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Background: The concept of stigma has been widely used to understand patterns of discrimination and negative ideas surrounding people with mental health problems, yet we know little of the specific nuances of how this might operate beyond the 'Global North'. Aim: This paper aims to explore the notion of stigma in an Indian context by considering the lived experience of patients, carers and community members. Methods: A sample of 204 participants, representing mental health patients, informal carers and community members was recruited from urban and rural areas in Kerala, India. Participants took part in interviews where they were encouraged to talk about their experiences of mental ill health, attitudes towards these problems, barriers encountered and sources of support. Results: Experiences akin to the experience of stigma in Europe and the United States were elicited but there were important local dimensions specific to the Indian context. The difficulties faced by people with diagnoses of mental disorders in finding marriage partners was seen as an important problem, leading to marriage proposals being refused in some cases, and secrecy on the part of those with mental health problems. Rather than the 'self-stigma' identified in the US, participants were more likely to see this as a collective problem in that it could reflect badly on the family group as a whole rather than just the sufferer. Conclusions: In the Indian context, the idioms of stigma emphasised impairments in marriage eligibility and the implications for the family group rather than just the self. [ABSTRACT FROM AUTHOR]

Background: Over the past decade, antidepressant prescriptions have increased in European countries and the United States, partly due to an increase in the number of new cases of mental illness. This paper demonstrates an innovative approach to the classification of population level change in mental health status, using administrative data for a large sample of the Scottish population. We aimed to identify groups of individuals with similar patterns of change in pattern of prescribing, validate these groups by comparison with other indicators of mental illness, and characterise the population most at risk of increasing mental ill health., Methods: National Health Service (NHS) prescription data were linked to the Scottish Longitudinal Study (SLS), a 5.3% sample of the Scottish population (N = 151,418). Antidepressant prescription status over the previous 6 months was recorded for every month for which data were available (January 2009-December 2014), and sequence dissimilarity was computed by optimal matching. Hierarchical clustering was used to create groups of participants who had similar patterns of change, with multi-level logistic regression used to understand group membership., Results: Five distinct prescription pattern groups were observed, indicating: no prescriptions (76%), occasional prescriptions (10%), continuation of prior use of prescriptions (8%), a new course of prescriptions started (4%) or ceased taking prescriptions (3%). Young, white, female participants, of low social grade, residing in socially deprived neighbourhoods, living alone, being separated/divorced or out of the labour force, were more likely to be in the group that started a new course of antidepressant prescriptions., Conclusions: The use of sequence analysis for classifying individual antidepressant trajectories offers a novel approach for capturing population-level changes in mental health risk. By classifying individuals into groups based on their anti-depressant medication use we can better identify how over time, mental health is associated with individual risk factors and contextual factors at the local level and the macro political and economic scale.

Over the last half of the twentieth century, many advances in the field of psychiatry and mental health have occurred and continue today. Among these developments are the increasing recognition of patient rights and the expanding role of psychiatric nurses. This paper presents a view of how these changes have been reflected in film over a period of fifty years in both documentary and Hollywood movies. Discussion of advances in psychiatry, as identified in the selected films, is presented against the background of social change that was occurring in the United States and Western Europe during this period. [ABSTRACT FROM AUTHOR]

