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Perinatal depression can have enduring adverse effects on women and their children and families, incurring substantial ongoing economic and personal costs. A significant proportion of the cost of perinatal depression relates to adverse impacts on the child, most likely mediated through impairment to the mother-infant relationship. In recognition of this problem, Australia has invested in routine perinatal depression screening. Our previous research produced convergent findings suggesting that expected benefits for children have not yet been realised through perinatal depression screening. We question the potential of including a measure of personality in current perinatal depression screening for identifying maternal mental health problems and suboptimal mother-infant relationships. This paper reviews our previous research findings within the broader context of perinatal depression screening. We propose a position, that perinatal depression screening in Australia should be redesigned to more precisely detect vulnerable mother-infant relationships, parenting, maternal mental health, and infant psychosocial and psychological development. Practice change to appropriately target antenatal interventions may more efficiently improve both maternal and child outcomes, thereby contributing to greater efficiency and cost savings for the health system.

The World Association for Infant Mental Health (WAIMH) decided to compose a position paper on infants' rights in wartime, as there is still a general lack of attention paid to the impact of war-related traumas on infants' development and psychological health. Though there are numerous areas of violent conflicts around the globe, there have been few published studies that relate specifically to infants. Consequently, humanitarian aid programs tend to overlook infants' psychological needs and to pay more attention to those of older children. This position paper first reviews the studies identified through a literature search, about the impact of war-related traumas during pregnancy and postnatal periods, then describes the existing recommendations that have been added to the Children Rights Convention and their implications for infant mental health clinicians.

Recently, the Association of University and College Counseling Center Directors (AUCCCD) published a White Paper on a multidimensional understanding of organizational structures for counseling cent...

There is a need for a paradigm shift across mental health in primary care to improve the lives of millions of Europeans. To contribute to this paradigm shift, the European Forum for Primary Care (EFPC-MH) working group for Mental Health, produced a Position Paper for Primary Care Mental Health outlining 14 themes that needed prioritizing. These themes were developed and discussed interactively during the EFPC conferences between 2012 and 2019. The Position Paper on Mental Health gives direction to the necessary improvements over the next ten years. The themes vary from preferable healthcare model to the social determinants highlighting issues such as inequalities. The Statement of Mental Health in Primary Care will be established in cooperation with fellow organizations. ispartof: Primary Health Care Research And Development vol:21 issue:e56 pages:1-8 ispartof: location:England status: published

There is a need for a paradigm shift across mental health in primary care to improve the lives of millions of Europeans. To contribute to this paradigm shift, the European Forum for Primary Care (EFPC-MH) working group for Mental Health, produced a Position Paper for Primary Care Mental Health outlining 14 themes that needed prioritizing. These themes were developed and discussed interactively during the EFPC conferences between 2012 and 2019. The Position Paper on Mental Health gives direction to the necessary improvements over the next ten years. The themes vary from preferable healthcare model to the social determinants highlighting issues such as inequalities. The Statement of Mental Health in Primary Care will be established in cooperation with fellow organizations.

Open Dialogue is a need-adapted approach to mental health care that was originally developed in Finland. Like other need-adapted approaches, Open Dialogue aims to meet consumer’s needs and promote collaborative person-centred dialogue to support recovery. Need-adapted mental health care is distinguished by flexibility and responsiveness. Fidelity, defined from an implementation science perspective as the delivery of distinctive interventions in a high quality and effective fashion is a key consideration in health care. However, flexibility presents challenges for evaluating fidelity, which is much easier to evaluate when manualization and reproducible processes are possible. Hence, it remains unclear whether Open Dialogue and other need-adapted mental health interventions can be meaningfully evaluated for fidelity. The aim of this paper was to critically appraise and advance the evaluation of fidelity in need-adapted mental health care, using Open Dialogue as a case study. The paper opens a discussion about how fidelity should be evaluated in flexible, complex interventions, and identifies key questions that need to be asked by practitioners working in need-adapted mental health care to ensure they deliver these interventions as intended and in an evidence-based fashion.

This is part one of a series of two papers exploring a project that was conducted by two Australian Aboriginal researchers, one male and one female, and might be described as ‘reverse anthropology’, in the same way that people sometimes refer to positive discrimination as ‘reverse racism’. But we would just call it anthropology; a tidal river is still a river when it flows back the other way. The project could hardly be acknowledged as anthropology though, as it was based on Indigenous methods of inquiry that do not yet belong to a formal discipline. Initially the goal was to disrupt Australian colonial narratives of ‘black-on-black violence’ and hold up a mirror to the occupying culture, by applying customary Indigenous conflict protocols to an analysis of online street fight videos featuring settlers from various colonies. However, our early encounters with the field revealed that public violence in settler communities is a lot more rule-governed than we had expected, inspiring us to a deeper investigation that went beyond critique and culture jamming. These findings are reported in the second paper, while the first contains the literature review and outlines the Indigenous methods of inquiry and theoretical approach to the field, which will be of utility to researchers even in unrelated disciplines.

Positive psychology has fully examined the flourishing among healthy people but neglected to understand how "optimal human functioning" can apply to the life experiences of a vulnerable person. Considering methodological issues, this article gives a brief overview on how the conceptualization of mental health and mental disorders affects the consideration of strengths along with the presence of dysfunction with the emergence of positive psychology. First, we summarize the shortcomings of the applicability of clinical positive psychology, focusing especially on Hungarian clinical practice. Second, we discuss the problems with the conceptualization of mental health in positive psychological framework. Third, we propose a model, the Maintainable Positive Mental Health Theory based on capacities and competences. Finally, we conclude with methodological questions and present a research protocol. The key finding of our review is that the opportunity exists for psychiatrists and psychologists to embrace disability as part of human experiences and to show how people with vulnerabilities can be supported to recover. (Neuropsychopharmacol Hung 2022; 24(3): 113-119).

