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Implementing competency-based medical education curriculum in undergraduate psychiatric training in India: Opportunities and challenges 在印度本科精神病学培训中实施以能力为基础的医学教育课程:机遇与挑战
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-12-07 DOI: 10.1111/appy.12491
Sreeja Sahadevan MD, Neetu Kurian MD, Anu Mary Mani MD, Manohar Rao Kishor MD, Vikas Menon MD

Medical education in India is undergoing a landmark transformation under the National Medical Commission implementing competency-based medical education (CBME). The CBME approach intends to ensure that medical graduates acquire the competencies needed to fulfill the health needs of the patient and society. This outcome-based approach shifts the focus from the traditional knowledge-based training to skill-based training valued on attitude, ethics, and communication (AETCOM) competencies. CBME thus aims to create medical professionals capable of providing holistic care with compassion and excellence embracing the global trends. The opportunity posed by the CBME should be utilized to sensitize and create interest among the learners about the science and scope of psychiatry. However, there are many challenges in the successful implementation of CBME, which have to be identified and addressed on time for serving the purpose. A basic tenet in CBME is to continue training until the desired competencies are achieved; in other words, to de-emphasize time-based learning. Moreover, the current COVID 19 pandemic is posing a significant influence on the execution of CBME implemented in August 2019. Online platforms could have several advantages in assisting the implementation of CBME; they provide an alternative to continue teaching–learning and assessment during these times and allow learners with the flexibility to learn at their own pace. In this article, we discuss the opportunities, including digital platforms and challenges to be overcame as well as the need for training the faculty toward assimilating the curriculum in the undergraduate psychiatric training.

