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iSupport: a WHO global online intervention for informal caregivers of people with dementia issupport:世卫组织针对痴呆症患者非正式照护者的全球在线干预措施
IF 73.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2019-09-09 DOI: 10.1002/wps.20684
A. Pot, D. Gallagher-Thompson, L. Xiao, B. Willemse, Iris Rosier, K. Mehta, D. Zandi, T. Dua
In 2015, it was estimated that worldwide 47 million people had dementia, increasing to 75 million in 2030 and 132 million by 2050. Nearly 9.9 million people are expected to develop dementia each year, which translates to one new case every three seconds. While dementia occurs across all levels of socioeconomic status, nearly 60% of people with dementia currently live in low‐ and middle‐income countries (LMICs) and most new cases (71%) are expected to occur in those countries. The majority of people with dementia in those countries do not have access to care and support.
2015年,据估计,全球有4700万人患有痴呆症,2030年增至7500万人,2050年增至1.32亿人。预计每年有近990万人患上痴呆症,相当于每三秒就有一例新病例。虽然痴呆症发生在所有社会经济地位的阶层,但目前近60%的痴呆症患者生活在中低收入国家,大多数新病例(71%)预计将发生在这些国家。这些国家的大多数痴呆症患者无法获得护理和支持。
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引用次数: 28
Perspectives from resource poor settings 来自资源贫乏环境的视角
IF 73.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2017-02-01 DOI: 10.1002/wps.20380
P. Sharan
edge about specific medication effects and greater attention to the possible impact of psychotropic medications on the physical health of people with SMI can aid psychiatrists in selecting appropriate treatment. The same is true for primary care providers. Some primary care professionals hold negative attitudes toward this vulnerable group, or wrongly attribute physical illness signs and symptoms to concurrent mental disorders, leading to underdiagnosis and mistreatment of the physical conditions. It seems that there still is a lack of awareness among these providers that people with SMI face a greater risk of developing physical illnesses, such as heart disease, obesity and diabetes. Primary care providers may also not be knowledgeable about the health risks associated with psychotropic medications and the resulting health monitoring that is indicated for persons with SMI. They therefore should specifically be trained to identify and treat physical health problems in people with SMI. It is clear that deficiencies in the care of those with SMI, due to cultural and educational factors and unclear roles and responsibilities of their providers, continue to leave many service users with SMI vulnerable to serious physical health issues, which may limit their recovery. We can change these aspects through educational innovations. Only then we can leave the road of Cheshire cat and will multilevel interventions or strategies, as those proposed by Liu et al, result in improved outcomes for people with SMI.
对特定药物效果的关注,以及对精神药物对SMI患者身体健康可能产生的影响的更多关注,可以帮助精神科医生选择合适的治疗方法。初级保健提供者也是如此。一些初级保健专业人员对这一弱势群体持负面态度,或错误地将身体疾病的体征和症状归因于并发的精神障碍,导致对身体状况的诊断不足和虐待。这些提供者似乎仍然缺乏意识,即SMI患者患心脏病、肥胖和糖尿病等身体疾病的风险更大。初级保健提供者也可能不了解与精神药物相关的健康风险以及由此产生的SMI患者健康监测。因此,他们应该接受专门的培训,以识别和治疗SMI患者的身体健康问题。很明显,由于文化和教育因素以及服务提供者的角色和责任不明确,SMI患者的护理不足,继续使许多SMI服务用户容易受到严重的身体健康问题的影响,这可能会限制他们的康复。我们可以通过教育创新来改变这些方面。只有这样,我们才能离开柴郡猫的道路,刘等人提出的多层次干预或策略是否会改善SMI患者的预后。
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引用次数: 5
The WPA website: newly designed with state-of-the-art features, carrying out the mission of WPA. WPA网站:新设计的最先进的功能,执行WPA的使命。
