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A quarter of century after: The changing ecology of psychiatric emergency services 四分之一世纪后:精神科急救服务生态的变化
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-09-12 DOI: 10.1111/appy.12487
Wen-Hao Chen MD, Ming H. Hsieh MD, PhD, Shih-Cheng Liao MD, PhD, Chen-Chung Liu MD, PhD, Chih-Min Liu MD, PhD, Chi-Shin Wu MD, PhD, Yi-Ting Lin MD, Tzung-Jeng Hwang MD, PhD, Yi-Ling Chien MD, PhD

Introduction

Previous studies demonstrated a trend of increasing common mental disorders among the Emergency Department (ED) visitors in Western countries. Little is known about the current conditions of the emergency psychiatric services in Asian countries. This study aims to survey the current epidemiology and the changing ecology of emergency psychiatry services in Taiwan.

Methods

A total of 804 psychiatry consultations were initiated at the ED during the 1-year period from July 1, 2014 to June 30, 2015 in a medical center in northern Taiwan. Clinical data of gender, age, chief complaints, tentative diagnoses, dispositions, and ED staying hours were compared to a previous report in the same hospital in 1988.

Results

Psychiatry consultation was initiated in 0.72% of all ED visits (804/111,923). Among these visits, females were 1.73 times of the males. The most common chief complaints were psychosis/mania (33.5%) and suicide/self-harm (33.2%), followed by homicide/violence (12.8%) and anxiety/depression (10.3%). Top tentative diagnoses were schizophrenia spectrum and other psychotic disorders (31.3%), trauma- and stressor-related disorders (17.5%), bipolar disorders (15.9%), and depressive disorders (14.2%). Compared to 1988, there are three major changes: (1) over-representation of female patients, (2) an increase of “neurosis” patients, and (3) an increase of suicide/self-harm as chief problem.

Discussion

This study portrays the current epidemiology and changing ecology of psychiatric emergency in Taiwan. The increase of neurotic and suicide/self-harm patients requires more services and clinical training in managing common mental disorders and suicide in the ED.

以往的研究表明,在西方国家急诊科(ED)访客中,常见的精神障碍呈上升趋势。人们对亚洲国家紧急精神科服务的现状知之甚少。摘要本研究旨在探讨台湾急症精神科的流行病学现况与变迁生态。方法对2014年7月1日至2015年6月30日在台湾北部某医疗中心急诊科进行的804次精神病学咨询进行分析。将性别、年龄、主诉、初步诊断、性情、急诊科住院时间等临床资料与1988年同一医院的报告进行比较。结果0.72%的急诊患者(804/111,923)有精神病学咨询。其中,女性是男性的1.73倍。最常见的主诉是精神病/躁狂(33.5%)和自杀/自残(33.2%),其次是杀人/暴力(12.8%)和焦虑/抑郁(10.3%)。暂定诊断最多的是精神分裂症谱系和其他精神障碍(31.3%)、创伤和压力相关障碍(17.5%)、双相情感障碍(15.9%)和抑郁症(14.2%)。与1988年相比,有三个主要变化:(1)女性患者比例过高,(2)“神经症”患者增加,(3)自杀/自残增加为主要问题。本研究描述台湾精神科急症的流行病学现况与变迁生态。神经症和自杀/自残病人的增加需要急诊科提供更多的服务和临床培训,以处理常见的精神障碍和自杀。
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引用次数: 2
Resilience and its inter-relationship with symptomatology, illness course, psychosocial functioning, and mediational roles in schizophrenia: A systematic review 精神分裂症的恢复力及其与症状学、病程、社会心理功能和中介作用的相互关系:系统综述
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-08-25 DOI: 10.1111/appy.12486
Jerry Jay Yeo MBBS Candidate, Qian Hui Chew B.Soc.Sci (Hons), Kang Sim MBBS, MMed (Psychiatry), Grad Dip Psychotherapy (Distinction), MS-HPEd, FAMS

Background

Schizophrenia is a major psychiatric disorder which poses substantial illness burden on affected individuals. In view of the need to better understand the growing literature on resilience (adaptation in the face of adversity) and its clinical correlates to inform and optimize clinical management in schizophrenia, we sought to summarize the extant literature which examined the inter-relationships between resilience and demographic features, phenomenology, illness course, psychosocial functioning, and its mediational role among relevant factors.

