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Objective: The authors characterized hearing loss among individuals diagnosed as having schizophrenia to inform provision of routine behavioral health services to this population., Methods: Audiometry data collected between October 2019 and December 2021 from 84 community-dwelling adults with schizophrenia and 81 age-matched participants without the condition were analyzed. Rates of hearing loss were identified within groups and across age decades (20-50 years). Hearing threshold and rates of hearing loss were compared between groups., Results: Participants with schizophrenia had significantly higher mean hearing thresholds (p=0.006), indicating worse hearing. This difference remained significant after controlling for age (p=0.01). A significantly larger proportion of participants with schizophrenia had mild hearing loss (24%) compared with age-matched participants (6%) (p = 0.002), with higher rates of mild hearing loss observed across all ages., Conclusions: Screening for and detection of hearing loss among adults with schizophrenia may be an unmet need. Hearing loss is a treatable source of cognitive and psychosocial disability, warranting scalable assessment and intervention practices.

The field of psychiatry has placed a growing emphasis on research-based diagnostic and treatment practices related to mental illness. Involuntary hospitalization is a controversial and potentially lifesaving intervention in psychiatric care; yet, to what degree is this practice evidence based? This Open Forum examines the ethical and logistical limitations to traditional research, such as randomized controlled trials and observational studies, surrounding involuntary psychiatric hospitalization. Given recent efforts across the United States to expand the use of involuntary hospitalization, the authors call for systematic data collection to monitor, study, and guide the use of this intervention.

Research safety protocols are ubiquitous in mental health research involving human subjects and have the potential to harm research participants from racial-ethnic minority populations. For mental health emergencies, such protocols commonly rely on law enforcement for crisis intervention. The authors review inequities experienced by individuals with mental illness in law enforcement encounters, especially Black, Latinx, and other minoritized populations. They then describe the development of a research safety protocol that uses community-based crisis intervention programs as alternatives to law enforcement and provide a roadmap for researchers and institutional review boards to revisit and revise their human subjects safety protocols.

Purpose: Social determinants of health (SDoH) impact psychiatric conditions. Routinely collected health data are frequently used to evaluate important psychiatric clinical and health services outcomes. This study explored how key SDoH are used in psychiatric research employing routinely collected health data., Methods: A search was conducted in PubMed for English-language articles published in 2019 that used routinely collected health data to study psychiatric conditions. Studies (n = 19,513) were randomly ordered for title/abstract review; the first 150 meeting criteria progressed to full-text review. Three key SDoH categories were assessed: (1) gender and sex, (2) race and ethnicity, and (3) socioeconomic status. Within each category, data were extracted on how variables were included, defined, and used in study design and analysis., Results: All studies (n = 103) reported on at least one of the key SDoH variables; 102 (99.0%) studies included a gender and/or sex variable, 30 (29.1%) included a race and/or ethnicity variable, and 55 (53.4%) included a socioeconomic status variable. No studies explicitly differentiated between gender and sex, and SDoH were often defined only as binary variables. SDoH were used to define the target population in 14 (13.6%) studies. Within analysis, SDoH were most often included as confounders (n = 65, 63.1%), exposures or predictors (n = 23, 22.3%), and effect modifiers (n = 14, 13.6%). Only 21 studies (20.4%) disaggregated results by SDoH and 7 (6.8%) considered intersections between SDoH., Conclusions: Results suggest improvements are needed in how key SDoH are used in routinely collected health data-based psychiatric research, to ensure relevance to diverse populations and improve equity-oriented research., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

The causal mechanisms and manifestations of psychiatric illness cannot be neatly narrowed down or quantified for diagnosis and treatment. Large-scale genome-wide association studies (GWAS) might renew hope for locating genetic predictors and producing precision medicines, however such hopes can also distract from appreciating social factors and structural injustices that demand more socially inclusive and equitable approaches to mental healthcare. A more comprehensive approach begins with recognizing that there is no one type of contributor to mental illness and its duration that should be prioritized over another. We argue that, if the search for biological specificity is to complement the need to alleviate the social distress that produces mental health inequities, psychiatric genomics must incorporate an intersectional dimension to models of mental illness across research priorities, scientific frameworks, and clinical applications. We outline an intersectional framework that will guide all professionals working in the expanding field of psychiatric genomics to better incorporate issues of social context, racial and cultural diversity, and downstream ethical considerations into their work., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Brown, Young and Martinez-Martin.)