IF 73.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2017-02-01 DOI: 10.1002/WPS.20400
R. Kallivayalil
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引用次数: 4
Persistence of psychosis spectrum symptoms in the Philadelphia Neurodevelopmental Cohort: a prospective two‐year follow‐up 费城神经发育队列中精神病谱系症状的持续:一项前瞻性两年随访
IF 73.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2017-02-01 DOI: 10.1002/wps.20386
M. Calkins, T. Moore, T. Satterthwaite, D. Wolf, B. Turetsky, D. Roalf, K. Merikangas, K. Ruparel, C. Kohler, R. Gur, R. Gur
Prospective evaluation of youths with early psychotic‐like experiences can enrich our knowledge of clinical, biobehavioral and environmental risk and protective factors associated with the development of psychotic disorders. We aimed to investigate the predictors of persistence or worsening of psychosis spectrum features among US youth through the first large systematic study to evaluate subclinical symptoms in the community. Based on Time 1 screen of 9,498 youth (age 8‐21) from the Philadelphia Neurodevelopmental Cohort, a subsample of participants was enrolled based on the presence (N=249) or absence (N=254) of baseline psychosis spectrum symptoms, prior participation in neuroimaging, and current neuroimaging eligibility. They were invited to participate in a Time 2 assessment two years on average following Time 1. Participants were administered the Structured Interview for Prodromal Syndromes, conducted blind to initial screen status, along with the Schizotypal Personality Questionnaire and other clinical measures, computerized neurocognitive testing, and neuroimaging. Clinical and demographic predictors of symptom persistence were examined using logistic regression. At Time 2, psychosis spectrum features persisted or worsened in 51.4% of youths. Symptom persistence was predicted by higher severity of subclinical psychosis, lower global functioning, and prior psychiatric medication at baseline. Youths classified as having psychosis spectrum symptoms at baseline but not at follow‐up nonetheless exhibited comparatively higher symptom levels and lower functioning at both baseline and follow‐up than typically developing youths. In addition, psychosis spectrum features emerged in a small number of young people who previously had not reported significant symptoms but who had exhibited early clinical warning signs. Together, our findings indicate that varying courses of psychosis spectrum symptoms are evident early in US youth, supporting the importance of investigating psychosis risk as a dynamic developmental process. Neurocognition, brain structure and function, and genomics may be integrated with clinical data to provide early indices of symptom persistence and worsening in youths at risk for psychosis.
对有早期精神病样经历的年轻人进行前瞻性评估可以丰富我们对临床、生物行为和环境风险以及与精神病障碍发展相关的保护因素的了解。我们旨在通过第一项评估社区亚临床症状的大型系统研究,调查美国青年精神病谱系特征持续或恶化的预测因素。根据时间1对费城神经发育队列中9498名青年(8-21岁)的筛查,根据基线精神病谱系症状的存在(N=249)或不存在(N=254)、先前参与神经影像学和当前神经影像学资格,招募了一个子样本参与者。他们被邀请在时间1之后平均两年参加时间2评估。参与者接受了前驱综合征结构化访谈,对最初的筛查状态视而不见,同时进行了分裂型人格问卷和其他临床测量、计算机神经认知测试和神经成像。使用逻辑回归检验症状持续性的临床和人口统计学预测因素。在时间2,51.4%的年轻人的精神病谱系特征持续存在或恶化。亚临床精神病的严重程度越高,整体功能越低,基线时既往接受过精神药物治疗,可以预测症状的持续性。尽管在基线时被归类为有精神病谱系症状但在随访时没有的年轻人在基线和随访时表现出相对较高的症状水平和较低的功能,但与典型的发展中的年轻人相比。此外,精神病谱系特征出现在少数年轻人身上,这些年轻人以前没有报告过显著症状,但表现出早期临床警告信号。总之,我们的研究结果表明,不同病程的精神病谱系症状在美国青年早期很明显,这支持了将精神病风险作为一个动态发展过程进行调查的重要性。神经认知、大脑结构和功能以及基因组学可以与临床数据相结合,为有精神病风险的年轻人提供症状持续性和恶化的早期指标。
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引用次数: 98