在国家医学委员会实施以能力为基础的医学教育(CBME)下,印度的医学教育正在经历一场具有里程碑意义的变革。CBME方法旨在确保医学毕业生获得满足患者和社会健康需求所需的能力。这种基于结果的方法将重点从传统的以知识为基础的培训转移到以态度、道德和沟通(AETCOM)能力为基础的技能培训。因此,CBME旨在培养能够提供全面护理的医疗专业人员,具有同情心和卓越性,拥抱全球趋势。应该利用CBME提供的机会,使学习者对精神病学的科学和范围敏感并产生兴趣。然而,在成功实施CBME方面存在许多挑战,必须及时识别和解决这些挑战,以达到目的。CBME的一个基本原则是继续培训,直到达到所需的能力;换句话说,不再强调基于时间的学习。此外,当前的COVID - 19大流行对2019年8月实施的CBME的执行产生了重大影响。在线平台在协助实施CBME方面可能有几个优势;在这些时间里,他们提供了一种继续教学和评估的选择,并允许学习者按照自己的节奏灵活地学习。在这篇文章中,我们讨论了机会,包括数字平台和需要克服的挑战,以及培训教师在本科精神病学培训中吸收课程的必要性。
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引用次数: 7
Education and training in psychiatry in low- and middle-income countries during and after the COVID-19 pandemic 在COVID-19大流行期间和之后,低收入和中等收入国家的精神病学教育和培训
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-12-07 DOI: 10.1111/appy.12500
Andrea Fiorillo MD, PhD, Afzal Javed MD
The World Psychiatric Association (WPA) is the largest scientific association in the mental health field, bringing together more than 250 000 psychiatrists from all over the world. It was first established in 1950, with the main aim to organize world psychiatric conferences (Fuss et al., 2019; Giallonardo, 2019; Kallivayalil, 2019; Perris, 2020; Sartorius & Sartorius, 2020). Along the decades, the association has broadened its scope to encompass educational (www.wpanet.org; Kutcher & Wei, 2020), scientific (Botbol, 2019, 2020), ethical (Herrman, 2019b), and clinical domains (Reynolds, 2020), with the final aim to improve psychiatric care for people with mental disorders (Herrman, 2019, 2020; Kallivayalil, 2020a, 2020b; Wasserman & Future, 2021) and professional development of psychiatrists (Javed, 2020; Pinto da Costa, 2020; Pinto da Costa et al., 2019). The attention devoted to education is witnessed by the presence of a Secretary for Education in the Executive Committee, whose role is to coordinate the educational activities of the WPA and to work with WPA Zonal Representatives, Member Societies, and the Secretaries of Sections and Meetings to ensure the dissemination of educational programs (Ng, 2020; Ng et al., 2019). Moreover, a specific Section on Education in Psychiatry was established in 1970, being one of the oldest WPA Scientific Sections (Fiorillo et al., 2013; Schulze, 2020a; Schulze, 2020b). The WPA has also an educational portal on its website (www. wpanet.org), with several materials for educators and trainees. All 70 WPA Scientific Sections are interested in education, covering basically all mental disorders (Cohen et al., 2019), therapeutic approaches (Linardon et al., 2019; Naeem et al., 2020), at-risk populations (Bertelli et al., 2020; Wasserman et al., 2021), and diagnostic techniques (Giordano & Borgwardt, 2019; Torous et al., 2020). In this special issue of Asia-Pacific Psychiatry, the WPA Section on Education in Psychiatry has collected contributions from researchers and scholars from different parts of the world, specifically focusing on the quality of training in lowand middle-income countries (LMICs) (Kallyvayallil & Enara, 2021). This issue includes also the views of early career psychiatrists