International Journal of Social Psychiatry最新文献

Background: Complex post-traumatic stress disorder (C-PTSD) has been included in the International Classification of Diseases 11th Revision (ICD-11) to capture symptomatology caused by extreme, prolonged, or multiple forms of trauma.

Aims: The present systematic review and meta-analysis sought to assess the one-month prevalence of this disorder in the community setting.

Method: A systematic search was conducted in four databases (Google Scholar, PubMed, Web of Science, and Scopus) where relevant studies were subjected to explicit eligibility criteria, resulting in 16 included studies and 22 effect sizes. Study characteristics were tabulated, their methodological quality was assessed and findings were synthesized using a random-effects meta-analysis.

Results: Findings indicated overall that C-PTSD has a moderate prevalence in this population (PREV = 8.59%, 95% CI [5.84%, 11.34%], I² = 98.6%). Moderator analyses indicated that prevalence differed significantly by continent, scale, sample type, country, and language.

Conclusions: The results of this study strongly indicate that 9 out of 100 people in the community are at risk for C-PTSD, making it a primary focus of attention and the public policies that it represents. Future research should further explore the prevalence of C-PTSD among specific population groups who experienced specific episodes of trauma.

Background: With ongoing conflicts worldwide, the refugee crisis has escalated into a global humanitarian crisis, straining mental health professionals supporting war refugees. Growing demands and the emotional toll of witnessing trauma of the survivors of war highlight the need for research to better equip these professionals.

Aims: This study examines influence of age on burnout and secondary traumatic stress (STS) among 103 mental health professionals working with war refugees in Pakistan, focusing on the moderating roles of detachment and work hours.

Method: In this cross-sectional study, 103 mental health professionals completed the Professional Quality of Life Scale, Experiences Questionnaire, and Secondary Traumatic Stress Scale. Regression, moderation, and mediation analyses were conducted using SPSS PROCESS macro.

Results: Increased work hours intensified the burnout-STS relationship, while detachment served as a protective factor by moderating this relationship rather than directly predicting STS. Additionally, burnout mediated the relationship between age and STS, with older professionals reporting lower burnout and, in turn, lower STS symptoms.

Conclusions: These findings highlight the importance of addressing burnout in efforts to reduce STS among refugee-serving professionals and suggest that fostering detachment and managing work hours may provide protective benefits.

Background: In Arab countries, the integration of community mental health services is a meaningful way to improve access to culturally sensitive mental health care that promotes the recovery process and reduces societal stigma. However, despite the most recent movements that are leaning more toward the community, there are barriers to effective treatment: a lack of resources and stigma associated with mental health still make the delivery of mental health services difficult.

Aim: This review aims to examine the challenges and opportunities involved in integrating community mental health services (CMHS) in Arab countries.

Methods: This scoping review explored the literature in PubMed and Scopus, focusing on studies published between 2015 and 2024. Utilizing the Arksey and O'Malley framework and following PRISMA guidelines, we reviewed 16 articles to pinpoint barriers to the implementation of community mental health services in the Arab world. Two independent reviewers meticulously evaluated the data extracted from each study. A narrative synthesis analysis was conducted to evaluate the effectiveness of community mental health services (CMHS) in Arab nations, based on a theoretical framework designed to understand their role.

Results: Key barriers identified were stigma associated with mental illness of these conditions, lack of resources, inadequate training of health care practitioners, and fragmentation of services. Cultural constraints and legal inadequacies contribute to the challenges surrounding service provision, as social media fosters new trends in self-diagnosis and self-medication.

Discussion: To enhance the quality and access of community mental health facilities, the integral barriers must be resolved. Strategies must improve public awareness, foster cultural sensitivity in service delivery, and reform policies to support mental health initiatives.

Conclusion: Community mental health training, investment in resources, and targeted mental health policies can facilitate the successful integration of community mental health services into existing healthcare infrastructures in Arab countries.

Clinical relevance: This paper provides a comprehensive overview of the barriers to integrating community mental health services in Arab countries, highlighting critical issues such as stigma, resource limitations, and cultural challenges. It emphasizes the need for targeted strategies to enhance public awareness, improve training for healthcare providers, and develop supportive policies and initiatives.

Background: Hikikomori, marked by intense social withdrawal and isolation, was first reported in Japan and has since been identified globally, including in Singapore. While excessive internet use has been proposed as a potential contributing factor, its influence remains contested. Rather, a person's negative and cynical view of their social environment may better explain the tendency to withdraw which is mediated by internet use.

Aims: This study investigates social cynicism as a potential antecedent of Hikikomori among Singaporean adults, exploring whether problematic internet use mediates this relationship.

Methods: The study employed a cross-sectional design with a sample of 229 adults in Singapore, using validated measures to assess levels of social cynicism, problematic internet use, and Hikikomori tendencies. Path analyses were applied to determine both direct and mediated effects.

Results: Results indicated that social cynicism and problematic internet use significantly predicted Hikikomori tendencies, with social cynicism having a stronger effect. Furthermore, internet use partially mediated the relationship between social cynicism and Hikikomori, suggesting that while internet use contributes, social cynicism exerts a more robust influence on Hikikomori tendencies in Singapore.

Conclusion: These findings highlight the importance of addressing social cynicism in interventions to mitigate Hikikomori in Singapore. Targeting cynical beliefs about societal environments may enhance social integration and reduce the prevalence of social withdrawal. Future research and interventions should thus prioritize addressing these cynical perspectives to support well-being and reduce Hikikomori in the Singaporean context.

