcare workers. This accompanying research aimed to understand the telehealth model and structures that would sustain an engaged community of practice and support the development of professional networks across the Pacific.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Quantitative and qualitative feedback was analyzed to understand participation and self-rated measures of skills, knowledge, and confidence in providing health care for children and young people, as well as experiences of training, including access, engagement, and applicability of the initiative to the Pacific Islands health care organizations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ophelia Training was able to meet the stated learning objectives. The data from all stakeholders identifies the value of a telehealth initiative incorporating training, technical assistance, knowledge networks, and professional coaching as a capacity building approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This program offers an integration of research and practice. This regional approach to understanding telehealth capacity for Pacific Island mental health services is valuable for informing decision-making with respect to clinical care, management, workforce training and policy. It also provided an opportunity to improve health inequalities, by improving access to CAMH training via telehealth.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2022-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39628054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Romanian psychiatric residents' opinions on factors that influence their decision to emigrate: A 5-year follow-up study","authors":"Adriana Mihai MD, PhD,&nbsp;Silvia Maria Trandafir MD, PhD,&nbsp;Lavinia Duica MD, PhD,&nbsp;Alex Mihai MD,&nbsp;Cosmin Lungu MD,&nbsp;Mihail Cristian Pirlog PhD","doi":"10.1111/appy.12507","DOIUrl":"10.1111/appy.12507","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>To evaluate the situation of migration of psychiatrists from Romania and a prioritization exercise of main factors related with psychiatric residents' decision to emigrate could be a starting point of elaboration of a strategy of reforms. Important changes have been done in economic status of residents in 2018. The impact of these measures in changing opinions was checked.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a cross sectional evaluation study on a randomized selected sample of Romanian psychiatric residents' opinions on factors that influence decision of migration in EU countries in two time points, 2015 and 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-eight percent of residents intend to work abroad comparing with 78% before the economic changes (25.8% vs. 71.7% for a limited period of time and 15.7% vs. 28.3% intend to emigrate) and 2% vs. 5% intend to leave the specialty. The important factors for decision to emigrate changed from “Better working conditions” (15.7% vs. 37.3% residents) to “Better training”; the factor “respect and appreciation by colleagues” remained important for 19.1% versus 17.9%. “Lack of working place for partner” was considered by 26.7% of responders as an important disadvantage of working abroad. “Being far from family members”, which was considered 5 years ago by 64.2% of responders as an important disadvantage of working abroad, nowadays concerns only 6.7%, probably because it seems easier to go abroad together with the family members.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The factors (better training in psychiatry and psychotherapy, better supervision, more involvement in research) that influence the residents' decision to emigrate represent the starting points for future reforms in educational and medical system in psychiatry.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"13 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39649182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teaching psychiatry in a low-income country during the COVID-19 pandemic: A hybrid collaborative psychiatry course","authors":"Sanya Virani,&nbsp;Jibril I. M. Handuleh,&nbsp;Victor Pereira-Sanchez,&nbsp;Daniel Fekadu Wolde-Giorgis","doi":"10.1111/appy.12503","DOIUrl":"10.1111/appy.12503","url":null,"abstract":"<p>Amoud University in Borama is located in the self-declared state of Somaliland, in the Horn of Africa. Past conflicts and resulting economic hardship have led to a lack of local academic psychiatry faculty and resources. Amoud has been for some years partnering with voluntary faculty in the United Kingdom to teach psychiatry to its medical students through in-person “teaching missions.” This was recently led by a Borama-native psychiatry resident in Ethiopia. COVID-19 added further hardships due to restrictions to travel and in-person gatherings. These challenges also created the opportunity for the development of an innovative, international, hybrid (online onsite), self-sustaining partnership model which has been successful in improving psychiatry teaching for undergraduate students in 2020–2021 and will continue in 2021–2022. An international, ‘online-connected’ department of psychiatry comprising a primary care physician in Somaliland, three postgraduate trainees in Ethiopia and the United States, and three senior psychiatrists in the United Kingdom developed a local faculty-led, hybrid-delivered, dynamic curriculum (bedside teaching, in person and online lecturing) that adapted to the needs, resources, faith and culture of Somaliland. While 2020–2021 has been the pilot year for the program, the overall experience has been enriching for students and faculty, leading to valuable cross-cultural conversations with impact on teaching and research. While learning about Somalilanders' and trauma, the program leads, also the authors of this article, have identified ways to harness the resilience and faith of students to bring about improvements in global mental health.