on difficulties and advantages of being trained in psychiatry in LMICs (El Halabi et al., 2021; Mihai et al., 2021; Giurgiuca et al., 2021; Sahadevan et al., 2021). A specific paper deals with education on addiction psychiatry, a neglected topic in the scientific literature, but which is particularly relevant for psychiatric practice in LMICs (Balhara et al., 2021). The impact of the COVID-19 pandemic on training and education in psychiatry (Fiorillo & Gorwood, 2020; Gorwood & Fiorillo, 2021; Kuzman et al., 2020; Wasserman et al., 2020), which has been particularly significant in LMICs (Banerjee et al., 2020; De Sousa et al., 2020; Javed et al., 2021), has been further analyzed by Kalayasiri and Wainipitapong (2021). The results
世界精神病学协会(WPA)是心理健康领域最大的科学协会,汇集了来自世界各地的25万多名精神科医生。它最初成立于1950年,主要目的是组织世界精神病学会议(Fuss et al., 2019;Giallonardo, 2019;Kallivayalil, 2019;Perris, 2020;缝匠肌,缝匠肌,2020)。几十年来,该协会已将其范围扩大到教育领域(www.wpanet.org;库彻,Wei, 2020),科学(Botbol, 2019, 2020),伦理(Herrman, 2019b)和临床领域(Reynolds, 2020),最终目的是改善精神障碍患者的精神护理(Herrman, 2019, 2020;植物化学学报,2020a, 2020b;沃瑟曼,未来,2021)和精神科医生的专业发展(Javed, 2020;Pinto da Costa, 2020;Pinto da Costa等人,2019)。在执行委员会中,教育秘书的存在见证了对教育的关注,他的作用是协调WPA的教育活动,并与WPA地区代表、会员协会、部门和会议秘书合作,以确保教育计划的传播(Ng, 2020;Ng et al., 2019)。此外,1970年成立了一个专门的精神病学教育部门,这是WPA最古老的科学部门之一(Fiorillo等人,2013;舒尔茨,2020;舒尔茨,2020 b)。WPA在其网站(www.wpanet.org)上也有一个教育门户网站,其中有一些供教育工作者和受训人员使用的材料。所有70个WPA科学部门都对教育感兴趣,基本上涵盖了所有精神障碍(Cohen等人,2019),治疗方法(Linardon等人,2019;Naeem et al., 2020),高危人群(Bertelli et al., 2020;Wasserman et al., 2021)和诊断技术(Giordano &Borgwardt, 2019;Torous et al., 2020)。在本期《亚太精神病学》特刊中,WPA精神病学教育部分收集了来自世界各地的研究人员和学者的文章,特别关注中低收入国家(LMICs)的培训质量(kallyvayalll &Enara, 2021)。这一问题还包括早期职业精神科医生对中低收入国家接受精神病学培训的困难和优势的看法(El Halabi et al., 2021;Mihai et al., 2021;Giurgiuca等人,2021;Sahadevan et al., 2021)。一篇专门的论文涉及成瘾精神病学的教育,这是科学文献中一个被忽视的话题,但它与中低收入国家的精神病学实践特别相关(Balhara et al., 2021)。COVID-19大流行对精神病学培训和教育的影响(Fiorillo &Gorwood, 2020;Gorwood,Fiorillo称,通常情况下2021;Kuzman et al., 2020;Wasserman et al., 2020),这在中低收入国家尤为重要(Banerjee et al., 2020;De Sousa et al., 2020;Javed et al., 2021), Kalayasiri和Wainipitapong(2021)对此进行了进一步分析。在WPA当选主席Danuta Wasserman教授的监督下,WPA精神病学教育部门进行了一项关于会员协会和WPA区域实际教育需求的在线调查,结果也被呈现出来(Sampogna et al., 2021)。Baessler等人(2021)讨论了由WPA精神病学教育部门开展的第一次在线培训师研讨会的结果,该研讨会汇集了来自世界各地的100多名参与者。最后,还强调了使用数字资源和在线平台促进和改善全球教育计划和活动传播的重要性,特别是在中低收入国家(Nasir等人,2020;Orsolini et al., 2021;Ouanes et al., 2021)。我们希望学员、教育工作者和所有与心理健康有关的人都能和我们一起阅读这期特刊,我们特别感谢编辑Allan Tasman教授,他是WPA精神病学教育部门的前主席和WPA前教育秘书,他使这一努力成为可能。
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引用次数: 2
Training the trainers: Finding new educational opportunities in the virtual world 培训培训师:在虚拟世界中寻找新的教育机会
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-12-07 DOI: 10.1111/appy.12499
Franziska Baessler MD, MME, Norman Sartorius MD, PhD, FRCPsych, Afzal Javed MD, Allan Tasman MD, DFAPA, FRCPsych, Bulent Coskun MD, MPH, Dorota Frydecka MD, PhD, Olga Kazakova MD, PhD, Gaia Sampogna MD, PhD, Olena Zhabenko MD, PhD, Katja Koelkebeck MD, MME, Cenan Hepdurgun MD, Ali Zafar MA, MSc, Andrea Fiorillo MD, PhD

