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Dans cette communication, nous montrons que la littérature sur la prévalence des troubles psychiatriques et liés à l'usage de substances en milieu pénitentiaire est riche. Son interprétation se heurte toutefois à plusieurs difficultés : (i) une grande hétérogénéité des systèmes judiciaire et de soins de santé mentale entre les pays et (ii) des spécificités de l'environnement carcéral parfois négligées dans la méthodologie des études. Forts de ce constat, nous développons les résultats d'un certain nombre de travaux de référence sur la prévalence des troubles psychiatriques et liés à l'usage de substances dans les prisons françaises. Nous discutons enfin les perspectives en termes d'épidémiologie psychiatrique en milieu pénitentiaire. In this paper, we show that the literature on the prevalence of psychiatric and susbtance use disorders in prisons is substantial. However, there are a number of difficulties one encounters in interpreting this literature: (i) there is considerable heterogeneity between countries' judicial and mental health care systems, and (ii) the specific features of the prison environment are sometimes overlooked in the methodology used to conduct such studies. With this in mind, we discuss a number of benchmark studies on the prevalence of psychiatric and substance use disorders in French prisons. Finally, we discuss the perspectives for psychiatric epidemiology in prisons. [ABSTRACT FROM AUTHOR]

This paper explores how distinctions between 'intended' and 'side' effects are troubled in personal narratives of taking psychotropic medications. Grounded in interviews with 29 participants diagnosed with mental illness in Victoria, Australia between February and December 2014, we consider how people interpret pharmaceutical compounds beyond their desired or intended effects, and how such effects shape and transform subjectivity and their relationship with their bodies. This paper contributes to recent discussions of mental illness and medication effects, informed by feminist science studies. It emphasises the co-constitution of social, affective and material relations in the context of 'taking' psychotropic medication. This paper discusses three key themes as important to the phenomenology of the nexus of illness and psychotropic medication: movement, ambivalence, and sociality. Our analysis demonstrates how psychotropic drugs are productive of subjectivity through their promises and potential, their unexpected harms and the institutions from which they are inseparable. • Analyses accounts of mental illness using feminist science and technology studies. • Focus on experiences of taking psychotropic drugs and impact on subjectivity. • Moves beyond distinctions between 'therapeutic' and 'side' effects of drugs. • Unique contribution to understandings of experiences of taking psychotropic drugs. [ABSTRACT FROM AUTHOR]

Ramos et al. paper offers a narrative review of Spanish Organic Law 3/2021, which regulates euthanasia, focusing on its application to individuals with mental disorders. Ramos et al. examine the application of legal prerequisites from an ethical-legal perspective to ascertain the conditions under which psychiatric euthanasia might be considered legitimate and compliant with legal stipulations. Nevertheless, it is apparent that the core ethical inquiries linked to this matter have not been exhaustively investigated. The criteria laid out are, in our assessment, still open to further debate and broader deliberation. Our article emphasizes the need for a comprehensive ethical and legal debate in Spain regarding psychiatric euthanasia. Competency assessment is central to the legislation, but there are concerns about the validity of assessment tools and the subjective nature of interviews. Furthermore, defining irreversible suffering in mental health contexts poses challenges. The article advocates for a deeper understanding of the needs of individuals with mental disorders before considering euthanasia and emphasizes the importance of comprehensive care and psychosocial interventions in reducing the desire for euthanasia. Ultimately, it underscores the ethical complexities of euthanasia in mental health and the necessity of prioritizing comprehensive care in addressing these complexities. [ABSTRACT FROM AUTHOR]

Over the past decade, psychiatric research has been on an important hunt for biomarkers of psychiatric disease. In psychiatry, the term "biomarker" is a broad umbrella term used to identify any biological variable that can be objectively measured and applied to a diagnosis; this includes genetic and epigenetic assessments, hormone levels, measures of neuro-anatomy and many other scientific modalities. However, despite hundreds of studies on the topic being published yearly and other medical specialties having success in discovering biomarkers, clinical psychiatric practice has not had the same success. This paper aims to consolidate the many opinions on the search for psychiatric biomarkers to suggest key methodological and clinical challenges that psychiatric biomarker research faces. Psychiatry as a specialty has many fundamental differences compared to other medical specialties in methods of diagnosing, underlying etiology and disease pathologies that may be limiting the success of biomarker research in itself and puts strict requirements on the research being conducted. The academic and clinical environment in which the research is being conducted also heavily influences the translation of the findings. Finally, once biomarkers are identified, more often than not they are inapplicable to clinical settings, unable to integrate into clinical practice and fail to outperform current diagnostic practices and guidelines. We also make six recommendations for more promising future research in psychiatric biomarkers. • For biomarker research to be successful, multiple techniques must be combined. • There are intricacies unique to psychiatry that make successful biomarker identification difficult. • Improved research methodologies that are easily combined are needed. • Multidisciplinary teams should be involved at all stages of biomarker research. [ABSTRACT FROM AUTHOR]

