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An evaluation of the Stratford multiagency, multidisciplinary, assessment clinic 斯特拉特福德多机构、多学科评估诊所的评估
IF 1.2 Q4 PSYCHIATRY Pub Date : 2021-08-23 DOI: 10.1108/mhrj-02-2021-0012
C. Cooper, H. Liu, Tobias A. Rowland, Riddhi Prajapati, Tayla Hurlock, A. Owen
PurposeThis study aims to assess a novel clinic whereby new patients were discussed in a multi-agency, multi-disciplinary panel and given feedback on the same day. The objectives were to determine the impacts on time to commencing treatment, need for further assessment, discharges and staff and patient experiences.Design/methodology/approachOutcomes from the new assessment clinic were compared to previous individual assessments. Feedback questionnaires were given to patients, while a focus group was conducted with staff.FindingsThere was a significant reduction in the time to agreeing a treatment plan (34 days to <1 day), the need for further assessment (61%–23.2%) and a significant increase in the proportion discharged from secondary care (26.9%–49.8%). Clinician and patient feedback on the clinic was positive.Practical implicationsThe model of a multi-agency, multi-disciplinary clinic could be used for assessing new referrals to community mental health teams.Originality/valueThe use of a multi-agency, multi-disciplinary clinic is a novel approach within community mental health teams which led to improvements in efficiency, while demonstrating positive patient and clinician feedback.
目的本研究旨在评估一家新诊所,在该诊所中,新患者在多机构、多学科小组中进行讨论,并在同一天得到反馈。目的是确定对开始治疗的时间、进一步评估的必要性、出院以及工作人员和患者体验的影响。设计/方法/方法将新评估诊所的结果与以前的个人评估进行比较。向患者发放了反馈问卷,并与工作人员一起进行了重点小组讨论。发现达成治疗计划的时间显著缩短(34 天至<1天),需要进一步评估(61%-23.2%),从二级护理出院的比例显著增加(26.9%-49.8%)。临床医生和患者对诊所的反馈是积极的。实际意义多机构、多学科诊所的模式可用于评估社区心理健康团队的新转诊。独创性/价值使用多机构、多学科诊所是社区心理健康团队中的一种新方法,它提高了效率,同时展示了患者和临床医生的积极反馈。
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引用次数: 0
Mental health service users’ lived experiences of recovery-oriented services: a scoping review 心理健康服务使用者对康复服务的生活经验:范围审查
IF 1.2 Q4 PSYCHIATRY Pub Date : 2021-08-21 DOI: 10.1108/mhrj-09-2020-0064
R. Lau, A. Hutchinson
PurposeOver the past 15 years, mental health organisations have taken steps to move towards providing services that are more recovery-oriented. This review was undertaken to explore what is known about service users’ experience of services that have introduced a recovery-oriented approach to service provision. There is limited research evaluating consumers’ lived experiences of recovery-orientated care; a scoping review was chosen to provide an overview of the available research in this area (Munn et al., 2018). The purpose of this review was to summarize and synthesize current qualitative research exploring consumers’ experience of recovery orientated mental health care provision.Design/methodology/approachThis scoping review was undertaken as outlined by Arksey and O'Malley (2005). The five steps consisted identifying the research question; searching for relevant studies; selecting the studies; charting the studies; and collating, summarising and reporting the findings.FindingsThree key themes emerged from this review: translation of recovery policy to practice; ward environment; and recovery principles with five subthemes: engagement; not being listened to; shared decision-making; informational needs; and supportive and collaborative relationships. The themes and subthemes identified in each of the 18 studies are presented in Table 3.Research limitations/implicationsThis review highlights the different degree to which service users have received recovery-oriented recovery care. In the majority of cases, most service users reported few opportunities for nursing engagement, poor communication, inadequate information provision, a lack of collaborative care and mostly negative experiences of the ward environment. Because of the limited studies on mental