Mental health care and treatment in prisons: a new paradigm to support best practice 监狱中的心理健康护理和治疗:支持最佳实践的新模式
IF 73.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2017-02-01 DOI: 10.1002/wps.20395
B. McKenna, J. Skipworth, K. Pillai
R. Lovelace’s 17th century poem To Althea, from Prison alludes to the ability of a “quiet” mind to transcend the imposition implied by institutions which deprive people of their liberty. But our prisons are not full of “minds innocent and quiet”; rather they are overloaded by minds troubled by the experience of mental illness. There is a need to reach into prisons to address mental health needs, but “stone walls” and “iron bars” constitute barriers to this intent. Systems designed to care for and treat mental illness struggle in institutions designed to punish, deter and incapacitate. Yet people are sent to prison as punishment, not for punishment, which requires us to understand how humane treatment can be delivered in such environments. The existence of various international human rights instruments (such as the International Covenant on Civil and Political Rights, and the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment) are necessary, but not sufficient by themselves, to ensure appropriate and humane care for some of the most vulnerable members of our citizenry. Worldwide more than 10 million people are held in penal institutions at any given time and more than 30 million people pass through prisons each year, with some regions experiencing prison growth well above population growth. There is an elevated risk of all-cause mortality, including suicide, for prisoners in custody and for ex-prisoners soon after release. We therefore have a collective interest in ensuring that health related need is identified and effective care is delivered during incarceration and the critical period of transition to community life. Research in this area has yielded increasing clarity about the central issues that need to be addressed to provide a comprehensive model of care for mentally unwell prisoners. First, the prison must screen for mental illness, at reception and at other critical times. At least five such screening instruments have been developed. However, additional triage and casefinding measures are needed to ensure comprehensive case identification. Once need is identified, hospital transfer may be required for the most unwell. Mental health legislation needs to accommodate such transfers. For others, prison-based care is often delivered through mental health in-reach teams, which have become increasingly systematic in creating care and treatment pathways for prisoners with serious mental illness, including contribution to release processes to enable sustained clinical involvement on release. Systems of prison mental health care are not bereft of innovation. Multi-disciplinary teams can address complex mental health and social care needs and include cultural expertise in jurisdictions where indigenous populations or ethnic minorities are over-represented in prisoner populations. Release planning constitutes an opportunity for “critical time intervention”, focusing on ensuring continuity of care across a range