The COVID-19 pandemic has disrupted scientific gatherings and conferences, opening up opportunities for virtual learning platforms. Realizing the potential of online academic exchanges, the World Psychiatric Association (WPA) also developed virtual avenues and information systems for capacity building of mental health professionals across the world. Among its first such initiatives, the WPA organized a virtual Train the Trainers workshop, where 123 psychiatrists, psychiatric trainees, and educators from 45 countries participated. The innovative and interactive workshop allowed participants to get to know each other, exchange educational and professional experiences, and ask questions or receive advice from experts. Keynote speakers, including WPA President Prof. Afzal Javed and Prof. Norman Sartorius, stressed upon the importance of finding innovative solutions in psychiatry training and the need to improve teaching and training in the field of psychiatry, especially in the provision of leadership and communication skills. Online training methods can provide easy access to academics and students while reducing the organizational and logistical costs. They have the potential to improve educational equality and allow the voice of the underprivileged scientists to be heard across the globe. The devastating impact on access to mental health services during COVID-19 underscores the urgent need for online training, particularly in countries where the ratio of psychiatrists to patients is inadequate and doctors concentrate more on treatment than on research and education. Virtual educational interventions could prove incredibly useful in the future just as they are being successfully utilized in local and regional contexts during the pandemic.

2019冠状病毒病大流行扰乱了科学聚会和会议,为虚拟学习平台提供了机会。认识到网上学术交流的潜力,世界精神病学协会(WPA)也开发了虚拟途径和信息系统,用于世界各地精神卫生专业人员的能力建设。在其第一批此类倡议中,世界精神病学协会组织了一个虚拟培训教员讲习班,来自45个国家的123名精神科医生、精神病学受训人员和教育工作者参加了讲习班。创新和互动的研讨会使参与者能够相互了解,交流教育和专业经验,并提出问题或听取专家的建议。包括WPA主席Afzal Javed教授和Norman Sartorius教授在内的主讲人强调了在精神病学培训中寻找创新解决方案的重要性,以及改善精神病学领域教学和培训的必要性,特别是在提供领导能力和沟通技巧方面。在线培训方法可以为学者和学生提供方便,同时降低组织和后勤成本。它们有可能改善教育平等,让世界各地都能听到贫困科学家的声音。COVID-19对获得精神卫生服务的破坏性影响凸显了在线培训的迫切需要,特别是在精神科医生与患者比例不足、医生更注重治疗而不是研究和教育的国家。虚拟教育干预措施在未来可能证明非常有用,正如它们在大流行期间在地方和区域范围内得到成功利用一样。
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引用次数: 3
Training and education in digital psychiatry: A perspective from Asia-Pacific region 数字精神病学的培训和教育:来自亚太地区的视角
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-12-07 DOI: 10.1111/appy.12501
Laura Orsolini MD, Chonnakarn Jatchavala MD, Isa Multazam Noor MD, Ramdas Ransing MD, Yuto Satake MD, Sheikh Shoib MD, Bigya Shah MD, Irfan Ullah MD, Umberto Volpe MD, PhD

Background

Digital mental health interventions and digital psychiatry have been rapidly implemented over the past decade, particularly with the intent to offer a cost-effective solution in those circumstances in which the current mental health services and infrastructure are not able to properly accommodate the patients' needs. However, mental health workforce is often poorly theoretical/practical trained in digital psychiatry and in delivering remote consultations safely and effectively, not being common to own curricula-specific training requirements in digital psychiatry and skills.

Methods

A web-based international cross-sectional survey was carried out by a working group constituted by one or two national representative(s) of each WHO South-East Asia and Western Pacific Regions (APAC), with the aim to evaluate the level of training, knowledge, experience, and perception regarding the topic of digital psychiatry in a sample constituted by medical students, psychiatry trainees, and early career psychiatrists from APAC.

Results

An overall lack of theoretical and/or practical training on new digital tools and digital health interventions in psychiatry was observed. The level of training influences knowledge background, which, in turns, influences young professionals' perceptions and opinions regarding digital psychiatry and interventions in mental health.

Conclusion

Implementing psychiatry training programs may significantly improve the level of knowledge and use of digital tools in mental healthcare. Moreover, mental health services and infrastructures should be properly adapted to the digital era, considering the overall weak and heterogeneous technical support and equipment, issues of internet connectivity, and other administrative-related challenges observed in APAC.

在过去十年中,数字精神卫生干预措施和数字精神病学得到了迅速实施,特别是为了在目前的精神卫生服务和基础设施无法适当满足患者需求的情况下提供具有成本效益的解决方案。然而,精神卫生工作人员在数字精神病学和安全有效地提供远程咨询方面往往缺乏理论/实践培训,在数字精神病学和技能方面没有自己的课程特定培训要求。方法由世卫组织东南亚和西太平洋区域(APAC)的一名或两名国家代表组成的工作组进行了一项基于网络的国际横断面调查,目的是评估由医学生、精神病学学员、以及来自亚太地区的早期职业精神病学家。结果观察到精神病学总体上缺乏关于新的数字工具和数字健康干预的理论和/或实践培训。培训水平影响知识背景,知识背景反过来影响青年专业人员对数字精神病学和心理健康干预措施的看法和意见。结论实施精神病学培训可显著提高精神卫生数字化工具的知识水平和使用水平。此外,考虑到亚太地区整体薄弱和异构的技术支持和设备、互联网连接问题以及其他与行政有关的挑战,心理健康服务和基础设施应适当适应数字时代。
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引用次数: 11
How to overcome barriers to publication in low- and middle-income countries: Recommendations from early career psychiatrists and researchers from around the world 如何克服在低收入和中等收入国家出版的障碍:来自世界各地早期职业精神科医生和研究人员的建议
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-12-07 DOI: 10.1111/appy.12495
Sarah El Halabi, Zargham Abbas, Fisayo Adesokun, Frances Adiukwu, Agaah Ashrafi, Renato de Filippis, Jibril Handuleh, Florence Jaguga, Ruta Karaliuniene, Ozge Kilic, Sachin Nagendrappa, Margaret Ojeahere, Oluseun Peter Ogunnubi, Dorottya Őri, Laura Orsolini, Victor Pereira-Sanchez, Mariana Pinto da Costa, Ramdas Ransing, Sheikh Shoib, Irfan Ullah, Ramya Vadivel, Bita Vahdani, Rodrigo Ramalho