This paper provides an overview of the rapidly evolving paradigm of "Integrative Mental Health (IMH)." The paradigm of contemporary biomedical psychiatry and its contrast to non-allopathic systems of medicine is initially reviewed, followed by an exploration of the emerging paradigm of IMH, which aims to reconcile the bio-psycho-socio-spiritual model with evidence-based methods from traditional healing practices. IMH is rapidly transforming conventional understandings of mental illness and has significant positive implications for the day-to-day practice of mental health care. IMH incorporates mainstream interventions such as pharmacologic treatments, psychotherapy, and psychosocial interventions, as well as alternative therapies such as acupuncture, herbal and nutritional medicine, dietary modification, meditation, etc. Two recent international conferences in Europe and the United States show that interest in integrative mental health care is growing rapidly. In response, the International Network of Integrative Mental Health (INIMH: www.INIMH.org) was established in 2010 with the objective of creating an international network of clinicians, researchers, and public health advocates to advance a global agenda for research, education, and clinical practice of evidence-based integrative mental health care. The paper concludes with a discussion of emerging opportunities for research in IMH, and an exploration of potential clinical applications of integrative mental health care., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Epidemiological evidence suggests that regular physical activity (PA) positively impacts individuals' mental health (MH). The PA-MH relationship may be critical among immigrants owing to psycho-social-cultural influences. This scoping review of 61 studies employed a holistic bio-psycho-socio-cultural framework to thoroughly investigate the complex relationship between PA (across life domains) and immigrants' MH in Western countries. A systematic search of five electronic databases (Medline, PubMed, Embase, PsycINFO and Anthropology Plus) was conducted to locate relevant articles. No limitations were applied to study design, age, gender, home country, MH condition or PA type. A bio-psycho-socio-cultural-informed conceptual model guided the analysis of the multi-domain PA-MH relationship. Immigrant PA-MH studies were conducted and reported most commonly in the USA (38%), Australia (18%), and Canada (11%). Overall, PA was positively related to MH. Each domain-specific PA appeared to be associated with unique MH-promoting pathways/mechanisms. Leisure-related PA may support MH by enhancing self-agency and minimizing risky behaviors, whilst travel- and domestic-related PA may promote self-accomplishment and physical engagement. Ethnic sports appeared to enhance resilience. Occupational-related PA was associated with either positive or negative MH, depending on the type of occupation. A bio-psycho-socio-cultural-informed model is required to gain an encompassing and integrated understanding of immigrants' health. The first iteration of such a model is presented here, along with an illustration of how the model may be used to deepen analysis and understanding of the multi-domain PA-MH relationship among immigrants and inform public health planners and practitioners. [ABSTRACT FROM AUTHOR]

We present evidence that psychological well-being is U-shaped through life. A difficulty with research on this issue is that there are likely to be omitted cohort effects (earlier generations may have been born in, say, particularly good or bad times). First, using data on 500,000 randomly sampled Americans and West Europeans, the paper designs a test that can control for cohort effects. Holding other factors constant, we show that a typical individual's happiness reaches its minimum - on both sides of the Atlantic and for both males and females - in middle age. Second, evidence is provided for the existence of a similar U-shape through the life-course in East European, Latin American and Asian nations. Third, a U-shape in age is found in separate well-being regression equations in 72 developed and developing nations. Fourth, using measures that are closer to psychiatric scores, we document a comparable well-being curve across the life cycle in 2 other data sets (1) in GHQ-N6 mental health levels among a sample of 16,000 Europeans, and (2) in reported depression-and-anxiety levels among 1 million UK citizens. Fifth, we discuss some apparent exceptions, particularly in developing nations, to the U-shape. Sixth, we note that American male birth-cohorts seem to have become progressively less content with their lives. Our results are based on regression equations in which other influences, such as demographic variables and income, are held constant.

In recent years, job stress and stress management have emerged as key issues in health promotion in the workplace in all of the post-industrialized countries. In the EU, the European Survey on Working Conditions has reveals that stress and musculo-skeletal disorders are the main health risks at work. In the US, NORA (national occupational research agenda) identifies 21 research priorities, in which "organization of work" is included as a job stress related factor. In this paper, trends and characteristics in occupational stress management in western countries, especially in the EU are overviewed. Presently, most stress management activities are oriented towards secondary or tertiary prevention, and are worker-oriented. But in future, priority strategy for intervention should be primary prevention, and focused on the organization as the generator of risk. In the group of countries paying a lot of attention to work stress, health policies or legal framework at the national level and a variety of activities for stress prevention at the company level are well integrated. By analyzing various stress management cases or projects, key factors for a successful approach to stress prevention are extracted as follows: 1. A stepwise and systematic approach, 2. clear determination of aims, tasks, responsibilities, planning and financial means, 3. An adequate diagnosis of risk analysis, 4. A combination of work-directed and worker-directed measures, 5. A participative approach, 6. Top management support. Costs-benefit assessment should be introduced to evaluate the effectiveness of stress prevention and to promote more integrated approaches in the workplace.