Methods

A systematic review was conducted on published empirical studies examining the topic of resilience and clinical correlates within schizophrenia spectrum conditions up until December 2020.

Results

Higher level of resilience was associated with lower severity of specific symptomatology including positive, negative, depressive symptoms, suicidal ideation, cognitive deficits, and better insight. Moreover, higher resilience was significantly associated with different aspects of illness course (such as shorter duration of untreated psychosis, longer duration of illness, improved symptom remission and recovery), internal factors (such as lower stigma, better self-esteem), and psychosocial functioning (better overall, real-life, social and interpersonal functioning, better quality of life). Resilience also acts as a mediator in pathways leading to depression, functioning, and quality of life within schizophrenia spectrum conditions.

Discussion

Viewed within the context of various resiliency models (compensatory, challenge, protective factor models), suggestions were made to enhance resilience and balance risk versus protective factors in order to improve disease management. Future research should seek to better elucidate associated biomarkers, inter-relationships with carer resilience, and evaluate the efficacy of suitable resilience-targeted interventions in schizophrenia.

精神分裂症是一种严重的精神疾病,给患者带来了沉重的疾病负担。鉴于有必要更好地理解越来越多的关于心理弹性(面对逆境的适应)及其临床相关性的文献,以便为精神分裂症的临床管理提供信息和优化,我们试图总结现有的文献,这些文献研究了心理弹性与人口特征、现象学、病程、社会心理功能之间的相互关系,以及其在相关因素中的中介作用。方法对截至2020年12月已发表的实证研究进行了系统回顾,研究了精神分裂症谱系条件下的弹性和临床相关因素。结果高水平的恢复力与较低的特定症状严重程度相关,包括阳性、阴性、抑郁症状、自杀意念、认知缺陷和更好的洞察力。此外,较高的复原力与病程的不同方面显著相关(如精神病未治疗的持续时间较短,疾病持续时间较长,症状缓解和恢复改善),内部因素(如更低的耻辱,更好的自尊)和心理社会功能(更好的整体,现实生活,社会和人际功能,更好的生活质量)。在精神分裂症谱系条件下,恢复力也在导致抑郁、功能和生活质量的途径中起中介作用。在各种复原力模型(补偿、挑战、保护因素模型)的背景下,提出了增强复原力和平衡风险与保护因素的建议,以改善疾病管理。未来的研究应寻求更好地阐明相关的生物标志物,与照顾者心理弹性的相互关系,并评估针对精神分裂症的心理弹性干预措施的有效性。
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引用次数: 11
Language disorder as a marker for schizophrenia 语言障碍是精神分裂症的标志
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-07-30 DOI: 10.1111/appy.12485
Dhenni Hartopo MD, Royke Tony Kalalo MD, Sp.KJ(K), FISCM

A language disorder is a significant symptom of schizophrenia. A psychiatrist can find this disorder when interviews with a patient. Screening and diagnosis in patients with schizophrenia alone rely heavily on interviews conducted on patients and any instructions captured from patients both verbally and nonverbally. A psychiatrist can also analyze the language aspects in schizophrenia from a language level perspective ranging from phonetic to pragmatic. This analysis paves the way for the process of interference detection since the prodromal phase. Language disorder in schizophrenia is often associated with impaired thinking processes. However, with the development of science and technology today, there is an objective and quantitative method of computational analysis of language through the Natural Language Processing process with a semantic space model that allows a psychiatrist to learn aspects of the human language process, especially in semantic and pragmatic aspects. The review provides a groundbreaking proposal for biomarkers for schizophrenia that have not been available so far through the assessment of language disorders in patients with schizophrenia. Objective and accurate detection of language disorders in schizophrenia can be a modality for psychiatrists to screen, make diagnoses, determine prognosis, evaluate therapies, and monitor recurrence using existing technology media.