Objective: The goal of this study was to examine and compare the psychometric properties of a patient-reported outcome measure (PROM) generated with patients’ input (Views on Inpatient Care [VOICE]) and a PROM conventionally generated without patients’ input (Service Satisfaction Scale: Residential Services Evaluation [SSS-Res]) for assessing a patient’s perception of psychiatric ward care., Methods: In a stepped-wedge cluster-randomized trial conducted in the United Kingdom, 1,058 participants admitted to 16 wards reported on their perceptions of care via VOICE and SSS-Res before or up to 2 years after the staff training. Exploratory and confirmatory factor analyses were used to investigate the structure of the PROMs and to assess reliability and convergent validity as well as sensitivity to change; the analyses also considered whether study participants had been admitted voluntarily to the ward., Results: Two factors emerged from VOICE, labeled “trust” and “involvement,” and from SSS-Res, labeled “environment” and “care,” at baseline. All subscales had high internal consistency and good convergent validity. An ability to detect change in care due to the staff training was observed on the trust subscale of VOICE (N=1,058, mean difference=−0.25, 95% CI=−0.48 to −0.02), but no change was detected on any of the SSS-Res subscales. Patients admitted involuntarily benefited the most from the staff training., Conclusions: VOICE captured patients’ perceptions of ward care better than SSS-Res and was sensitive to changes in aspects of trust, suggesting that participatory approaches for developing PROMs improve patients’ self-reports on the care they received.

Alcohol misuse during adolescence (AAM) has been associated with disruptive development of adolescent brains. In this longitudinal machine learning (ML) study, we could predict AAM significantly from brain structure (T1-weighted imaging and DTI) with accuracies of 73 -78% in the IMAGEN dataset (n∼1182). Our results not only show that structural differences in brain can predict AAM, but also suggests that such differences might precede AAM behavior in the data. We predicted 10 phenotypes of AAM at age 22 using brain MRI features at ages 14, 19, and 22. Binge drinking was found to be the most predictable phenotype. The most informative brain features were located in the ventricular CSF, and in white matter tracts of the corpus callosum, internal capsule, and brain stem. In the cortex, they were spread across the occipital, frontal, and temporal lobes and in the cingulate cortex. We also experimented with four different ML models and several confound control techniques. Support Vector Machine (SVM) with rbf kernel and Gradient Boosting consistently performed better than the linear models, linear SVM and Logistic Regression. Our study also demonstrates how the choice of the predicted phenotype, ML model, and confound correction technique are all crucial decisions in an explorative ML study analyzing psychiatric disorders with small effect sizes such as AAM., Competing Interests: RR, Ed, JK, KG, MT, MR, TB, AB, SD, HF, AG, HG, PG, RB, JM, MM, EA, FN, DP, HL, TP, LP, JF, LR, MS, JW, RW, GS, HW, AH, KR No competing interests declared, (© 2022, Rane et al.)

Objective: The objective of this project was to develop a set of patient-reported outcome measures for adolescents and adults who meet criteria for a psychotic disorder., Methods: A research team and an international consensus working group, including service users, clinicians, and researchers, worked together in an iterative process by using a modified Delphi consensus technique that included videoconferencing calls, online surveys, and focus groups. The research team conducted systematic literature searches to identify outcomes, outcome measures, and risk adjustment factors. After identifying outcomes important to service users, the consensus working group selected outcome measures, risk adjustment factors, and the final set of outcome measures. International stakeholder groups consisting of >100 professionals and service users reviewed and commented on the final set., Results: The consensus working group identified four outcome domains: symptoms, recovery, functioning, and treatment. The domains encompassed 14 outcomes of importance to service users. The research team identified 131 measures from the literature. The consensus working group selected nine measures in an outcome set that takes approximately 35 minutes to complete., Conclusions: A set of patient-reported outcome measures for use in routine clinical practice was identified. The set is free to service users, is available in at least two languages, and reflects outcomes important to users. Clinicians can use the set to improve clinical decision making, and administrators and researchers can use it to learn from comparing program outcomes.