Background: Metrics of journal's impact factor may suggest the journal's influence in a particular field, but they have been used inadvertently as a measure of the journal and individual publications' scientific quality.Methods: We assessed how scientific journals in the field of psychiatry and mental health are ranked (top 20) according to the scores of distinct metrics (Eigenfactor score, Google Scholar Metrics, Journal Citation Reports, Scimago Journal & Country Rank, and Source Normalized Impact per Paper), described their main characteristics and perfomed a spearman's correlation analyses to investigate to which extent these metrics are associated. We also discussed the limitations of dealing with these metrics and the rankings they provide as a proxy of the journal's quality.Results: Only 5 (12.5%) journals appear in all metrics (JAMA Psychiatry, American Journal of Psychiatry, Molecular Psychiatry, Schizophrenia Bulletin, and the Journal of Child Psychology and Psychiatry), more than one-third of the journals show up in only one and less than half (42.5%) appear in three or more. Only JAMA Psychiatry is in one of the first five positions of all metrics. No journal ranked in the same position across the metrics. On the other hand, we found the correlations between all the metrics were statistically significant.Limitations: The metrics included are not exhaustive.Conclusions: Although each metric provides a particular ranking, they are highly correlated. Rankings also change according to distinct subject categories in which they are assessed. We suggest less emphasis should be given to Journal Metrics to infer journal's quality. [ABSTRACT FROM AUTHOR]

Dans le présent article, nous proposons une revue de l'évolution de la conception de la schizophrénie du phénoménologue belge Marc Richir au travers des concepts d'affectivité et de dissociation (Spaltung). Notre objectif est de montrer comment ces notions trouvent leur place dans la refondation de la phénoménologie de Richir et de réfléchir à la pertinence clinique possible de ces conceptions. La Spaltung que nous thématisons dans cet article n'est pas un mode déficient de structures transcendantes ou existentielles, mais caractérise dans une certaine mesure chaque existence humaine. Et c'est paradoxalement à l'endroit de la Spaltung que Richir propose une distinction renouvelée entre le normal et le pathologique inspiré de la phénoménologie. Nous présentons une revue systématique des conceptions de Richir sur la Spaltung et la schizophrénie, depuis ses premiers travaux sur la psychopathologie à la fin des années 1980 jusqu'à ses derniers travaux présentés dans son maître-ouvrage sur les psychopathologies, Phantasia , imagination, affectivité, en 2004. La perspective de Richir offre une nouvelle compréhension de l'expérience schizophrène et de la relation thérapeutique qui peut embrasser les dimensions à la fois incarnée, intersubjective et imaginaire de l'expérience humaine. Elle pourrait ainsi constituer un dispositif heuristique fécond pour la recherche translationnelle en psychiatrie. In the present article we propose to review the evolution of phenomenologist Marc Richir's conception of schizophrenia through the prism of affectivity and dissociation (Spaltung). Although this concept is not at all new – indeed, already Bleuler has proposed to describe the "group of schizophrenias" with this term – we can nevertheless affirm that it appears in a new light in Richir's phenomenological anthropology. Furthermore, the term of Spaltung is absent on the description of schizophrenia in the DSM-5 and reserved for the dissociative disorders. We argue that this notion can be made fruitful not only in the context of a historical analysis of these troubles, but also in the context of phenomenological psychopathology. Our aim is to show how this concept finds its place in Richir's refoundation of transcendental phenomenology and to reflect on the possible clinical relevance of his conception. This objective is related to a second one, implied by Richir's conception of schizophrenia, and namely that of showing that affective troubles associated with mental health issues should not be conceived of in terms of deficiencies. The Spaltung that we thematize in this paper is not a deficient mode of transcendental or existential structures but characterizes to some extent each and every human existence. Paradoxically, it is in the area of Spaltung that Richir proposes a renewed distinction between the normal and the pathological inspired by phenomenology. In order to answer these questions, we present a systematic review of Richir's conceptions of Spaltung and schizophrenia from his first works on psychopathology in late 1980s to his latest work presented in his groundwork on psychopathologies Phantasia, imagination, affectivité in 2004. We were able to identify three moments of Richir's thought: (1) Firstly Richir's understanding of psychosis is in terms of formation of sense (Sinnbildung) and symbolic institution related to the affective tonality (Stimmung) of the experience in general. He describes formation of sense as an inner division of Stimmung in normal and pathological embodied experience. (2) In the second moment, we focus on a further development of the question of affectivity in intersubjective and embodied relationship. Here Richir analyzes this archaic character in its embodied dimension and more precisely in its intersubjective circulation through what he calls the Phantasieleib , a flesh of phantasy. Through the structures of inter-corpreality, affectivity can even be contagious, pass from the intimacy of one flesh to the other, and it is precisely through this contagion-character of the affective circulation that we can also speak of a peculiar contact with the affectivity of a patient suffering from schizophrenia. (3) Lastly, we pursue the analyses of affectivity and its relation the embodiment and imaginary life by drawing on Richir's main work on psychopathology and phenomenological anthropology: Phantasia, imagination, affectivité. In this, he offers a renewed perspective on dissociation (Spaltung): between an embodied affectivity in the Phantasieleib and delusional affectivity that is not embodied, but makes up what Richir calls a Phantomleib. The Spaltung is thus a dissociation of affectivity of its original embodiment and it is characterized by an "atmopsherisation" that relates it to the pure imaginary that functions autonomously, independently of its phenomenological base in phantasy life. These analyses show that a phenomenological approach to schizophrenia is possible without understanding this latter a deficient mode of human experience. Rather, one has to pass through the field of phenomenological anthropology and the phenomenological analysis of sense formations, phantasy, affectivity. Richir's perspective offer a new comprehensive modelisation of schizophrenic experience and therapeutic relationship that can embrasse both embodied, intersubjective and imaginary dimension of human experience. It could be thus a fruitful heuristic device for translational sciences in psychiatry. [ABSTRACT FROM AUTHOR]