语言障碍是精神分裂症的一个重要症状。精神科医生在与病人面谈时可以发现这种障碍。精神分裂症患者的筛查和诊断在很大程度上依赖于对患者进行的访谈和从患者口头和非口头获取的任何指示。精神科医生还可以从语言层面分析精神分裂症的语言方面,从语音到语用。这一分析为从前驱阶段开始的干扰检测过程铺平了道路。精神分裂症的语言障碍通常与思维过程受损有关。然而,随着当今科学技术的发展,有了一种客观定量的语言计算分析方法,通过自然语言处理过程和语义空间模型,使精神科医生能够了解人类语言过程的各个方面,特别是语义和语用方面。这篇综述为精神分裂症的生物标志物提供了一个突破性的建议,迄今为止还没有通过评估精神分裂症患者的语言障碍。客观准确地检测精神分裂症患者的语言障碍,可以成为精神科医生筛查、诊断、判断预后、评估治疗和监测复发的一种方式。
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引用次数: 5
Suicide prevention is everybody's business 预防自杀是每个人的事
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-07-01 DOI: 10.1111/appy.12483
Gabriel Ivbijaro MBE, MBBS, MA, MMedSci, PhD, FRCGP, FWACPsych, IDFAPA
There have been many suicide prevention initiatives, some focused on the individual, some on the environment, some on systems and some on carers and caregivers, with each contributing to reducing suicide risk. Suicide is preventable and prevention should be everybody's business. We are grateful to Wiley, the Asia-Pacific Psychiatry and the Editor in Chief, Professor Allan Tasman for commissioning this special issue of the journal focused on suicide prevention. I am also grateful to Michelle Riba, Lakshmi Vijayakumar, Tsuyoshi Akiyama, Soumitra Pathare, Danuta Wasserman, Norman Sartorius and David Goldberg for the support that they have provided in preparing this special issue, and to all our peer reviewers for their contribution. Suicide prevention in childhood and adolescence (Wasserman et al., 2021) highlights some of the key papers in the field providing the building blocks for understanding what is required to prevent suicide in this age group noting that many countries have achieved reductions in rates of suicide. This reduction is not universal, and those countries that have increased rates need to look at what interventions have been successful in other parts of the world to reduce rates of suicide in childhood and adolescence further. Adopting the concept that suicide prevention is everybody's business is likely to be helpful because it will enable a holistic approach to addressing this problem. Suicide prevention in psychiatric patients (Wasserman, Carli, et al., 2021) highlights that the provision of cognitive behavior therapy and other brief interventions, including psychoeducation to people with a diagnosis of schizophrenia can decrease the risk of suicide and provides a summary of interventions that reduce risk of suicide in a range of mental disorders recommending a comprehensive suicide risk assessment as the first step in providing effective suicide prevention in psychiatric patients. Suicide prevention in older adults (de Mendoça Lima et al., 2021) in this special issue brings together the dynamic interaction of community, systems and individuals and its importance in reducing rates of suicide in older adults, noting that a public health approach is essential. Reducing access to methods of suicide is also important. In his review, McInnis et al. (2021) examine the issue of access to firearms suggesting self-exclusion agreements as a potential way forward. This is innovative, non-stigmatizing and gives the power to an individual with a known mood disorder to protect themselves and society and is especially important for countries where issues of gun control can be divisive and political. Families and carers matter and should not be forgotten as part of a of protective network that can support an individual during periods when they are at increased risk of suicide. Edwards et al. (2021) propose a practical way of history taking, including emotional engagement, that enables the family member who is feeling suicidal to feel respected