Clinical research relies on patients being willing to participate in research projects, and making this possible for patients with mental health problems can be a particular challenge. In the modern era, many countries have seen a movement to give a stronger voice to patients both in choices around their care and in how research is conducted. How to achieve effective patient and public involvement (PPI) and to make the patients real partners in this effort is itself a subject of research evaluation. This opinion piece—based on a keynote lecture given at the European General Practice Research Network 2017 autumn meeting in Dublin—describes both the reasons for expanding PPI, how it can usefully be achieved, and how this may relate to the particular context of mental health. There can be moral, methodological or policy reasons for PPI. The three commonest models of good practice in PPI are the ‘one off,’ the ‘fully embedded’ and the ‘outreach’ models. In research into common mental health problems in family practice, ‘outreach’ approaches that minimize commitment over time may work best. ‘Expert patients’ from mental health charities can sometimes play this role. PPI may be challenging and involve extra effort, but the gains for all may be considerable. Wonca Europe networks including EGPRN can extend this message and findings.

A systematic review of publications from 7 databases on the hypothesis of chemical imbalances causing mental distress ("the chemical imbalance theory")

The prevalence and public health burden of chronic heart failure (CHF) in Europe is steadily increasing mainly caused by the ageing population and prolonged survival of patients with CHF. Frequent hospitalizations, high morbidity and mortality rates, and enormous healthcare costs contribute to the health-related burden. However, multidisciplinary frameworks that emphasize effective long-term management and the psychological needs of the patients are sparse. The present position paper endorsed by the European Association of Preventive Cardiology (EAPC) provides a comprehensive overview on the scientific evidence of psychosocial aspects of heart failure (HF). In order to synthesize newly available information and reinforce best medical practice, information was gathered via literature reviews and consultations of experts. It covers the evidence for aetiological and prospective psychosocial risk factors and major underlying psycho-biological mechanisms. The paper elucidates the need to include psychosocial aspects in self-care concepts and critically reviews the current shortcomings of psychotherapeutic and psycho-pharmacological interventions. It also highlights the need for involvement of psychological support in device therapy for patients with HF and finally calls for better palliative care in the final stage of HF progression.

The physical demands of daily life in developed countries have decreased remarkably during the last two centuries. General leisure time has increased and the age at retirement has decreased. General health has improved and life expectancy has increased. Most people can expect to live 20-30 years after retirement. By 2050, one in four people in Europe and North America will be aged 65 or over. Furthermore, women live longer than men. Generally, the physical demands on older women will be low. Thus, their physical fitness will decline, which in turn will affect a variety of organ systems and functions, and so impact on mental health, quality of life and independent living. This opinion paper explores exercise strategies for healthy ageing.

This is the second article in a series written to present and address the position of the International Society of Psychiatric-Mental Health Nurses (ISPN) related to the notion of behavioral healthcare integration and the role of nurses in the 21st century. The first article addressed assumptions, definitions and roles related to the integration of behavioral healthcare. The purpose of this article is to focus on Integrated Care within the context of recent initiatives that endeavor to improve quality, safety and reduce costs in the US healthcare system also known as the "Triple Aim" (or more recently, the Quadruple Aim). This paper specifically focuses on the role of nurses and nursing practice by: (a) connecting the concept of integrated behavioral healthcare to quality improvement (QI) and the Quadruple Aim, and (b) highlighting examples of models of integration currently in use. Discussion of models of integration compares ways various models reinforce and actualize integration of behavioral health within primary care, in various special populations across the continuum of care, and in both inpatient and community settings. This paper also stresses innovative training programs offering nurses the skills for learning behavioral health integration through online modules and participation in Interprofessional Education (IPE) activities often through simulation approaches. This 2nd manuscript is consistent with the ISPN 2016 Position Paper and reinforces the necessity for all nurses to be educated on both the Quadruple Aim and behavioral health integration to improve patient care and subsequent care outcomes.

Introduction A positive childbirth experience promotes women’s health, both during and beyond the perinatal period. Understanding what constitutes a positive childbirth experience is thus critical to providing high-quality maternity care. Currently, there is no clear, inclusive, woman-centered definition of a positive childbirth experience to guide practice, education, and research. Aim To formulate an inclusive woman-centered definition of a positive childbirth experience. Methods A six-step process was undertaken: (a) Key concepts associated with a positive childbirth were derived from a rapid literature review; (b) The key concepts were used by interdisciplinary experts in the author group to create a draft definition; (c) The draft definition was presented to clinicians and researchers during a European research meeting on perinatal mental health; (d) The authors integrated the expert feedback to refine the working definition; (e) A revised definition was shared with women from consumer groups in six countries to confirm its face validity; and (f) A final definition was formulated based on the women’s feedback (n = 42). Results The following definition was formulated: “A positive childbirth experience refers to a woman’s experience of interactions and events directly related to childbirth that made her feel supported, in control, safe, and respected; a positive childbirth can make women feel joy, confident, and/or accomplished and may have short and/or long-term positive impacts on a woman’s psychosocial well-being.” Conclusions This inclusive, woman-centered definition highlights the importance of provider interactions for facilitating a positive childbirth experience. Feeling supported and having a sense of control, safety, and respect are central tenets. This definition could help to identify and validate positive childbirth experience(s), and to inform practice, education, research, advocacy, and policy-making. CC BY-NC-ND 4.0Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)© 2022 The Authors. Birth published by Wiley Periodicals LLC.First published: 05 July 2022Correspondence Julia Leinweber, PhD, RM, Institute of Midwifery, Charité - University Medicine Berlin, Oudenarder Strasse 16, 13347 Berlin, Germany. Email: julia.leinweber@charite.de

