Giampaolo Perna,Daniela Caldirola,Alan F Schatzberg,Charles B Nemeroff
{"title":"Advancements, challenges and future horizons in personalized psychiatry.","authors":"Giampaolo Perna,Daniela Caldirola,Alan F Schatzberg,Charles B Nemeroff","doi":"10.1002/wps.21257","DOIUrl":"https://doi.org/10.1002/wps.21257","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"5 1","pages":"460-461"},"PeriodicalIF":73.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142246782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Physician-assisted dying in people with mental health conditions - whose choice?","authors":"M E Jan Wise","doi":"10.1002/wps.21235","DOIUrl":"https://doi.org/10.1002/wps.21235","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"4 1","pages":"395-396"},"PeriodicalIF":73.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142246770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>In 1966, a researcher at the Massachusetts Institute of Technology introduced ELIZA, a computer program that simulated a psychotherapist in the Rogerian tradition, rephrasing a patient's words into questions according to simple but effective scripts. This was one of the first (and few) successes of early artificial intelligence (AI). To the dismay of its creator, some people took ELIZA for a real psychotherapist, perhaps because of our innate tendency to project consciousness when we detect intelligence, especially intelligent speech.</p> <p>ELIZA's stuttering attempt at AI has now become an immensely eloquent golem. ChatGPT can easily outspeak, outwrite and outperform S. Freud. Because large language models (LLM) benefit from superhuman lexicon, knowledge, memory and speed, artificial brains can now trump natural ones in most tasks.</p> <p>ELIZA was named after the flower-girl in G.B. Shaw's play Pygmalion, supposedly because it learned to improve its speech with practice. The original myth of Pygmalion – the sculptor who carved the ideal woman Galatea out of ivory and hoped to bring her to life – is even more apt: does the creation of AI portend artificial consciousness, perhaps even superhuman consciousness? Two camps are beginning to emerge, with radically different answers to this question.</p> <p>According to the dominant computational/functionalist stance in cognitive neuroscience, the answer is yes<span><sup>1</sup></span>. Cognitive neuroscience assumes that we are ultimately machines running sophisticated software (that can derail and be reprogrammed). Neural algorithms recognize objects and scenes, direct attention, hold items in working memory, and store them in long-term memory. Complex neural computations drive cognitive control, decision making, emotional reactions, social behaviors, and of course language. In this view, consciousness must be just another function, perhaps the global broadcasting of information<span><sup>2</sup></span> or the metacognitive assessment of sensory inputs<span><sup>3</sup></span>. In this case, whenever computers can reproduce the same functions as our brain, just implemented differently (the functionalists’ “multiple realizability”), they will be conscious like we are.</p> <p>Admittedly, despite LLMs sounding a lot like conscious humans nowadays, there is no principled way for determining whether they are already conscious and, if so, in which ways and to what degree<span><sup>1</sup></span>. Nor is it clear how we might establish whether they feel anything (just asking, we suspect, might not do…).</p> <p>Cognitive neuroscience typically takes the <i>extrinsic perspective</i>, introduced by Galileo, which has been immensely successful in much of science. From this perspective, consciousness is either a “user illusion”<span><sup>4</sup></span>, or a mysterious “emergent” property. However, as recognized long ago by Leibniz, this leaves experience – what we see, hear, think and feel – entirely unacco
{"title":"Artificial intelligence, consciousness and psychiatry","authors":"Giulio Tononi, Charles Raison","doi":"10.1002/wps.21222","DOIUrl":"https://doi.org/10.1002/wps.21222","url":null,"abstract":"<p>In 1966, a researcher at the Massachusetts Institute of Technology introduced ELIZA, a computer program that simulated a psychotherapist in the Rogerian tradition, rephrasing a patient's words into questions according to simple but effective scripts. This was one of the first (and few) successes of early artificial intelligence (AI). To the dismay of its creator, some people took ELIZA for a real psychotherapist, perhaps because of our innate tendency to project consciousness when we detect intelligence, especially intelligent speech.</p>\u0000<p>ELIZA's stuttering attempt at AI has now become an immensely eloquent golem. ChatGPT can easily outspeak, outwrite and outperform S. Freud. Because large language models (LLM) benefit from superhuman lexicon, knowledge, memory and speed, artificial brains can now trump natural ones in most tasks.</p>\u0000<p>ELIZA was named after the flower-girl in G.B. Shaw's play Pygmalion, supposedly because it learned to improve its speech with practice. The original myth of Pygmalion – the sculptor who carved the ideal woman Galatea out of ivory and hoped to bring her to life – is even more apt: does the creation of AI portend artificial consciousness, perhaps even superhuman consciousness? Two camps are beginning to emerge, with radically different answers to this question.</p>\u0000<p>According to the dominant computational/functionalist stance in cognitive neuroscience, the answer is yes<span><sup>1</sup></span>. Cognitive neuroscience assumes that we are ultimately machines running sophisticated software (that can derail and be reprogrammed). Neural algorithms recognize objects and scenes, direct attention, hold items in working memory, and store them in long-term memory. Complex neural computations drive cognitive control, decision making, emotional reactions, social behaviors, and of course language. In this view, consciousness must be just another function, perhaps the global broadcasting of information<span><sup>2</sup></span> or the metacognitive assessment of sensory inputs<span><sup>3</sup></span>. In this case, whenever computers can reproduce the same functions as our brain, just implemented differently (the functionalists’ “multiple realizability”), they will be conscious like we are.</p>\u0000<p>Admittedly, despite LLMs sounding a lot like conscious humans nowadays, there is no principled way for determining whether they are already conscious and, if so, in which ways and to what degree<span><sup>1</sup></span>. Nor is it clear how we might establish whether they feel anything (just asking, we suspect, might not do…).</p>\u0000<p>Cognitive neuroscience typically takes the <i>extrinsic perspective</i>, introduced by Galileo, which has been immensely successful in much of science. From this perspective, consciousness is either a “user illusion”<span><sup>4</sup></span>, or a mysterious “emergent” property. However, as recognized long ago by Leibniz, this leaves experience – what we see, hear, think and feel – entirely unacco","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"3 1","pages":""},"PeriodicalIF":73.3,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giorgia Michelini, Christina O. Carlisi, Nicholas R. Eaton, Jed T. Elison, John D. Haltigan, Roman Kotov, Robert F. Krueger, Robert D. Latzman, James J. Li, Holly F. Levin-Aspenson, Giovanni A. Salum, Susan C. South, Kasey Stanton, Irwin D. Waldman, Sylia Wilson
