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Psychiatric research has increased remarkably over recent decades to help in understanding the current trends and better therapeutic options for illness. On the other hand, there is also a trend toward higher rates of retraction of published papers in the recent years. Ethics is required to maintain and increase the overall quality and morality of research. Psychiatric research faces several unique ethical challenges. Ethical guidelines are very important tool of research which safeguards participants; however, there is a dearth of such guidelines in India. The present paper aims to review available ethical issues and guidelines pertaining to psychiatric research. A search was conducted on Pubmed using search terms (e.g., "ethics," "psychiatry," "research"). Relevant studies were selected for the review after manual screening of title/abstract. Additional sources were referred to using cross references and Google Scholar. Psychiatric research has several important ethical issues which are different from other medical disciplines. These issues are related to informed consent, confidentiality, conflict of interest, therapeutic misconception, placebo related, vulnerability, exploitation, operational challenges, among others. The current paper has made several recommendations to deal with ethical challenges commonly faced in psychiatric research. The ethical guidelines are utmost needed for Indian psychiatric research. Specific guidelines are lacking pertaining to psychiatric research. The issues and recommendations merit a further discussion and consideration. [ABSTRACT FROM AUTHOR]

The article presents a paper, a part of a planned series of Elements of Care papers, focusing on identifying common elements which are important for providing appropriate psychiatric care in different models of care in Canada. It focuses on direct patient care or service for payment in traditional care model and also discusses indirect services involved in such models, like diagnostic assessment or patient management. It also focuses on involvement of family or caregivers in indirect services.

The notion of recovery has been embraced by key stakeholders across Canada and elsewhere. This has led to a proliferation of definitions, models, and research on recovery, making it vitally important to examine the data to disentangle the evidence from the rhetoric. In this paper, first we ask, what do people living with severe mental illness (SMI) say about recovery in autobiographical accounts? Second, what do they say about recovery in qualitative studies? Third, from what we have uncovered about recovery, can we learn anything from quantitative studies about proportions of people leading lives of recovery? Finally, can we identify interventions and approaches that may be consistent or inconsistent with the grounded notions of recovery unearthed in this paper? We found that people with mental illness frequently state that recovery is a journey, characterized by a growing sense of agency and autonomy, as well as greater participation in normative activities, such as employment, education, and community life. However, the evidence suggests that most people with SMI still live in a manner inconsistent with recovery; for example, their unemployment rate is over 80%, and they are disproportionately vulnerable to homelessness, stigma, and victimization. Research stemming from rehabilitation science suggests that recovery can be enhanced by various evidence-based services, such as supported employment, as well as by clinical approaches, such as shared decision making and peer support. But these are not routinely available. As such, significant systemic changes are necessary to truly create a recovery-oriented mental health system. [ABSTRACT FROM AUTHOR]

This commentary speaks to several issues that arise from the papers in this special issue. Two articles--Kessler (2002) and Mirowsky and Ross (2002)--focus on a major measurement issue: dimensional versus diagnostic-type assessments. One topic requires greater attention: the correspondence of these measures with the underlying states they supposedly measure--constructs in the psychometric tradition and empirically defined illnesses in the medical or psychiatric tradition. Conclusions about the nature of these unobserved states remain tentative at this time. Three articles--Keyes (2002), Schwartz (2002), and Umberson, Williams, and Anderson (2002)--address the expansion of mental health outcomes. The existing reliance on emotional distress is problematic for sociological research because a single disorder is not a good proxy for estimates of the overall mental health consequences of social arrangements. Although these papers present diverse and sometimes conflicting perspectives, collectively they demonstrate that no one approach to outcomes is best for all research questions. [ABSTRACT FROM AUTHOR]