• Emotion mining is a novel technique used in Artificial Intelligence to extract and analyse the emotions of individuals and populations. • In recent years these techniques have been applied to the field of Medical Artificial Intelligence (AI). • The use of emotion mining has widespread implications for both individual patient health and for population health. • Existing medical curriculums and ethical frameworks are not fit for purpose when it comes to these new e-health technologies. • A new approach is suggested for appraising medical AI, for both clinicians and policy makers. Background: The tools of emotion mining were developed in the field of computer science to detect and evaluate human emotions. The development of social media and digital phenotyping has empowered researchers to apply these techniques to the field of medicine. In recent years we have seen an evolution of novel health technologies that utilise data-driven emotion mining for mental health diagnostics and assessment. Aim: In this review of psychiatric AI we provide a high level overview of these technologies and their integration into clinical practice. The aim of this paper is to describe novel ethical scenarios posed by these models through a series of case studies, and establish how existing ethics frameworks can be adapted to meet these new challenges. With the techniques of emotion mining being used increasingly for predictions of self-harm, suicide and homicide this review comes at a crucial time. Methods: The article is presented as a narrative review and therefore does not detail the methodology of a systematic literature review. Instead, we offer a high level overview of AI in mental health and explore a number of case studies which highlight the novel ethical challenges these tools present. Results and Conclusion: Despite the growth of these technologies, there has not been a parallel growth in the ethical debate. For digital health to be implemented in an equitable manner, clinicians must be ethically equipped to appraise these systems. In the final section of our review we provide practical recommendations for healthcare professionals who are faced with implementing these new systems. [ABSTRACT FROM AUTHOR]

Maternal health and wellbeing is crucial to ensure the best outcomes for babies and children. Pregnancy and the perinatal period are particularly vulnerable times for mothers and children. Almost 1 in 5 mothers will experience some form of depression or anxiety during the perinatal period and other presentations, such as postpartum psychosis are specific to this period. Healthcare professionals, including paediatricians, whose clinical practice is devoted to the care of children often feel inadequately prepared to deal with these issues. Perinatal mental illnesses can feel daunting with anxiety about treatment impacting on the developing fetus, neonate or the breastfeeding infant. This short paper covers some common perinatal psychiatric presentations and aspects of treatment relevant for paediatricians. [ABSTRACT FROM AUTHOR]

This paper complicates the notion of the suicide bomber as represented in mental health literature. Most authors apply Western psychiatric concepts to understand suicide bombers without accounting for value differences around life and death or terrorism and martyrdom. Accordingly, these researchers replicate arguments to explain individual behaviour from a particular epistemological perspective. In contrast, critical approaches to this literature can expose the worldviews of the analysers and the analysed to devise sounder interpretations. This paper scrutinises mental health discourse on suicide bombing to ask: (1) What do we learn about the authors of suicide bombers in these articles? (2) How do their analyses demonstrate the relationship between knowledge and power? These conclusions can enable researchers to reduce biases and devise behavioural models that more accurately reflect the realities of their subjects. [ABSTRACT FROM AUTHOR]

This paper is not a comprehensive review of the literature. Rather, it is a viewpoint based upon advances in other fields of medicine and genetics that may provide a model for guiding research in psychiatry. The paper discusses the major limitations of the medicines currently used to treat schizophrenia and bipolar illness. The limitations in our understanding of the molecular causes of these two illnesses and our lack of a clear mechanism of action for many of the medicines used to treat them continue to confound the field and impede progress towards finding novel treatments. Until the genetic bases of bipolar illness and schizophrenia are unambiguously identified, progress towards improved diagnosis and treatment will be retarded. An approach to identifying risk genes based upon association studies starting with very large sample sizes based upon currently available diagnoses of bipolar disorder and schizophrenia is advocated. [Copyright &y& Elsevier]

Heart rate variability (HRV) indexes functioning of the vagus nerve, arguably the most important nerve in the human body. The Neurovisceral Integration Model has provided a structural framework for understanding brain-body integration, highlighting the role of the vagus in adaptation to the environment. In the present paper, we emphasise a temporal framework in which HRV may be considered a missing, structural link between psychological moments and mortality, a proposal we label as Neurovisceral Integration Across a Continuum of Time (or NIACT). This new framework places neurovisceral integration on a dimension of time, highlighting implications for lifespan development and healthy aging, and helping to bridge the gap between clearly demarcated disciplines such as psychology and epidemiology. The NIACT provides a novel framework, which conceptualizes how everyday psychological moments both affect and are affected by the vagus in ways that have long-term effects on mortality risk. We further emphasize that a longitudinal approach to understanding change in vagal function over time may yield novel scientific insights and important public health outcomes. [ABSTRACT FROM AUTHOR]