R.Lovelace 17世纪的诗歌《致阿尔西亚,来自监狱》暗示了一个“安静”的头脑有能力超越剥夺人们自由的制度所隐含的强加。但我们的监狱里并不是充满了“天真而安静的思想”;相反,他们被精神疾病的经历困扰着。有必要深入监狱以满足心理健康需求,但“石墙”和“铁棍”构成了这一意图的障碍。旨在照顾和治疗精神疾病的系统在旨在惩罚、威慑和丧失能力的机构中挣扎。然而,人们被送进监狱是为了惩罚,而不是为了惩罚,这要求我们了解如何在这种环境中提供人道待遇。各种国际人权文书(如《公民权利和政治权利国际公约》和《禁止酷刑和其他残忍、不人道或有辱人格的待遇或处罚公约》)的存在是必要的,但其本身并不足以确保对我国公民中一些最弱势的成员给予适当和人道的照顾。在世界范围内,任何时候都有1000多万人被关押在刑罚机构,每年有3000多万人通过监狱,一些地区的监狱增长远远超过人口增长。在押囚犯和获释后不久的前囚犯,包括自杀在内的全因死亡风险增加。因此,我们有共同的利益,确保在监禁和向社区生活过渡的关键时期确定与健康相关的需求,并提供有效的护理。这一领域的研究使人们越来越清楚地认识到需要解决的核心问题,以便为精神不适的囚犯提供全面的护理模式。首先,监狱必须在接待处和其他关键时刻对精神疾病进行筛查。至少已经开发了五种这样的筛查仪器。然而,还需要采取额外的分流和案件调查措施,以确保全面查明案件。一旦确定需要,最不舒服的人可能需要转院。心理健康立法需要适应这种转移。对其他人来说,监狱护理通常是通过心理健康外展团队提供的,这些团队在为患有严重精神疾病的囚犯创建护理和治疗途径方面变得越来越系统,包括为释放过程做出贡献,以使释放时能够持续的临床参与。监狱精神卫生保健系统并非缺乏创新。多学科团队可以满足复杂的心理健康和社会护理需求,并在囚犯群体中土著人口或少数民族比例过高的司法管辖区提供文化专业知识。释放计划是“关键时间干预”的机会,重点是确保囚犯通过大门时,一系列提供者的护理连续性。这种努力取得成功的证据越来越多,有迹象表明,系统的监狱内护理模式对发现需要援助的人和改善释放后与心理健康服务的接触产生了积极影响。现代监狱的结果越来越侧重于减少释放后的再犯,为此,我们有一个共同的目标,那就是最终释放一名精神健康和成瘾需求得到满足的康复囚犯。然而,实现这一集体目标的途径往往依赖于个别监管人员的善意,或者监狱心理健康联络小组在“安全和保障”优先于人类痛苦时克服体制障碍的能力。我们的社会机构正面临着重新思考这种孤立心态的挑战。无论变化最终来自对侵犯人权行为的法律挑战,还是务实的新自由主义对财政约束的强调,都是向机构间合作的转变。再加上以人为中心的方法,各机构重新关注他们所服务的人,而不是机构本身自我延续的要求。在法庭上,这种转变是以“治疗法学”原则为先导的,这些原则要求法律体系从治疗的角度看待其过程。人们认识到,成瘾、精神疾病和社会护理需求(如家庭支持、住房和就业)与犯罪率有着密不可分的联系,以至于传统的对抗性法庭已经成为罪犯的旋转门,因为罪犯的犯罪行为是由心理社会挑战引起的。“以解决方案为中心”的法院激增,它们利用法律程序的杠杆作用鼓励人们解决犯罪原因,并积极让可以提供帮助的社会机构参与进来。 青年司法拘留服务的模式转变尤其明显。研究表明,参与司法的年轻人遭受创伤的比率很高。儿童时期的身体、性和心理虐待对随后的生活轨迹产生了负面影响,导致精神疾病和持续参与司法系统的可能性增加。在创伤知情护理模式下,年轻人对自己的冒犯行为负责,但所有相关方都认识到创伤对
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引用次数: 8
Reversing the downward spiral for people with severe mental illness through educational innovations 通过教育创新,扭转严重精神疾病患者的恶性循环
IF 73.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2017-02-01 DOI: 10.1002/wps.20377
M. De Hert, J. Detraux
In two earlier papers on physical diseases in people with severe mental illness (SMI) which appeared in this journal, we indicated that the screening, assessment and management of physical health aspects in these patients were poor, even in developed countries. Although (young and adult) people with SMI are entitled to the same standards of care as the rest of the population, Liu et al report now, half a decade later, that little to no progress has been made. Moreover, it seems that the mortality gap between these people and the general population is only increasing over time. Thus, despite numerous calls to take their physical health seriously, people with SMI still suffer excess morbidity and mortality from physical causes and receive inferior physical health care. It is a fact that the integration of physical and mental health care systems is still a long way from becoming a reality and that poor or absent liaison links limit the ability of most psychiatrists to focus beyond their own specialty. Moreover, in several countries, reforms in mental health, emphasizing on community care and ambulant therapies, have led to shorter and infrequent hospital admissions with less time available to deal with physical health problems. In their paper, Liu et al propose a multilevel model of interventions to reduce the excess mortality in people with SMI. This model assumes that an effective approach must comprehensively implement interventions or strategies that focus on the individual, the health system, and the community. Although we believe that the adoption of this model would contribute to a significant improvement in the physical and related mental health of people with SMI (despite that actions are not easy to realize at a system level, especially for developing countries), there is more than meets the eye. The physical health of people with SMI is an issue that should concern both primary and secondary care services. However, it seems that most psychiatrists and primary care providers or