health service users’ lived experiences of a recovery-oriented service, more clinical studies are needed and in different cultural contexts.Practical implicationsOn hindsight, the authors should have included service users in this review process as consumer inclusion is progressively emphasised in mental health educational and research activities. This review highlights that not all studies have involved service users or consumers in their research activity.Social implicationsService users need relevant information in a timely manner to participate in decision-making regarding their treatment and care. This review found that either no information was provided to the service users or it was provided in a limited and fragmented manner. This review also found inpatients reported limited opportunities to have meaningful participation in decision-making about their care. These findings have important social implications, as greater consumer engagement in the design and delivery of mental health services will increase community trust in the care provided. This in turn has the potential to facilitate greater community engagement in preventative mental health care.Originality/value
目的:在过去15年中,精神卫生组织已采取步骤,向提供更加注重康复的服务迈进。进行这项审查的目的是探讨在提供服务时采用以恢复为导向的方法的服务用户的体验情况。评估消费者对康复导向护理的生活体验的研究有限;选择范围审查来概述该领域的现有研究(Munn et al., 2018)。本综述旨在总结和综合目前的质性研究,探讨以康复为导向的心理卫生保健服务的消费者体验。设计/方法/方法这一范围审查是按照Arksey和O'Malley(2005)的概述进行的。这五个步骤包括确定研究问题;查找相关研究;选择研究;绘制研究图表;整理、总结和报告研究结果。从这次回顾中出现了三个关键主题:将恢复政策转化为实践;病房环境;恢复原则有五个主题:参与;不被倾听的;共同决策;信息需求;以及支持和合作关系。表3列出了18项研究中确定的主题和次主题。研究局限/意义本综述强调了服务使用者接受康复导向康复护理的不同程度。在大多数情况下,大多数服务使用者报告护理参与的机会很少,沟通不良,信息提供不足,缺乏协作护理,并且对病房环境的体验大多是负面的。由于对心理健康服务使用者对康复服务的生活体验的研究有限,需要在不同的文化背景下进行更多的临床研究。事后看来,由于心理健康教育和研究活动日益强调将消费者纳入其中,作者本应将服务使用者纳入这一审查过程。本综述强调,并非所有的研究都将服务使用者或消费者纳入其研究活动。社会影响服务使用者需要及时获得相关信息,以便参与有关其治疗和护理的决策。这一审查发现,要么没有向服务用户提供信息,要么以有限和分散的方式提供信息。本综述还发现,住院患者报告说,有意义地参与其护理决策的机会有限。这些发现具有重要的社会意义,因为更多的消费者参与精神卫生服务的设计和提供将增加社区对所提供护理的信任。这反过来又有可能促进社区更多地参与预防性精神卫生保健。原创性/价值这是第一次系统地综合消费者对服务提供者在多大程度上实现了在其服务提供中实施以恢复为导向的实践的目标的观点。尽管有重要的政策变化,但本次审查的结果表明,需要做更多的工作才能真正实施并将这些原则转化为实践。
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引用次数: 1
Religion and mental health among older adults in Thailand: a national survey study 泰国老年人的宗教与心理健康:一项全国性调查研究
IF 1.2 Q4 PSYCHIATRY Pub Date : 2021-08-16 DOI: 10.1108/mhrj-06-2020-0039
Suriya Klangrit, David D. Perrodin, Yasotara Siripaprapakon, F. R. Choudhry, Thittayawadee Intaranggkul, Suthat Pratoomkaew, Khunthong Khemsiri, Kan Saengrung, Watchara Vachirayano
PurposeThis study aims to investigate the association between mental health and religion among Thailand’s elderly population. The role of religion and culture remains limited despite the significant number of devout followers of religions in Thailand. Thai cultural and religious contexts have a dominant and persuasive influence on the lives of Thai older adults.Design/methodology/approachData was collected in 2018 via face-to-face interaction using a structured questionnaire by the Thailand National Statistical Office. The sample consisted of 67,454 individuals, with 13,800 elderly Thai people aged 60 years or older selected for the study.FindingsThe results showed logistic regression with the association between religious activities and mental health in the understudied context of Buddhist elderly in Thailand. The variables were significantly associated with mental health at a 95% confidence level.Originality/valueThe model revealed that particular demographic and socioeconomic factors (age, education and marital status) were related to mental health for older adults. Regression analysis also revealed Buddhist religious activities (giving food to monks, mediation, monkhood, New Year praying, learning Dhamma for solving life’s problems, belief in Buddhism and practicing Buddhist principles) were significantly associated with the mental health of the older adult population in Thailand.
