{"title":"The alliance construct in psychotherapies: from evolution to revolution in theory and research","authors":"J. Muran","doi":"10.1002/wps.20973","DOIUrl":"https://doi.org/10.1002/wps.20973","url":null,"abstract":"","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43503565","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":"Post‐traumatic stress disorder as moderator of other mental health conditions","authors":"R. Bryant","doi":"10.1002/wps.20975","DOIUrl":"https://doi.org/10.1002/wps.20975","url":null,"abstract":"","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45485083","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}
Post-traumatic stress disorder (PTSD) entered the DSM just over 40 years ago. Since then, there have been more than 300 completed randomized controlled trials (RCTs) of therapies for this condition, about two thirds of which have included one or more psychotherapies. It is therefore not surprising that there is a robust evidence base of effective psychotherapies for PTSD. Trauma-focused psychotherapies, in which processing memories and emotions related to the traumatic event is a primary focus throughout the treatment, have emerged as the most effective. Meta-analyses generally show large effect sizes for PTSD symptom reduction and high rates of loss of diagnosis or remission for these treatments. Among trauma-focused psychotherapies, prolonged exposure (PE) therapy, cognitive processing therapy (CPT), cognitive therapy, and eye movement desensitization and reprocessing stand out as having the strongest evidence, because they have been studied the most, by investigators different from those who developed the treatments, and with the broadest variety of populations and comorbidities. All involve manualized protocols usually completed in about 12 sessions, most often delivered weekly. While there have been few direct comparisons of psychotherapies and pharmacotherapies for PTSD, a meta-analysis that compared effect sizes across studies found larger effects for psychotherapies (g=1.14) than medications (g=0.42). There is also evidence that PTSD can be treated effectively with nontrauma-focused psychotherapies, which generally aim to improve specific skills, but effect sizes are generally smaller than for trauma-focused psychotherapies. The availability of effective treatments has fundamentally shifted our view of PTSD from a chronic condition that we can at best hope to manage, to a condition from which it is possible to recover. While this is tremendously good news, there is still a great deal of work left to do. Not everyone with PTSD is willing or able to engage in a trauma-focused psychotherapy; dropout from PTSD treatment remains high (this is true across PTSD treatment types, in part because a hallmark symptom of PTSD is avoidance); and a number of people who engage in these treatments remain partial responders or non-responders. Ongoing work to further improve the effectiveness of psychotherapies for PTSD can be divided broadly into two categories: a) research to improve engagement in and outcomes of existing trauma-focused psychotherapies, and b) research to develop and evaluate novel psychotherapies. A delivery adaptation that is promising in terms of improving engagement in existing psychotherapies is massed treatment, that is, psychotherapy sessions offered on consecutive days or multiple times per week. This format allows patients to complete treatment in 2-4 weeks, rather than in 3-4 months as is usually the case with weekly sessions. Field studies and a small number of RCTs show treatment completion rates upward of 85%, with effectiven
{"title":"Effectiveness of currently available psychotherapies for post‐traumatic stress disorder and future directions","authors":"S. Norman","doi":"10.1002/wps.20974","DOIUrl":"https://doi.org/10.1002/wps.20974","url":null,"abstract":"Post-traumatic stress disorder (PTSD) entered the DSM just over 40 years ago. Since then, there have been more than 300 completed randomized controlled trials (RCTs) of therapies for this condition, about two thirds of which have included one or more psychotherapies. It is therefore not surprising that there is a robust evidence base of effective psychotherapies for PTSD. Trauma-focused psychotherapies, in which processing memories and emotions related to the traumatic event is a primary focus throughout the treatment, have emerged as the most effective. Meta-analyses generally show large effect sizes for PTSD symptom reduction and high rates of loss of diagnosis or remission for these treatments. Among trauma-focused psychotherapies, prolonged