Question Most adolescents live in low- and middle-income countries (LMIC), and about 10% of them face mental problems. The mental health provision gap in low- and middle-income countries could be addressed by evidence-based practices, however costs are implementational barriers. Digitalization can improve the accessibility of these tools and constitutes a chance for LMIC to use them more easily at a low cost. We reviewed free and brief evidence-based mental health assessment tools available for digital use to assess psychopathology across different domains in youth. Methods For the current study, instruments from a recent review on paper-based instruments were re-used. Additionally, a systematic search was conducted to add instruments for the personality disorder domain. We searched and classified the copyright and license terms available from the internet in terms of free usage and deliverability in a digital format. In the case that this information was insufficient, we contacted the authors. Results In total, we evaluated 109 instruments. Of these instruments, 53 were free and digitally usable covering 11 mental health domains. However, retrieving information on copyright and license terms was very difficult. Conclusions Free and digitally adaptable instruments are available, supporting the strategy of using instruments digitally to increase access. The instrument’s authors support this initiative, however, the lack of copyright information and the difficulties in contacting the authors and licence holders are barriers to using this strategy in LMIC. A comprehensive, online instrument repository for clinical practice would be an appropriate next step to make the instruments more accessible and reduce implementation barriers.

This position paper aims to increase awareness among primary care practitioners and policymakers about the specific and complex health needs of people who experience incarceration. We focus on the importance of primary care and of continuity of care between prison and community. We highlight what is known from the literature on the health of people who experience incarceration, on the organisation of prison health care, and on the role of primary care both during and after detention. We present three case descriptions of detainees’ encounters with the organisation of prison health care in three European countries. Finally, we describe the position that the European Forum for Primary Care takes. Prisoners and ex-prisoners have a worse physical and mental health compared with a cross-section of the population. However, access to good quality treatment and care is often worse than in the outside situation. In particular, well-organised primary care in the prison context could benefit prisoners and, indirectly, society at large. Moreover, continuity of care between the community and the prison situation needs improvement.

Psychiatric genomics has the potential to radically improve the prevention and early intervention of serious mental and neurodevelopmental disorders worldwide. However, little work has been done on the ethics of psychiatric genomics – an oversight that could result in poor local uptake, reduced practical / clinical application, and ethical violations in this rapidly developing area of scientific research. As part of the Global Project of the Stanley Center for Psychiatric Research, Global Initiative in Neuropsychiatric GenEthics (NeuroGenE) based at the University of Oxford aims to embed ethical inquiry within scientific investigation and engage with fundamental ethical questions around a psychiatric genomics approach to mental and neurodevelopmental disorder. This position paper sets out the core aims of the NeuroGenE research programme and explores the importance of a cross-cutting research orientation in this field based on multidisciplinary methodologies which can ensure that efforts to translate and apply global psychiatric genomics in public policy and clinical practice are ethically grounded strategies, respectful of different cultures and contexts.

More than 150,000 in Europe and 800,000 people worldwide, die every year by suicide (WHO, 2015), accounting for 1·4% of all annual deaths. Suicide is the second, and in some European countries even the first leading cause of death amongst young people aged 15-24 years (WHO, 2015), thus exceeding the number of accidental deaths.The European parliament resolution on Mental Health 2008/2209 (INI) adopted a series of recommendations for European member states. It proposed areas for priority action as defined in the European Pact on Mental Health and Well-Being. Recently, 29 suicide prevention experts from 17 European countries (The Task Force for the European Evidence-Based Suicide Prevention Program, EESPP) performed a systematic review of evidence for the effectiveness of suicide prevention interventions that has been published over the last decade. During three face-to-face meetings, the EESPP group developed a consensus declaration that, based on the findings of the systematic reviews, summarizes the minimal requirements for a national suicide prevention programs and of the strategies to employ.

Background: Poor mental health is considered a major health challenge globally, not least for young people, who will form families within forthcoming years. Research related to childbirth and parenthood transition has focused on how to promote good mental health by preventing mental illness. Aim: We discuss how a salutogenetic approach to mental health in parenthood transition is beneficial, and specifically how the component of meaningfulness in Sense of Coherence (SoC), could be investigated to optimize good mental health during parenthood transition. Discussion: In more recent understandings of meaningfulness, ideas from existential philosophy and psychology have been included. We discuss how, from an existential psychological perspective, open and explorative questioning of life conditions and dilemmas may help to regain one's footing and get in touch with one's driving force – meaningfulness. Such questioning implies that someone, a professional or a friend, actively and relationally helps explore existential aspects of life. Conclusion: We believe that investigating and asking research questions pointing at optimizing a salutogenetic perspective, specifically focusing on the component of meaningfulness and its embedded existential aspects of life, could lead to new knowledge on how to promote good mental health in maternity care.