Features of autism spectrum disorder, attention-deficit/hyperactivity disorder, learning disorders, intellectual disabilities, and communication and motor disorders usually emerge early in life and are associated with atypical neurodevelopment. These “neurodevelopmental conditions” are grouped together in the DSM-5 and ICD-11 to reflect their shared characteristics. Yet, reliance on categorical diagnoses poses significant challenges in both research and clinical settings (e.g., high co-occurrence, arbitrary diagnostic boundaries, high within-disorder heterogeneity). Taking a transdiagnostic dimensional approach provides a useful alternative for addressing these limitations, accounting for shared underpinnings across neurodevelopmental conditions, and characterizing their common co-occurrence and developmental continuity with other psychiatric conditions. Neurodevelopmental features have not been adequately considered in transdiagnostic psychiatric frameworks, although this would have fundamental implications for research and clinical practices. Growing evidence from studies on the structure of neurodevelopmental and other psychiatric conditions indicates that features of neurodevelopmental conditions cluster together, delineating a “neurodevelopmental spectrum” ranging from normative to impairing profiles. Studies on shared genetic underpinnings, overlapping cognitive and neural profiles, and similar developmental course and efficacy of support/treatment strategies indicate the validity of this neurodevelopmental spectrum. Further, characterizing this spectrum alongside other psychiatric dimensions has clinical utility, as it provides a fuller view of an individual's needs and strengths, and greater prognostic utility than diagnostic categories. Based on this compelling body of evidence, we argue that incorporating a new neurodevelopmental spectrum into transdiagnostic frameworks has considerable potential for transforming our understanding, classification, assessment, and clinical practices around neurodevelopmental and other psychiatric conditions.
{"title":"Where do neurodevelopmental conditions fit in transdiagnostic psychiatric frameworks? Incorporating a new neurodevelopmental spectrum","authors":"Giorgia Michelini, Christina O. Carlisi, Nicholas R. Eaton, Jed T. Elison, John D. Haltigan, Roman Kotov, Robert F. Krueger, Robert D. Latzman, James J. Li, Holly F. Levin-Aspenson, Giovanni A. Salum, Susan C. South, Kasey Stanton, Irwin D. Waldman, Sylia Wilson","doi":"10.1002/wps.21225","DOIUrl":"https://doi.org/10.1002/wps.21225","url":null,"abstract":"Features of autism spectrum disorder, attention-deficit/hyperactivity disorder, learning disorders, intellectual disabilities, and communication and motor disorders usually emerge early in life and are associated with atypical neurodevelopment. These “neurodevelopmental conditions” are grouped together in the DSM-5 and ICD-11 to reflect their shared characteristics. Yet, reliance on categorical diagnoses poses significant challenges in both research and clinical settings (e.g., high co-occurrence, arbitrary diagnostic boundaries, high within-disorder heterogeneity). Taking a transdiagnostic dimensional approach provides a useful alternative for addressing these limitations, accounting for shared underpinnings across neurodevelopmental conditions, and characterizing their common co-occurrence and developmental continuity with other psychiatric conditions. Neurodevelopmental features have not been adequately considered in transdiagnostic psychiatric frameworks, although this would have fundamental implications for research and clinical practices. Growing evidence from studies on the structure of neurodevelopmental and other psychiatric conditions indicates that features of neurodevelopmental conditions cluster together, delineating a “neurodevelopmental spectrum” ranging from normative to impairing profiles. Studies on shared genetic underpinnings, overlapping cognitive and neural profiles, and similar developmental course and efficacy of support/treatment strategies indicate the validity of this neurodevelopmental spectrum. Further, characterizing this spectrum alongside other psychiatric dimensions has clinical utility, as it provides a fuller view of an individual's needs and strengths, and greater prognostic utility than diagnostic categories. Based on this compelling body of evidence, we argue that incorporating a new neurodevelopmental spectrum into transdiagnostic frameworks has considerable potential for transforming our understanding, classification, assessment, and clinical practices around neurodevelopmental and other psychiatric conditions.","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"36 1","pages":""},"PeriodicalIF":73.3,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Galderisi et al<span><sup>1</sup></span> provide an excellent overview of the complex ethical challenges in psychiatry. We subscribe to the authors’ criticism of mental health laws employing a “disorder + risk” schema for involuntary intervention, and their conclusion that these laws discriminate against people with a mental health condition. The authors put forward instead a “single law” proposal in which “involuntary treatment would only be permitted when the objecting person has an impairment of decision-making ability – from any cause – and if treatment is in the person's best interests”<span><sup>1</sup></span>. We strongly endorse the core of this proposal, but would like to suggest three refinements to it.