When I began my psychiatric residency training in Boston in the late 1950s, sociologists and other social scientists were active members of many major academic departments of psychiatry. Collaboration between psychiatrists and sociologists and anthropologists was widespread and had considerable influence on theory and clinical practice. NIMH had established its Laboratory of Socio-Environmental Studies under the leadership of John Clausen. Sociologists and anthropologists were active in policy-making and research activities at NIMH and at many foundations. The influential works of Stanton and Schwartz (1954), Hollingshead and Redlich (1958), and Greenblatt, Levinson, and Williams (1957) reflect this period of collaboration. Over the subsequent three decades, the relationship between sociology and psychiatry changed considerably. Now relatively few academic departments of psychiatry have social scientists on their full-time faculty. Interaction between psychiatrists and social scientists, in many instances, has become adversarial. This adversarial quality, I believe, is reflected in the paper by Mirowsky and Ross. Their paper illustrates a genre of social science criticism of psychiatry which challenges the scientific validity of the concept of mental illness and raises important issues in measurement. Mirowsky and Ross, however, go beyond the scientific issues; they offer a social criticism of recent changes in psychiatry which they perceive to be the "legacy of nineteenth-century epidemiology and microbiology." Mirowsky and Ross are correct in their perception that significant shifts have occurred within psychiatry over the past decade. Yet their historical reconstruction of those changes and their understanding of the scientific basis for current research and clinical practice are seriously limited; they reflect their ideological commitment more than an appreciation of the increased sophistication of recent theoretical discourse and empirical research in psychiatry. In my commentary I will attempt to correct this imbalance by reconstructing the recent history and by explicating the rationale behind the current approach to psychiatric diagnostic categories. [ABSTRACT FROM AUTHOR]

Drawing on the stress paradigm and using data from the Duke Mental Health Study, this paper investigates the links between violence by and against persons with severe mental illness and their caregivers' financial burden (e.g., number of financial contributions and perceived financial strain). In addition to violence, substance use and medication noncompliance are included in a series of multivariate regression models predicting caregiver financial burden that include measures for disruptive behaviors, personal needs, social supports, and caregiver characteristics. The findings show that violent perpetration and violent victimization increase the number of financial contributions and perceived financial strain. Nonviolent victimization, in contrast, decreases caregiver financial burden. Number of financial contributions and perceived financial strain are greatest when the family member is violent and extremely disruptive or needs assistance with personal care. Neither substance use nor medication noncompliance contributed to caregiver financial burden. Co-residence, female sex, parenthood, and instrumental social support were also associated with financial burden. [ABSTRACT FROM AUTHOR]

In Ukraine, mental health problems are common yet the mental health services available are still old fashioned and based on healthcare approaches used in the Soviet Union, providing mainly inpatient services and rudimentary community services. The World Health Organization (WHO) introduced the Mental Health Gap Action Programme (mhGAP) to reduce the mental health treatment gap all over the world and 2 years later introduced the WHO mhGAP-Intervention Guide (mhGAP-IG), version 2.0 (2016) as not only an educational tool, but also an evidence based guideline to scale up services for mental, neurological and substance use (MNS) conditions with an objective to reduce gap between available health systems capacity and resources for mental health. The main aim of this paper is to describe reforms of undergraduate psychiatry training in Ukraine using Kyiv Medical University as a case example. Kyiv Medical University (KMU) is the first university in Ukraine to introduce the mhGAP-IG in Ukraine. The revised psychiatry curricula in KMU aims to strengthens the evidence based teaching practices, to put emphasis on community orientated mental health care, and to use interactive teaching methods that the university hopes will attract more future doctors to psychiatry and ideally contribute towards the reduction of the mental health treatment-gap in Ukraine. [ABSTRACT FROM AUTHOR]

In Ukraine, mental health problems are common yet the mental health services available are still old fashioned and based on healthcare approaches used in the Soviet Union, providing mainly inpatient services and rudimentary community services. The World Health Organization (WHO) introduced the Mental Health Gap Action Programme (mhGAP) to reduce the mental health treatment gap all over the world and 2 years later introduced the WHO mhGAP-Intervention Guide (mhGAP-IG), version 2.0 (2016) as not only an educational tool, but also an evidence based guideline to scale up services for mental, neurological and substance use (MNS) conditions with an objective to reduce gap between available health systems capacity and resources for mental health. The main aim of this paper is to describe reforms of undergraduate psychiatry training in Ukraine using Kyiv Medical University as a case example. Kyiv Medical University (KMU) is the first university in Ukraine to introduce the mhGAP-IG in Ukraine. The revised psychiatry curricula in KMU aims to strengthens the evidence based teaching practices, to put emphasis on community orientated mental health care, and to use interactive teaching methods that the university hopes will attract more future doctors to psychiatry and ideally contribute towards the reduction of the mental health treatment-gap in Ukraine. [ABSTRACT FROM AUTHOR]