Context The effectiveness of seclusion and restraint (SR) reduction programs has not been well established. Objective To examine the effectiveness of SR reduction programs in mental health settings. Data sources A systematic review of English and French articles, using CINALH, Web of Science, PubMed, Medline, Embase, and the Cochrane Library. Additional studies were added by searching the references of identified papers. Study selection All evaluative studies on SR reduction programs in mental health were included based on predefined criteria ( n = 23 articles). Data extraction Data extraction of articles was performed using predefined data fields. The three authors conducted quality assessments independently. Data synthesis In the 23 articles analyzed, six key components were predominant in SR reduction programs: 1) leadership, 2) training, 3) post-seclusion and/or restraint review, 4) patient involvement, 5) prevention tools, and 6) the therapeutic environment. Conclusion Despite wide variability in SR indicators and methodological rigor, it remains that the outcomes argue in favor of SR reduction program implementation. [ABSTRACT FROM AUTHOR]

In Pakistan, the transgender community faces many challenges. Transgender identity is considered taboo and people tend to distance themselves from them without knowing their issues. They face difficulties seeking education, jobs, and even basic human rights. They also face violence and social exploitation. Due to the lack of support from their family members, they're more prone to develop psychological problems and suicidality. Trans rights are human rights - the purpose of our paper is to expose the dire state of mental health of the transgender community in Pakistan on an international platform. We aim to bring a global concern to this problem because we hope that it will spur the relevant authorities to take steps to mitigate the current situation. Special attention should be paid to the protection and education of transgender individuals. If they're suffering from any psychiatric disorder, healthcare professionals should be there to help them. [ABSTRACT FROM AUTHOR]

Depuis le 16 mars 2020, date de l'annonce du premier confinement en France dans le contexte de pandémie liée à la COVID-19 et de crise sanitaire, les Français ont connu un bouleversement brutal et durable de leurs rythmes et habitudes. La crise sanitaire a eu un impact fort sur la population générale et sur les patients souffrant de troubles psychiatriques. La demande de prise en charge en santé mentale est particulièrement accrue chez les jeunes, qui semblent les plus impactés par cette crise. Dans la première partie de cet article, nous décrirons l'impact de la crise sanitaire sur la santé mentale des jeunes et sur la fréquentation des urgences psychiatriques, avec une revue exhaustive de la littérature française et internationale. La littérature traitant de la santé mentale des enfants et des jeunes durant la crise sanitaire est vaste et régulièrement actualisée. Au 31 décembre 2021, seules quelques données concernant l'état de santé mentale des jeunes sont chiffrées et publiées. Dans la seconde partie, nous présenterons une étude épidémiologique descriptive réalisée dans le plus grand centre d'urgences psychiatriques français, afin de mettre en évidence les changements des flux de consultations des patients âgés de 15 à 25 ans durant la première année de la crise sanitaire, comparativement aux trois années précédentes. En conclusion, nous évoquerons les mesures et adaptations du système de soins français mises en place pour prendre en charge les besoins accrus en santé mentale de cette population spécifique des 15–25 ans, particulièrement malmenée par la crise sanitaire, véritable enjeu national de santé publique. Since March 16, 2020, the date of the announcement of the first confinement in France in the context of the COVID-19 pandemic and health crisis, French residents have experienced a brutal and lasting disruption in their rhythms and habits. The health crisis has had a strong impact on the general population and especially on patients suffering from psychiatric disorders. The demand for mental health care has particularly heightened among young people, who seem to be the most affected by this crisis. In the first part of this article, we will describe the impact of the health crisis on the mental health of young people and on the attendance of psychiatric emergencies, with a review of French and international literature. In the second part, we will present a descriptive epidemiological study carried out in the largest French psychiatric emergency center. Our sample included 9,771 young patients from 15 to 25 years old. The main objective of our study is to highlight the changes in the flow of consultations of patients aged 15 to 25 years during the first year of the health crisis, compared to the three previous years. We calculated and compared the proportion of the target population consulting between the period of the first year of the health crisis (COVID period) and the period encompassing the previous three years (pre-COVID period). We also compared different variables, between the 2,179 young people consulting during the first year of COVID-19 health crisis and the 7,592 young people during the three last years: age, sex, marital status, symptoms, environmental context and CIM-10 diagnoses. We observed a significant increase in the proportion of patients aged 15 to 25 during the COVID period (n = 29.4% vs. 27.6%; P < 0,001). The patients during the COVID period were predominantly female. We have seen a significant increase in patients coming for consultations for anxiety (+4.3%; P < 0.001), sleep disorders (+2.8%; P < 0.001) and suicidal thoughts (+2.7%; P = 0.006) during the COVID period. During the first year of the health crisis, the target population consulted less for claustration, withdrawal or odd behavior. Family conflicts, traumatic events and other life events were more frequent. Schizophrenia, schizotypal and delusional disorders were less frequently diagnosed. The health crisis has had a considerable impact on the mental health of the youth population. The mental health of young people is a current subject of concern and a major public health issue. Data from the literature warns of the impact of the health crisis on the mental health of this population and the need for early treatment, even as the supply of psychiatric care is decreasing. [ABSTRACT FROM AUTHOR]