</p> <p>First, we propose combining capacity assessment with supported decision-making, to ensure that no one is found to lack decision-making capacity before all reasonably available resources of supported decision-making have been exhausted. Second, we propose replacing the best interests standard by the substituted judgment standard, to achieve a closer alignment of substitute decisions with the will and preferences of the person concerned. Third, we suggest to explicitly define additional criteria for involuntary intervention, to avoid what we will call “the fallacious inference from substitute decision-making to coercion”. The proposed refinements are based on what we call the “combined supported decision-making model”, a model for the informed consent process that provides a non-discriminatory basis for decision-making about involuntary intervention<span><sup>2-5</sup></span>. In this commentary, we focus on the last two refinements.</p> <p>Galderisi et al refer to a terminological distinction used in a judgment of the German Federal Constitutional Court to show that the “single law” proposal is consistent with the general principles of the United Nations (UN) Convention on the Rights of People with Disabilities (CRPD) and the wording of Article 12, particularly its insistence that “measures relating to the exercise of legal capacity respect the rights, will and preferences of the person”. The terminological distinction is between “free will” (<i>freier Wille</i>) and “natural will” (<i>natürlicher Wille</i>), which, according to the authors, maps on to the CRPD's distinction between “will” and “preferences”.</p> <p>This terminological distinction plays an important role in the legal discourse around the German guardianship law (<i>Betreuungsrecht</i>), which is part of the German Civil Code and applies to all people who need support in managing their own affairs, regardless of whether they have a mental health condition<span><sup>6</sup></span>. The term “free will” (<i>freier Wille</i>) refers to the contemporaneous preferences of a person who possesses decision-making capacity regarding the decision at hand. Expressions of a person's free will must be respected by clinicians and have the status of consent or withdrawal of cons
{"title":"Aligning the “single law” proposal to the CRPD standard of “will and preferences”","authors":"Jakov Gather, Matthé Scholten","doi":"10.1002/wps.21233","DOIUrl":"https://doi.org/10.1002/wps.21233","url":null,"abstract":"<p>Galderisi et al<span><sup>1</sup></span> provide an excellent overview of the complex ethical challenges in psychiatry. We subscribe to the authors’ criticism of mental health laws employing a “disorder + risk” schema for involuntary intervention, and their conclusion that these laws discriminate against people with a mental health condition. The authors put forward instead a “single law” proposal in which “involuntary treatment would only be permitted when the objecting person has an impairment of decision-making ability – from any cause – and if treatment is in the person's best interests”<span><sup>1</sup></span>. We strongly endorse the core of this proposal, but would like to suggest three refinements to it.</p>\u0000<p>First, we propose combining capacity assessment with supported decision-making, to ensure that no one is found to lack decision-making capacity before all reasonably available resources of supported decision-making have been exhausted. Second, we propose replacing the best interests standard by the substituted judgment standard, to achieve a closer alignment of substitute decisions with the will and preferences of the person concerned. Third, we suggest to explicitly define additional criteria for involuntary intervention, to avoid what we will call “the fallacious inference from substitute decision-making to coercion”. The proposed refinements are based on what we call the “combined supported decision-making model”, a model for the informed consent process that provides a non-discriminatory basis for decision-making about involuntary intervention<span><sup>2-5</sup></span>. In this commentary, we focus on the last two refinements.</p>\u0000<p>Galderisi et al refer to a terminological distinction used in a judgment of the German Federal Constitutional Court to show that the “single law” proposal is consistent with the general principles of the United Nations (UN) Convention on the Rights of People with Disabilities (CRPD) and the wording of Article 12, particularly its insistence that “measures relating to the exercise of legal capacity respect the rights, will and preferences of the person”. The terminological distinction is between “free will” (<i>freier Wille</i>) and “natural will” (<i>natürlicher Wille</i>), which, according to the authors, maps on to the CRPD's distinction between “will” and “preferences”.</p>\u0000<p>This terminological distinction plays an important role in the legal discourse around the German guardianship law (<i>Betreuungsrecht</i>), which is part of the German Civil Code and applies to all people who need support in managing their own affairs, regardless of whether they have a mental health condition<span><sup>6</sup></span>. The term “free will” (<i>freier Wille</i>) refers to the contemporaneous preferences of a person who possesses decision-making capacity regarding the decision at hand. Expressions of a person's free will must be respected by clinicians and have the status of consent or withdrawal of cons","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"237 1","pages":""},"PeriodicalIF":73.3,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Naomi A. Fineberg, Dan J. Stein, Katharina Domschke, Eric Hollander, Susanne Walitza, Michael Van Ameringen, Bernardo Dell'Osso, Joseph Zohar