general practitioners are wandering on the road of the Cheshire cat. Like the conversation between Alice and the Cheshire cat in the famous novel Alice’s Adventures in Wonderland, there still seems to be a lot of confusion and uncertainty. Before interventions or strategies can result in improved outcomes for people with SMI, it is important that both know which way they have to go. According to a 2014 report of the UK National Audit of Schizophrenia, the monitoring of people with SMI for physical health problems falls well below agreed standards. Only about one fifth of people with schizophrenia had had their physical health properly monitored – following the clinical guidelines on schizophrenia of the UK National Institute for Health and Care Excellence (NICE) – by their general practitioner and, of those with documented evidence of risk factors, many were not receiving appropriate treatment. Recently, the NICE published a new set of quality standards which specif
在本刊之前发表的两篇关于严重精神疾病(SMI)患者身体疾病的论文中,我们指出,即使在发达国家,对这些患者身体健康方面的筛查、评估和管理也很差。尽管(年轻人和成年人)重度精神障碍患者有权享受与其他人群相同的护理标准,但Liu等人在5年后的今天报告称,这方面几乎没有取得任何进展。此外,随着时间的推移,这些人与普通人群之间的死亡率差距似乎只会越来越大。因此,尽管许多人呼吁认真对待他们的身体健康,但重度精神分裂症患者仍然因身体原因而遭受过高的发病率和死亡率,并得到较差的身体保健。事实上,身体和精神卫生保健系统的整合离成为现实还有很长的路要走,而且糟糕或缺乏联络联系限制了大多数精神科医生专注于自己专业以外的能力。此外,在一些国家,精神健康方面的改革强调社区护理和流动治疗,这导致住院时间缩短,住院次数减少,治疗身体健康问题的时间减少。Liu等人在他们的论文中提出了一个多层次的干预模型,以降低重度精神分裂症患者的超额死亡率。该模型假定,有效的方法必须全面实施以个人、卫生系统和社区为重点的干预措施或战略。尽管我们相信,采用这种模式将有助于显著改善重度精神障碍患者的身体和相关的心理健康(尽管在系统层面上采取行动并不容易实现,尤其是在发展中国家),但实际情况并非如此。重度精神分裂症患者的身体健康是一个初级和二级保健服务都应关注的问题。然而,大多数精神科医生、初级保健提供者或全科医生似乎都在柴郡猫的道路上徘徊。就像著名小说《爱丽丝梦游仙境》中爱丽丝和柴郡猫的对话一样,似乎仍然有很多困惑和不确定性。在干预措施或策略可以改善重度精神障碍患者的结果之前,重要的是双方都知道他们必须走哪条路。根据2014年英国国家精神分裂症审计报告,对重度精神分裂症患者身体健康问题的监测远远低于商定的标准。只有大约五分之一的精神分裂症患者的身体健康得到了他们的全科医生的适当监测——按照英国国家健康和护理卓越研究所(NICE)关于精神分裂症的临床指导方针——在那些有危险因素的书面证据的人中,许多人没有得到适当的治疗。最近,NICE发布了一套新的质量标准,专门针对患有精神分裂症的年轻人和成年人身体健康状况不佳的问题。本指南要求初级保健提供者对所有精神分裂症服务使用者的身体健康风险因素进行监测。为了避免初级护理人员和精神科医生的责任缺乏明确和共识,规定专业精神保健小组应在头12个月或直到服务使用者的病情稳定为止承担主要责任,此后初级保健提供者应承担这一责任,除非有特殊理由继续由二级保健机构承担。例如,精神卫生保健提供者可能比初级保健提供者更频繁地看到重度精神分裂症患者,并且可能更愿意由前者进行监测。无论如何,照顾重度精神障碍患者的身体健康还需要支持在初级保健和二级保健之间快速分享常规身体健康监测的结果。然而,要扭转重度精神障碍患者的负面恶性循环,需要的不仅仅是新的建议和结构性改变。首先,我们认为迫切需要改变精神科医生和初级保健提供者的文化,他们认为病人的精神和身体健康仍然是相互排斥的责任。其次,我们必须向他们提供更多关于通常与重度精神障碍有关的身体健康问题的信息。两者都可以通过教育创新来实现。一方面,我们应该在精神科医生的培训过程中教导他们,他们必须确保重度精神障碍患者的身体健康问题得到适当的治疗,并且监测简单和可改变的健康风险因素,如体重和血压,应该是常规精神科护理的一部分。 因此,他们应该学会不要过分强调心理健康而忽视身体健康。此外,他们应该提高他们的沟通技巧,避免错误地认为病人有能力改变他们的生活方式,并坚持治疗指南。后者尤其重要。除了精神疾病相关因素、卫生保健获取和利用方面的差异、耻辱和生活方式因素外,精神药物还可能导致身体疾病的出现或加重。高剂量和多药似乎对大多数身体疾病有更大的影响。这并不像看起来那么简单。《柳叶刀》杂志的一篇社论提请人们注意精神科医生和精神科护士在身体健康需求方面缺乏“令人担忧”的培训。因此,从事精神病学工作的医生应该接受教育和培训,以识别身体疾病并采取行动
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引用次数: 10
Update on WPA Operational Committee on Scientific Publications WPA科学出版物运作委员会的最新情况
IF 73.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2017-02-01 DOI: 10.1002/wps.20401
M. Riba
Electronic communication is paramount in today’s world, its importance rising day by day. The WPA website (www.wpanet.org) has now been thoroughly re-designed with state-of-the-art features and with useful, attractive and up-to-date content, utilizing the latest technology. The website currently has a responsive design, which means that the size and dimensions of its pages now get automatically modified so as to make them properly fit the screens of various devices like smart phones and tablets. The website is also integrated with Google Translate, which can automatically translate its content to 103 