exposure (PE) therapy, cognitive processing therapy (CPT), cognitive therapy, and eye movement desensitization and reprocessing stand out as having the strongest evidence, because they have been studied the most, by investigators different from those who developed the treatments, and with the broadest variety of populations and comorbidities. All involve manualized protocols usually completed in about 12 sessions, most often delivered weekly. While there have been few direct comparisons of psychotherapies and pharmacotherapies for PTSD, a meta-analysis that compared effect sizes across studies found larger effects for psychotherapies (g=1.14) than medications (g=0.42). There is also evidence that PTSD can be treated effectively with nontrauma-focused psychotherapies, which generally aim to improve specific skills, but effect sizes are generally smaller than for trauma-focused psychotherapies. The availability of effective treatments has fundamentally shifted our view of PTSD from a chronic condition that we can at best hope to manage, to a condition from which it is possible to recover. While this is tremendously good news, there is still a great deal of work left to do. Not everyone with PTSD is willing or able to engage in a trauma-focused psychotherapy; dropout from PTSD treatment remains high (this is true across PTSD treatment types, in part because a hallmark symptom of PTSD is avoidance); and a number of people who engage in these treatments remain partial responders or non-responders. Ongoing work to further improve the effectiveness of psychotherapies for PTSD can be divided broadly into two categories: a) research to improve engagement in and outcomes of existing trauma-focused psychotherapies, and b) research to develop and evaluate novel psychotherapies. A delivery adaptation that is promising in terms of improving engagement in existing psychotherapies is massed treatment, that is, psychotherapy sessions offered on consecutive days or multiple times per week. This format allows patients to complete treatment in 2-4 weeks, rather than in 3-4 months as is usually the case with weekly sessions. Field studies and a small number of RCTs show treatment completion rates upward of 85%, with effectiven","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48810551","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":"Subjectivity, psychosis and the science of psychiatry","authors":"Louis Sass","doi":"10.1002/wps.20986","DOIUrl":"https://doi.org/10.1002/wps.20986","url":null,"abstract":"","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49127611","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}
M. First, Lamyaa Yousif, D. Clarke, Philip S. Wang, N. Gogtay, P. Appelbaum
World Psychiatry 21:2 June 2022 Understanding the factors discussed above helps make sense of what, for many scientists and health professionals, is one of the most exasperating and difficult-to-understand features of the vaccination debate: facts are not enough. Merely repeating evidence has been a notoriously ineffective way of shifting attitudes among those who self-identify as anti-vaccination. One reason for this is that people do not always behave like cognitive scientists, weighing up evidence before reaching a conclusion. Frequently, we behave more like cognitive lawyers, selectively exposing ourselves, critiquing, and remembering evidence that reinforces a conclusion that feels “right” for us. Successful communication requires deep listening and an attentiveness to the fears, worldviews and ideologies that might be motivating COVID-19 refusal. Persuasion attempts that are responsive to these underlying “attitude roots” are more likely to be successful than those that sail above them with an exclusive focus on facts and data. Finally, mental health professionals recognize as much as anyone the importance of communication that is non-stigmatizing and inclusive. Although the public face of the anti-vaccination movement sometimes seems strident and unworthy of empathy, community members who align with those views are frequently characterized by anxiety and uncertainty. There is the potential for negative feedback loops, where the vaccine hesitant feel misunderstood and stigmatized, reinforcing their worldview that the system is corrupted and lacking in humanity. Feeling socially isolated, vaccine refusers may be driven toward the online communities and misinformation echo chambers that reinforce their fears. Respectful and inclusive communication is not just the “nice” thing to do; on a pragmatic level, it is a pre-requisite for enabling positive change.