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引用次数: 1
Comprehensive approaches to youth suicide prevention 预防青少年自杀的综合方法
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-07-01 DOI: 10.1111/appy.12484
Andres J. Pumariega M.D.
This issue of the Asia-Pacific Psychiatry dedicated to suicide prevention contains three articles that present a road map for more robust and systematic approaches to addressing the scourge of suicide among children, adolescents, and young adults. As has been previously reported. More than 60 000 children and adolescents aged 10– 19 across the world died from suicide in 2016, and suicide represents the third leading cause of death in 15–19-year-olds, after road injury and interpersonal violence (causes that can often overlap with suicide; World Health Organization, 2019). Additionally, the prevalence of child and adolescent suicide has been on a persistent upward trend since the 1990s, seeming to stabilize during the late 2010's but later aggravated during the COVID pandemic. For example, in addition to articles referenced in this issue, the U.S. Center for Disease Control and Prevention (Yard et al., 2021) reported an estimated increase in emergency room visits by youth ages 12 to 17 for suicide attempts of 22.3% higher during summer 2020 and 39.1% higher during winter 2021 than during the corresponding periods in 2019 in the United States, with the majority of the increase in adolescent girls. Though suicide at any age is a tragic outcome, it is even more tragic when it has become a growing epidemic which prematurely ends promising lives. It behooves all of us in pediatric mental health to mount all possible efforts toward reversing this trend, particularly using a public health model with clear universal, secondary, and tertiary levels of prevention. The article by Wasserman et al. (2021) directly touches on the topic of suicide prevention in this age group, presenting a narrative review of current knowledge on risk and protective factors and effectiveness of interventions. Although the comprehensive review of risk factors in this article is quite impressive, its core lies in the sections addressing preventive interventions. The authors identify the existence of various evidence-based awareness and skills training programs aimed at universal prevention with youth populations, particularly in school-based settings. They cite programs such as Signs of Suicide (SOS), Youth Aware of Mental Health (YAM), and the Good Behavior Game (GBG) ask promising, but also site the SEHER trial in India as well as other work supporting the implementation of school based mental health promotion interventions in low-and-middle income countries. The latter are quite important, especially given an anticipated increase in risk for suicidality in developing nations as their youth face the various social and developmental pressures encountered in developed nations. An example of this is Turkey, for which studies such as Dalkilic et al. (2013) suggest an increasing risk of suicidality among adolescents, accompanied by increasing substance use, depression, and pressures resulting with urbanization. Wasserman et al. (2021) cited the use of Gatekeeper programs and screenin
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引用次数: 0
Suicide prevention and COVID-19 预防自杀和COVID-19
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-06-11 DOI: 10.1111/appy.12482
Gabriel Ivbijaro MBE, MBBS, MA, MMedSci, PhD, FRCGP FWACPsych, IDFAPA, Lucja Kolkiewicz MBBS, MRCPsych, IFAPA, David Goldberg KBE, Isatou N. S. N'jie BA Hons, DPS, MCLIP, MInstLM, Todd Edwards BA, MA, PhD, Michelle B. Riba MD, MS, Igor Švab MD, PhD, Jeffrey Geller MD, MPH, Yaccub Enum BSc, MSc, DLSHTM