There is an increasing movement toward international collaboration and global discussion in mental health. If provided with the right opportunities, early career psychiatrists (ECPs) and researchers in mental health can contribute meaningfully to this discussion. However, they often experience multiple barriers when attempting to add their voices via academic publications. We represent a diverse group of ECPs and researchers from all six World Health Organization regions. In this piece, we discuss these barriers, grounded in our first-hand experiences, and put forth a series of recommendations. The most potentially beneficial and immediate way forward is ensuring a much-needed mentorship and support, particularly for low- and middle-income countries. In this regard, international organizations, especially those with a particular focus on education, such as the Section on Education in Psychiatry of the World Psychiatric Association, can play a pivotal role.

在精神卫生方面的国际合作和全球讨论日益增加。如果提供了合适的机会,早期职业精神病学家(ECPs)和心理健康研究人员可以为这一讨论做出有意义的贡献。然而,当他们试图通过学术出版物发表自己的声音时,往往会遇到多重障碍。我们代表来自世界卫生组织所有六个区域的不同群体的ecp和研究人员。在这篇文章中,我们将根据我们的第一手经验讨论这些障碍,并提出一系列建议。最可能有益和最直接的前进方式是确保提供急需的指导和支持,特别是对低收入和中等收入国家。在这方面,国际组织,特别是那些特别注重教育的组织,如世界精神病学协会的精神病学教育科,可以发挥关键作用。
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引用次数: 4
Training and retaining mental health professionals: The Romanian experience in the European Union 培训和留住精神卫生专业人员:罗马尼亚在欧洲联盟的经验
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-12-07 DOI: 10.1111/appy.12498
Ana Giurgiuca MD, PhD, Catalina Giurgi-Oncu MD, PhD, Valentin Petre Matei MD, PhD

Background

Romania has been a member of the European Union since 2007. According to the World Health Organization, the national burden of mental disorders is high, with 2743.69 disability-adjusted life years per 100.000 population. Moreover, in a country of 19 million people, Romania's mental health system is currently functioning at capacity, with 5.66 adult psychiatrists/100.000 population and only 0.56 child and adolescent psychiatry (CAP) doctors per 100.000 population.

Method

we conducted a simple narrative review of the current literature on the topic of training of psychiatry trainees in Romania.

Results

Undergraduate training consists of only 4 weeks of clinical and theoretical work for adult and CAP. Psychiatry postgraduate training lasts 5 years and is still duration-oriented. Psychiatric trainees mostly spend their clinical work in inpatient units due to the scarcity of other services or the lack of integration of training programs in the existing psychiatric services. Theoretical training is not nationally formalized, and, during training, yearly assessments tend to be neglected. An ongoing challenge in Romania has been retaining young career psychiatrists.

Conclusion

Although in a trend toward improvement of health services, "brain drain" has been and continues to be a massive phenomenon among Romanian psychiatrists, mainly driven to Western-European countries due to financial reasons, various shortcomings in overall infrastructure, and because of the lack of continuous professional and personal development opportunities. As the world is currently facing an unprecedented mental health crisis, steps must be taken to improve psychiatric training, retain psychiatrists in Romania, and provide better national mental health services.