<p>The WPA Section on Anxiety and Obsessive-Compulsive Disorders focuses its activities on a broad range of common and burdensome psychiatric conditions encompassing anxiety and fear-related disorders, obsessive-compulsive and related disorders, and behavioural addiction disorders, including problematic Internet use. This is an exciting area of developing clinical practice, as anxiety and obsessive-compulsive symptoms are increasingly played out in the digital environment.</p> <p>The Section provides a forum for clinician scientists and academics to exchange experiences and research advances. It organizes activities at WPA meetings, produces scientific publications and develops guidance on relevant topics, in collaboration with key stakeholder groups such as the World Health Organization (WHO), the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) (www.icocs.org), the Anxiety Disorders and Obsessive-Compulsive Research Networks of the European College of Neuropsychopharmacology (ECNP) (www.ecnp.eu), and the European Network for Problematic Usage of the Internet (www.internetandme.eu). Here we review some of the Section's recent initiatives and its ambitions for the next five years.</p> <p>The ICD-11 has refined and expanded the classification of anxiety disorders, and created two new groupings, one for Obsessive-Compulsive and Related Disorders and another for Disorders due to Addictive Behaviours, including several new diagnoses.</p> <p>The ICD-11 grouping of Anxiety or Fear-Related Disorders differentiates fear-related disorders (i.e., phobias related to discrete aversive situations) from anxiety disorders related to a sustained expectation that diffuse aversive events will occur. Separation anxiety disorder and selective mutism have been moved into this grouping.</p> <p>Obsessive-compulsive and related disorders often present late for treatment, resulting in poor clinical outcomes. To improve recognition and diagnosis, some members of our Section worked with the WHO to reclassify disparate diagnoses into a single Obsessive-Compulsive and Related Disorders grouping. A seminal field study demonstrated that health care practitioners make more accurate diagnoses of these disorders using the ICD-11 vs. ICD-10<span><sup>1</sup></span>. Moreover, this new classification has advanced research heuristics establishing compulsivity as a transdiagnostic neuropsychological domain.</p> <p>Another new ICD-11 grouping was created for Disorders due to Addictive Behaviours. This includes two new disorders – gaming disorder and gambling disorder (on- or off-line) – and a residual category for possible diagnosis of other forms of problematic behaviour with addictive, impulsive and/or compulsive features, including buying or shopping, pornography use, social media use, cyberchondria, digital hoarding, and online streaming.</p> <p>Evidence of overlap between compulsive and addictive mechanisms and disorders has led to the establishment of the
{"title":"An update from the WPA Section on Anxiety and Obsessive-Compulsive Disorders","authors":"Naomi A. Fineberg, Dan J. Stein, Katharina Domschke, Eric Hollander, Susanne Walitza, Michael Van Ameringen, Bernardo Dell'Osso, Joseph Zohar","doi":"10.1002/wps.21255","DOIUrl":"https://doi.org/10.1002/wps.21255","url":null,"abstract":"<p>The WPA Section on Anxiety and Obsessive-Compulsive Disorders focuses its activities on a broad range of common and burdensome psychiatric conditions encompassing anxiety and fear-related disorders, obsessive-compulsive and related disorders, and behavioural addiction disorders, including problematic Internet use. This is an exciting area of developing clinical practice, as anxiety and obsessive-compulsive symptoms are increasingly played out in the digital environment.</p>\u0000<p>The Section provides a forum for clinician scientists and academics to exchange experiences and research advances. It organizes activities at WPA meetings, produces scientific publications and develops guidance on relevant topics, in collaboration with key stakeholder groups such as the World Health Organization (WHO), the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) (www.icocs.org), the Anxiety Disorders and Obsessive-Compulsive Research Networks of the European College of Neuropsychopharmacology (ECNP) (www.ecnp.eu), and the European Network for Problematic Usage of the Internet (www.internetandme.eu). Here we review some of the Section's recent initiatives and its ambitions for the next five years.</p>\u0000<p>The ICD-11 has refined and expanded the classification of anxiety disorders, and created two new groupings, one for Obsessive-Compulsive and Related Disorders and another for Disorders due to Addictive Behaviours, including several new diagnoses.</p>\u0000<p>The ICD-11 grouping of Anxiety or Fear-Related Disorders differentiates fear-related disorders (i.e., phobias related to discrete aversive situations) from anxiety disorders related to a sustained expectation that diffuse aversive events will occur. Separation anxiety disorder and selective mutism have been moved into this grouping.</p>\u0000<p>Obsessive-compulsive and related disorders often present late for treatment, resulting in poor clinical outcomes. To improve recognition and diagnosis, some members of our Section worked with the WHO to reclassify disparate diagnoses into a single Obsessive-Compulsive and Related Disorders grouping. A seminal field study demonstrated that health care practitioners make more accurate diagnoses of these disorders using the ICD-11 vs. ICD-10<span><sup>1</sup></span>. Moreover, this new classification has advanced research heuristics establishing compulsivity as a transdiagnostic neuropsychological domain.</p>\u0000<p>Another new ICD-11 grouping was created for Disorders due to Addictive Behaviours. This includes two new disorders – gaming disorder and gambling disorder (on- or off-line) – and a residual category for possible diagnosis of other forms of problematic behaviour with addictive, impulsive and/or compulsive features, including buying or shopping, pornography use, social media use, cyberchondria, digital hoarding, and online streaming.</p>\u0000<p>Evidence of overlap between compulsive and addictive mechanisms and disorders has led to the establishment of the","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"10 1","pages":""},"PeriodicalIF":73.3,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jiang Long, Na Zhong, Jingjing Huang, Geoffrey M. Reed, Zhen Wang, Yifeng Xu, Min Zhao