The aim of this paper is to provide a review of controlled studies of the use of Virtual Reality in psychological treatment (VRT). Medline, PsychInfo, Embase and Web of Science were searched. Only studies comparing immersive virtual reality to a control condition were included. The search resulted in 1180 articles published between 2012 and 2015, of these, 24 were controlled studies. The reviewed studies confirm the effectiveness of VRT compared to treatment as usual, and show similar effectiveness when VRT is compared to conventional treatments. Current developments and future research are discussed. [ABSTRACT FROM AUTHOR]

Psychiatric practitioners are currently encouraged to adopt a patient centered approach that emphasizes the sharing of decisions with their clients, yet recent research suggests that fully collaborative decision making is rarely actualized in practice. This paper uses the methodology of Conversation Analysis to examine how psychiatrists justify their psychiatric treatment recommendations to clients. The analysis is based on audio-recordings of interactions between clients with severe mental illnesses (such as, schizophrenia, bipolar disorders, etc.) in a long-term, outpatient intensive community treatment program and their psychiatrist. Our focus is on how practitioners design their accounts (or rationales) for recommending for or against changes in medication type and dosage and the interactional deployment of these accounts. We find that psychiatrists use two different types of accounts: they tailor their recommendations to the clients' concerns and needs ( client-attentive accounts ) and ground their recommendations in their professional expertise ( authority-based accounts ). Even though psychiatrists have the institutional mandate to prescribe medications, we show how the use of accounts displays psychiatrists' orientation to building consensus with clients in achieving medical decisions by balancing medical authority with the sensitivity to the treatment relationship. [ABSTRACT FROM AUTHOR]

Using letters sent to British playwright J. B. Priestley in 1963, this paper explores the intersection between patient-focused history of psychiatry and the history of parapsychology in everyday life. Priestley's study of precognition lay outside the main currents of parapsychology, and his status as a storyteller encouraged confidences about anomalous temporal experience and mental illness. Drawing on virtue epistemology, I explore the regulation of subjectivity operated by Priestley in establishing the credibility of his correspondents in relation to their gender and mental health, and investigate the possibility of testimonial justice for these witnesses. Priestley's ambivalent approach to madness in relation to visions of the future is related to the longer history of prophecy and madness. Letters from the television audience reveal a variety of attitudes towards the compatibility of precognition with modern theories of the mind, show the flexibility of precognition in relation to mental distress, and record a range of responses from medical and therapeutic practitioners. Testimonial justice for those whose experience of precognition intersects with psychiatric care entails a full acknowledgement of the tensions and complicities between these two domains as they are experienced by the witness, and an explicit statement of the hearer's orientation to those domains. [ABSTRACT FROM AUTHOR]

Contact!Unload , a research-based theatre production, portrays veterans experiencing mental health challenges and overcoming them through therapeutic enactment. It was performed eight times by veteran performers in 2017 for audiences in two Canadian cities comprised of civilians and military-connected personnel and their families (n = 525). Drawing upon qualitative and quantitative data sources, this paper evaluates the immediate and longer-term impacts of Contact!Unload as a knowledge translation intervention for audience members. Our findings suggest that the performance: 1) improved knowledge of mental health concerns and symptoms that some veterans experience when transitioning to civilian life, 2) increased knowledge of the need for mental health supports and care for veterans, 3) sustained impacts on awareness and knowledge six months after the play and 4) sparked dialogue and actions after the show for some audience members. Moreover, theatre was seen as a powerful medium to engage audience members both cognitively and affectively in the topic. Research-based theatre has significant potential as a knowledge translation intervention for mental health topics. The work also points to the untapped potential of using RbT to engage audience members in a mental health literacy intervention. Future work is needed to study how to effectively combine research-based theatre with intervention design frameworks and other mental health literacy interventions. • Research-based theatre (RbT) is an effective method for knowledge translation. • The embodied experience of theatre bolsters empathy and receptivity to learning. • Short and longer-term cognitive and affective impacts for audiences were achieved. • RbT can also shift social responses to and professional practices in mental health. • RbT holds untapped potential as a mental health literacy intervention. [ABSTRACT FROM AUTHOR]

Abstract: The recovery approach in mental health care emphasises the importance of the service user leading a fulfilling, meaningful life beyond the limitations of illness or symptomatology. This approach to care is increasingly included as a central part of mental health policy and service provision in a number of countries including the UK and Ireland, to address the needs of people who have severe and enduring mental disorders. It is an autonomous, holistic and empowering way of working with individuals as they journey towards healing. Fundamental to this model is the relationship fostered between service users and health professionals. The recovery philosophy of care mirrors some of the core principles of music therapy, including the importance of the therapeutic relationship and the possibilities for change and growth within this. This paper explores the congruence between music therapy and the recovery approach by providing: (1) An overview of current published evidence for music therapy in mental health care. (2) A discussion of this psycho-social creative arts therapy intervention within the specialized area of recovery in psychiatry, and (3) case vignettes to illustrate the application of this philosophy in music therapy work within a recovery service. [Copyright &y& Elsevier]