<div> <section> <h3> Introduction</h3> <p>Suicide prevention during Covid 19 has become a global priority because the current pandemic has led to societal difficulties threatening the fabric of our lifestyle with increased morbidity and mortality. Modelling studies published since the COVID 19 pandemic was declared in March 2020 estimate that suicide rates will increase by anywhere between 1% to 145% globally in response to the pandemic and action needs to be taken.</p> </section> <section> <h3> Methods</h3> <p>A narrative literature review on high quality evidence sources limited to human studies and publications written in English language only has been used to examine the relationship of COVID 19 and existing mental illness or history of mental illness, suicide prevention strategies and changes in overall suicide rates.</p> </section> <section> <h3> Results</h3> <p>A total of 39 papers are summarised and grouped using the headings aetiological factors, proposed interventions to increase access and national policies to provide a framework for suicide prevention during pandemics such as COVID 19. This review indicates that 1) investing in active labour market programmes will result in a decreased suicide rate during times of high unemployment 2) People in low paid and casual jobs require specific support because they are most financially vulnerable during a pandemic related crisis 3) Women require specific support during a pandemic because of the type of employment they have and because they often carry a greater proportion of the domestic burden and are at increased risk of domestic violence during lockdown and crisis 4) Mental health and substance misuse services need to be appropriately funded and prioritised during and post pandemic, due to the associated increase in substance misuse during a pandemic causing worsening mental health and increased risk of suicide 5) National Suicide Prevention Strategies should be developed by all countries and should anticipate response to a range of disasters, including a pandemic 6) Suicide prevention is everybody's business and National Suicide Prevention Strategies should adopt a whole-systems approach including mental health services, primary care, social care, NGO's and other community stakeholders 7) Suicide is preventable 8) It is essential to prioritise suicide prevention strategies in the COVID and post-COVID period to ensure that lives are saved.</p> </section> <section> <h3> Discussion</h3> <p>Increase in suicide is not inevitable and suicide prevention during pandemics and post COVID 19 pandemics
2019冠状病毒病期间的自杀预防已成为全球优先事项,因为当前的大流行导致社会困难,威胁到我们的生活方式结构,发病率和死亡率上升。自2020年3月宣布COVID - 19大流行以来发表的建模研究估计,为应对这一大流行,全球自杀率将增加1%至145%,需要采取行动。方法采用基于人类研究和英文出版物的高质量证据来源的叙述性文献综述,探讨COVID - 19与现有精神疾病或精神疾病史、自杀预防策略和总体自杀率变化的关系。结果共对39篇论文进行了汇总和分组,标题为病因因素、增加获取的建议干预措施和国家政策,为COVID - 19等大流行期间的自杀预防提供框架。这一审查表明,1)投资于积极的劳动力市场方案将导致在高失业率时期自杀率下降;2)从事低薪和临时工作的人需要特别支持,因为在与大流行病有关的危机期间,他们在经济上最脆弱;3)妇女在大流行病期间需要特别支持,因为她们的就业类型,而且她们往往承担更大比例的家庭负担,面临更大的家庭负担风险4)在大流行期间和大流行之后,精神健康和药物滥用服务需要得到适当的资助和优先考虑,因为大流行期间药物滥用会增加,导致精神健康恶化和自杀风险增加。5)所有国家都应制定国家预防自杀战略,并应预测对一系列灾害的反应;6)预防自杀是每个人的事,国家自杀预防战略应采取全系统方法,包括精神卫生服务、初级保健、社会保健、非政府组织和其他社区利益相关者7)自杀是可以预防的8)在COVID和COVID后时期优先考虑自杀预防战略,以确保挽救生命。自杀率的上升并非不可避免,大流行期间和后COVID - 19大流行期间的自杀预防需要一种协作的全系统方法。我们需要实时数据来为动态行动计划提供信息。
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引用次数: 15
Suicide prevention in older adults 老年人自杀预防
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-06-10 DOI: 10.1111/appy.12473
Carlos Augusto de Mendonça Lima, Diego De Leo, Gabriel Ivbijaro, Igor Svab