<p>Since 2007, China has been actively collaborating with the World Health Organization (WHO) and international colleagues in the revision, field testing, training, and implementation of the ICD-11 chapter on mental, behavioural and neurodevelopmental disorders, and the related Clinical Descriptions and Diagnostic Requirements (CDDR)<span><sup>1</sup></span>. In 2018, the National Health Commission clearly highlighted the importance of the ICD-11 and requested all health care providers in China to use the ICD-11 in their clinical practice<span><sup>2</sup></span>. The ICD-11 CDDR are particularly instrumental to achieving this goal in mental health systems in China, as a vast country with over 30 provincial-level administrative regions and a population of more than 1.4 billion.</p> <p>The Shanghai Mental Health Center (SMHC), as a WHO Collaborating Centre for Research and Training in Mental Health and a National Center for Mental Disorders, has led the field testing and implementation of the ICD-11 CDDR in China<span><sup>3</sup></span>. Together with other WHO Collaborating Centers in China, National Centers for Mental Disorders, and prestigious institutions across the country, the SMHC has built a core team for ICD-11 CDDR implementation with over 60 national mental health leaders, including heads of leading mental health institutions and presidents of scientific and professional mental health associations. The implementation of the CDDR in China involves an interrelated and growing set of activities including translation, field testing, research, advocacy and training.</p> <p>Translation is the cornerstone of implementing the ICD-11 CDDR in China. The translation process started in 2016, and was a collective effort by experts from Shanghai, Beijing and Changsha, coordinated by the SMHC. It was an iterative process involving eight rounds of review and revision over eight years, with 24 translators and 12 reviewers contributing to the work. The final Chinese version of the ICD-11 CDDR is now available for all mental health professionals in China.</p> <p>In conjunction with the translation process, China conducted field testing of the ICD-11 CDDR from 2016 to 2021, following the protocols provided by the WHO. The SMHC was designated as an International Field Study Centre by the WHO, and the president of the SMHC, Min Zhao, was selected as chair of the ICD-11 International Advisory Group on Training and Implementation.</p> <p>The Chinese field-testing work involved 2,224 patients, 59 clinical raters, 59 referring clinicians, and 23 research assistants from 10 field testing sites nationwide. The field testing was conducted through a rigorous, multidisciplinary and participatory approach, and the results were submitted to the WHO in 2021 to support the ICD-11 CDDR validation and finalization.</p> <p>In June 2018, after most of the content in the CDDR had been finalized, the SMHC coordinated efforts with various government and professional agencies t
{"title":"Implementation of the ICD-11 CDDR in China","authors":"Jiang Long, Na Zhong, Jingjing Huang, Geoffrey M. Reed, Zhen Wang, Yifeng Xu, Min Zhao","doi":"10.1002/wps.21251","DOIUrl":"https://doi.org/10.1002/wps.21251","url":null,"abstract":"<p>Since 2007, China has been actively collaborating with the World Health Organization (WHO) and international colleagues in the revision, field testing, training, and implementation of the ICD-11 chapter on mental, behavioural and neurodevelopmental disorders, and the related Clinical Descriptions and Diagnostic Requirements (CDDR)<span><sup>1</sup></span>. In 2018, the National Health Commission clearly highlighted the importance of the ICD-11 and requested all health care providers in China to use the ICD-11 in their clinical practice<span><sup>2</sup></span>. The ICD-11 CDDR are particularly instrumental to achieving this goal in mental health systems in China, as a vast country with over 30 provincial-level administrative regions and a population of more than 1.4 billion.</p>\u0000<p>The Shanghai Mental Health Center (SMHC), as a WHO Collaborating Centre for Research and Training in Mental Health and a National Center for Mental Disorders, has led the field testing and implementation of the ICD-11 CDDR in China<span><sup>3</sup></span>. Together with other WHO Collaborating Centers in China, National Centers for Mental Disorders, and prestigious institutions across the country, the SMHC has built a core team for ICD-11 CDDR implementation with over 60 national mental health leaders, including heads of leading mental health institutions and presidents of scientific and professional mental health associations. The implementation of the CDDR in China involves an interrelated and growing set of activities including translation, field testing, research, advocacy and training.</p>\u0000<p>Translation is the cornerstone of implementing the ICD-11 CDDR in China. The translation process started in 2016, and was a collective effort by experts from Shanghai, Beijing and Changsha, coordinated by the SMHC. It was an iterative process involving eight rounds of review and revision over eight years, with 24 translators and 12 reviewers contributing to the work. The final Chinese version of the ICD-11 CDDR is now available for all mental health professionals in China.</p>\u0000<p>In conjunction with the translation process, China conducted field testing of the ICD-11 CDDR from 2016 to 2021, following the protocols provided by the WHO. The SMHC was designated as an International Field Study Centre by the WHO, and the president of the SMHC, Min Zhao, was selected as chair of the ICD-11 International Advisory Group on Training and Implementation.</p>\u0000<p>The Chinese field-testing work involved 2,224 patients, 59 clinical raters, 59 referring clinicians, and 23 research assistants from 10 field testing sites nationwide. The field testing was conducted through a rigorous, multidisciplinary and participatory approach, and the results were submitted to the WHO in 2021 to support the ICD-11 CDDR validation and finalization.</p>\u0000<p>In June 2018, after most of the content in the CDDR had been finalized, the SMHC coordinated efforts with various government and professional agencies t","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"65 1","pages":""},"PeriodicalIF":73.3,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nora D. Volkow, Michael P. Schaub, Anja Busse, Vladimir Poznyak, Dzmitry Krupchanka, Giovanna Campello
<p>Since 2014, the United Nations Office on Drugs and Crime (UNODC) - World Health Organization (WHO) Informal Scientific Network (ISN) has brought the voice of science to international drug policy discussions at the Commission on Narcotic Drugs, the drug-control policy-making body of the United Nations (UN). The public health dimensions of substance use, including prevention and treatment of substance use disorders, have become prominent in policy debates within the UN system.</p> <p>Adolescence, which is the focus of this ISN statement, has been defined as individuals aged between 10 and 19 years<span><sup>1</sup></span>. While no global data on substance use within this full age range could be located, global data among more limited subsets are available. Alcohol is the most commonly used substance among all people 15+ years of age<span><sup>2</sup></span>: 155 million, i.e. more than a quarter (26.5%) of all those aged 15-19, are current drinkers. In addition, the 15-19 age group exhibits higher rates of heavy episodic drinking when compared to the total population of drinkers<span><sup>3</sup></span>. Cannabis is the internationally controlled substance most widely used by adolescents, and its use among 15-16-year-olds varies by region, from less than 3% annual prevalence in Asia to over 17% in Oceania. In most geographical areas, the proportion of adolescents using cannabis is higher than in the general population aged 15-64<span><sup>3</sup></span>.