Background: Promoting social inclusion is crucial for people living with severe mental illness (SMI), who often experience high levels of social exclusion. However, research that uses a psychometric social inclusion measure to identify factors that determine varying levels of social inclusion in individuals with SMI is scarce.

Aims: This study aimed to examine to what extent people with SMI feel socially included and to identify factors associated with perceived social inclusion among people with SMI.

Method: A cross-sectional multicenter investigation of psychiatric inpatients and day hospital patients with SMI aged 18 to 65 years (n = 358) was conducted. Perceived social inclusion, sociodemographic, and clinical characteristics were assessed using the Measure of Participation and Social Inclusion for Use in People with a Chronic Mental Disorder (F-INK). Hierarchical multiple linear regression was performed to analyse the association between social inclusion and potential predictors.

Results: The participants' overall level of social inclusion was moderate (F-INK social inclusion total score M = 1.9, SD = 0.6). Age, relationship status, diagnostic group, employment status, and living situation emerged as predictors of social inclusion. Greater subjective social inclusion was predicted by older age (p = .027), being in a committed intimate relationship (p = .037), diagnosis of schizophrenia spectrum disorder (compared to diagnosis of depression, p = .020), being competitively employed or in education (compared to being in sheltered employment, p = .022; compared to being unemployed or receiving a disability pension, p = .007), and living with other people (p = .042).

Conclusions: The results confirm deficiencies in social inclusion of people with SMI. Individuals with SMI who are younger, single, have a diagnosis of depression, are in sheltered employment, are unemployed or receiving a disability pension, and are living alone seem to be particularly at risk of experiencing low social inclusion. These findings highlight the importance of psychosocial interventions in rehabilitative mental healthcare.

Background: Given the long lasting physical and psychological effects of child sexual abuse (CSA), especially in light of its traumatic nature, and recognizing the dearth of knowledge regarding CSA and its associated risks within the context of Kerala, South India, this study endeavours to fill this critical gap.

Aim: To investigate the psychosocial and clinical characteristics of children with alleged history of child sexual abuse (CSA), particularly within the unique setting of a tertiary mental health care centre in Kerala.

Methods: This is a retrospective chart review carried out in the child and adolescent psychiatric unit of IMHANS, Kozhikode, between January 2016 and December 2023. Data collected includes, socio demographic details, CSA characteristics, perpetrator characteristics, adherence to mandatory reporting protocols, level of willingness regarding reporting under Protection of Children from Sexual Offences Act, 2012 (POCSO Act) and the clinical profile of the victim of CSA at the time of presentation. Statistical analysis were performed using SPSS.

Result: The study comprised 114 children, and the mean age of the victims at the first instance of abuse was 11.3 ± 3.52 years. 92.1% of perpetrators of CSA were individuals known to the victims. The most common form of CSA was genital contact without penetration (34.2%). The commonest psychiatric diagnosis was Adjustment Disorder (28.9%). Older children were associated with lower odds of parental reluctance in reporting cases under Protection of children from sexual offense act, 2012 (B = 0.167; OR = 0.84; CI [0.730, 0.981]). The odds of parental reluctance to reporting was approximately four times higher in cases where the perpetrator is a family member (B = 1.518; OR = 4.01; CI [1.724, 9.346]).

Conclusion: Overall, the study emphasizes the urgent need for raising awareness regarding legal procedures as well the manifestation of psychological symptoms, promoting early detection, providing specialized interventions, and establishing robust support systems to address the complex psychological and social concerns of the child sexual abuse victims.

Background: In this study, it was focused not on mental disorders that arise after a natural disaster, but on how psychiatric patients diagnosed with mental disorders were affected by the earthquake.

Objective: This study was aimed at investigating the relationship between death anxiety, one of the subheadings of Terror Management Theory, and post-traumatic cognitions and coping strategies in individuals diagnosed with Major Depressive Disorder (MDD) after a natural disaster.

Method: This cross-sectional, descriptive, and correlational study was conducted in the psychiatry outpatient clinic of a tertiary hospital in Adıyaman, one of the provinces affected by the February 6, 2023 earthquake in Turkey between February 2024 and May 2024. The study sample consisted of 75 patients diagnosed with Major Depressive Disorder who were affected by the earthquake. The data of the study were collected with the Posttraumatic Cognitions Inventory, Thorson-Powell's Death Anxiety Scale, and Strategies of Coping with Earthquake Stress Scale using the face-to-face intervention technique.

Results: In the study, while a negative and significant correlation was determined between the positive reappraisal levels of the patients with Major Depressive Disorder and their negative cognitions about themselves (r = -.321, p = .005), a significant and negative correlation was determined between their positive reappraisal coping mechanism and post-traumatic cognitions (r = -.329, p = .001). In the mediation model analysis, it was concluded that death anxiety played a mediating role in the relationship between post-traumatic cognitions and coping with earthquake stress (β = -.0442, p = .0061).

Conclusion: It was determined that as the positive reappraisal levels of the patients with Major Depressive Disorder decreased after the trauma they experienced, their negative cognitions about themselves and their post-traumatic negative cognitions increased. It was also determined that post-traumatic cognitions increased death anxiety, which negatively affected individuals' ability to cope with the earthquake stress.