</p>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"13 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/appy.12503","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39649181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social distance towards schizophrenia in health professionals","authors":"Chen-Hua Lin MS,&nbsp;Tzu-Yu Lai MD,&nbsp;Yu-Jen Chen MD,&nbsp;Shun-Ku Lin MD","doi":"10.1111/appy.12506","DOIUrl":"10.1111/appy.12506","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The stigma and prejudice of the public regarding psychiatric disorders are a long-standing social problem. However, health professionals are more likely to have negative attitudes and label people with mental health conditions. This study aimed to investigate how self-rated familiarity and literacy about schizophrenia are related to social distancing towards schizophrenia patients among health professionals in Taiwan.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Method&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study used a cross-sectional questionnaire survey and invited respondents to complete the survey either electronically or in a pencil/paper format. Respondents included health professionals in different disciplines and students under medical placements. The survey instrument consists of three parts: sociodemographic information, the 18-item Social Distance Scale for schizophrenia, and the 19-item Schizophrenia Experience and Knowledge Questionnaires. Data were analyzed using linear regression models to explore sociodemographic factors, self-rated familiarity, and literacy total scores about social distance, attitude, and opinions towards schizophrenia.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Result&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In total, 420 health professionals completed the questionnaire, of which 24.5% were physicians, 36.0% nurses, 6.7% pharmacists, and 28.6% interns. The majority of respondents (&lt;i&gt;n&lt;/i&gt; = 360, 85.7%) had contact experience with schizophrenia patients, and approximately 60% rated their experience as a positive impression. Although 62.9% of respondents had received psychiatric education or training, 86% believed that such education/training was insufficient. Moreover, over half of the respondents did not have confidence in their knowledge of schizophrenia. Older age, being married, and having more working experience were associated with high social distance, a negative attitude, and high prejudice. More familiarity with schizophrenia was associated with low social distance, a positive attitude, and less prejudice. A high literacy score was associated with a positive attitude and less prejudice, but no significant correlation was observed with social distance (&lt;i&gt;β&lt;/i&gt; ± SE = −0.26 ± 0.14, &lt;i&gt;p&lt;/i&gt; = .057). Among respondents who rated their past contact experiences as negative, neither familiarity nor literacy was associated with social distance.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;High levels of self-rated familiarity and high literacy about schizophrenia were associated with low social distance, a positive attitude, and less prejudice towards schizophrenia among health professionals. Therefore, sufficient education and trainin","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2021-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39844132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profiling mentally ill offenders in Hong Kong: A 10-year retrospective review study","authors":"Bonnie Wei Man Siu FHKCPsych,&nbsp;Eric Shek Kin Lai MSocSc,&nbsp;Jessica Pui Yan Lam FHKCPsych,&nbsp;Clement Chan MSc,&nbsp;Anita Wai Lan Chan MSc,&nbsp;Kin Yan Chu MSc,&nbsp;Sek Lim Leong MPH,&nbsp;Sing Heung Lui FHKCPsych,&nbsp;Amy Ching Yung Liu FHKCPsych,&nbsp;Dorothy Yuen Yee Tang FHKCPsych,&nbsp;Wai Lam So FHKCPsych,&nbsp;Hon Wah Leung MBA,&nbsp;Cycbie Ching Man Mok MSc,&nbsp;Ming Lam FHKCPsych","doi":"10.1111/appy.12505","DOIUrl":"10.1111/appy.12505","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study aimed to analyze the estimated prevalence of mental disorders among offenders and compare the estimated crime rate between mentally ill patients and the total population in Hong Kong.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Service data of offenders referred to psychiatrists at the Siu Lam Psychiatric Centre from January 2011 to December 2020 were analyzed. Demographic data of gender, age on admission, educational level, principal psychiatric diagnosis, index offense, and assessment outcome were collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data of 7535 offenders (74.8% males) aged 14 to 97 (mean: 41.3 ± 13.7) years were analyzed. More than 60% (66.2%) had a diagnosable mental disorder. The most prevalent principal psychiatric diagnosis was schizophrenia and related disorder (22.8%), followed by mental and behavioral disorders due to psychoactive substance use (18.6%), and mood disorders (8.8%). The commonest index offenses were theft and related offenses (20.5%), followed by acts intended to cause injury (19.7%), and illicit drug offenses (11.6%). The estimated prevalence of mental illness among prison population was 7.1% (male: 8.2%, female: 5.0%). The estimated crime rate for mentally ill patients was found to be 43.3 to 263.2 per 100 000 population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The estimated prevalence of mental disorders among offenders and the estimated crime rate for mentally ill patients are relatively low in Hong Kong. The result was an important effort to document the changing characteristics of mentally ill offenders and provide an estimation of the prevalence and crime rate for mentally ill patients in Hong Kong.