</p> <p>Consistent with Sustainable Development Goals<span><sup>4</sup></span> and other international commitments<span><sup>5</sup></span>, UN Member States called for comprehensive, evidence-based prevention of substance use, including early prevention<span><sup>6</sup></span> and available, accessible, diverse, evidence-based treatment and care for children and young people with substance use disorders<span><sup>7</sup></span>. There is a joint responsibility for policy makers, scientists, service providers, and communities to implement effective demand-reduction strategies and to adequately address prevention, treatment and recovery support, as well as measures to reduce the negative health and social consequences of substance use disorders among adolescents.</p> <div>The UNODC-WHO ISN makes the following recommendations: <ul> <li>Expand the availability and use of evidence-based prevention, treatment and care strategies and interventions for adolescents, and ensure sustainable funding for their implementation.</li> <li>Facilitate the availability of evidence-based prevention programs in the public domain with reimbursement schemes, thus allowing for preventive interventions to be inclusive and to address the needs of socio-economically disadvantaged groups, ensuring that minoritized populations, Indigenous groups; and lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ+) people are included.</li> <li>Promote population-based and environmental prevention measures, such as enfor
{"title":"Prevention, treatment and care of substance use disorders among adolescents. Statement by the UNODC-WHO Informal Scientific Network, 2024","authors":"Nora D. Volkow, Michael P. Schaub, Anja Busse, Vladimir Poznyak, Dzmitry Krupchanka, Giovanna Campello","doi":"10.1002/wps.21260","DOIUrl":"https://doi.org/10.1002/wps.21260","url":null,"abstract":"<p>Since 2014, the United Nations Office on Drugs and Crime (UNODC) - World Health Organization (WHO) Informal Scientific Network (ISN) has brought the voice of science to international drug policy discussions at the Commission on Narcotic Drugs, the drug-control policy-making body of the United Nations (UN). The public health dimensions of substance use, including prevention and treatment of substance use disorders, have become prominent in policy debates within the UN system.</p>\u0000<p>Adolescence, which is the focus of this ISN statement, has been defined as individuals aged between 10 and 19 years<span><sup>1</sup></span>. While no global data on substance use within this full age range could be located, global data among more limited subsets are available. Alcohol is the most commonly used substance among all people 15+ years of age<span><sup>2</sup></span>: 155 million, i.e. more than a quarter (26.5%) of all those aged 15-19, are current drinkers. In addition, the 15-19 age group exhibits higher rates of heavy episodic drinking when compared to the total population of drinkers<span><sup>3</sup></span>. Cannabis is the internationally controlled substance most widely used by adolescents, and its use among 15-16-year-olds varies by region, from less than 3% annual prevalence in Asia to over 17% in Oceania. In most geographical areas, the proportion of adolescents using cannabis is higher than in the general population aged 15-64<span><sup>3</sup></span>.</p>\u0000<p>Consistent with Sustainable Development Goals<span><sup>4</sup></span> and other international commitments<span><sup>5</sup></span>, UN Member States called for comprehensive, evidence-based prevention of substance use, including early prevention<span><sup>6</sup></span> and available, accessible, diverse, evidence-based treatment and care for children and young people with substance use disorders<span><sup>7</sup></span>. There is a joint responsibility for policy makers, scientists, service providers, and communities to implement effective demand-reduction strategies and to adequately address prevention, treatment and recovery support, as well as measures to reduce the negative health and social consequences of substance use disorders among adolescents.</p>\u0000<div>The UNODC-WHO ISN makes the following recommendations: <ul>\u0000<li>Expand the availability and use of evidence-based prevention, treatment and care strategies and interventions for adolescents, and ensure sustainable funding for their implementation.</li>\u0000<li>Facilitate the availability of evidence-based prevention programs in the public domain with reimbursement schemes, thus allowing for preventive interventions to be inclusive and to address the needs of socio-economically disadvantaged groups, ensuring that minoritized populations, Indigenous groups; and lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ+) people are included.</li>\u0000<li>Promote population-based and environmental prevention measures, such as enfor","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"15 1","pages":""},"PeriodicalIF":73.3,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>The concept of emotion regulation (ER) is receiving considerable attention in research on psychiatric disorders and their treatment. The popularity of the concept is largely rooted in its premise that deficits in adaptive responses toward undesired affective states contribute to the development and maintenance of most forms of psychopathology.</p> <p>This appears obvious when considering psychiatric disorders that are primarily defined by an excess of undesired affective states (e.g., anxiety and mood disorders). For these conditions, it follows almost by definition that the perpetuation or escalation of undesired affective states results from the individual's inability to regulate them.