Research is urgently needed to help understand the mental health consequences of the covid-19 pandemic on healthcare workers and the public, researchers have argued in a position paper published in the Lancet Psychiatry .1 The paper, funded by the Academy of Medical Sciences, looks at the psychological, social, and neuroscientific effects of covid-19. It warns of major adverse consequences of the pandemic, including increased social isolation and loneliness, which are “strongly associated with anxiety, depression, self-harm, and suicide attempts across the lifespan.” The authors suggest a number of immediate and longer term actions to mitigate the mental health consequences of this pandemic and any similar future situations, including better monitoring systems and rapidly rolling out evidence based programmes and treatments that can be accessed remotely. These priorities were informed by two surveys of the public and a panel of 24 experts, including people with lived experience of a mental health issue. The surveys, conducted by Ipsos MORI (1099 people) and the mental health research charity MQ (2198 …

Adopting a children’s rights perspective, a critique and analysis underpinned by documentary research methodology was undertaken in order to assess the extent to which the government’s Green Paper (Department of Health and Social Care and Department of Education, 2017. Transforming children and young people’s mental health provision: a green paper. Available at: https://www.gov.uk/government/consultations/transforming-children-and-young-peoples-mental-health-provision-a-green-paper (accessed 7 December 2017)) addresses the mental health and well-being needs of refugee children and young people in England and Wales, identifying strengths, limitations and challenges for future policy and practice. Findings suggest that there is much of potential benefit to refugee children and young people’s future mental health and well-being. However, a paradigm shift, explicit in implications, scale and time frame, will be required, if the Green Paper is to achieve those changes in attitudes, practice and service delivery which it anticipates. We argue that this Green Paper’s overarching challenge is that it is premised on Western-centric models in its understanding of the experiences of refugee children and young people, and management of trauma and mental health. It fails to recognize the meanings and significance of culture, and of diversity and difference, and the need to invest in all communities in facilitating engagement and support for children and young people’s mental health issues.

Background Expectations of pregnant women regarding parenthood are often positive. Nevertheless, their experiences are not always in line with these expectations. Unmet parenthood expectations, when experiences are not as positive as expected, might lead to poorer adjustment to parenthood and to mental health problems. There are some indications that social support might have a protective role. Aims and Objectives To test the buffering hypothesis, i.e. that social support reduces the negative effect of unmet expectations on anxiety and depression across the transition to motherhood. Method 98 Dutch mothers (Mage = 31.81; 62% primiparous) completed a questionnaire four months before giving birth (average) about their expectations regarding motherhood, feelings of anxiety and depression (T1) and a second questionnaire eight months after giving birth (average) regarding their motherhood experiences, feelings of anxiety and depression and experienced social support (T2). Multiple regression analyses were used with anxiety and depression at T2 as the dependent factors, unmet parenthood expectations (differences between expectations and experiences), social support (a lot or a little) and the interaction between unmet parenthood expectations and social support as the independent factors, and anxiety and depression at T1 as control variables. Results Mothers with unmet expectations (when experiences are not as positive as expected) had increased feelings of anxiety and depression. This relationship existed regardless of mothers’ experienced social support. Interpretation / Discussion To help mothers make the transition to motherhood, one could steer towards realistic expectations in pregnancy consultations and courses. Conclusions Mothers report more feelings of anxiety and depression when parenthood expectations during pregnancy are not met during the first year of the child. Social support does not have a buffering role in this relationship.

IntroductionUnderstanding the complexities of change in eating behaviours, mental health, well-being and weight is crucial to inform healthcare and service provision, particularly in light of the exacerbating effects of the COVID-19 pandemic. This study aims to address the need for more comprehensive cross-sectional and longitudinal evidence, by tracking eating behaviours, mental health, health related behaviours and weight over a 12-month period, in a sample of young adults (18–35 years) in the UK and Australia.Methods and analysisOnline surveys administered via the Prolific online research platform will be used for data collection at baseline, 6 months and 12 months. The survey (approximately 45 min) measures demographics, the impact of COVID-19, body mass index (BMI), weight management and health service usage, eating behaviours, personality, mental health, and health-related behaviours. An optional substudy component at each time point aims to validate self-reported weight in the main survey through images. Study inclusion criteria are; aged 18–34 years at baseline, BMI ≥20 kg/m2, and residing in the UK or Australia. A target of 500 participants at baseline was set, recruited through Prolific, and with recruitment stratified by BMI, sex and country. The proposed analyses include creating static predictive models using baseline data (eg, using latent class analysis, factor analysis or similar), and mapping changes longitudinally (eg, using multivariate regressions). These analyses will enable changes in the study measures to be identified, as well as predictors and outcomes of change.Ethics and disseminationEthical approval was granted by Leeds Beckett University, UK (reference number 86004) and the University of Newcastle, Australia (reference number H-2022–0110). Study findings will be disseminated through scientific journals, conferences, institute websites and social media, and briefings tailored to policy, practice and the public, with the intention to help inform the future development of health and well-being care and support for young adults across Australia and the UK.

