Search

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

The COVID-19 pandemic has changed life in Europe and globally. The pandemic affects both individuals and the broader society across many domains, including physical and psychological health, the economy and general welfare. The measures taken to counteract the pandemic have significantly altered daily life and, along with the threat of contracting the coronavirus and uncertainties surrounding future developments, created a complex system of stressors with a negative impact on public mental health. This paper aims to outline the ESTSS strategy to address mental health issues related to COVID-19 and focuses on (1) trauma-informed policies, (2) capacity building, (3) collaborative research and (4) knowledge-exchange. To facilitate implementation of a trauma-informed approach and appropriate measures, ESTSS has developed a toolkit of recommendations on mental health and psychosocial assistance to be provided during the different phases of crisis and its aftermath. To promote capacity building, ESTSS offers a certification programme based on a curriculum in psychotraumatology and corresponding on-line training to the European community of mental health professionals. To assure evidence-based approaches and methods tailored to current circumstances, ESTSS has initiated a pan-European research project with international cooperation aimed at studying the mental health consequences of the pandemic, with a focus on psychological trauma and other stress-related reactions. To foster knowledge-exchange, the European Journal of Psychotraumatology (EJPT), the official journal of ESTSS, is publishing a special issue on COVID-19.La pandemia de COVID-19 ha cambiado la vida en Europa y en todo el mundo. La pandemia afecta tanto a los individuos como a la sociedad en general en muchos ámbitos, incluida la salud física y psicológica, la economía y el bienestar general. Las medidas tomadas para contrarrestar la pandemia han alterado significativamente la vida diaria y, junto con la amenaza de contraer el coronavirus y las incertidumbres que rodean los desarrollos futuros, crearon un complejo sistema de estresores con un impacto negativo en la salud mental pública. En este artículo se pretende esbozar la estrategia de la ESTSS para abordar los problemas de salud mental relacionados con COVID-19 y se centra en: 1. Políticas informadas en trauma, 2. capacitación, 3. investigación colaborativa, 4. e intercambio de conocimientos. Para facilitar la implementación de un enfoque basado en el trauma y las medidas apropiadas, la ESTSS ha desarrollado un conjunto de herramientas de recomendaciones sobre salud mental y asistencia psicosocial que se proporcionará durante las diferentes fases de la crisis y sus consecuencias. Para fomentar la capacitación, la ESTSS ofrece un programa de certificación basado en un plan de estudios en psicotraumatología y la formación on-line correspondiente a la comunidad europea de profesionales de la salud mental. Para asegurar enfoques y métodos basados en la evidencia adaptados a las circunstancias actuales, la ESTSS ha iniciado un proyecto de investigación paneuropeo con cooperación internacional, destinado a estudiar las consecuencias de la pandemia en la salud mental, con enfoque en el trauma psicológico y otras reacciones relacionadas con el estrés. Para fomentar intercambio de conocimiento, la European Journal of Psychotraumatology (EJPT), la revista oficial de ESTSS, publica un número especial sobre COVID-19.COVID-19疫情改变了欧洲乃至全球的生活。疫情影响着个人和整个社会, 涉及众多领域, 包括身心健康, 经济和一般福利。为应对疫情采取的措施已大大改变了人们的日常生活, 并且随着冠状病毒感染的威胁及未来发展的不确定性, 造成了一个复杂的应激源系统, 对公共心理健康产生了负面影响。本文旨在概述ESTSS解决COVID-19相关心理健康问题的策略, 并重点关注:1.创伤知情政策, 2.能力建设, 3.合作研究以及 4.知识交流。为了促进创伤知情方法和适当措施的实行, ESTSS开发了一套工具包, 包含可在危机不同阶段及之后提供的关心理健康和社会心理援助的建议。为了促进能力建设, ESTSS提供了基于精神创伤学课程的认证计划, 并向欧洲精神卫生专业人员社区提供了相应的在线培训。为了确保采取针对当前情况定制的循证方法, ESTSS与国际合作启动了一项泛欧研究项目, 旨在研究疫情的心理健康后果, 重点关注心理创伤和其他应激相关反应。为了促进知识交流, ESTSS的官方杂志《欧洲精神创伤学杂志》 (EJPT) 正在出版COVID-19相关特刊。.