Background and Objectives Grandparents are key resources in grandchildren care globally. However, mixed findings indicated that multiple role engagement may enhance well-being and bring demands on grandparent caregivers in different contexts. This systematic review examines the association between the intensity of grandparent caregiving and their health and well-being (i.e. physical, mental, cognitive, and life satisfaction) by continent and country/region. Research Design and Methods Systematic searches were conducted in 4 databases. Peer-reviewed articles with quantitative designs published between 1990 and November 2021 were identified. A rigorous selection process was followed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The studies were critically appraised, and their results were narratively synthesized. Results Sixty-five articles from 29 countries/regions were included. Findings suggested a concave curvilinear relationship between the intensity of grandparent caregiving and their health and well-being, with the optimal caregiving intensity varying across sociocultural contexts. In Europe, Oceania, the Middle East, and South America, providing supplementary or occasional care seems beneficial for grandparents' health and well-being, especially supporting dual-earner families. In East Asia, economic resources appear to buffer the adverse effect of primary care on grandparents' well-being. In the United States, findings vary across ethnicity/race. Discussion and Implications Collectively, the intensity of grandparent caregiving, health, and well-being is complicated by grandparents' roles in the family and cultural differences. Acknowledging the bidirectional relationship between well-being and grandparents' capacity for providing care, the well-being as outcome is a limitation. Despite so, this systematic review calls for culturally-tailored family programs to support grandparent caregiving. [ABSTRACT FROM AUTHOR]

Background: The Double OT (DOT) assessment is occupation-based and dynamic, designed with a clientcentered format requiring skill demonstration. It was developed to support youth transitioning into the workplace. This research intended to analyze initial validity and users' experience. Method: This study includes qualitative and quantitative analyses of data collected from surveys from 169 client participants (APs) and 30 recipient participants (ARRs) from eight sites in the USA and Europe. AP were 14 to 25 years of age and engaged in residential, educational, and vocational settings. The ARRs comprised partners who had received DOT assessment summaries about APs with whom they worked. Results: The APs showed high engagement and learning; average ratings for each item fell between 4.24-4.54 on a 5-point Likert scale. The ARRs agreed on the validity and usability of the DOT; average ratings for each item fell between 3.75 and 4.53 on a 5-point Likert scale. Qualitative themes indicated that the DOT is: "fun and engaging," "vocationally informative and applicable," and that there is an absence of commonly used assessments informing vocational transitions. Conclusion: The results support initial validity of the DOT. Users find it to be highly engaging, with good usability, and indicate that it facilitates participant learning. [ABSTRACT FROM AUTHOR]

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Background: The US National Institutes of Mental Health Research Domain Criteria (RDoC) seek to stimulate research into biologically validated neuropsychological dimensions across mental illness symptoms and diagnoses. The RDoC framework comprises 39 functional constructs designed to be revised and refined, with the overall goal of improving diagnostic validity and treatments. This study aimed to reach a consensus among experts in the addiction field on the 'primary' RDoC constructs most relevant to substance and behavioural addictions. Methods: Forty‐four addiction experts were recruited from Australia, Asia, Europe and the Americas. The Delphi technique was used to determine a consensus as to the degree of importance of each construct in understanding the essential dimensions underpinning addictive behaviours. Expert opinions were canvassed online over three rounds (97% completion rate), with each consecutive round offering feedback for experts to review their opinions. Results: Seven constructs were endorsed by ≥ 80% of experts as 'primary' to the understanding of addictive behaviour: five from the Positive Valence System (reward valuation, expectancy, action selection, reward learning, habit); one from the Cognitive Control System (response selection/inhibition); and one expert‐initiated construct (compulsivity). These constructs were rated to be related differentially to stages of the addiction cycle, with some linked more closely to addiction onset and others more to chronicity. Experts agreed that these neuropsychological dimensions apply across a range of addictions. Conclusions: The study offers a novel and neuropsychologically informed theoretical framework, as well as a cogent step forward to test transdiagnostic concepts in addiction research, with direct implications for assessment, diagnosis, staging of disorder, and treatment. [ABSTRACT FROM AUTHOR]

Objectives We explore marital and depression trajectories over time for men and women, and distinguish between mood and somatic depression across contexts. Method We use longitudinal data from 2002 to 2013 from the United States, England, Europe, Korea, and China to explore depression among individuals married at baseline and follow their trajectories into widowhood with married as the reference group. We use random effects models to estimate these trajectories using the Center for Epidemiologic Studies Depression Scale (CES-D) or EURO-D scales for men and women. Results Depression peaks within the first year of widowhood for men and women, but women recover to levels comparable to married counterparts in all countries. Men sustain high levels of depression even 6–10 years post-widowhood everywhere except Europe. Widowed women have higher somatic depression compared to men, who have higher mood depression. Family plays differential roles in mediating depression across countries. Discussion Our research shows the complex global relationship between widowhood and depression. Studies that do not compare depression trajectories over time may make incorrect inferences about the persistence of depression by gender and country. Interventions should target different components of depression: mood-related symptoms for men and somatic-related symptoms for women for most effective recovery. [ABSTRACT FROM AUTHOR]