{"title":"DSM‐5‐TR: overview of what’s new and what’s changed","authors":"M. First, Lamyaa Yousif, D. Clarke, Philip S. Wang, N. Gogtay, P. Appelbaum","doi":"10.1002/wps.20989","DOIUrl":"https://doi.org/10.1002/wps.20989","url":null,"abstract":"World Psychiatry 21:2 June 2022 Understanding the factors discussed above helps make sense of what, for many scientists and health professionals, is one of the most exasperating and difficult-to-understand features of the vaccination debate: facts are not enough. Merely repeating evidence has been a notoriously ineffective way of shifting attitudes among those who self-identify as anti-vaccination. One reason for this is that people do not always behave like cognitive scientists, weighing up evidence before reaching a conclusion. Frequently, we behave more like cognitive lawyers, selectively exposing ourselves, critiquing, and remembering evidence that reinforces a conclusion that feels “right” for us. Successful communication requires deep listening and an attentiveness to the fears, worldviews and ideologies that might be motivating COVID-19 refusal. Persuasion attempts that are responsive to these underlying “attitude roots” are more likely to be successful than those that sail above them with an exclusive focus on facts and data. Finally, mental health professionals recognize as much as anyone the importance of communication that is non-stigmatizing and inclusive. Although the public face of the anti-vaccination movement sometimes seems strident and unworthy of empathy, community members who align with those views are frequently characterized by anxiety and uncertainty. There is the potential for negative feedback loops, where the vaccine hesitant feel misunderstood and stigmatized, reinforcing their worldview that the system is corrupted and lacking in humanity. Feeling socially isolated, vaccine refusers may be driven toward the online communities and misinformation echo chambers that reinforce their fears. Respectful and inclusive communication is not just the “nice” thing to do; on a pragmatic level, it is a pre-requisite for enabling positive change.","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":"21 1","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51240798","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}
World Psychiatry 21:2 June 2022 services, based on evidencebased public policies and practices on a national level. International research groups, including scientists and service users from low and middleincome countries, are the key to the collection and timely dissemination of data on the best models and practices, with the goal to provide the evidence for sus tainable acute psychiatric care delivery.
{"title":"After the acute crisis – engaging people with psychosis in rehabilitation‐oriented care","authors":"D. Siskind, Alison Yung","doi":"10.1002/wps.20970","DOIUrl":"https://doi.org/10.1002/wps.20970","url":null,"abstract":"World Psychiatry 21:2 June 2022 services, based on evidencebased public policies and practices on a national level. International research groups, including scientists and service users from low and middleincome countries, are the key to the collection and timely dissemination of data on the best models and practices, with the goal to provide the evidence for sus tainable acute psychiatric care delivery.","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42935045","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}
243 ate adaptations in psychiatric intensive care units, secure mental health services, emergency departments, and wards for other age groups. However, the staff short ages and considerable pressures faced by those working in mental health care also create considerable barriers for those im plementing interventions and undertak ing related research. A narrative review of the literature found a relatively small body of research on the use of closed circuits television (CCTV) to increase security for patients and staff in acute psychiatric units, but recognized the tradeoff with privacy. CCTV increased sub jective feelings of safety amongst patient and staff, but there was no evidence that it increased objective security or reduced vi olence. CCTV and, more recently, infrared cam eras have also been used to conduct close ob servations and monitoring of vital signs in patients, including in seclusion. Such tech nology can be less invasive for patients, reduce sleep disruption when making checks, and can be preferred by some pa tients as it avoids staff entering a person’s private space. This may reduce triggers for conflict and aggression, and subsequent psychological harm associated with con tainment measures. Video monitoring can also allow overstimulated patients to be left alone, while enabling staff to carry out their observations. On the other hand, the use of electronic surveillance can be seen as distancing and dehumanizing. Studies suggest that the main factor in comforting patients and re ducing trauma during an episode of se clu sion or restraint is contact and commu nication with staff. Symptoms of fear, dis trust or delusions can be worsened in some patients, and there are concerns that