Mental illness accounts for about one-third of adult disability globally, reflecting marked societal and personal suffering, and enormous social and economic costs. On a global level, mental healthcare has failed to adequately address urgent unmet needs of the mentally ill. These circumstances call for change in the paradigm and practices of mental healthcare, including fundamental reforms in education, clinician-training, and research priorities. This White Paper outlines current challenges in mental healthcare, and characterizes the emerging field of Integrative Mental Health (IMH), a critical element in the large-scale changes needed to transform mental healthcare in the 21st century. Strategic recommendations for advancing IMH are outlined including increasing research in key areas, improving clinician training and education, and promoting a public health agenda. The field of IMH adopts the bio-psycho-socio-spiritual model, utilizing evidence-based and evidence-guided treatments from both traditional healing systems and modern scientific practices. IMH incorporates mainstream interventions including the judicious use of psychopharmacology and psychosocial therapies, in addition to evidence-based complementary and alternative (CAM) medicines and therapies, and health-promoting lifestyle changes (i.e. enhancement of dietary, exercise, sleep, work/relaxation patterns). The clinical application of IMH takes into account the range of socio-cultural, economic and spiritual considerations affecting mental healthcare practice in different countries. To meet the challenges facing mental healthcare, the International Network of Integrative Mental Health (INIMH: www.INIMH.org) was established in 2010 (officially launched in October 2012) with the objective of creating an international organization consisting of clinicians, researchers, educators, and public health advocates. INIMH was created to advance a global agenda for research, education and the clinical practice of evidence-based integrative mental healthcare. In authoring this White Paper, the board of INIMH is inviting global dialogue on critical issues surrounding mental health care in the hope of achieving integrated, compassionate, individualized, person-centered mental healthcare.

Background The computerized administration of self-report psychiatric diagnostic and outcomes assessments has risen in popularity. If results are similar enough across different administration modalities, then new administration technologies can be used interchangeably and the choice of technology can be based on other factors, such as convenience in the study design. An assessment based on item response theory (IRT), such as the Patient-Reported Outcomes Measurement Information System (PROMIS) depression item bank, offers new possibilities for assessing the effect of technology choice upon results. Objective To create equivalent halves of the PROMIS depression item bank and to use these halves to compare survey responses and user satisfaction among administration modalities—paper, mobile phone, or tablet—with a community mental health care population. Methods The 28 PROMIS depression items were divided into 2 halves based on content and simulations with an established PROMIS response data set. A total of 129 participants were recruited from an outpatient public sector mental health clinic based in Memphis. All participants took both nonoverlapping halves of the PROMIS IRT-based depression items (Part A and Part B): once using paper and pencil, and once using either a mobile phone or tablet. An 8-cell randomization was done on technology used, order of technologies used, and order of PROMIS Parts A and B. Both Parts A and B were administered as fixed-length assessments and both were scored using published PROMIS IRT parameters and algorithms. Results All 129 participants received either Part A or B via paper assessment. Participants were also administered the opposite assessment, 63 using a mobile phone and 66 using a tablet. There was no significant difference in item response scores for Part A versus B. All 3 of the technologies yielded essentially identical assessment results and equivalent satisfaction levels. Conclusions Our findings show that the PROMIS depression assessment can be divided into 2 equivalent halves, with the potential to simplify future experimental methodologies. Among community mental health care recipients, the PROMIS items function similarly whether administered via paper, tablet, or mobile phone. User satisfaction across modalities was also similar. Because paper, tablet, and mobile phone administrations yielded similar results, the choice of technology should be based on factors such as convenience and can even be changed during a study without adversely affecting the comparability of results.

Background: The strengths and difficulties questionnaire (SDQ) is one of the most common screening tools to detect children and adolescents who are at risk of mental health problems or have psychiatric disorders. The standard mode of SDQ completion is on paper; however, some studies used phone administration and argued that this is a feasible and valid method that can substitute in-person administration. However, few studies have investigated the validity and reliability of phone administration of the SDQ. Objectives: The current study aimed to compare the telephone versus paper-and-pencil administration of the SDQ among Iranian child and adolescent outpatients. Methods: Sixty six parents with children aged 3 to 15 years completed the SDQ questionnaire using paper-and-pencil and telephone interview techniques. The study was performed in 2016, and participants were from the city of Tehran (capital of Iran). Participants were first divided into two groups. Then, one of them first completed the questionnaire using the face-to-face interviews, and 3 to 4 days later, they again completed the questionnaire using the telephone interview. And the vice versa occurred for the other group. The Pearson correlation analysis was used to calculate the correlation between the two methods in each group separately. Intra-class correlation (ICC) analysis was used to investigate the association between the two administration methods. Results: A significant positive correlation was found between the two types of administration in both groups (P < 0.05). Intra-class correlation coefficients indicated a good correlation between the scores obtained from each method of administration (all P values were < 0.001). Conclusions: Telephone administration of SDQ is a reliable method for collecting data when studying emotional and behavioral symptoms in children and adolescents attending outpatient psychiatric centers.

BackgroundAttention-Deficit Hyperactivity Disorder (ADHD) is a common psychiatric complication in children, which affects about 5-10% of the population. Although ADHD is a multi-factorial disorder, one of its causes refers to dysfunction of the arousal.ObjectivesThe current study aimed at investigating whether a change in arousal level in children with ADHD differs from the control group.Materials & MethodsTo achieve the research objectives, the mean Skin Conductance Levels (SCLs) as an useful index of measuring arousal levels was used, and then the changes during resting eyes-open condition and after that during playing computer games on 15 male subjects aged 8 to 12 years as the ADHD group and other 15 age-gender matched in the control group were evaluated; then, the recorded data were analyzed with repeated measures analysis of variance. The study was conducted in a child mental health services center in Tabriz, Iran, in 2012.ResultsAcross conditions, mean SCL index was lower in the ADHD group than that of controls. Computer games caused a significant increase in SCL index, which was not different between the both groups. The findings showed a similar pattern of changes during testing conditions for both the ADHD and control groups F(1,28)=85.90; P