Representation of people who identify as members of sexual and gender minority (SGM) groups is lacking in psychiatric research. Few researchers openly identify as members of an SGM group, and those who do continue to face career obstacles. Separately, in the context of psychiatric research studies, little attention has been paid to how participants' SGM identities might intersect with other factors to influence each individual's experience of mental illness. In this brief commentary, we summarize these and related issues, then offer suggestions for how institutions, professional societies, labs, and individuals might help to improve SGM representation in psychiatric research., (Published by Elsevier B.V.)

The conduct of clinical psychiatric research is critical to advance the science and efficacy of treatment while also safeguarding the interests of participants. This article emerges from the authors' experience, providing practical guidance to colleagues seeking input on how to design and implement clinical research protocols in accordance with key ethical considerations. Thus, the intent of this article is to provide (1) an overview of common ethical considerations when conducting psychiatric clinical research along with (2) practical advice for preparing Institutional Review Board applications and associated materials in the ethical conduct of psychiatric clinical research., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: The prevalence of mental health disorders is increasing globally. Countries in South Asia, Southeast Asia and the Middle East regions carry high burdens of mental health need; however, there are relatively few mental health research publications from this region, suggesting inadequate research funds and a paucity of qualified research personnel. To increase and strengthen the pool of mental health researchers in India and Egypt, we conducted three psychiatric research programmes in these countries: the Training Program for Psychiatric Genetics in India (2002-2011), the Tri-National Training Program for Psychiatric Genetics (2009-2014) and the Cross-Fertilized Research Training for New Investigators in Egypt and India (2014-2019). A total of 66 trainees, including psychiatrists, psychiatric social workers, clinical psychologists and research psychologists, were supported in research development, which included didactic training, proposal development, hands-on research and manuscript preparation., Methods: The aim of this study is to evaluate these three training programmes using the four-level Kirkpatrick Model of Training Evaluation that assesses reaction, learning, behaviour and outcomes. A descriptive analysis was used to explore the data collected throughout the duration of the three training programmes. Online surveys were crafted and sent to the mentors and trainees of the three programmes to supplement objective training data., Results: In addition to positive changes in the areas of reaction, learning and behaviour, significant outcomes were demonstrated. As of the writing of this manuscript, the trainees published a total of 130 papers, 59 as first author. In addition, 26 trainees have co-authored papers with one or more trainees or mentors, which demonstrates successful research networking and collaboration., Conclusion: Our findings suggest that our training approach is a successful model for building independent mental health researchers. This is a critical step in the development of effective mental health interventions in low- and middle-income countries.

The ClinicalTrials.gov registry was established in 2000 to address concerns about publication bias and public access to information about clinical trials. We aimed to evaluate differences between for-profit and non-profit sponsors of efficacy mental health trials registered in ClinicalTrials.gov on key trial characteristics that relate to data integrity. We also sought to evaluate whether the registry is fulfilling its purpose as a means of promoting transparency between researchers and the public by providing complete and quality information about the trials it contains. We found that trials tend to be small, use a placebo instead of an active comparator, and employ randomization and blinding. We discuss the implications of these design characteristics and the limitations of the registry., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The communication between G. S Bose and Sigmund Freud is a well-documented fact, and philosophical blend of rich cultural experiences is unique to modification of traditional psychoanalysis in the context of development of psychiatry in West Bengal. The Calcutta lunatic asylum was established at Bhowanipore, and first general hospital psychiatric unit was formed at R. G. Kar Medical College, Calcutta. Prof. Ajita Chakraborty was a pioneer to describe her struggling days in the early career and shared her views with experiences in her autobiography. The volume and quality of research work, especially in the field of epidemiology led by Dr. D. N. Nandi is worth mentioning. A jail had been converted to mental hospital which is the largest in terms of bed strength ( n = 350) at Berhampore, Murshidabad district where Kazi Nazrul Islam and Netaji Subhas Chandra Bose had spent some period as prisoner during British rules. Bankura was the first district in West Bengal to start District Mental Health program. The various nongovernmental organizations are working together in public-private partnership model or indigenous ways in tandem over years for the betterment of mental health services both at institutional and community level., Competing Interests: There are no conflicts of interest.