目的本研究旨在调查泰国老年人的心理健康与宗教信仰之间的关系。尽管泰国有大量虔诚的宗教信徒,但宗教和文化的作用仍然有限。泰国的文化和宗教背景对泰国老年人的生活具有主导和说服力的影响。设计/方法/方法2018年,泰国国家统计局通过面对面的互动,使用结构化问卷收集数据。样本包括67454人,其中13800名60岁的泰国老年人 年龄或以上的研究对象。研究结果显示,在泰国佛教老年人研究不足的情况下,宗教活动与心理健康之间的关系呈逻辑回归。在95%的置信水平下,这些变量与心理健康显著相关。独创性/价值该模型显示,特定的人口和社会经济因素(年龄、教育和婚姻状况)与老年人的心理健康有关。回归分析还显示,佛教宗教活动(给僧侣提供食物、调解、僧侣活动、新年祈祷、学习佛法以解决生活问题、信仰佛教和实践佛教原则)与泰国老年人的心理健康显著相关。
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引用次数: 1
Current scenario of diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD) in urban India: a pilot study 印度城市注意力缺陷/多动障碍(ADHD)的诊断和治疗现状:一项试点研究
IF 1.2 Q4 PSYCHIATRY Pub Date : 2021-08-12 DOI: 10.1108/mhrj-03-2021-0018
Sandhya Basu, Bidisha Banerjee
PurposeThe current literature on attention-deficit/hyperactivity disorder (ADHD) shows a tangled picture of its etiology and diagnosis. It directs at over-medicalization in ADHD cases due to the pharmaceutical-based models surrounding its treatment. Further, the authors observed the negligible reporting of India’s ADHD scenario in the reviewed literature. Thus, this study aims to explore the status of ADHD in India’s urban setting through a pilot study.Design/methodology/approachSocial constructivist viewpoint guided this study. The authors conducted the pilot in two phases: face-to-face semi-structured qualitative interviews with 11 mental health professionals in the first phase, and, in the second phase, five mental health professionals responded to an online survey with same questions. After qualitative analysis, four major themes were identified: participants’ opinions on ADHD etiology, issues in diagnosis, social context of ADHD and alternatives to medication.FindingsThe findings highlight the need to re-visit the ADHD narrative in the Indian context. These findings also emphasize future investigation on the medicalization of ADHD in India.Research limitations/implicationsA countrywide epidemiological survey is required to explore the distribution of the disorder to standardize diagnosis and treatment procedures pan-India. This paper is an attempt to iron out the ADHD-related information that needs further exploration and research.Originality/valueWith in-depth interviews of mental health professionals, the study explores the state of ADHD in an urban setting in India. Future research must build on the current findings to establish the etiological and diagnostic framework of ADHD.