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

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

Various epidemiological and biological evaluations and the recent publication of the DSM-V (diagnostic and statistical manual of mental disorders) has imposed on the scientific community a period of reflection on the diagnosis and treatment of what in the DSM-IV was defined as "addiction". To date, the term "addiction" has been replaced by the DSM-5, because there is no global scientific consensus that has unequivocally characterized its clinical characteristics. This, we will talk about substance/alcohol use disorders (SUDs/AUDs) and disorders related to behavioral alterations (DBA) that can generate organic diseases, mental disorders, and social problems. In the first psychotic episode 40-70% of subjects meet the criteria of a SUDs/AUDs, excluding tobacco dependence. Substances can not only be the cause of a psychotic onset, but they can also disrupt a psychotic picture or interfere with drug therapy. The pharmacodynamic profiles of many substances are able to provoke the phenomenology of the main psychotic symptoms in a way that can be superimposed onto those presented by psychotic subjects without a history of SUDs/AUDs. The Department of Addictions (DAs) must not be absorbed by or incorporated into the Departments of Mental Health (DMH), with which, however, precise operational cooperation protocols will have to be defined and maintained, but it will have to maintain its own autonomy and independent connotation. Addiction Medicine is a discipline that brings together elements of public health, prevention, internal medicine, clinical pharmacology, neurology, and even psychiatry. The inclusion of the DAs in those of DMH refers purely to a problem of pathology that has to do with lifestyle, choices, and behaviors. These, over time, show their dysfunctionality and only then do related problems emerge. Moreover, epidemiological, social, and clinical motivations impose the creation of alcohological teams dedicated to alcohol-related activities. The collaboration with self-help-groups (SHGs) is mandatory. The action of SHGs is accredited in numerous international recommendations both on the basis of consensus and evidence in the literature.

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

Background As yet, little is known about the effects of mental health stigma on sustainable employment. This is surprising, as mental health stigma is common, and because people with severe and common mental disorders are 7 and 3 times more likely to be unemployed, respectively, than people with no disorders. As the global lifetime prevalence of mental disorders is 29%, the high unemployment rates of people with these health problems constitute an important and urgent public health inequality problem that needs to be addressed. Main text The aim of this position paper is to illustrate the assumption that stigma contributes to the unemployment of people with mental illness and mental health issues with evidence from recent scientific studies on four problem areas, and to provide directions for future research. These four problem areas indicate that: (1) employers and line managers hold negative attitudes towards people with mental illness or mental health issues, which decreases the chances of people with these health problems being hired or supported; (2) both the disclosure and non-disclosure of mental illness or mental health issues can lead to job loss; (3) anticipated discrimination, self-stigma and the ‘Why Try’ effect can lead to insufficient motivation and effort to keep or find employment and can result in unemployment; and (4) stigma is a barrier to seeking healthcare, which can lead to untreated and worsened health conditions and subsequently to adverse occupational outcomes (e.g. sick leave, job loss). Conclusions The paper concludes that stigma in the work context is a considerable and complex problem, and that there is an important knowledge gap especially regarding the long-term effects of stigma on unemployment. To prevent and decrease adverse occupational outcomes in people with mental illness or mental health issues there is an urgent need for high quality and longitudinal research on stigma related consequences for employment. In addition, more validated measures specifically for the employment setting, as well as destigmatizing intervention studies are needed.

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

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

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

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

Evidence-based Practice in Child and Adolescent Mental Health (EPCAMH) is now accepting papers for a special issue focused on acute, intensive, and residential mental health services for youth, gue...

International audience; There is growing interest in non-invasive brain stimulation (NIBS) as a novel treatment option for substance-use disorders (SUDs). Recent momentum stems from a foundation of preclinical neuroscience demonstrating links between neural circuits and drug consuming behavior, as well as recent FDA-approval of NIBS treatments for mental health disorders that share overlapping pathology with SUDs. As with any emerging field, enthusiasm must be tempered by reason; lessons learned from the past should be prudently applied to future therapies. Here, an international ensemble of experts provides an overview of the state of transcranial-electrical (tES) and transcranial-magnetic (TMS) stimulation applied in SUDs. This consensus paper provides a systematic literature review on published data - emphasizing the heterogeneity of methods and outcome measures while suggesting strategies to help bridge knowledge gaps. The goal of this effort is to provide the community with guidelines for best practices in tES/TMS SUD research. We hope this will accelerate the speed at which the community translates basic neuroscience into advanced neuromodulation tools for clinical practice in addiction medicine.

This article presents an undergraduate student research project on a position paper about if the Scottish national party should support Scotland to legalize, decriminalize, or prohibit cannabis conducted on a study abroad program in Edinburgh, Scotland.