Background:\ud \ud Participation in physical activity has been found to be beneficial for mental and physical health outcomes among cancer survivors. However, to date no intervention exists specifically to promote physical activity among bladder cancer survivors. In light of this knowledge a home-based exercise intervention was co-created for those recently diagnosed with bladder cancer.\ud \ud Aim:\ud \ud The aim of the present study, financially supported by Action Bladder Cancer UK [1], is to pilot the home-based exercise intervention tailored specifically for bladder cancer survivors (i.e. from the point of diagnosis) to improve physical and mental health outcomes (during treatment and beyond) in this population.\ud \ud Methods:\ud \ud This study will use a randomised controlled trial design. Arm one will consists of the 14 week home-based exercise intervention and arm two usual care (15 participants will be randomised to each arm). Baseline data collection will take place shortly after clinical diagnosis of bladder cancer, and follow-up approximately 7 weeks and then again approximately 14 weeks after commencement of the intervention. At each data collection point data will be collected from participants relating to demographics, physical and mental health. Participants will aslo be asked to wear an Actigraph Accelerometer at each data collection point for seven consecutive days. Immediately after baseline data collection participants in the intervention arm will be given the home-based exercise booklet.\ud \ud Ethics and dissemination:\ud \ud Ethical approval was obtained for the present study via The London- City and East Research Ethics Committee (ID:291676). Results of this study will be disseminated through peer-reviewed publications and scientific presentations.

Background: The capital of Croatia was hit by several earthquakes during the COVID-19 pandemic in 2020, simultaneously introducing two sources of stressors to the same cohort. This study aimed to determine the individual and joint effects on children’s mental health. Methods: The study comprised a web-based survey for parents (N = 22,202), deployed in February 2021. Exposure to COVID-19 and earthquake related stressors were assessed using scales constructed for this study and symptoms of posttraumatic stress symptoms (PTS) and anxiety/depression were assessed using the CATS-C and RCADS-25-P. Demographic data were used to assess the effects of gender and age. Regression analyses were conducted to identify and evaluate predictors of PTS and anxiety/depression and test for possible interactions between pandemic-related and earthquake-related factors. Findings: Results indicate that impaired mental health is more likely among girls, children who were affected by earthquake and suffered more home damage, and those who are at increased risk for severe illness from COVID-19 or have a family member at risk. Further, anxiety/depression symptoms were higher among children whose family member was self-isolated and whose homes were more damaged. Interpretation: Our findings link earthquake exposure and pandemic related stressors to symptoms of PTS, anxiety, and depression. It demonstrated limited interactions of both stressors on children’s mental health. The risk was higher for girls and no age differences were found. Future studies should expand the aspects of both resilience and risk factors, allowing for development of effective intervention strategies. Funding: The study was self-funded by the authors. Declaration of Interest: The authors declare that they have no conflicts of interest. Ethical Approval: The study design was approved by the Ethics Committee of the Zagreb Child and Youth Protection Centre, Ministry of Education and Croatian Education and Teacher Training Agency

Els educadors i educadores socials en l’actualitat lluiten perquè la seva figura estigui present i sigui reconeguda en l’àmbit de la salut mental. El model biomèdic predomina en la majoria dels entorns de la salut mental i el valor dels educadors socials queda invisibilitzat. L’article vol posar en valor l’educació social i la figura de l’educador i educadora social com peça clau en els recursos de la salut mental. Aquest estudi analitza l’evolució de les funcions dels educadors socials per comprovar les diferents limitacions que presenten en l’àmbit de la salut mental, tan així com les diferents funcions i la percepció dels altres professionals de l’àmbit. L’anàlisi es realitza mitjançant una metodologia qualitativa de recerca a través d’entrevistes semiestructurades com a instruments de recollida d’informació. Els resultats evidencien la valoració positiva dels educadors socials dins de l’àmbit de la salut mental i la seva acció socioeducativa

Schools are front and centre in the new child mental health proposals, but these plans will need to be honed and implemented swiftly if they are to address the current crisis, argues Anna Feuchtwang

ObjectiveTo compare online and paper-based screening for depression and anxiety in adults with cystic fibrosis (CF).Design and settingCross-sectional study in CF clinics in Ireland and through the Cystic Fibrosis Ireland online community.Participants160 adult patients aged 18 or above were recruited. Of these, 147 were included in the analysis; 83 online and 64 paper-based. The remaining 13 were excluded because of incomplete data.MeasuresDepression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS). Data on pulmonary function (forced expiratory volume in 1 s %) and body mass index were self-reported based on clinical assessments. Sociodemographic data were collected.ResultsCompared with the paper-based participants, the online participants were more likely to be female (61.7% vs 48.4%), older (mean 32.2 vs 28.2 years) and were more likely to be married (32.5% vs 15.6%), living with their spouse or partner (42.5% vs 22.6%) and working either full time (33.7% vs 15.9%) or part time (30.1%vs 17.5%). The prevalence rates of elevated anxiety and depression were not significantly different (P=0.71 and P=0.56). HADS anxiety and depression scores were not statistically different between online (P=0.83) and paper-based (P=0.92) participants based on Mann-Whitney U test. A significant negative correlation was found between depression and pulmonary function (r=−0.39, P=0.01) and anxiety and pulmonary function (r=−0.36, P=0.02). Based on Cronbach’s alpha, there were no statistically significant differences between the online and paper-based participants on the internal consistency of the HADS anxiety (P=0.073) and depression (P=0.378) scales.ConclusionsOur findings suggest that online and paper-based screening for depression and anxiety in adult patients with CF yield comparable findings on prevalence rates and scores, associations with health and internal consistency of subscales. This study highlights that online screening offers an alternative method to paper-based screening. Further research with a larger sample and assessment of measurement equivalence between online and paper based screening is needed to confirm our results.