罗马尼亚自2007年以来一直是欧盟成员国。根据世界卫生组织的数据,精神障碍的国家负担很高,每10万人中有2743.69残疾调整生命年。此外,在一个拥有1900万人口的国家,罗马尼亚的精神卫生系统目前正在满负荷运转,每10万人中有5.66名成年精神科医生,每10万人中只有0.56名儿童和青少年精神科医生。方法:我们对目前有关罗马尼亚精神病学受训人员培训的文献进行了简单的叙述回顾。结果本科阶段成人和CAP的临床和理论工作仅为4周,研究生阶段精神病学培训为5年,仍以学时为主。由于缺乏其他服务或现有精神科服务缺乏培训项目的整合,精神科学员大多在住院病房进行临床工作。理论培训没有在全国范围内正式进行,而且在培训期间,年度评估往往被忽视。罗马尼亚面临的一个持续挑战是留住年轻的职业精神科医生。结论:虽然保健服务有改善的趋势,但"人才外流"在罗马尼亚精神科医生中一直是而且继续是一个大规模现象,主要是由于财政原因、总体基础设施的各种缺陷以及缺乏持续的专业和个人发展机会而被驱使到西欧国家。由于世界目前正面临前所未有的精神健康危机,必须采取步骤改进精神病学培训,在罗马尼亚保留精神科医生,并提供更好的国家精神卫生服务。
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引用次数: 1
Training of psychiatry and mental health in a low- and middle-income country: Experience from Thailand before and after COVID-19 outbreak 低收入和中等收入国家的精神病学和精神卫生培训:来自泰国在COVID-19爆发前后的经验
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-12-07 DOI: 10.1111/appy.12493
Rasmon Kalayasiri MD, Sorawit Wainipitapong MD

Since the start of COVID-19 pandemic in March 2020, training of psychiatry and mental health has been impacted considerably. We illustrated the change of academic and clinical psychiatric residency training procedure at Chulalongkorn University in Bangkok, Thailand, a developing country situated in South East Asia which is categorized in the low and middle income category of countries. The training setting has set up a task force responsible to set various strategies in response to the COVID-19 measure of social and physical distancing to maintain standard of care for psychiatric patients and educational experience for psychiatric residents. The strategies include online education, service team separation, and avoidance of contact between teams, reduction of non-urgent clinical activities, and the use of telemedicine for psychiatric patients. Despite exposure to the difficulties of training during the pandemic, all senior residents were qualified and licensed at the national examination. Residents reported that pandemic did affect the academic activities and services and also the quality of living and satisfaction. Academic issues, including the inconvenience of studying online, were the most concerned problems among psychiatric residents at the time of pandemic.

自2020年3月COVID-19大流行开始以来,精神病学和精神卫生培训受到了很大影响。我们说明了泰国曼谷朱拉隆功大学的学术和临床精神病学住院医师培训程序的变化,泰国是一个位于东南亚的发展中国家,属于低收入和中等收入国家。培训机构设立了专门小组,负责制定应对新冠疫情的各种战略,即保持社会和身体距离措施,以维持对精神病人的标准护理和精神病人的教育体验。这些战略包括在线教育、服务团队分离和避免团队之间的接触、减少非紧急临床活动以及对精神病患者使用远程医疗。尽管在大流行期间面临培训困难,但所有老年居民都在国家考试中获得了资格和执照。居民报告说,大流行确实影响了学术活动和服务,也影响了生活质量和满意度。学术问题,包括网上学习的不便,是流行病期间精神科住院患者最关心的问题。
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引用次数: 3
A comparison of child and adolescent psychiatry in the Far East, the Middle East, and Southeast Europe 远东、中东和东南欧儿童和青少年精神病学的比较
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-10-17 DOI: 10.1111/appy.12490
Martine Stecher Nielsen, Carolyn E. Clausen, Tomoya Hirota, Hojka Kumperscak, Anthony Guerrero, Hitoshi Kaneko, Norbert Skokauskas