Abstract: This paper examines the experiences and perspectives of ex-military servicemen in the UK. It focuses specifically on the complex links between emotional distress and various constructions of ‘masculinity’ in a military context. Aspects of military culture that exacerbate vulnerability and also those that are protective to mental health are identified and discussed with reference to the theoretical constructs relating to hegemonic masculinity. A qualitative research design using semi-structured interviews provided in-depth accounts of the experiences of 20 ex-servicemen aged 23–44, all but one of whom were in the Army. We found that in a military setting hegemonic masculinity is embedded in the construction of a soldier identity and expression of emotion may be seen as inappropriate. As a result soldiers often lack a language with which to express distress (in a context in which they may witness extremely distressing events), which may result in delays in recognising and treating mental health problems. However, constructions of masculinity in this setting to some degree also promote a caring, sharing ethos based on strong inter-dependent bonds. A young soldier who can cope with the stresses of military life ‘becomes a man’, adopts a masculine/soldier identity and is well-placed to benefit from these protective factors, notably the camaraderie that is part of service life. In this manner a caring ethos in which some admissions of weakness may be permissible is situated within hegemonic masculinity. This seeming paradox between hyper masculinity and caring masculinities appears to be embedded within military culture, perhaps reflecting the flexibility and ambiguity inherent in constructions of hegemonic masculinity. [ABSTRACT FROM AUTHOR]

Abstract: In Arab communities, several cultural factors, derived mainly from the subordinate position of women, have been shown to affect the prevalence, clinical picture, health seeking behaviour, course and management of psychopathology in women. Women are definitely at a greater risk of developing mental disorders such as depressive, somatoform, anxious or eating disorders, as well as suicidal behaviors. Furthermore, mentally ill women are more stigmatized, have less access to care and suffer from a worse social outcome. This paper describes a series of culture-related risk factors such as education, work, sexuality, marriage, and infertility, which significantly contribute to triggering mental disorders in females, or to worsen their course and outcome. The authors recommend that mental health providers should play a critical role by addressing the cultural as well as psychological conditions that create and maintain threats to women''s mental health. [Copyright &y& Elsevier]

Abstract: This paper was initially presented during the scientific workshop of the French society for child and adolescent psychiatry and allied professions (SFPEADA), devoted to psychomotricity and its current bonds with child and adolescent psychiatry (Paris, September 29, 2005). The authors are a child and adolescent psychiatrist, using daily psychoanalytical psychotherapies in a universitary public hospital and two psychomotricians, who work in a child and adolescent public department, in a private activity and in a specialized institute (therapeutic, educational and teaching institute or ITEP). They present here the results of their clinical practices, exchanges and thoughts about a complex and discussed subject, which touches in more than one way with the bases of our clinical and therapeutic practices with children and adolescents: how do we choose the differential indications between psychotherapies and psychomotor therapies? [Copyright &y& Elsevier]

Abstract: Discriminated against and marginalised groups of people within our communities continue to be over represented within mental health services and frequently their particular needs are not met. Challenging discrimination and working towards more equitable services are a vital part of anyone''s role working within mental health services. This paper provides a review of guidance documents on diversity issues with a particular focus on ethnicity, gender, sexuality, learning disability, spirituality, homelessness and age. The review concludes with a summary of the range of approaches that are currently being advocated for translating guidelines and recommendations into improved and equitable mental health services that meet the needs of service users from a wide range of diverse groups. [Copyright &y& Elsevier]

Abstract: There are few examples in the literature of the application of functional analysis to psychiatric inpatient aggression. Structural assessment approaches have dominated. This paper introduces a system for classifying the functions of aggression in psychiatric inpatients that was applied to 502 aggressive behaviours exhibited by patients in a secure forensic psychiatric hospital. At least one function was identified for the majority of aggressive incidents; the most common functions pertaining to patients’ responses to the restrictions and demands of the inpatient setting, to express anger or to punish others perceived as provocative, and to maintain status. There was little evidence suggesting that aggression was used to obtain tangible rewards, to reduce social isolation, or to simply observe the suffering of others. Differences in the function of aggressive behaviour were found across victim types. Results of this study have implications for the prediction and prevention of inpatient aggression and for the treatment of aggressive inpatients. [Copyright &y& Elsevier]

Abstract: UK “Psychiatric Survivors”—a variety of activist groups comprising individuals who have been on the “receiving end” of psychiatric treatment—have, since the mid-1980s, mounted a challenge to the psychiatric system. “Survivors” have formulated their own knowledge-base concerning a range of human problems hitherto regarded as the province of “official” psychiatry only. “Official” knowledge stresses scientific classification, professional expertise, and statistical evidence: “Survivor” knowledge, by contrast, emphasises individual experience, the traumas of the life-course, and the personal testimony of the survivor as itself expert data. This paper focuses upon the truth-claims enacted by the “testimony of the survivor” and the relation of “testimony” to political practice. Specifically, I analyse a key text containing the testimonies of female survivors whose behaviour has been officially labelled as “deliberate self-harm”; that is, women who harm themselves, through self-poisoning or self-laceration, and subsequently receive medical/psychiatric treatment. The main focus is upon the political functions of testimony in theory and practice—the ways in which “survivors” challenge the power of psychiatry. [Copyright &y& Elsevier]