Background

Suicide among older adults is a multifactorial problem with several interrelated factors involved that vary with age, gender and culture. The number of suicides is highest in those aged 70 years or older in almost all regions of the world. With the increase in life expectancy, and the decrease in mortality due to other causes of death, we could expect the absolute number of older adults' suicide continue increasing.

Methods

Review of the literature on suicide protective factors of suicide among older adults.

Results

Improvements on social determinants of health and the timely detection and early treatment of affective disorders are key interventions. Prevention based on community actions and training of gatekeepers may have positive impact. Community programs that promote a sense of usefulness, belonging and that contribute to preserve social integration should be encouraged. Governments should develop the improvement of retirement programs and the development of support systems. The access to general health and mental health services should be facilitated and Primary Care professionals should receive proper training to detect and manage older persons at risk. Actively promoting a culture of coping to different stages of life and to the changes imposed by the advancing of age should form the essential part of a process bringing to better successful aging avenues.

Conclusions

Suicide prevention in older adults should broaden its focus and pay attention to the many socio-environmental conditions that may be relevant in older age, especially social isolation, financial security and physical health.

背景:老年人自杀是一个多因素问题,涉及的几个相互关联的因素因年龄、性别和文化而异。在世界上几乎所有地区,70岁以上的人自杀人数最多。随着预期寿命的延长,以及其他死因导致的死亡率的下降,我们可以预期,老年人自杀的绝对数量将继续增加。方法回顾有关老年人自杀保护因素的文献。结果改善健康的社会决定因素,及时发现和早期治疗情感性障碍是关键的干预措施。以社区行动和培训看门人为基础的预防可能产生积极影响。应该鼓励促进有用感、归属感和有助于保持社会融合的社区项目。政府应制定完善的退休计划和支持系统的发展。应便利获得一般保健和精神保健服务,初级保健专业人员应接受适当培训,以发现和管理处于危险中的老年人。积极推动一种文化,使人们能够适应人生的不同阶段和年龄的增长所带来的变化,这应该是通向更成功的老龄道路的过程的重要组成部分。结论老年人自杀预防应拓宽重点,关注可能与老年相关的多种社会环境条件,特别是社会孤立、经济安全和身体健康。
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引用次数: 31
The role of internet gaming in the association between anxiety and depression: A preliminary cross-sectional study 网络游戏在焦虑和抑郁之间关系中的作用:一项初步的横断面研究
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-05-20 DOI: 10.1111/appy.12474
Vasileios Stavropoulos, Jeremy Vassallo, Tyrone Leonard Burleigh, Rapson Gomez, Michelle Colder Carras

Background

Disordered Internet gaming is thought to be perpetuated by one's need to escape their real-life distress or mental health symptoms, which may in turn generate depressive feelings. Nevertheless, moderate engagement with Internet games has also been suggested to provide relief, thus improving one's mood. This study aspires to clarify the contribution of Internet gaming and gender in the association between anxiety and depression.

Methods

A large sample of Internet gamers (N = 964) were recruited online. Disordered Internet gaming was assessed with the Internet Gaming Disorder Scale, 9 Items Short Form (IGD9S-SF). Anxiety and depression symptoms were assessed using the Depression, Anxiety and Stress Scale, 21 items (DASS-21).

Results

Regression, moderation and moderated moderation analyses accounting for the effects of gender on the relationship between disordered gaming, anxiety, and depression found a significant effect for anxiety symptoms on depression symptoms and a significant interaction between anxiety and Internet gaming disorder on depression symptoms. Findings support the theory that although anxious gamers bear a higher depression risk, this is buffered with lower and exacerbated with higher disordered gaming symptoms.

Conclusion

Findings suggest a dual role of Internet gaming in the association between anxiety and depression, depending on the intensity of one's disordered gaming symptoms. Depression prevention and intervention protocols should be optimized by considering the effects of Internet gaming among anxious gamers by focusing on the intensity of a gamer's involvement and any gaming disorder symptoms. Further research should include clinical samples to better understand this interaction.