different languages. The site is also integrated with popular social media sites. The home page prominently displays the latest news from WPA Member Societies, Scientific Sections, Zonal Representatives, and Affiliated Associations. WPA position papers on various issues can be downloaded from the site. Their translations in several languages are also available. Past issues of the WPA Newsletter, from way back in 1997, are available for download. The E-Learning section features more than 30 educational videos of clinically relevant presentations by some of the leaders in psychiatry today. The Public Education Gallery has articles on the most common mental disorders. The Education section features downloadable materials such as the WPA Template for Undergraduate and Graduate Psychiatric Education and the Essentials of the WPA International Guidelines for Diagnostic Assessment. One of the most popular sections of the website is that including World Psychiatry, the WPA official journal. The new impact factor of the journal is 20.205. It ranks now no. 1 among psychiatry journals worldwide! Issues of the journal, from way back in 2002, are provided for free download, along with translations in Spanish, Russian, Japanese, Romanian, French, Polish, Chinese, Turkish and Arabic. Recent additions to the website include the WPA Position Statements on Spirituality and Religion in Psychiatry, on Gender Identity and Same-Sex Orientation, Attraction and Behaviours, on Europe Migrant and Refugee Crisis, and on Intimate Partner Violence and Sexual Violence Against Women; as well as the WPA Curriculum on Intimate Partner Violence and Sexual Violence Against Women, and updates on WPA Scientific Sections and publications. The relevance and attractiveness of the site’s contents are proven by the fact that it now has a Google Page Rank of 6, a measure of how many other important websites have provided links to its pages. The usage data from January 1 to October 24, 2016 reveal that the site has been visited from 199 countries and 7023 cities across the world. The total number of visitors has been 67,947, and the total number of page views has been 263,742. In tune with the changing times, more exposure will be given in the future to the site’s content, for both the professional and lay audiences, in the social media. Provision will be developed for live streaming of variou
电子通信在当今世界至关重要,其重要性与日俱增。WPA网站(www.wpanet.org)现在已经利用最新技术进行了彻底的重新设计,具有最先进的功能和有用、有吸引力和最新的内容。该网站目前采用了响应式设计,这意味着其页面的大小和尺寸现在会自动修改,以使其适合智能手机和平板电脑等各种设备的屏幕。该网站还集成了谷歌翻译,可以自动将其内容翻译成103种不同的语言。该网站还与流行的社交媒体网站相结合。主页突出显示了WPA成员协会、科学部门、地区代表和附属协会的最新消息。WPA关于各种问题的立场文件可以从该网站下载。还提供了几种语言的翻译。早在1997年,WPA通讯的过去几期都可以下载。电子学习部分展示了30多个由当今精神病学领域的一些领导者进行的临床相关演示的教育视频。公共教育画廊有关于最常见的精神障碍的文章。教育部分提供了可下载的材料,如WPA本科生和研究生精神病学教育模板和WPA国际诊断评估指南的要点。该网站最受欢迎的部分之一是WPA官方期刊《世界精神病学》。该期刊的新影响因子为20.205。它现在在世界精神病学期刊中排名第一!早在2002年,该杂志就提供了免费下载,并提供了西班牙语、俄语、日语、罗马尼亚语、法语、波兰语、中文、土耳其语和阿拉伯语的翻译。该网站最近增加的内容包括WPA关于精神病学中的精神和宗教、性别认同和同性取向、吸引力和行为、欧洲移民和难民危机以及亲密伴侣暴力和对妇女的性暴力的立场声明;以及WPA关于亲密伴侣暴力和对妇女的性暴力的课程,以及WPA科学部分和出版物的更新。该网站内容的相关性和吸引力已经得到了证明,它现在的谷歌页面排名为6,这是衡量有多少其他重要网站提供了其页面链接的指标。2016年1月1日至10月24日的使用数据显示,该网站已访问了全球199个国家和7023个城市。访问者总数为67947人,页面浏览量总数为263742次。随着时代的变化,未来将在社交媒体上为专业观众和非专业观众提供更多的网站内容曝光率。将为各种WPA节目的直播提供资金,这样我们的活动就可以毫不拖延地接触到更多的观众,并且只需最少的额外费用。WPA秘书长作为网站的编辑,在WPA执行委员会的合作和帮助下,并在WPA秘书处的协助下,仍然致力于实现这一目标。未来还可能涉及在网站上进行WPA赞助的自定进度(点播)或定时课程。网络研讨会也可能是WPA可以利用的一个领域。低带宽直播网络研讨会可以就该领域专家的相关主题进行一系列讨论。潜在的兴趣还包括WPA应用程序的开发,它肯定会增加访问网站内容的便利性,并让用户了解精神病学世界的最新事件和新闻。以下是我们对未来的一些计划!