CCTV might increase paranoid thoughts or trig ger distressing memories of prior abuse involving videos. Video cameras might di rectly contribute to an atmosphere of de tachment, control and fear, which could promote occurrence of the very events that surveillance is supposed to reduce. Video ing patients, especially in distress, can fuel feelings of shame and touches the right to privacy. These concerns and the need for more re search are important, as the increasing avail ability and affordability of digital technol ogies has seen body worn cameras (BWC) being introduced to inpatient units, in emer gency departments and for paramedics in ambulances. BWCs are small devices that can be worn on clothing, which record sights and sounds in the vicinity of the wearer. Men tal health staff are being asked to wear BWCs and to switch them on dur ing inci dents, or sometimes at the request of a pa tient. It is hoped that the use of BWCs will defuse situations, reduce aggression, and increase accountability and evidence gathering around serious incidents. How ever, a recent systematic review of the liter ature identified only two lowquality eval uations of BWC use in mental health wards, with mixed results though some indication of
{"title":"Centering equity in mental health crisis services","authors":"Matthew L. Goldman, Sarah Y. Vinson","doi":"10.1002/wps.20968","DOIUrl":"https://doi.org/10.1002/wps.20968","url":null,"abstract":"243 ate adaptations in psychiatric intensive care units, secure mental health services, emergency departments, and wards for other age groups. However, the staff short ages and considerable pressures faced by those working in mental health care also create considerable barriers for those im plementing interventions and undertak ing related research. A narrative review of the literature found a relatively small body of research on the use of closed circuits television (CCTV) to increase security for patients and staff in acute psychiatric units, but recognized the tradeoff with privacy. CCTV increased sub jective feelings of safety amongst patient and staff, but there was no evidence that it increased objective security or reduced vi olence. CCTV and, more recently, infrared cam eras have also been used to conduct close ob servations and monitoring of vital signs in patients, including in seclusion. Such tech nology can be less invasive for patients, reduce sleep disruption when making checks, and can be preferred by some pa tients as it avoids staff entering a person’s private space. This may reduce triggers for conflict and aggression, and subsequent psychological harm associated with con tainment measures. Video monitoring can also allow overstimulated patients to be left alone, while enabling staff to carry out their observations. On the other hand, the use of electronic surveillance can be seen as distancing and dehumanizing. Studies suggest that the main factor in comforting patients and re ducing trauma during an episode of se clu sion or restraint is contact and commu nication with staff. Symptoms of fear, dis trust or delusions can be worsened in some patients, and there are concerns that CCTV might increase paranoid thoughts or trig ger distressing memories of prior abuse involving videos. Video cameras might di rectly contribute to an atmosphere of de tachment, control and fear, which could promote occurrence of the very events that surveillance is supposed to reduce. Video ing patients, especially in distress, can fuel feelings of shame and touches the right to privacy. These concerns and the need for more re search are important, as the increasing avail ability and affordability of digital technol ogies has seen body worn cameras (BWC) being introduced to inpatient units, in emer gency departments and for paramedics in ambulances. BWCs are small devices that can be worn on clothing, which record sights and sounds in the vicinity of the wearer. Men tal health staff are being asked to wear BWCs and to switch them on dur ing inci dents, or sometimes at the request of a pa tient. It is hoped that the use of BWCs will defuse situations, reduce aggression, and increase accountability and evidence gathering around serious incidents. How ever, a recent systematic review of the liter ature identified only two lowquality eval uations of BWC use in mental health wards, with mixed results though some indication of ","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42353548","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}
Christine Mauro, Robert A. Tumasian, Natalia A Skritskaya, Margaret Gacheru, Sidney Zisook, Naomi M. Simon, Charles F. Reynolds, M. Shear
World Psychiatry 21:2 June 2022 2. Wolpe J. Psychotherapy by reciprocal inhibition. Stanford: Stanford University Press, 1958. 3. Lewinsohn PM, Libet J. J Abnorm Psychol 1972;79:291-5. 4. Bellack AS, Hersen M. Research and practice in social skills training. London: Plenum, 1979. 5. Meichenbaum DW, Goodman J. J Abnorm Psychol 1971;77:115-26. 6. Beck AT. Am Psychol 1991;46:368-75. 7. Linehan M. Bull Menn Clin 1987;51:261-76. 8. Banta HD, Saxe L. Am Psychol 1983;38:918-23. 9. Kanfer FH, Saslow G. Arch Gen Psychiatry 1965;12:529-38.