What happens when health research is measured by market size? How does this change the dynamics of medical research, and how is its growth envisioned and managed? In this article, I build on my arguments in Drugs for Life: How Pharmaceutical Companies Define our Health, which focused primarily on the development and marketing of mass medications for heart disease and I examine the market dynamics that are used to drive research into and out of psychiatric and other neuromedicines, such as the closing of mental health research at most major pharmaceutical companies. Industry compares entire sectors of medical research to evaluate their relative chances of profits and growth; it is willing to sacrifice a whole region of effective and profitable medicine if it can grow profits more in other regions. Baudrillard, Pignarre, and Stengers are used to consider whether this situation can best be described as one of infernal alternatives, and how to analyze the responses of psychiatric leaders.

One of the major goals of basic studies in psychiatry is to find etiological mechanisms or biomarkers of mental disorders. A standard research strategy to pursue this goal is to compare observations of potential factors from patients with those from healthy controls. Classifications of individuals into patient and control groups are generally based on a diagnostic system, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases ( ICD ). Several flaws in these conventional diagnostic-based approaches have been recognized. The flaws are primarily due to the complexity in the relation between the pathogenetic factors (causes) and disorders: The current diagnostic categories may not reflect the underlying etiological mechanisms. To overcome this difficulty, the National Institute of Mental Health initiated a novel research strategy called Research Domain Criteria (RDoC), which encourages studies to focus on the neurobiological mechanisms and core aspects of behavior rather than to rely on traditional diagnostic categories. However, how RDoC can improve research in psychiatry remains a matter of debate. In this article, we propose a theoretical framework for evaluating psychiatric research strategies, including the conventional diagnostic category-based approaches and the RDoC approach. The proposed framework is based on the statistical modeling of the processes of how the disorder arises from pathogenetic factors. This framework provides the statistical power to quantify how likely relevant pathogenetic factors are to be detected under various research strategies. On the basis of the proposed framework, we can discuss which approach performs better in different types of situations. We present several theoretical and numerical results that highlight the advantages and disadvantages of the strategies. We also demonstrate how a computational model is incorporated into the proposed framework as a generative model of behavioral observations. This demonstration highlights how the computational models contribute to designing psychiatric studies., Competing Interests: Competing Interests: The authors declare no conflicts of interests.

Research dissemination is becoming more and more global. There is, however, limitation in allowing researchers who speak a language other than Chinese to follow the research trends in China, a country with the largest population in the world. Therefore, the purpose of this review article was to introduce the current research studies conducted in Mainland China. We limited our search of publications between 2012 and 2013 from three tier one Chinese mental health journals. We identified and reviewed seven papers which were highly downloaded by Chinese readers and which had not been published in English., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Low-and middle-income countries (LAMIC), with more than 80% of the global population, bear the greatest burden of mental disorders. Yet these countries are very under-represented in published psychiatric research. There are barriers to publication of mental health research from LAMIC and to the representation of research from these countries in the main literature databases worldwide. The World Psychiatric Association (WPA) aimed to help investigate the reasons for the under-representation of LAMIC in published psychiatric research and consider how to support improved research dissemination, relevant for better mental health and mental health care in all countries. As part of its work plan for the years 2008 to 2011, WPA developed a project to encourage efforts to offer support to psychiatric journals in LAMIC. A WPA publications taskforce was appointed in 2008 to promote the dissemination of research from LAMIC. The taskforce began work together with journal editors to strengthen their chances of being indexed in international databases. Among the first journals participating in the project was the IJP, which is now an inspiration and source of support for other journals.