Background: It is possible that some people who quit smoking experience improved mental health after cessation and therefore remain abstinent, whereas other people who quit may experience worse mental health after cessation and therefore be more likely to relapse to smoking. Thus, in this study we aimed to examine the association between an enduring change in mental health following the cessation period and future risk of relapse.Methods: A secondary analysis of prospective data pooled from five placebo-controlled randomised trials for smoking reduction conducted in Europe, USA and Australia. Change in mental health (SF-36, scored 0-100) was measured from baseline to four months for those who were biologically-validated as point-prevalence abstainers at four month follow-up. Thereafter we assessed whether relapse to smoking by 12 months was more likely in those whose mental health had worsened between baseline and four months compared with those who saw no change or an improvement.Results: After adjustment for baseline mental health and other major covariates, there was no greater tendency to relapse at 12 months for those whose mental health worsened after cessation compared with those who had no change or an improvement. The odds ratio and 95% confidence interval was 1.01 (0.97 to 1.05).Conclusions: People whose mental health worsens after smoking cessation are at no greater risk of subsequent relapse to smoking than those whose mental health stays the same or improves. [ABSTRACT FROM AUTHOR]

Adolescent behavior problems such as substance use, antisocial behavior problems, and mental health problems have extremely high social costs and lead to overburdened mental health and juvenile justice systems in the United States and Europe. The prevalence of these problems is substantial, and at-risk youth often present with a combination of concerns. An understanding of risk and protective factors at multiple levels, including the child, family, peer, school, and community, has influenced intervention development. At the individual and family levels, the most effective and cost-effective programs work intensively with youth and their families or use individual and group cognitivebehavioral approaches. However, there is a paucity of careful studies of effective policies and programs in the juvenile justice system. Research is needed that focuses on adoption, financing, implementation, and sustainable use of evidence-based programs in public service systems. In addition, the field needs to understand better for whom current programs are most effective to create the next generation of more effective and efficient programs. [ABSTRACT FROM AUTHOR]

This article surveys evolving and competing medico-legal concepts of pyromania and insane arson. Exploiting evidence from medical jurisprudence, medico-legal publications, medical lexicography and case histories, it seeks to explicate the key positions in contemporary professional debates concerning arson and mental derangement. A major focus is the application of the doctrines of moral and partial insanity, monomania, instinctive insanity and irresistible impulse to understandings of pyromania and insane arson. The limited extent to which mental defect provided a satisfactory diagnosis and exculpatory plea for morbid arson is also explored. Additionally, this article compares and contrasts contemporary debates about other special manias, especially kleptomania. Part 2 will be published in the next issue, History of Psychiatry 21(4). [ABSTRACT FROM AUTHOR]

International terrorism has become a major global concern. Several studies conducted in North America and Europe in the aftermath of terrorist attacks reveal that international terrorism represents a significant shortterm and longterm threat to mental health. In the present article, the authors clarify the concept and categories of terrorism and then present central findings from studies conducted in the United States and Europe, which mainly focus on negative impacts on mental health, such as emotional stress and PTSD. Furthermore, the authors outline experiments that focus on social interaction princesses thought to be triggered by international terrorism and which are assumed to be related indirectly to mental health processes. Next, they highlight the potential positive outcomes on the resilience side, in line with the current theory on posttraumatic growth in adversity. Finally, theoretical and practical implications as well as limitations and future directions are discussed. [ABSTRACT FROM AUTHOR]

The Psychiatry Service of Memorial Sloan-Kettering Cancer Center, the European School of Oncology, American Italian Foundation for Cancer Research, the International Psycho-Oncology Society and the American Society of Psychiatric Oncology and AIDS, sponsored a psycho-oncology update in New York City on October 2-4, 1993. The conference entitled "Psycho-oncology V: Psychosocial Factors in Cancer Risk and Survival" was attended by over 300 participants from medical and mental health backgrounds from over 20 different countries spanning North and South America, Europe, Africa, Asia, and Australia.