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引用次数: 5
Mind and body: physical health needs of individuals with mental illness in the 21st century 心理与身体:21世纪精神疾病患者的生理健康需求
IF 73.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2017-02-01 DOI: 10.1002/wps.20381
D. Bhugra, A. Ventriglio
It is well recognized that individuals with severe mental illness show high rates of suicide and also various physical illnesses which contribute to reduced longevity. This is a major public health challenge in the 21st century. Drugs and alcohol consumption and tobacco use further add to the increased rates of morbidity and mortality. The delays in helpseeking, whether it is for physical illness or psychiatric illness, and the underdiagnosis due to stigma and other factors contribute further to this disparity. Liu et al provide a model based on a multilevel approach at individual, health care systems and social determinant levels to cope with the excess mortality among mentally ill people. We believe that it is a relevant proposal in the framework of modern medicine. At the individual level, although early recognition of physical comorbidity and early interventions are effective strategies to reduce mortality, it is also relevant to explore what people seek help for and where they seek it from. In fact, culture and explanatory models will guide people to the sources of help, especially those which are easily available and accessible. Explanations of distress and symptoms (explanatory models) will vary across cultures and communities and also be related to educational and socioeconomic status. Health care systems need to be geographically and emotionally available and accessible for people affected by mental illness, so that they can seek help early. Some of the physical comorbidity may not be recognized by clinicians and on occasion the responsibility for managing physical illness may be left to primary care physicians or specialists who in turn may not recognize mental illness or due to stigma may not intervene early enough. This might be due, in the West at least, to a somewhat rigid division between mental health and physical health services. For centuries, the mind-body dualism attributable to Descartes’ dogma has affected clinical practice and has increased the dichotomy between psychiatric and physical health care services. This dualism may well have contributed to stigma against mental illness, the mentally ill and the psychiatric services. Furthermore, if physicians are not very good at identifying psychiatric disorders or carrying out mental state examinations, psychiatrists are often not very good at identifying and managing physical illnesses either. When interventions have taken place in partnerships between services, physical health of patients with severe mental illness has been shown to improve. At a social level, explanatory models of disease do not only vary across cultures and communities. They may also differ between the patients, their families and their carers, who may interpret these experiences on the basis of physical or psychosocial factors. More industrialized societies are likely to have psychological, medical or social causative factors as explanations, whereas more traditional societies may hold supra-natural and nat
众所周知,患有严重精神疾病的人自杀率很高,还有各种导致寿命缩短的身体疾病。这是21世纪的重大公共卫生挑战。毒品、酒精消费和烟草使用进一步增加了发病率和死亡率。无论是身体疾病还是精神疾病,寻求帮助的延迟,以及由于污名和其他因素导致的诊断不足,都进一步加剧了这种差异。刘等人提供了一个基于个人、医疗保健系统和社会决定因素水平的多层次方法的模型,以应对精神病患者的超额死亡率。我们认为,这是现代医学框架内的一项相关建议。在个人层面,尽管早期认识到身体共病和早期干预是降低死亡率的有效策略,但探索人们寻求帮助的目的以及从哪里寻求帮助也是相关的。事实上,文化和解释模型将引导人们找到帮助的来源,尤其是那些容易获得和获得的来源。对痛苦和症状的解释(解释模型)因文化和社区而异,也与教育和社会经济地位有关。医疗保健系统需要在地理和情感上为受精神疾病影响的人提供和使用,以便他们能够尽早寻求帮助。一些身体共病可能没有得到临床医生的认可,有时管理身体疾病的责任可能留给初级保健医生或专家,而他们可能没有意识到精神疾病,或者由于污名化,可能没有及早干预。这可能是由于,至少在西方,心理健康和身体健康服务之间存在着某种程度的僵化划分。几个世纪以来,笛卡尔教条所导致的身心二元论影响了临床实践,并增加了精神和身体保健服务之间的二分法。这种二元论很可能助长了对精神疾病、精神病患者和精神病服务的污名化。