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39830086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpersonal psychotherapy for complex posttraumatic stress disorder related to childhood physical and emotional abuse with great severity of depression: A case report","authors":"Yuko Toshishige,&nbsp;Masaki Kondo,&nbsp;Tatsuo Akechi","doi":"10.1111/appy.12504","DOIUrl":"10.1111/appy.12504","url":null,"abstract":"Patients may develop posttraumatic stress disorder (PTSD)—a chronic and incapacitating disorder—following exposure to a traumatic events such as natural disaster, threat of death, serious injury, or sexual violence. In particular, PTSD associated with abuse during childhood is harmful owing to its association with multiple forms of trauma during childhood and adulthood; the traumas include emotional abuse, physical assault, sexual assault, and domestic violence (Coid et al., 2001). The International Classification of Diseases 11th Revision (ICD11) recently defined the diagnosis of complex PTSD (cPTSD) by disturbances in self-organization (DSO) through affective dysregulation, negative self-concept, and disturbed relationship in addition to the classical PTSD symptom cluster (Karatzias et al., 2017). Considering this, particularly overwhelming, long-lasting, repeated childhood traumas are considered a risk factor for the development of cPTSD (de Aquino Ferreira et al., 2018). Childhood abuse is also related to depression. Reportedly, recurrent and persistent depressive episodes were twice as likely to occur in patients who had experienced childhood abuse or neglect (Nanni et al., 2012). Furthermore, data from outpatient samples revealed that adults who have experienced childhood abuse and neglect present with depression that has a relatively higher severity, earlier age of onset, and longer illness duration (Miniati et al., 2010). In patients diagnosed with cPTSD, Powers et al. reported that the likelihood of having a secure attachment was reduced and susceptibility of comorbidity with other psychiatric conditions was increased, compared with those diagnosed with PTSD alone (Powers et al., 2017). Moreover, individuals with comorbid PTSD and major depression have higher suicide attempt rates than those with either disorder alone (Oquendo et al., 2005). Numerous expert bodies and pertinent treatment guidelines recommend cognitive behavioral therapy (CBT), in particular exposurebased treatment, as the first-line treatment for PTSD. However, not all PTSD patients benefit from exposure-based treatment, and the effectiveness of treatments for cPTSD has been less widely studied. For example, a meta-analysis found that PTSD remission was not observed in 17%–42% of patients who underwent an exposure-based treatment course, and PTSD continued to persist in 13%–50% of the patients who completed CBT with some variation of exposure-based treatment (Bradley et al., 2005). Despite recommendation and encouragement from experienced and persuasive clinicians, some patients do not wish to undergo exposure therapy (Markowitz et al., 2016). Moreover, the complex picture of PTSD includes strong interpersonal themes. Patients with PTSD have interpersonal difficulties, such as emotional withdrawal from relationships, because they mistrust not only their interpersonal environments but also their own selves (Bleiberg & Markowitz, 2005). Patients with cPTSD, which may be tr","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39794446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of modern technology in psychiatry training in a middle-income country","authors":"Sami Ouanes MD, MSc,&nbsp;Amine Larnaout MD,&nbsp;Lamia Jouini MD","doi":"10.1111/appy.12496","DOIUrl":"10.1111/appy.12496","url":null,"abstract":"<p>Recent advances in information technology (IT) provided us with novel teaching solutions, with the potential of a new enhanced learning experience, that is, more adapted to the needs and preferences of the younger generations of psychiatric trainees. These tools include the use of online/virtual whiteboards, live surveys/polls, live quizzes, virtual classrooms, and virtual reality. In the present paper, we describe the implementation of modern technology in psychiatric training in Tunisia, a North-African middle-income country. We discuss the potential benefits arising from this implementation, and we report the challenges and difficulties. Overall, the implementation of these modern technology-based tools in psychiatric training has been successful, with a very few obstacles. It seems that the integration of these novel approaches is possible even in middle and low-income countries without much hassle. These tools can enhance trainees' participation, motivation, and engagement, thereby potentially improving learning outcomes. Most disadvantages are related to potential technical glitches, and are likely to improve as technology progresses. Teaching is the art of tailoring the educational tools to the learning objectives and to the learners' characteristics and preferences. To achieve optimal learning outcomes, it is often needed to use a mixture of different “modern” and “less modern” techniques.</p>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"13 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/appy.12496","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39698800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}