Two main approaches concerning the relation between sexism and psychiatry have been developed in the feminist literature. One, now less fashionable, follows Phyllis Chesler's influential Women and Madness (1972) in emphasising the centrality of sexism within psychiatry and its constructs of mental illness. The other, emphasising the sexism within Society as a whole and the way it generates mental suffering and disturbance, suggests the potential of psychiatry and the mental health professions to ameliorate that suffering. This paper looks once more at the second approach to see whether it should now be abandoned. It analyses the role gender plays within psychiatry, distinguishing three levels of definition and identification -- official definition, the delineation of `normal cases', and the identification of individual cases. It points to the way in which issues of gender impinge on all three levels and argues that there is little evidence of the increasing marginalisation of the dimension of gender within psychiatry. [ABSTRACT FROM AUTHOR]

The paper analyses an interview describing how K came to be defined by her friends as mentally ill. The method of analysis assumes that the structure of the conceptual scheme `mental illness' which the reader uses in recognizing 'mental illness' is isomorphic with that organizing the text and hence is discoverable 'in' it. The full text of the interview is presented as the data. The analysis explicates the interpretation of the text as a method of reading. The text is found to provide instructions for its interpretation and for the authorization of its facticity. K's mental illness is to be located in the collection of instances of K's behaviour which the interview records. How is behaviour to be described as `mentally ill type' behaviour? It is suggested that the interview as a whole organizes a `cutting-out' procedure whereby K's behaviour is presented as making sense neither to her friends nor to the reader of the text. The procedure involves showing for each instance of her behaviour as well as for the collection as a whole that K's behaviour is not properly provided for by relevant social rules or definitions of the situation. To be recognizable as 'mentally ill type' behaviour examples of K's actions must be constituted as anomalies rather than as deviations from a norm or rule. [ABSTRACT FROM AUTHOR]

This paper examines the process of psychiatric diagnosis in a community mental health center walk-in clinic. The results indicate a great deal of conflict and contradiction in the psychiatric evaluation. This is discussed in light of several tensions: (1) mixed agendas surrounding diagnosis; (2) conflict between training and professional practice; (3) conflict created when a public facility is staffed by an elite medical school; (4) conflict between providing mental health services while serving the needs of other public agencies and mandates; and (5) conflict between an ascendant biopsychiatric model and the daily work of clinical therapeutic service. [ABSTRACT FROM AUTHOR]

This paper coin pares the conceptions of mental illness held by a group of psychiatrists and a random sample of the general public in the same locality. The hypothesis was that the public, but not the psychiatrists, would tend to consider troublesome behavior as being more indicative of mental illness than non-troublesome behavior. Statements representing five pairs of troublesome non-troublesome types of behavior were rated by both groups as indicators of mental illness. Analysis of the data, using the statements at face value and with a weighting system, did not support the hypothesis. Both public and psychiatrists appear to have similar views but not in the expected order. Most notably, manic behavior ranked very low among the conceptions of mental illness. This finding accords with recent reports of a decline in the incidence of manic- depressive psychoses. Is this decline due to changes in modern society that alter public and psychiatric conceptions of mental illness? [ABSTRACT FROM AUTHOR]

This article presents information about the book "Report of the International Study Group of the World Federation of Mental Health," vol. 2, "Mental Health and Contemporary Thought," and vol. 3, "Mental Health in the Service of the Community," edited by Kenneth Soddy and Robert H. Ahrenfeldt. In June 1961 the World Federation of Mental Health assembled a study group of twenty-four experts for an extended period of extempore discussion. The participants prepared working papers in advance of the meeting and tape recordings were made of the discussions. Using these materials two members of the Study Group have produced a three-volume report of the proceedings. In his Preface the Chairman of the Study Group seeks to anticipate criticisms from the natural science purists of such an unsystematic, unorthodox approach to problem solving. In vol. 2, social, demographic, diplomatic and military problems get some decidedly amateurish handling. About ninety pages of introduction and bibliography are common to all three volumes.

The article presents Michael Hughes' introduction, the editor of the "Journal of Health and Social Behavior." When he applied for the post of editor he pledged that he would encourage the submission of more articles with an institutional or organizational focus on health care and health care delivery. During his editorship, the journal did not receive an inordinate number of submissions on health care, and from March 2001 through June 2004, the "Journal of Health and Social Behavior," published health care organization and delivery articles at about the same rate as it had over the previous six years. Most papers submitted to and published in the journal continued to be on the etiology and epidemiology of health problems, including a very high proportion of studies on mental health and the stress process. As his background is in social psychological approaches to mental health, he had to lean heavily on those with the appropriate expertise. He thanks Ann Flood, deputy editor, who was immensely helpful in initial planning for the issue and in helping him work through the problem of identifying an editor.