Introduction

Despite the high proportion of children and adolescents living in low- and middle-income countries, 95% of all specialized child and adolescent mental health resources are located in high-income countries. To strengthen child and adolescent mental health services (CAMHS), first it is necessary to complete an assessment of the available services and training programs to determine what is needed, particularly in regions with young populations, such as Southeast Europe, the Far East, and the Middle East. The aim of this article is to compare the status of child and adolescent psychiatry (CAP) training programs and the workforce in CAMHS in three geographical regions, to identify similar problems, highlight success stories, and to make recommendations for future studies.

Methods

This study compared CAP training programs and CAMHS workforce using the World Psychiatric Association, CAP Section's regional studies data.

Results

This study included data from 44 countries: 18 countries in the Far East, 15 countries in the Middle East, and 11 countries in Southeast Europe. There were significant differences both within, and between, the three included regions with regards to availability and infrastructure of CAP training programs. Besides Greece, all included countries reported the need for more child and adolescent psychiatrists and allied child and adolescent mental health professionals.

Discussion

There is an urgent need for more qualified child and adolescent psychiatrists and allied professionals in a very large group of countries in three different geographic regions with great differences in religion, culture, and economy.

尽管生活在低收入和中等收入国家的儿童和青少年比例很高,但95%的儿童和青少年心理卫生专业资源位于高收入国家。为了加强儿童和青少年心理健康服务(CAMHS),首先有必要完成对现有服务和培训计划的评估,以确定需要什么,特别是在东南欧、远东和中东等人口年轻的地区。本文的目的是比较三个地理区域的儿童和青少年精神病学(CAP)培训计划和CAMHS劳动力的现状,找出相似的问题,突出成功的案例,并为未来的研究提出建议。方法本研究使用世界精神病学协会CAP分部的区域研究数据,对CAP培训项目和CAMHS工作人员进行比较。结果本研究包括44个国家的数据:18个远东国家,15个中东国家,11个东南欧国家。在这三个地区内部和之间,在CAP培训项目的可用性和基础设施方面存在显著差异。除希腊外,所有纳入的国家都报告需要更多的儿童和青少年精神病医生以及相关的儿童和青少年心理健康专业人员。在宗教、文化和经济存在巨大差异的三个不同地理区域的众多国家中,迫切需要更多合格的儿童和青少年精神科医生及相关专业人员。
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引用次数: 2
Predictors of prolonged grief disorder in Chinese elderly shidu parents: The role of perceived stigma and perceived stress 中国失独老人长期悲伤障碍的预测因素:感知污名和感知压力的作用
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-09-30 DOI: 10.1111/appy.12489
Shuang Zhao BM, Longfei Ren MS, Qiong Wang MS, Meijun Long BA, Hui Wu PhD, Yang Wang PhD

Introduction

Parents who have lost their only child and over the age of 60 are known as elderly shidu parents. This study aimed to investigate predictors of prolonged grief disorder (PGD) among Chinese elderly shidu parents.

Methods

Two hundred and ninety-eight elderly shidu parents from Shenyang were included in this cross-sectional study. Participants completed a questionnaire including the Prolonged Grief questionnaire-13 (PG-13), the PTSD (post-traumatic stress disorder) Checklist for DSM-5 (PCL-5), the Center for Epidemiologic Studies Depression Scales (CES-D), the Self-Rating Anxiety Scale (SAS), and the Perceived Stress Scale-10 (PSS-10). Multiple linear regression was used to examine socio-demographic, bereavement-related and perceived stress associated with PGD symptoms.

Results

The prevalence of PGD among Chinese elderly shidu parents was 13.8%. Among the 41 PGD patients, 29, 39, 36 patients had comorbidity of PTSD, depressive symptoms and anxiety, respectively. Perceived stress, higher educational level, lower annual household income, perceived stigma, violent death of the child, and being in debt were associated with severer PGD symptoms.