Asia has some of the largest conglomerations of human populations and also the fastest growing economies of the world. About 23% of the world's population lives in the South Asian region, and one-fifth of psychiatrically ill patients in the world live in this part of the world. Despite vast cultural, religious, geographical, and political diversities, the factors influencing mental health remain the same throughout this wide region, as highlighted at the recently concluded Asian summit, where the slogan, 'One vision, one identity, one community,' was launched. Thus, the need to strengthen regional cooperation in the field of mental health has always been felt. This article highlights facts about influence of Indian Psychiatry research as well as of some Asian countries in the world psychiatry and vice versa.

The need for good research in psychiatry has never been more important than in this era of 'Evidence-based medicine' (EBM).[1] The countries in south Asia have to rise to the challenge and abandon the emphasis placed on 'Experiencebased medicine', as was popular in the traditional systems of medicine - the art was handed down from father to son or guru to shishya (student).Evidence-based medicine does not abandon clinician experience, skills, and judgment, but rather complements it with the best available evidence and patient choice.[2] This article explores the challenges in obtaining the best available evidence in the south Asian context.

The classically structured clinical trial does not offer enough flexibility to make use of continuously emerging knowledge that is generated as the trial progresses. In this regard, there are consistent issues impeding effective psychiatric research, including limitations in efficiency, difficulty demonstrating significant differences between treatment arms, poor external validity, and ethical constraints. For example, research in the field of psychiatry shows that it is growing increasingly more challenging to demonstrate superiority of interventions to placebo in part related to the increasing placebo response rates. Various design innovations and other tricks of the trade have surfaced to improve sensitivity towards detecting drug-placebo differences and reduce sources of bias in psychiatric research. Diverse strategies have been developed to address these obstacles and improve the outcomes of clinical research in psychiatry. The current review highlights many of these innovations and describes examples of their practical use, mainly focusing on the study design and conduct perspectives. In the study design issues, adaptive, equipoise stratified, sequential parallel and effectiveness design will be explored. The proper strategies for pragmatic and ethical conduction of clinical trials will be also discussed in-depth.

Background: Reporting of informed consent and ethical approval are important aspects of published papers which indicate the knowledge and sensitivity about ethical aspects of research by the researchers., Materials and Methods: This study reports description of informed consent and ethical approval in the published psychiatric research in the main journal of psychiatry in India. All original research articles (n=157) published in the Indian Journal of Psychiatry in the years 2000, 2003 to 2007 were included., Results: Informed consent was mentioned in 51% of studies in 2000, which gradually rose to 82% by the year 2007. Ethics committee approvals were mentioned in 2% of studies in 2000, and 25% of reports in 2007. Consent was reported to be written in only 40%, content of the consent forms was mentioned in 17%, and the language of consent form was reported in 3% of the studies where consent was reported., Conclusions: Regulation of ethical principles and formulation of necessary guidelines or rules for research as well as for publications are necessary and desirable to ensure the safety of participants and good quality of research.

It is getting more difficult to get papers published that it used to be, even though many more journals are available. This article is written mainly for young researchers who are ambitious to get their research published in the best possible journals. A systematic strategic policy is suggested that does not necessarily contradict the aims of achieving the best possible science.

Most clinicians and researchers are concerned with recent advances in psychiatry. This involves the danger whether something time-tested may get sidelined for extra-scientific reasons. That the pharmaceutical industry and superspecialist researcher may keep churning out new findings to impress audiences is only a partial truth. Research progresses by refutation and self-correction. Acceptance in science is always provisional; changing paradigms, frameworks of enquiry and raising new questions is integral to break through in scientific knowledge. Hence, there is in science a constant concern with the new. Moreover, the number of treatment non- responders to the time-tested swells with time, and researchers feel challenged to find ways and means of resolving their difficulties. Newer challenges need newer strategies. Obsession with the most recent can lead us astray, but a healthy evidence-based acceptance of the new is essential for advancement in psychiatric research. As indeed of research in all fields of medicine. And of science in general. The role of lithium and newer mood stabilizers in bipolar disorders are taken as examples to highlight this point.