目的目前关于注意力缺陷/多动障碍(ADHD)的文献显示了其病因和诊断的混乱局面。由于围绕其治疗的药物模型,它针对ADHD病例的过度药物化。此外,作者观察到,在综述的文献中,印度多动症的报道微不足道。因此,本研究旨在通过一项试点研究来探索多动症在印度城市环境中的地位。设计/方法论/方法社会建构主义观点指导了本研究。作者分两个阶段进行了试点:第一阶段对11名心理健康专业人员进行了面对面的半结构化定性访谈,第二阶段对5名心理健康专家进行了同样问题的在线调查。经过定性分析,确定了四个主要主题:参与者对多动症病因的看法、诊断问题、多动症的社会背景和药物替代方案。发现这些发现强调了在印度背景下重新审视多动症叙事的必要性。这些发现还强调了未来对印度ADHD医学化的调查。研究局限性/影响需要进行一项全国性的流行病学调查,以探索该疾病的分布,从而使印度的诊断和治疗程序标准化。本文试图挖掘出与多动症相关的信息,需要进一步的探索和研究。独创性/价值通过对心理健康专业人士的深入采访,该研究探讨了印度城市环境中多动症的状态。未来的研究必须建立在当前发现的基础上,以建立多动症的病因和诊断框架。
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引用次数: 0
Exploring the interface between mental health provision and the benefits system: clinical psychologists’ experiences of working in the context of the UK benefits system 探索心理健康提供和福利制度之间的接口:临床心理学家在英国福利制度背景下的工作经验
IF 1.2 Q4 PSYCHIATRY Pub Date : 2021-07-29 DOI: 10.1108/MHRJ-02-2021-0013
E. Cantrell, H. Higson
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引用次数: 1
“It doesn’t stop when you get to 18”: experiences of self-harm in adults “18岁时它不会停止”:成年人的自残经历
IF 1.2 Q4 PSYCHIATRY Pub Date : 2021-07-12 DOI: 10.1108/mhrj-12-2020-0087
M. Boyce
PurposeSelf-harm can affect people of all ages, yet the high prevalence rate in adolescents and the potential risk factor of suicide in adults 60 years and above has meant research has tended to focus within these areas. Therefore, the purpose of this exploratory study is to examine the experiences of self-harm in people from early adulthood to late middle age to gain greater insight and understanding in this underexplored area.Design/methodology/approachAn online open-ended survey was used to collect the data from a UK user-led moderated online forum that supports people who self-harm.FindingsThematic data analysis indicates that feelings of shame and guilt were intensified, due to the double stigma participants face as adults that self-harm. Although most participants had seen a reduction in the frequency of their self-harm many experienced an increase in the severity of harm. In not fitting the assumed typical profile of someone that self-harm participants often struggled to gain formal support.Research limitations/implicationsThis was a small-scale online survey; hence, it is not possible to generalise the findings to all adults who self-harm.Practical implicationsThe findings from this research provide evidence that greater recognition needs to be given to the reality that self-harm can affect people of all ages. As a result, access to support needs to be widened as a means of supporting those who do not fit the typical profile of someone who self-harms.Originality/valueThis exploratory online study provides insights around the tensions and challenges facing adults that self-harm, which remains an under-researched and largely ignored area.
自残可以影响所有年龄段的人,然而青少年的高患病率和60岁及以上成年人自杀的潜在风险因素意味着研究往往集中在这些领域。因此,本探索性研究的目的是研究从成年早期到中年晚期的人们的自我伤害经历,以在这一尚未被探索的领域获得更大的见解和理解。设计/方法/方法一项在线开放式调查用于收集来自英国用户主导的在线论坛的数据,该论坛支持自残者。研究结果:专题数据分析表明,由于参与者作为成年人面临自我伤害的双重耻辱,羞耻感和内疚感被强化了。尽管大多数参与者的自残频率有所降低,但他们的自残程度却有所增加。由于不符合自残者的典型形象,自残者往往难以获得正式的支持。研究局限性/启示这是一项小规模的在线调查;因此,不可能将研究结果推广到所有有自残行为的成年人。实际意义这项研究的发现提供了证据,表明我们需要更多地认识到自残会影响所有年龄段的人这一现实。因此,需要扩大获得支持的途径,作为支持那些不符合自我伤害者典型形象的人的一种手段。原创性/价值这个探索性的在线研究提供了关于成年人自残所面临的紧张和挑战的见解,这仍然是一个研究不足和很大程度上被忽视的领域。
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引用次数: 0
Social media use for supporting mental health (SMILE) 使用社交媒体支持心理健康(SMILE)
IF 1.2 Q4 PSYCHIATRY Pub Date : 2021-07-08 DOI: 10.1108/MHRJ-10-2020-0079
Gill Brown, A. Rathbone, J. Prescott
PurposeThe SMILE study (social media as informal support for people with mental illness: an exploratory study) aimed to explore how people with mental health issues use and value social media as a support mechanism.Design/methodology/approachA systematic search of Facebook and Twitter identified groups and pages relating to mental health issues. In total, 203 users over the age of 18 were recruited via Facebook and Twitter. Any user who considered themselves to experience mental health problems could opt to participate and no exclusion criteria were applied. A mixed-methods online survey retrieved demographic and qualitative data by asking users to describe their personal experiences when using social media for mental health support.FindingsUsers perceive Facebook and Twitter as useful online resources to gain informational and emotional support and to share experiences. The benefits were; ease of access, anonymity and personal control over engagement levels. Users had subjective experiences of engagement, however, overall these were deemed positive. Using Facebook and Twitter for mental health provided users with a sense of connectedness and reduced feelings of isolation.Originality/valueThe qualitative methodology allowed participants to share their experiences and views, with positive implications for services. Social media was discussed as a prospective tool for raising awareness and reducing stigma. The study highlights the scope for mental health service providers to tap into the social media consumer market and provide quality online support provision.