Discussion

The present study revealed the prevalence of PGD and the important role of PGD in diagnosing other mental disorders in Chinese elderly shidu parents. Providing financial help, eliminating social stigma, and stress should be included in PGD prevention among Chinese elderly shidu parents.

失去独生子女的年龄超过60岁的父母被称为老年失独父母。本研究旨在探讨中国失独老人长期悲伤障碍(PGD)的预测因素。方法采用横断面研究方法对沈阳市298名老年失独父母进行调查。参与者完成了一份问卷,包括延长悲伤问卷-13 (PG-13)、DSM-5创伤后应激障碍(PTSD)检查表(PCL-5)、流行病学研究中心抑郁量表(CES-D)、焦虑自评量表(SAS)和感知压力量表-10 (PSS-10)。多元线性回归用于检验与PGD症状相关的社会人口统计学、丧亲相关和感知压力。结果中国老年失独父母PGD患病率为13.8%。41例PGD患者中,合并PTSD者29例,合并抑郁症状者39例,合并焦虑者36例。感知到的压力、较高的教育水平、较低的家庭年收入、感知到的耻辱、儿童的暴力死亡和负债与严重的PGD症状有关。本研究揭示了中国老年失独父母PGD的患病率以及PGD在诊断其他精神障碍中的重要作用。提供经济帮助、消除社会耻辱感和压力应包括在中国老年失都父母的PGD预防中。
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引用次数: 5
Analysis of the trends of polypharmacy and high-dose prescriptions in Japan 日本多药及大剂量处方趋势分析
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-09-14 DOI: 10.1111/appy.12488
Naotaka Shinfuku M.D. Ph.D.

Introduction

After extensive research, this study explored whether high-dose prescriptions and polypharmacy remain more frequent in Japan than elsewhere. If confirmed, we aimed to identify the factors that contributed to this unique trend.

Methods

The psychotropic drug prescription patterns for patients with schizophrenia in Japan were reviewed. This was based on a large sample collected from surveys of the Research on Asian Psychotropic Prescription Patterns, an international collaborative research project conducted by Asian psychiatrists to monitor prescriptions of psychotropic drugs for people with mental disorders, in 2001, 2004, 2008, and 2016.

Results

The 2016 Research on Asian Psychotropic Prescription Patterns survey revealed that Japan continued to demonstrate the highest rate of polypharmacy and the highest dosages of psychotropic prescription drugs for patients with schizophrenia among the 15 countries and areas that participated in the survey.

Discussion

The Research on Asian Psychotropic Prescription Patterns surveys demonstrated that science plays a limited role in the decision-making process for prescriptions of psychotropic medications. Such prescriptions are influenced by a wide range of factors, such as the national mental health policy, prescription-financing systems, the history of psychiatry in each country, and the prevailing culture. Hospital-based national mental health policies and mental health financing systems have been the primary obstacles to reducing polypharmacy in Japan.

经过广泛的研究,本研究探讨了日本是否比其他地方更频繁地使用大剂量处方和多种药物。如果得到证实,我们的目标是找出导致这一独特趋势的因素。方法回顾日本精神分裂症患者的精神药物处方情况。这是基于从2001年、2004年、2008年和2016年亚洲精神科医生开展的一项国际合作研究项目“亚洲精神药物处方模式研究”调查中收集的大量样本得出的,该项目旨在监测精神障碍患者的精神药物处方。结果《2016年亚洲精神药物处方模式调查研究》显示,在参与调查的15个国家和地区中,日本仍然是精神分裂症患者使用多种药物比例最高、使用精神处方药剂量最高的国家和地区。亚洲精神药物处方模式调查研究表明,科学在精神药物处方决策过程中的作用有限。这些处方受到多种因素的影响,例如国家精神卫生政策、处方融资系统、每个国家的精神病学历史以及流行文化。在日本,以医院为基础的国家精神卫生政策和精神卫生筹资系统一直是减少综合用药的主要障碍。
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引用次数: 7
期刊
Asia‐Pacific Psychiatry
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