{"title":"The efficacy of complicated grief therapy for DSM‐5‐TR prolonged grief disorder","authors":"Christine Mauro, Robert A. Tumasian, Natalia A Skritskaya, Margaret Gacheru, Sidney Zisook, Naomi M. Simon, Charles F. Reynolds, M. Shear","doi":"10.1002/wps.20991","DOIUrl":"https://doi.org/10.1002/wps.20991","url":null,"abstract":"World Psychiatry 21:2 June 2022 2. Wolpe J. Psychotherapy by reciprocal inhibition. Stanford: Stanford University Press, 1958. 3. Lewinsohn PM, Libet J. J Abnorm Psychol 1972;79:291-5. 4. Bellack AS, Hersen M. Research and practice in social skills training. London: Plenum, 1979. 5. Meichenbaum DW, Goodman J. J Abnorm Psychol 1971;77:115-26. 6. Beck AT. Am Psychol 1991;46:368-75. 7. Linehan M. Bull Menn Clin 1987;51:261-76. 8. Banta HD, Saxe L. Am Psychol 1983;38:918-23. 9. Kanfer FH, Saslow G. Arch Gen Psychiatry 1965;12:529-38.","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48463316","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}
World Psychiatry 21:2 June 2022 provide a wide range of interventions. Vari ations among team practices suggest that it is hard to practice all elements or compo nents well, and that sometimes different components can compete, e.g., ensuring rapid response to new referrals vs. provid ing intensive care with frequent visits to current service users. Local adaptations are often necessary, and this may add to challenges in comparing complex inter ventions across sites and countries. Johnson et al’s overview describes a wide range of acute psychiatric care mod els used in various stages and contexts. For most of these models, there is a lack of researchbased evidence, and achiev ing evidence for all these models may not be possible. However, a possible path may be to use research models currently under development for complex interventions to study individual elements of acute psychi atric care. If such research could identify which elements are critical for what types of clinical effect, these elements could be applied and studied within various models and contexts. One dilemma of the increasing special ization and differentiation in mental health services, including acute psychiatric care, is the increasing discontinuity of care for service users who need services through several phases of illness. Models with more generic or integrated teams may secure more continuity in the personal relation ships between the service user and the service provider. Efficiency requirements focus on management of disorders, but often leave little room for the interaction of providers with persons with these dis orders. We need to know more about which out comes are most important for service users and what elements of acute psychi atric care contribute to the various out comes. As a part of this, it is important to better understand how continuity of care and therapeutic relationships contribute to positive patient experiences and out comes in acute psychiatric care, and how these two critical elements may be pro vided.
{"title":"Activities and technologies: developing safer acute inpatient mental health care","authors":"Alan Simpson","doi":"10.1002/wps.20967","DOIUrl":"https://doi.org/10.1002/wps.20967","url":null,"abstract":"World Psychiatry 21:2 June 2022 provide a wide range of interventions. Vari ations among team practices suggest that it is hard to practice all elements or compo nents well, and that sometimes different components can compete, e.g., ensuring rapid response to new referrals vs. provid ing intensive care with frequent visits to current service users. Local adaptations are often necessary, and this may add to challenges in comparing complex inter ventions across sites and countries. Johnson et al’s overview describes a wide range of acute psychiatric care mod els used in various stages and contexts. For most of these models, there is a lack of researchbased evidence, and achiev ing evidence for all these models may not be possible. However, a possible path may be to use research models currently under development for complex interventions to study individual elements of acute psychi atric care. If such research could identify which elements are critical for what types of clinical effect, these elements could be applied and studied within various models and contexts. One dilemma of the increasing special ization and differentiation in mental health services, including acute psychiatric care, is the increasing discontinuity of care for service users who need services through several phases of illness. Models with more generic or integrated teams may secure more continuity in the personal relation ships between the service user and the service provider. Efficiency requirements focus on management of disorders, but often leave little room for the interaction of providers with persons with these dis orders. We need to know more about which out comes are most important for service users and what elements of acute psychi atric care contribute to the various out comes. As a part of this, it is important to better understand how continuity of care and therapeutic relationships contribute to positive patient experiences and out comes in acute psychiatric care, and how these two critical elements may be pro vided.","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45680582","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}
Muhammad Waqar Azeem, Howard Y. Liu, N. Imran, Bernardo Ng, Khalid Bazaid, Pronob K. Dalal, Mohan Issac, Afzal Javed