Abstract: Previous research in Gospel Oak indicates high-rates of common mental disorder. This paper explores how far deficits in social capital may be linked to these rates. Interviews, focus groups and participant observation were conducted to assess social capital in Gospel Oak from the phenomenological experience of residents. The data suggested that most residents perceived the neighbourhood to be rich in well-developed facilities, services and associational activity. Residents also generally expressed satisfaction with local trust and reciprocity. The results do not support the hypothesis that rates of common mental disorder in Gospel Oak are linked to deficits in social capital. Compositional factors may be more important in accounting for these rates. [Copyright &y& Elsevier]

This paper is concerned with how housing improvements instigated either publicly or privately influence the degree of psychological stress reported by council estate residents in South Manchester. Stress is measured on the GHQ12 scale containing standard symptomatic items. Potential sources of variation in this indicator are analysed within a geographical setting where repeated samples of residents were drawn from two adjacent suburban council housing estates before and after the implementation of a single regeneration budget (SRB) housing initiative in late 1999. The residents of one of these estates (Wythenshawe) were targeted by this funding while those in the other (Mersey Bank) were not. The latter, therefore, serve as a control for the effects of the enhanced incidence of housing improvement activity promoted by this SRB. Regression analyses revealed that stress was raised significantly among the SRB residents perhaps on account of the additional environmental nuisance they encountered. The experience of stress among all residents, however, was dominated by measures of personal psychosocial risk and it is argued that future regeneration initiatives should address the manifestation of these risks in the effort to achieve better mental health. [ABSTRACT FROM AUTHOR]

The present paper uses an adaptational-continuum model of personality, based on health psychology model integrating Eysenck personality factors and coping style, to provide a context for examining the relationship between forgiveness and mental health. Three hundred and twenty respondents completed measures of personality, coping style, forgiveness (forgiveness of self, others, likelihood, presence of positive forgiveness, absence of negative forgiveness), general health, stress, positive and negative affect and life satisfaction. Among respondents, all measures of forgiveness, bar one, load negatively on a neuroticism-coping factor. The remaining measure of forgiveness (presence of positive forgiveness) loaded on an extraversion-coping factor. The relationship of the neuroticism-coping-forgiveness factor was associated with poorer mental health, suggesting forgiveness is associated with better mental health within the context of this personality-coping factor. Significant positive relationships were found between the extraversion-coping-forgiveness factor and two measures of positive mental health outcomes (positive affect and life satisfaction) suggesting forgiveness is associated with some aspects of mental health within the context of this personality-coping factor. The present findings suggest that forgiveness, or failure to forgive, can be conceptualised within an adaptational-continuum model of personality. [Copyright &y& Elsevier]

Religion''s effects on mental health have been debated for years, yet only in the last half century have these theories been empirically tested. While a number of mental health constructs have been linked to religion, one of the most prevalent and debilitating mental health indices, anxiety, has been largely ignored. This paper categorizes and critically reviews the current literature on religion and general indices of anxiety in terms of findings linking decreased anxiety to religiosity, increased anxiety to religiosity, and those finding no relation between anxiety and religiosity. Results from 17 studies are described and synthesized. Conceptual and methodological weaknesses that potentially threaten the validity and generalizability of the findings are discussed. Finally, conclusions and directions for future research are provided. [Copyright &y& Elsevier]

Abstract: Psychiatry, unlike other medical specialties, frequently involves the treatment of patients against their will. Criteria and rules governing compulsion are set out in mental health legislation. In response to major shifts in the nature of mental health services, particularly its emphasis on community-based rather than hospital-based treatment, many have argued that mental health legislation needs reform to take account of these changes. In turn, this has led to new questions about the underlying assumptions and justifications shaping mental health legislation. In England and Wales, the Mental Health Act 1959 marked a transition from the ‘legalism’ of the Lunacy Act 1890, with its 19th-century libertarian concerns, to a welfare statute in which decisions about involuntary treatment for mental disorders became primarily a matter for doctors. In the Mental Health Act 1983 a revived form of legalism set some limits to medical discretion. A recent White Paper followed by a draft Mental Health Bill (Department of Health, 2002), a modified form of which will soon be presented in Parliament, promises to mark a new shift in which professional discretion is extremely broad in terms of definitions of mental disorder and treatment, but where considerations of risk are uppermost. [Copyright &y& Elsevier]

Methods of conducting psychotherapy in the most severe forms of childhood posttraumatic stress disorder (PTSD), especially in those traumas discovered very early in life, are rarely reported. This paper presents such a report and in the process emphasizes three elements of treatment: abreaction (full emotional expression of the traumatic experience), context (understanding and gaining perspective on the experience), and correction (finding ways personally or through society to prevent or repair such experiences). With traumatized children, all three elements may be inserted into their therapeutic play, art, and/or talk. An overarching mood of light humor helps the transference stay positive and the child interested. The case of "Cammie," an infant who was bitten, shaken, and sexually abused, and whose 25-day-old sister was discovered at home, murdered, is the subject of this report. This little girl, upon removal at 13 months of age from her home of origin, growled, bit, sniffed sexual organs, rarely spoke, and behaved like the "feral children" described in the classic psychiatric literature. Two respected professionals diagnosed her as mentally retarded. A year in an outstanding foster home did little to improve her. At 29 months of age she was brought to the author, who saw enough imagination and pithy language to believe the child to be intelligent but severely traumatized. The author had begun to conceptualize three principles of PTSD treatment after a study of normal schoolchildren's reactions to the 1986 Challenger disaster. These three principles were used with varying emphases at different phases throughout the "wild child's" 12-year course of once-monthly therapy. Improvement beyond anyone's expectations ensued. [ABSTRACT FROM AUTHOR]