此外,如果医生不太善于识别精神疾病或进行精神状态检查,那么精神科医生通常也不太善于发现和管理身体疾病。当干预措施在服务之间的伙伴关系中进行时,严重精神疾病患者的身体健康状况已经得到改善。在社会层面上,疾病的解释模型不仅因文化和社区而异。他们也可能因患者、他们的家人和护理人员而异,他们可能会根据身体或心理社会因素来解释这些经历。更工业化的社会可能有心理、医学或社会原因作为解释,而更传统的社会可能持有超自然和自然的解释。在许多文化中,精神和身体被视为相互联系的,患者可能会将他们的症状与身体和精神联系起来,从而以整体的方式理解他们的经历。例如,在印度和巴基斯坦的旁遮普妇女中,这种痛苦可能表现在身体的不同部位,同时感到冷热。因此,当他们向没有意识到这些文化差异的医生寻求帮助时,临床医生可能会完全错过痛苦和潜在的精神障碍。2013年,在英国心理健康基金会的一份报告中,我们建议在多个层面进行整合,类似于刘等人的模型。其中一个潜在的解决方案可能是开发基于医学联络的单位,例如咨询联络精神病学,医生与精神科医生合作,帮助早期诊断和管理。此外,我们认为刘等人提出的多层次模型对训练具有重要意义。培训卫生专业人员是让他们了解患者健康的各个组成部分的关键第一步。此外,对可能影响身心健康的文化因素进行教育也是相关的。一种选择很可能是在培训的早期阶段教授社会科学和医学人文学科,以便临床医生意识到文化对表现的影响以及身心之间的互动。需要广泛解释和利用关于精神病患者身体健康的心理教育方案,因为众所周知这些方案是有效的。除了关于各种风险因素的一般信息外,还必须为弱势群体和个人制定具体的方案。此外,在治疗的早期阶段进行筛查可能有助于减少身体并发症,改善精神状况。融入社会护理可以帮助患有慢性精神疾病的人,使他们的所有需求都能在一个停靠港得到满足。 初级和二级护理、身心健康以及社会和医疗保健的综合护理意味着培训、招聘和再培训-
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引用次数: 27
The long‐term impact of bullying victimization on mental health 欺凌对心理健康的长期影响
IF 73.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2017-02-01 DOI: 10.1002/wps.20399
L. Arseneault
3. Hiday VA, Swartz MS, Swanson JW et al. Psychiatr Serv 1999;50:62-8. 4. Lehman AF, Linn LS. Am J Psychiatry 1984;141:271-4. 5. Walsh E, Moran P, Scott C et al. Br J Psychiatry 2003;183:233-8. 6. Silver E, Arseneault L, Langley J et al. Am J Public Health 2005;95:2015-21. 7. Maniglio R. Acta Psychiatr Scand 2009;119:180-91. 8. Latalova K, Kamaradova D, Prasko J. Neuropsychiatr Dis Treat 2014;10: 1925-39. 9. Tsai AC, Weiser SD, Dilworth SE et al. Am J Epidemiol 2015;181:817-26. 10. Khalifeh H, Johnson S, Howard LM et al. Br J Psychiatry 2015;206:275-82.
3.Hiday VA、Swartz MS、Swanson JW等,《精神病医生服务》,1999年;50:62-8.4。雷曼AF,林恩LS,Am J精神病学1984;141:271-4.5。Walsh E,Moran P,Scott C等人,Br J精神病学2003;183:233-8.6。Silver E,Arseneault L,Langley J等人,《2005年公共卫生杂志》;95:2015-21.7。Maniglio R.Acta精神病医生丑闻,2009年;119:180-91.8。Latalova K,Kamaradova D,Prasko J.神经精神病医生治疗2014;10:1925-39年。9.Tsai AC,Weiser SD,Dilworth SE等人,Am J Epidemiol 2015;181:817-26.10。Khalifeh H,Johnson S,Howard LM等人,Br J精神病学2015;206:275-82。
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引用次数: 128
Nonsuicidal self‐injury in men: a serious problem that has been overlooked for too long 男性非自杀性自伤:一个被忽视太久的严重问题
IF 73.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2017-02-01 DOI: 10.1002/wps.20358
N. Kimbrel, P. Calhoun, J. Beckham
conventional measures of SES, suggests that some aspects of social changes which are strongly associated with mental health have not been fully captured by those conventional measures. Some scholars have argued that income inequality and social polarization can heighten an individual’s sense of relative deprivation, resulting in frustration, anger and resentment. Our data suggest that how much one believes he/she has compared to others is more relevant than how much one actually has in understanding mental health problems in contemporary Korea. These findings may offer some lessons for the countries experiencing similar economic and social changes. Further research is needed to better understand how subjective social status is formed and what mechanisms underlie the strong link between subjective social status and mental health problems. Jihyung Hong, Jong-Hyun Yi Department of Healthcare Management, College of Social Science, Gachon University, Seongnam, South Korea; Department of Business Administration, College of Business and Economics, Gachon University, Seongnam, South Korea
社会经济状况的传统测量方法表明,与心理健康密切相关的社会变化的某些方面没有被这些传统测量方法充分捕捉到。一些学者认为,收入不平等和社会两极分化会加剧个人的相对剥夺感,从而导致沮丧、愤怒和怨恨。我们的数据表明,在理解当代韩国的心理健康问题方面,一个人相信自己比别人多多少比实际了解多少更重要。这些发现可能为经历类似经济和社会变革的国家提供一些教训。为了更好地理解主观社会地位是如何形成的,以及主观社会地位与心理健康问题之间的紧密联系背后的机制,需要进一步的研究。韩国城南嘉川大学社会科学学院保健管理系;韩国城南嘉川大学经济经济学院工商管理系
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引用次数: 23
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World Psychiatry
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