目的SMILE研究(social media as informal support for people with mental illness:一项探索性研究)旨在探讨心理健康问题人群如何使用和重视社交媒体作为一种支持机制。设计/方法/方法对Facebook和Twitter进行系统搜索,确定了与心理健康问题有关的群组和页面。通过Facebook和Twitter总共招募了203名18岁以上的用户。任何认为自己有精神健康问题的用户都可以选择参加,不适用任何排除标准。一项混合方法的在线调查通过要求用户描述他们在使用社交媒体寻求心理健康支持时的个人经历来检索人口统计和定性数据。用户认为Facebook和Twitter是获得信息和情感支持以及分享经验的有用在线资源。好处是;易于访问,匿名和个人控制参与水平。用户有主观的参与体验,但总的来说,这些都是积极的。使用Facebook和Twitter来促进心理健康,为用户提供了一种联系感,减少了孤独感。原创性/价值定性方法允许参与者分享他们的经验和观点,对服务产生积极影响。讨论了社交媒体作为提高认识和减少耻辱的潜在工具。该研究强调了心理健康服务提供者进入社交媒体消费者市场并提供高质量在线支持的范围。
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引用次数: 4
The psychological impact of COVID-19 on socially isolated individuals – a systematic review COVID-19对社会孤立个体的心理影响——一项系统综述
IF 1.2 Q4 PSYCHIATRY Pub Date : 2021-06-15 DOI: 10.1108/MHRJ-09-2020-0062
A. Shankar, B. Yu, Monali S. Malvankar-Mehta
Purpose: This study aims to assess the various psychological effects of the Coronavirus on those in isolation, the factors that cause these effects during the pandemic, as well as to discuss the recommendations and strategies that can be implemented to help reduce the negative psychological impact. Design/methodology/approach: Databases such as MEDLINE (Ovid), excerpta medica dataBASE (Ovid) and cumulative index of nursing and allied health literature (Elton B. Stephens Company), as well as grey literature, were used as a part of the search design to locate articles published on this subject. The search design was formatted in a way that aided in locating articles concerning a variety of mental health effects. Title and abstract screening and full text screening were conducted by two reviewers. The risk of bias assessment was conducted using AMSTAR2. Data extraction was performed by one reviewer and was confirmed by the other. Findings: A total of 28 articles were obtained, and of those, 11 were included in the review. From the data that was reviewed, the majority of the isolated individuals felt depressed and anxious. This negative psychological distress contributes to deteriorating health and quality of life in many people. Research limitations/implications: Few limitations include limited published research papers pertaining to the subject of the mental health effects of COVID-19 on individuals in social isolation. Therefore, this suggests the need for higher quality studies to be performed on this topic. Originality/value: This review provides a unique viewpoint on the effects of COVID-19, allowing for others to have a better understanding of the wide range of psychological impacts the pandemic has brought on. © 2021, Emerald Publishing Limited.