How might urban mental health be understood when animals reconfigure human wellbeing in the lived city? Drawing upon ethnographic fieldwork on people and macaques in New Delhi and forging novel conversations between urban studies, ecology and psychiatry, our ontology of urban mental health moves from lived experience of the built environment to those configured by dwelling with various interlocutors: animals, astral bodies and supernatural currents. These relations create microspaces of wellbeing, keeping forces of urban precarity at bay. This paper discusses mental health ecologies in different registers: subjectivity being environmental, its scale being relational rather than binary, enmeshed in the dynamics of other-than-human life, and involving conversations between medical and vernacular practices rather than hierarchies of knowledge. [ABSTRACT FROM AUTHOR]

Abstract: The following paper aims at finding and analyzing the objective conditions and the subjective processes which lead people to choose studying psychiatry. The authors have used the testimonies of 29 French psychiatrists who had been invited by the review Psychiatrie Internationale and who had been asked the question: “Why have you chosen to study psychiatry?” These texts were compiled and published in 1993 and have undergone content analysis. The results show that in order to explain this choice of studies, it is necessary to consider objective factors (social background, level of achievement during internship, etc.), contingent elements (encounters with professors and/or patients), and more subjective processes which make the choice of this medical specialization an answer to each person''s problems. Furthermore, the specificities of this original corpus show the importance of socio-historical conditions under which the choice of studies is done and invite us to reconsider the issue through the current context. [Copyright &y& Elsevier]

Structured risk assessment schemes can aid violence reduction in mental health and correctional settings. However, the properties and effectiveness of schemes for predicting imminent (within 24-h) violence have not been comprehensively reviewed. To systematically review the properties and predictive performance of structured schemes that have been used to predict imminent aggression. Systematic review and meta-analysis. Multiple electronic databases were searched, relevant reference lists and journals were hand-searched. Thirty-two structured risk assessment schemes were identified and used in a search for evidence about the prediction of imminent violence, or their psychometric properties when used for that purpose. Study findings were synthesised narratively and, where statistics about predictive validity were available, subjected to meta-analyses. Five schemes (Brøset Violence Checklist, HCR-20: Assessing Risk for Violence version 2.0 clinical subscale, Dynamic Appraisal of Situational Aggression and its variants for youth and for women) have been subject to relevant research. Fifty papers were included in a narrative review, and 31 comprising 26 samples involving 282,238 assessments for 2723 individuals were included in meta-analyses. Only the Dynamic Appraisal of Situational Aggression and the Brøset Violence Checklist were subject to implementation research in which the tools were largely rated as having utility for, and being acceptable to, user-participants. Many studies have not established interrater reliability of the tools in the field. After removing outliers, pooled effect sizes for prediction of aggression against people and for any aggression were, respectively: Hedges' g = 1.35[1.15–1.56]) and g = 1.24[0.99, 1.50] for the Brøset Violence Checklist and g = 1.04 [0.69, 1.39] and 0.88 [0.62, 1.15] for the Dynamic Appraisal of Situational Aggression. Moderator analyses revealed pooled effect sizes for both schemes were decreased by low study bias risk and increased by patient forensic vs. civil legal status. Research supports the value of both the Brøset Violence Checklist and the Dynamic Appraisal of Situational Aggression. Both are generally acceptable and feasible to implement, and their predictive value is broadly equivalent producing large pooled effect sizes. There is less evidence about the Dynamic Appraisal of Situational Aggression. variants for women and youth though initial studies are promising. [ABSTRACT FROM AUTHOR]

Introduction: Machine learning capability holds promise to inform disease models, the discovery and development of novel disease modifying therapeutics and prevention strategies in psychiatry. Herein, we provide an introduction on how machine learning/Artificial Intelligence (AI) may instantiate such capabilities, as well as provide rationale for its application to psychiatry in both research and clinical ecosystems.Methods: Databases PubMed and PsycINFO were searched from 1966 to June 2016 for keywords:Big Data, Machine Learning, Precision Medicine, Artificial Intelligence, Mental Health, Mental Disease, Psychiatry, Data Mining, RDoC, and Research Domain Criteria. Articles selected for review were those that were determined to be aligned with the objective of this particular paper.Results: Results indicate that AI is a viable option to build useful predictors of outcome while offering objective and comparable accuracy metrics, a unique opportunity, particularly in mental health research. The approach has also consistently brought notable insight into disease models through processing the vast amount of already available multi-domain, semi-structured medical data. The opportunity for AI in psychiatry, in addition to disease-model refinement, is in characterizing those at risk, and it is likely also relevant to personalizing and discovering therapeutics.Conclusions: Machine learning currently provides an opportunity to parse disease models in complex, multi-factorial disease states (e.g. mental disorders) and could possibly inform treatment selection with existing therapies and provide bases for domain-based therapeutic discovery. [ABSTRACT FROM AUTHOR]