</p> <p>However, given that many behavioral and cognitive symptoms of other psychiatric disorders can also be conceptualized as dysfunctional ER strategies, the scope of this paradigm extends much further. Consider, for example, when avoidance is used to reduce anxiety, when alcohol is consumed to numb loneliness, when binge eating serves to distract from emotional anguish, or when appraising a situation as uncontrollable and hopeless is used to reduce the pressure to solve one's problems or to shield oneself from further disappointment. In all these scenarios, behavioral or cognitive strategies yield short-lived relief from undesired affective states. Since the immediate ameliorating effects of these maladaptive strategies reinforce their usage, individuals tend to progressively increase their adoption until criteria for an anxiety, alcohol use, eating or mood disorder, etc. are met.</p> <p>Importantly, this trajectory is preventable if the individual realizes the negative mid- and long-term consequences of maladaptive strategies, and pivots to more adaptive ways of coping with undesired affective states. However, any such shift will fail to the extent that the individual lacks effective ER skills. Since all psychiatric disorders are arguably maintained by behaviors and cognitions that initially reduce negative affect, and since a distressed individual is more likely to utilize those strategies in the absence of more adaptive alternatives, it can be hypothesized that all psychiatric disorders are, to a significant degree, perpetuated by insufficient ER skills.</p> <p>Drawing on this framework, it can be deduced that patients with psychiatric disorders should benefit from treatments that systematically enhance effective ER skills. Evidence-based ER frameworks, such as the Adaptive Coping with Emotions Model<span><sup>1</sup></span>, posit that such treatments should foster the ability to modify the intensity and duration of undesired affective states, as well as the ability to accept and tolerate such states when modification is not possible.</p> <p>Additionally, these treatments should foster so-called preparatory ER skills that facilitate the successful utilization of modification- and acceptance-focused ER skills. Examples of such preparatory skills include
情绪调节（ER）的概念在精神疾病及其治疗的研究中备受关注。这一概念的流行在很大程度上源于它的前提，即对不良情绪状态的适应性反应的缺陷是大多数精神病理学发展和维持的原因。对于这些病症，从定义上就可以看出，不良情绪状态的持续或升级是由于个体无法调节这些情绪状态。然而，鉴于其他精神疾病的许多行为和认知症状也可以被概念化为功能失调的应急反应策略，因此这一范式的范围可以延伸得更远。举例来说，当回避被用来减轻焦虑时，当饮酒被用来麻痹孤独感时，当暴饮暴食被用来转移情绪上的痛苦时，或者当把某种情况评价为无法控制和毫无希望时，被用来减轻解决问题的压力或避免进一步的失望。在所有这些情况下，行为或认知策略都能在短期内缓解不想要的情绪状态。重要的是，如果个体意识到适应不良策略所带来的中长期负面影响，并转而采用适应性更强的方式来应对不良情绪状态，那么这一轨迹是可以避免的。然而，如果个体缺乏有效的应急技能，任何这种转变都会失败。由于所有的精神障碍都可以说是通过最初减少负面情绪的行为和认知来维持的，而且在没有更多适应性替代方法的情况下，痛苦的个体更有可能使用这些策略，因此可以假设，所有的精神障碍在很大程度上都是由于缺乏有效的应急反应技能而长期存在的。以证据为基础的ER框架，如 "适应性情绪应对模式"（Adaptive Coping with Emotions Model1），认为此类治疗应培养患者改变不良情绪状态的强度和持续时间的能力，以及在无法改变不良情绪状态时接受和容忍这种状态的能力。这些准备技能的例子包括意识到自己的感受、充分识别和标记自己的感受、建立一个解释自己目前的感受是如何维持的心理模型，最好是以验证和消除自己的经历的方式，同时也提出具体的工具来促进成功的改变/接受。因此，以ER为重点的治疗还应加强患者的自我支持技能，使其能够坚持不懈地采取适应性策略，尽管这些策略最初可能会加重患者的负面情绪。此外，大量的纵向研究和实验研究表明，这种关联是由急诊室技能缺陷影响心理健康造成的，而不是（完全）相反3。关于特定应急反应技能的重要性，大量证据支持重新评估、接纳和自我同情的有效性4、5。更多的研究表明，明确侧重于提高应急反应技能的治疗方法（如辩证行为疗法）可有效治疗多种精神障碍。文献中更具体的证据表明，专门针对提高ER技能的干预措施（如情感调节训练、情绪调节疗法）可有效治疗多种失调症2、6。最后，在这些研究中观察到的明显中介效应表明，ER技能的提高是症状严重程度减轻的主要驱动力7、8。虽然这些发现令人鼓舞，但精神病理学背景下的ER研究仍然充满了挑战。首先，关键术语的概念定义不够清晰，从情感一词开始，尽管已经有人提出了更具体的定义（如："情绪"、"情感 "和 "情绪"），但该词仍被广泛用于各种情感状态。
{"title":"Emotion regulation and mental health: current evidence and beyond","authors":"Matthias Berking","doi":"10.1002/wps.21244","DOIUrl":"https://doi.org/10.1002/wps.21244","url":null,"abstract":"<p>The concept of emotion regulation (ER) is receiving considerable attention in research on psychiatric disorders and their treatment. The popularity of the concept is largely rooted in its premise that deficits in adaptive responses toward undesired affective states contribute to the development and maintenance of most forms of psychopathology.</p>\u0000<p>This appears obvious when considering psychiatric disorders that are primarily defined by an excess of undesired affective states (e.g., anxiety and mood disorders). For these conditions, it follows almost by definition that the perpetuation or escalation of undesired affective states results from the individual's inability to regulate them.</p>\u0000<p>However, given that many behavioral and cognitive symptoms of other psychiatric disorders can also be conceptualized as dysfunctional ER strategies, the scope of this paradigm extends much further. Consider, for example, when avoidance is used to reduce anxiety, when alcohol is consumed to numb loneliness, when binge eating serves to distract from emotional anguish, or when appraising a situation as uncontrollable and hopeless is used to reduce the pressure to solve one's problems or to shield oneself from further disappointment. In all these scenarios, behavioral or cognitive strategies yield short-lived relief from undesired affective states. Since the immediate ameliorating effects of these maladaptive strategies reinforce their usage, individuals tend to progressively increase their adoption until criteria for an anxiety, alcohol use, eating or mood disorder, etc. are met.</p>\u0000<p>Importantly, this trajectory is preventable if the individual realizes the negative mid- and long-term consequences of maladaptive strategies, and pivots to more adaptive ways of coping with undesired affective states. However, any such shift will fail to the extent that the individual lacks effective ER skills. Since all psychiatric disorders are arguably maintained by behaviors and cognitions that initially reduce negative affect, and since a distressed individual is more likely to utilize those strategies in the absence of more adaptive alternatives, it can be hypothesized that all psychiatric disorders are, to a significant degree, perpetuated by insufficient ER skills.</p>\u0000<p>Drawing on this framework, it can be deduced that patients with psychiatric disorders should benefit from treatments that systematically enhance effective ER skills. Evidence-based ER frameworks, such as the Adaptive Coping with Emotions Model<span><sup>1</sup></span>, posit that such treatments should foster the ability to modify the intensity and duration of undesired affective states, as well as the ability to accept and tolerate such states when modification is not possible.</p>\u0000<p>Additionally, these treatments should foster so-called preparatory ER skills that facilitate the successful utilization of modification- and acceptance-focused ER skills. Examples of such preparatory skills include ","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"191 1","pages":""},"PeriodicalIF":73.3,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gaia Sampogna, Hasanen Al-Taiar, Franziska Baessler, Bulent Coskun, Hussien Elkholy, Mariana Pinto da Costa, Rodrigo Ramalho, Andrea Fiorillo