目的:本研究旨在评估冠状病毒对隔离人员的各种心理影响,以及在大流行期间造成这些影响的因素,并讨论可以实施的建议和策略,以帮助减少负面心理影响。设计/方法/方法:数据库,如MEDLINE(Ovid)、医学数据数据库摘录(Ovid)、护理和相关健康文献累积索引(Elton B.Stephens Company)以及灰色文献,被用作搜索设计的一部分,以定位发表在该主题上的文章。搜索设计的格式有助于定位有关各种心理健康影响的文章。标题和摘要筛选以及全文筛选由两名评审员进行。使用AMSTAR2进行偏倚风险评估。数据提取由一名审查员进行,并由另一名审查人员确认。研究结果:共获得28篇文章,其中11篇被纳入综述。从审查的数据来看,大多数被隔离的人感到沮丧和焦虑。这种消极的心理困扰导致许多人的健康和生活质量恶化。研究局限性/影响:很少有局限性包括发表的关于新冠肺炎对处于社会隔离状态的个人的心理健康影响的有限研究论文。因此,这表明需要对这一主题进行更高质量的研究。原创/价值:这篇评论对新冠肺炎的影响提供了一个独特的观点,让其他人更好地了解疫情带来的广泛心理影响。©2021,Emerald出版有限公司。
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引用次数: 2
Factors related to suicide among students: a narrative review of psychological literature 学生自杀的相关因素:心理学文献述评
IF 1.2 Q4 PSYCHIATRY Pub Date : 2021-05-17 DOI: 10.1108/MHRJ-08-2020-0061
S. Javed, Khadeeja Munawar
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引用次数: 0
Psychoeducation for borderline personality difficulties: a preliminary study 边缘型人格困难的心理教育初探
IF 1.2 Q4 PSYCHIATRY Pub Date : 2021-05-10 DOI: 10.1108/MHRJ-04-2020-0023
F. Rocca, Chloe Finamore, S. Stamp, Fiona Kuhn-Thompson, O. Dale
PurposeNational Institute for Clinical and Health Excellence guidelines (2009) state that low intensity psychological interventions should not be used for borderline personality disorder. However, an emerging body of evidence suggests brief interventions such as psychoeducation may be relevant for those presenting with borderline personality difficulties. The purpose of this study is to evaluate the benefit of learning about thinking, emotions and relationships (LATER), a co-produced psychoeducation programme for borderline personality difficulties in a community-based setting.Design/methodology/approachParticipants (n = 125) self-referred to LATER, a group-based psychoeducation programme delivered at the [NHS Trust] Recovery College. Participants were assessed pre- and post-intervention using the tailor-made psychological education group evaluation scale, the borderline evaluation of severity over time and work and social adjustment scale. Paired t-tests were conducted on pre- and post-scores, and effect sizes were calculated.FindingsAfter LATER, participants reported a significant decrease in negative thoughts and feelings, destructive behaviours and overall borderline symptom severity, but no significant increase in positive behaviours. Significant decreases were found in areas of work and social impairment. Participants’ overall understanding of personality difficulties significantly improved. Effect sizes were small to moderate.Research limitations/implicationsLimitations of the study include the lack of a control group, adjustment for confounders and follow-up. Replication with a more robust methodology is needed.Originality/valueThis study contributes to the evidence for the usefulness of brief interventions for personality difficulties, particularly in the context of a stepped model of care and adds to the research on co-production.
目的国家临床与健康卓越研究所指南(2009)指出,低强度心理干预不应用于边缘型人格障碍。然而,一组新出现的证据表明,心理教育等简短的干预措施可能与那些出现边缘人格困难的人有关。本研究的目的是评估学习思维、情绪和关系(LATER)的益处,这是一项针对社区环境中边缘人格困难的联合心理教育计划。设计/方法论/方法参与者(n = 125)自荐LATER,这是一个在[英国国家医疗服务体系信托]康复学院提供的基于群体的心理教育项目。参与者在干预前和干预后使用量身定制的心理教育小组评估量表、严重程度随时间变化的临界评估量表以及工作和社会适应量表进行评估。对前后评分进行配对t检验,并计算影响大小。研究结果之后,参与者报告说负面想法和感受、破坏性行为和总体临界症状严重程度显著减少,但积极行为没有显著增加。工作和社会障碍领域的失业率显著下降。参与者对人格困难的总体理解显著提高。效果大小从小到中等。研究局限性/含义研究的局限性包括缺乏对照组、对混杂因素的调整和随访。需要使用更稳健的方法进行复制。独创性/价值这项研究有助于证明短暂干预对人格困难的有用性,特别是在阶梯式护理模式的背景下,并增加了对共同生产的研究。
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引用次数: 0
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Mental Health Review Journal
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