World Psychiatry 21:2 June 2022 WPA public health mission to emphasize the importance of risk factors and to adopt evidence-based preventive and rehabilitative interventions. The WPA Working Group on IDD has participated this year in the initiative called Rehabilitation 2030, sponsored by the WHO Department of Noncommunicable Diseases, Disability, Violence, and Injury Prevention, aiming to develop a package of rehabilitative interventions along with specified resource requirements for their delivery. The overarching goal is the improved care of persons with IDD across the lifespan, with a particular emphasis on LMICs. Following on these ground-breaking approaches in classification and evidencebased interventions, the Working Group is now promoting a second paradigm shift aiming to include training on IDD within mainstream psychiatry, once again with a particular emphasis on LMICs. Three important arguments justify this call. First, when polled about their knowledge on the impact of IDD, many trainees in psychiatry recognize the disproportionately high burden of co-occurring mental disorders in persons with IDD. Second, when offered opportunities to interact with persons with IDD during rotations, many trainees in psychiatry regard such experiences as highly formative and inspiring. Third, and most important, psychiatry as a profession has the potential to improve significantly the care for persons with IDD. Furthermore, the gap in mental health services for persons with IDD is too significant to be compensated by an ad hoc reliance on individual providers and families, and their resilience is not limitless. Moreover, within the context of the COVID-19 pandemic, persons with IDD are facing the utmost intensification of inequities in term of underlying medical liabilities, inability to socially distance, increased infection and mortality risks, challenges to participate in telehealth services, and ensuing social isolation and adverse mental health outcomes. The Working Group and the WPA leadership invite Member Societies to work collectively to enhance efforts for the development of inclusive training models in the mental care of persons with IDD. The Working Group is ready to provide awareness raising, training, and research collaboration to promote and disseminate effective services and thereby improve the lives and outcomes for persons with IDD. For this purpose, the Working Group is developing an open access handbook focusing on global aspects of the psychiatry of IDD, with authorship from both LMICs and high-income countries. In parallel, the Working Group is developing online educational materials summarizing the key aspects of psychiatric care in people with IDD. These resources will be accessible through the WPA educational portal in 2022. The WPA Working Group on IDD encourages systematic exposure to and experience in this area for all psychiatrists, so that they can adjust treatments for cooccurring mental disorders and avoid diagnostic o
{"title":"WPA Working Group on Medical Students: current initiatives and future priorities","authors":"Muhammad Waqar Azeem, Howard Y. Liu, N. Imran, Bernardo Ng, Khalid Bazaid, Pronob K. Dalal, Mohan Issac, Afzal Javed","doi":"10.1002/wps.20980","DOIUrl":"https://doi.org/10.1002/wps.20980","url":null,"abstract":"World Psychiatry 21:2 June 2022 WPA public health mission to emphasize the importance of risk factors and to adopt evidence-based preventive and rehabilitative interventions. The WPA Working Group on IDD has participated this year in the initiative called Rehabilitation 2030, sponsored by the WHO Department of Noncommunicable Diseases, Disability, Violence, and Injury Prevention, aiming to develop a package of rehabilitative interventions along with specified resource requirements for their delivery. The overarching goal is the improved care of persons with IDD across the lifespan, with a particular emphasis on LMICs. Following on these ground-breaking approaches in classification and evidencebased interventions, the Working Group is now promoting a second paradigm shift aiming to include training on IDD within mainstream psychiatry, once again with a particular emphasis on LMICs. Three important arguments justify this call. First, when polled about their knowledge on the impact of IDD, many trainees in psychiatry recognize the disproportionately high burden of co-occurring mental disorders in persons with IDD. Second, when offered opportunities to interact with persons with IDD during rotations, many trainees in psychiatry regard such experiences as highly formative and inspiring. Third, and most important, psychiatry as a profession has the potential to improve significantly the care for persons with IDD. Furthermore, the gap in mental health services for persons with IDD is too significant to be compensated by an ad hoc reliance on individual providers and families, and their resilience is not limitless. Moreover, within the context of the COVID-19 pandemic, persons with IDD are facing the utmost intensification of inequities in term of underlying medical liabilities, inability to socially distance, increased infection and mortality risks, challenges to participate in telehealth services, and ensuing social isolation and adverse mental health outcomes. The Working Group and the WPA leadership invite Member Societies to work collectively to enhance efforts for the development of inclusive training models in the mental care of persons with IDD. The Working Group is ready to provide awareness raising, training, and research collaboration to promote and disseminate effective services and thereby improve the lives and outcomes for persons with IDD. For this purpose, the Working Group is developing an open access handbook focusing on global aspects of the psychiatry of IDD, with authorship from both LMICs and high-income countries. In parallel, the Working Group is developing online educational materials summarizing the key aspects of psychiatric care in people with IDD. These resources will be accessible through the WPA educational portal in 2022. The WPA Working Group on IDD encourages systematic exposure to and experience in this area for all psychiatrists, so that they can adjust treatments for cooccurring mental disorders and avoid diagnostic o","PeriodicalId":49357,"journal":{"name":"World Psychiatry","volume":" ","pages":""},"PeriodicalIF":73.3,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46104992","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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