<p>Education of mental health professionals should reflect the changes occurring at scientific, clinical and sociocultural levels, and thus it should be continuously updated. However, in many parts of the world, psychiatric education is still based on a knowledge formed in the last century, and the most recent knowledge on the structure and functioning of the brain, human behaviors and social relationships is missing.</p> <p>Moreover, the mission of psychiatrists has evolved over time, from the diagnosis and management of full-blown mental disorders to the identification of a series of mental health problems which are associated with high levels of personal and societal burden. The involvement of experts by experience in policy, clinical and research activities is now acknowledged as a priority<span><sup>1, 2</sup></span>, and the need for a clinical characterization of individual patients beyond diagnosis in order to personalize treatment is widely recognized<span><sup>3, 4</sup></span>. These changes should be taken into account by current educational curricula, but this is not always the case.</p> <p>The WPA Section on Education in Psychiatry is committed to improve training and education worldwide, with a special attention to low- and middle-income countries (LMICs), since the future of psychiatry as a discipline strongly depends on the education of the new generations of professionals.</p> <p>The Section is updating the type of educational materials available for mental health professionals, and is keen to disseminate them worldwide<span><sup>5</sup></span>. In the last triennium, it has contributed to several educational activities, including the development of informational packages for the general public to decrease misconceptions on people with mental disorders, the update of training curricula for undergraduate medical students, and the organization of educational workshops and meetings for psychiatrists and other mental health professionals.</p> <p>In the triennium 2020-2023, following the COVID-19 pandemic – which has represented an unprecedent traumatic event with a detrimental impact on education, training and practice worldwide – the Section has been particularly active in developing and producing new tools to improve education in mental health worldwide<span><sup>6-8</sup></span>.</p> <p>The Chair of the Section, in collaboration with the WPA Past-President, has promoted a survey targeting the WPA Zonal Representatives, to identify the educational needs and interests of professionals associated with the WPA<span><sup>9</sup></span>. The main finding has been that these professionals are mostly concerned with public mental health activities and with primary prevention of mental disorders. The main unmet need is the development, implementation and dissemination of educational activities in languages other than English, in order to broaden their accessibility.</p> <p>Moreover, the Section has collected experiences on education and tr
{"title":"Improving education in psychiatry in an evolving scenario: the activities of the WPA Section on Education in Psychiatry","authors":"Gaia Sampogna, Hasanen Al-Taiar, Franziska Baessler, Bulent Coskun, Hussien Elkholy, Mariana Pinto da Costa, Rodrigo Ramalho, Andrea Fiorillo","doi":"10.1002/wps.21258","DOIUrl":"https://doi.org/10.1002/wps.21258","url":null,"abstract":"<p>Education of mental health professionals should reflect the changes occurring at scientific, clinical and sociocultural levels, and thus it should be continuously updated. However, in many parts of the world, psychiatric education is still based on a knowledge formed in the last century, and the most recent knowledge on the structure and functioning of the brain, human behaviors and social relationships is missing.</p>\u0000<p>Moreover, the mission of psychiatrists has evolved over time, from the diagnosis and management of full-blown mental disorders to the identification of a series of mental health problems which are associated with high levels of personal and societal burden. The involvement of experts by experience in policy, clinical and research activities is now acknowledged as a priority<span><sup>1, 2</sup></span>, and the need for a clinical characterization of individual patients beyond diagnosis in order to personalize treatment is widely recognized<span><sup>3, 4</sup></span>. These changes should be taken into account by current educational curricula, but this is not always the case.</p>\u0000<p>The WPA Section on Education in Psychiatry is committed to improve training and education worldwide, with a special attention to low- and middle-income countries (LMICs), since the future of psychiatry as a discipline strongly depends on the education of the new generations of professionals.</p>\u0000<p>The Section is updating the type of educational materials available for mental health professionals, and is keen to disseminate them worldwide<span><sup>5</sup></span>. In the last triennium, it has contributed to several educational activities, including the development of informational packages for the general public to decrease misconceptions on people with mental disorders, the update of training curricula for undergraduate medical students, and the organization of educational workshops and meetings for psychiatrists and other mental health professionals.</p>\u0000<p>In the triennium 2020-2023, following the COVID-19 pandemic – which has represented an unprecedent traumatic event with a detrimental impact on education, training and practice worldwide – the Section has been particularly active in developing and producing new tools to improve education in mental health worldwide<span><sup>6-8</sup></span>.</p>\u0000<p>The Chair of the Section, in collaboration with the WPA Past-President, has promoted a survey targeting the WPA Zonal Representatives, to identify the educational needs and interests of professionals associated with the WPA<span><sup>9</sup></span>. The main finding has been that these professionals are mostly concerned with public mental health activities and with primary prevention of mental disorders. The main unmet need is the development, implementation and dissemination of educational activities in languages other than English, in order to broaden their accessibility.</p>\u0000<p>Moreover, the Section has collected experiences on education and tr","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"31 1","pages":""},"PeriodicalIF":73.3,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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