BackgroundThe psychometric properties of an online test are not necessarily identical to its paper and pencil original. The aim of this study is to test whether the factor structure of the Community Assessment of Psychic Experiences (CAPE) is measurement invariant with respect to online vs. paper and pencil assessment.MethodThe factor structure of CAPE items assessed by paper and pencil (N = 796) was compared with the factor structure of CAPE items assessed by the Internet (N = 21,590) using formal tests for Measurement Invariance (MI). The effect size was calculated by estimating the Signed Item Difference in the Sample (SIDS) index and the Signed Test Difference in the Sample (STDS) for a hypothetical subject who scores 2 standard deviations above average on the latent dimensions.ResultsThe more restricted Metric Invariance model showed a significantly worse fit compared to the less restricted Configural Invariance model (χ(2)(23) = 152.75, pConclusionsOur findings did not support measurement invariance with respect to assessment method. Because of the small effect sizes, the measurement differences between the online assessed CAPE and its paper and pencil original can be neglected without major consequences for research purposes. However, a person with a high vulnerability for psychotic symptoms would score 4.80 points lower on the total scale if the CAPE is assessed online compared to paper and pencil assessment. Therefore, for clinical purposes, one should be cautious with online assessment of the CAPE.

Evidence-Based Practice in Child and Adolescent Mental Health (EPCAMH) is now accepting papers for a special issue on evidence-based practice in mental health interventions for youth with autism sp...

Objective Only a minority of suicide decedents leave a suicide note. Typically, the notes are handwritten on paper; however, electronic suicide notes have been reported with increasing frequency. This emerging phenomenon remains generally under-researched. The aim of this study was to compare the psychosocial and clinical antecedents of suicide decedents who left E-notes with those who left paper notes or no notes. Method The study was embedded in the Southwestern Ontario Suicide Study (SOSS). The SOSS was a three-year case series of consecutive deaths by suicide that occurred in the region between 2012 and 2014. Data on psychosocial and clinical antecedents were collected with a modified version of the Manchester questionnaire used in the UK. Results Of the 476 suicides files reviewed, 45.8% contained a suicide note. A total of 383 separate suicide notes were left: 74.3% were paper notes and 25.7% were E-notes. The results of the multivariate regression analyses indicate that the likelihood of leaving a suicide note was negatively associated with a history of admissions to a mental health unit, while the likelihood of leaving an E-note was negatively associated with age, positively associated with presence of a mental disorder, and negatively associated with history of hospital admissions. Conclusions Future studies with larger samples need to consider the timing of the text messages, and appraise whether there was the intent of seeking help or rescue in the text messages.

Aims.Leucht et al. in 2012 described an overview of meta-analyses of the efficacy of medication in psychiatry and general medicine, concluding that psychiatric drugs were not less efficacious than other drugs. Our goal was to explore the dissemination of this highly cited paper, which combined a thought provoking message with a series of caveats.Methods.We conducted a prospectively registered citation content analysis. All papers published before June 1st citing the target paper were independently rated by two investigators. The primary outcome coded dichotomously was whether the citation was used to justify a small or modest effect observed for a given treatment. Secondary outcomes regarded mentioning any caveats when citing the target paper, the point the citation was making (treatment effectiveness in psychiatry closely resembles that in general medicine, others), the type of condition (psychiatric, medical or both), specific disease, treatment category and specific type. We also extracted information about the type of citing paper, financial conflict of interest (COI) declared and any industry support. The primary analysis was descriptive by tabulating the extracted variables, with numbers and percentages where appropriate. Co-authorship networks were constructed to identify possible clusters of citing authors. An exploratory univariate logistic regression was used to explore the relationship between each of a subset of pre-specified secondary outcomes and the primary outcome.Results.We identified 135 records and retrieved and analysed 120. Sixty-three (53%) quoted Leucht et al.’s paper to justify a small or modest effect observed for a given therapy, and 113 (94%) did not mention any caveats. Seventy-two (60%) used the citation to claim that treatment effectiveness in psychiatry closely resembles that in general medicine; 110 (91%) paper were about psychiatric conditions. Forty-one (34%) papers quoted it without pointing towards any specific treatment category, 28 (23%) were about antidepressants, 18 (15%) about antipsychotics. Forty (33%) of the citing papers included data. COIs were reported in 55 papers (46%). Univariate and multivariate regressions showed an association between a quote justifying small or modest effects and the point that treatment effectiveness in psychiatry closely resembles that in general medicine.Conclusions.Our evaluation revealed an overwhelmingly uncritical reception and seemed to indicate that beyond defending psychiatry as a discipline, the paper by Leucht et al. served to lend support and credibility to a therapeutic myth: trivial effects of mental health interventions, most often drugs, are to be expected and therefore accepted.Protocol registration: https://osf.io/9dqat/