The aim of the study was to assess the sexual and mental health of women suffering from connective tissue diseases and to determine the potential interrelationships between the studied clinical variables and sexual and mental health.The study was conducted in a group of women with connective tissue diseases. To assess somatic health, we used The Health Assessment Questionnaire (HAQ-DI), and to assess sexual health, we used the Female Sexual Function Index (FSFI) and Sexual Satisfaction Questionnaire (KSS). The mental health was assessed by using the Hospital Anxiety and Depression Scale (HADS-M) and the PERMA-Profiler (PL).The study involved 81 women suffering from connective tissue diseases, especially rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis (AS) and juvenile idiopathic arthritis (JIA). Clinical symptoms of sexual dysfunction were observed in 54% women. The biggest difficulties occur in sexual desire, orgasm and arousal. Patients had symptoms of anxiety and depressive disorders. Higher levels of anxiety and depression are associated with poorer overall sexual functioning and better overall sexual functioning, and all its dimensions are associated with a higher level of mental well-being. There was also an observed relationship with the functional limitation due to pain and duration of the disease.The study confirms the existence of difficulties in the sexual functioning of women suffering from connective tissue diseases and shows the relationship between sexual and mental health and basic disease. The observed relationships are important information in the treatment and medical care of people with this group of rheumatic diseases. Key Points • The article presents one of the few studies about sexual functioning of Polish population women with connective tissue diseases. • The aim was to assess the sexual and mental health of women with various connective tissue diseases and determine the potential interrelationships between the clinical variables and sexual and mental health. • The study confirms difficulties in the sexual functioning of women with connective tissue diseases. The biggest difficulties occur in sexual desire, orgasm and arousal. Patients also had mental disorders symptoms. • The study presents conclusions and indications which may be important and help specialists approach the treatment process in an interdisciplinary way.

Context: Worldwide outbreak of coronavirus has been declared by the World Health Organization as a global emergency. Quarantine, as one of the first important health measures to control and spread epidemic diseases, is the focus of health authorities and policymakers in most societies. This study was designed to obtain the psychological impact of quarantine and strategies to reduce it. Evidence Acquisition: This is a “narrative review” study done through advanced search with the keywords Quarantine, Home isolation, COVID-19, Coronavirus, Mental Health, Psychological effect in the Scopus, Pumped, Clinical Key, Google Scholar, ScienceDirect, Web of Science databases from 2019-2020. The articles were included in the study according to the inclusion and exclusion criteria. Systematic searching and screening of the titles resulted in 68 initial titles that decreased to 46 after reviewing the abstracts, and 19 articles were included in the final review. Results: Quarantine can lead to psychosocial problems from feeling lonely to depression and anxiety disorders. Certain counseling, as well as educational and supportive interventions, can make this situation tolerable. Conclusions: For acceptance and adherence to quarantine conditions, clear and transparent information about the disease and its prevalence and meeting the needs of people such as psychological, informational, and financial needs in each country are essential to reduce fear and anxiety.

Background Pregnant women’s perceptions of the risks and benefits during mental health screening impact their willingness to disclose concerns. Early research in violence screening suggests that such perceptions may vary by mode of screening, whereby women view the anonymity of e-screening as less risky than other approaches. Understanding whether mode of screening influences perceptions of risk and benefit of disclosure is important in screening implementation. Objective The objective of this randomized controlled trial was to compare the perceptions of pregnant women randomized to a Web-based screening intervention group and a paper-based screening control group on the level of risk and benefit they perceive in disclosing mental health concerns to their prenatal care provider. A secondary objective was to identify factors associated with women’s perceptions of risk and benefit of disclosure. Methods Pregnant women recruited from maternity clinics, hospitals, and prenatal classes were computer-randomized to a fully automated Web-based e-screening intervention group or a paper-based control. The intervention group completed the Antenatal Psychosocial Health Assessment and the Edinburgh Postnatal Depression Scale on a computer tablet, whereas the control group completed them on paper. The primary outcome was women’s perceptions of the risk and benefits of mental health screening using the Disclosure Expectations Scale (DES). A completer analysis was conducted. Statistical significance was set at P Results Of the 675 eligible women approached, 636 (94.2%) agreed to participate and were randomized to the intervention (n=305) and control (n=331) groups. There were no significant baseline differences between groups. The mode of screening was not associated with either perceived risk or benefit of screening. There were no differences in groups in the mean scores of the risk and benefit of disclosure subscales. Over three-quarters of women in both intervention and control groups perceived that mental health screening was beneficial. However, 43.1% (272/631) of women in both groups reported feeling very, moderately, or somewhat vulnerable during mental health screening. We found that women of low income, those treated previously for depression or anxiety, and those pregnant with their first child were more likely to perceive greater risk. However, these associations were very small. Conclusions Pregnant women in both the e-screening and paper-based screening groups perceived benefit and risk of disclosure similarly, suggesting that providers can implement the mode of screening that is most ideal for their clinical setting. Regardless of the mode of screening, a substantial number of women reported feeling vulnerable during mental health screening, highlighting the importance of the need to reduce women’s vulnerability throughout the screening process with strategies such as addressing women’s concerns, explaining the rationale for screening, and discussing how results will be used. Trial Registration Clinicaltrials.gov NCT01899534; https://clinicaltrials.gov/ct2/show/NCT01899534 (Archived by WebCite at http://www.webcitation.org/6tRKtGC4M)

IntroductionWe will use an occupational sample to study the impact of COVID-19 on current staff and postgraduate research students at a large UK university. The cohort study will address some of the key questions about COVID-19 for the international community, while also providing feedback to the employer and educator.Methods and analysisParticipants were recruited via email to their University email address. Administrative records were available to compare the composition of volunteer participants to underlying staff and postgraduate student populations of the University. The study comprises a baseline survey, longitudinal follow-up surveys and a viral antibody study. Baseline information was collected in April 2020 including demographics, working situation, current stresses and worries, mental health and neurological symptoms. Personal experiences of COVID-19, indirect experiences and attitudes towards the pandemic were queried, as well as satisfaction with communication and support at work. Longitudinal surveys will assess changes in COVID-19 exposure and mental health. A viral antibody detection component is being planned and will also be longitudinal in nature.Ethics and disseminationEthical approval has been gained from KCL’s Psychiatry, Nursing and Midwifery Research Ethics Committee (HR-19/20-18247). Participants were provided with information and agreed to a series of consent statements before enrolment. Data are kept on secure servers with access to personally identifiable information limited. Researchers may apply to have access to pseudonymised data. Findings will be disseminated internally to the University and participants, and externally through scientific publications.

Background As mental health services in outpatient medical clinics expand, psychiatrists must be trained to practice in these settings. Objectives The Academy of Consultation-Liaison Psychiatry residency education subcommittee convened a writing group with the goal of summarizing the current evidence about outpatient consultation-liaison psychiatry (CLP) training and providing a framework for CLP educators who are interested in developing outpatient CLP rotations within their programs. Method MEDLINE (via PubMed), Embase, and PsycINFO (via OVID) were reviewed each from inception to December 2019, for psychiatric CLP services in ambulatory settings that involved residents or fellows. The CLP education guidelines were reviewed for recommendations relevant to outpatient CLP. We also searched MedEd portal for published curriculums relevant to CLP. The group held 2 conferences to reach consensus about recommendations in setting up outpatient CLP rotations. Results Seventeen articles, 3 Academy of Consultation-Liaison Psychiatry–supported guidelines, and 8 online didactic resources were identified as directly reporting on the organization and/or impact of an outpatient CLP rotation. These manuscripts indicated that residents found outpatient CLP rotations effective and relevant to their future careers. However, the literature provided few recommendations for establishing formal outpatient CLP training experiences. Conclusions Outpatient CLP rotations offer multiple benefits for trainees, including exposure to specific clinical scenarios and therapeutic interventions applicable only in the outpatient setting, increased continuity of care, and the unique experience of providing liaison and education to non-mental health providers. The article outlines recommendations and examples for developing outpatient CLP rotations which CLP educators can incorporate in their programs.

During the 35th annual conference of Kerala State branch of Indian Psychiatric Society (SIPSCON 2019), conducted in Thrissur, a group activity was designed, titled ‘Voices from the floor: group activity on contemporary psychiatric issues in Kerala’. In this academic program, the participants were given the centre stage. It was designed as a group activity where all the delegates were divided into small groups to give their experiential account and reflection related to mental health care in Kerala. The topic of discussion and exploration in each group were chosen from either one of the broad perspectives of clinician, academician or mental health activist. This narrative is based on the introductory remarks made in the workshop, co-authored by all the authors and presented by the third author. From this activity, the outcome expected was to discover a treasure of information which could pave the way for further exploration and action plans. No consensus was aimed at. These could shape the future of Kerala mental health scenario.

Objective: to describe the risk factors that influence the self-injury behavior of adolescents assisted at a Psychosocial Care Center for Children and Adolescents, according to subjects’ own perceptions. Method: a descriptive, exploratory, qualitative study carried out through medical records and a focus group with 07 adolescents. The statements were submitted to thematic content analysis. Results: in the risk factors category, four subcategories emerged: Family adversity factors; Social contagion; Adverse life events; Personal characteristics. Conflicts, lack of support, drug use in the family, meeting someone who cuts themselves, social networks, religiosity, history of sexual violence and bullying were identified as risk factors that influence self-injury. Final Considerations: adolescents pointed out the need for prejudice-free dialogues in schools, in health and family devices, configuring protective factors to avoid this practice that comes from several negative events throughout life.

The COVID-19 pandemic has brought about many challenges and alterations to long-standing procedures within rehabilitation facilities. These updates of the processes undertaken by staff in such settings have been radical and ongoing. COVID-19 impact on the healthcare system should never be underestimated nor under appreciated. The impact that this pandemic has had on rehabilitation care is unique. This has been the catalyst to identifying significant challenges and subsequent changes within rehabilitation and mental health practices. Social measures that have been implemented in the community have had exaggerated and magnified effects both on the physical and mental wellbeing of rehabilitation and mental health patients. Over the course of these adaptations and implementations, impacts on communication, mental health, workload and care efficiencies were identified and explored. This paper is unique because different disciplines have shared their experiences of the impacts of the COVID-19 pandemic and how they provide rehabilitation. The paper will focus on the communication challenges using masks, not being able to engage families and carers, restriction of group therapies, social isolation of patients and healthcare workers while adhering to guidelines set by NSW Health (Sydney, Australia).

I never intended to become a scientist. My career developed on the basis of chance happenings, repeated failure, the willingness to take risks and the acceptance and provision of mentoring. My career has included periods of difficulty and shifted back and forth between academic health centers and universities in Canada. Although I have been amply recognized for my successes, my greatest learning has come from my failures. My greatest satisfaction has been in the development, evaluation and dissemination of interventions. The combination of intellectual stimulation and emotional gratification has meant a rewarding career.