人们认为,人们需要逃避现实生活中的痛苦或心理健康症状,从而产生抑郁情绪,从而导致网络游戏成瘾。然而,适度参与网络游戏也被建议提供缓解,从而改善一个人的情绪。本研究旨在阐明网络游戏和性别在焦虑和抑郁之间关系中的作用。方法对964名网络游戏玩家进行抽样调查。采用网络游戏障碍量表(IGD9S-SF)对网络游戏障碍进行评估。采用抑郁、焦虑和压力量表21项(DASS-21)评估焦虑和抑郁症状。结果对性别对游戏障碍、焦虑和抑郁关系的影响进行回归、调节和调节分析,发现焦虑症状对抑郁症状有显著影响,焦虑和网络游戏障碍对抑郁症状有显著交互作用。研究结果支持这样一种理论,即尽管焦虑的游戏玩家有更高的抑郁风险,但这种风险会被较低的游戏紊乱症状所缓冲,并随着游戏紊乱症状的加剧而加剧。研究结果表明,网络游戏在焦虑和抑郁之间具有双重作用,这取决于一个人的游戏症状紊乱的强度。通过关注游戏玩家的参与程度和任何游戏障碍症状,考虑网络游戏对焦虑玩家的影响,可以优化抑郁症的预防和干预方案。进一步的研究应该包括临床样本,以更好地了解这种相互作用。
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引用次数: 13
Prevention of suicide is possible 预防自杀是可能的
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-05-18 DOI: 10.1111/appy.12476
Norman Sartorius MD, PHD, FRCPsych
The 2019 report of the World Health Organization (WHO, 2019) showed – for the first time since its publication – a reduction of suicide rates in all but one region (America's) of the WHO. The number of people who died because of suicide in the most recent year reported was 10% lower than the number in the preceding report made more significant by the fact that the population of the world continued to increase. The incidence of suicide in the PR China (particularly among young women) in the 1980s was reported to be among the highest in the world: since then it has been reduced to a level similar to that seen in many European countries. The variation of suicide rates was explained by changes in the organization of health services, by control of pesticide availability and by a change of conditions related to urbanization (Phillips et al., 1999). A multicentre study of the World Health Organization (Fleischmann et al., 2008) showed the effectiveness of brief interventions to prevent suicide, in a variety of countries. Professor Hegerl's work (Hegerl et al., 2006) demonstrated that interventions by the health care sector (taken in collaboration with other social sectors) can lead to a reduction of suicide rates in urban settings. There are other studies and reports but the three examples mentioned above demonstrate that the incidence of suicide can be brought down by interventions by the health and social sectors and services; the WHO report however also shows that there are other factors which influence suicide rates, factors about which we still do not know enough. We could and should therefore hope that the future will see a universal application of measures of proven effectiveness in the prevention of suicide (e.g. the development of health services with a capacity to deal with suicide and suicide attempts) and a growth of the awareness that social change is a matter of life or death and must therefore be steered with care and humanitarian ideals in mind. At the same time, however a careful evaluation of effects of interventions and research on suicide and its prevention should continue and its results should help to guide action. The rates of suicide can be reduced and our action and behavior can make this happen.
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引用次数: 1
Mental health literacy: A systematic review of knowledge and beliefs about mental disorders in Malaysia 心理健康素养:对马来西亚关于精神障碍的知识和信念的系统审查
IF 3.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2021-05-08 DOI: 10.1111/appy.12475
Khadeeja Munawar PhD, Firdaus Mukhtar PhD, Fahad Riaz Choudhry PhD, Alvin Lai Oon Ng DPsych

Background

Mental health problems in Malaysia are on a rise. This study aimed at performing a systematic review of mental health literacy (MHL) in Malaysia.

Methods

Medline, Embase, ERIC/Proquest, ScienceDirect, Pubmed, PsycINFO, CINAHL, Scopus, EBM Reviews - Cochrane Central Register of Controlled Trials, Ovid Emcare and reference lists of included studies were searched in February 2020. Studies that evaluated at least one of the main components of MHL, including (1) knowledge related to mental health issues, and (2) stigma, were included irrespective of study design. As secondary findings, the review also synthesized results related to facilitators and barriers to seeking mental health services. Depending on the research design, the quality of each study was assessed through checklists.

Results

Forty six studies published between 1995 to 2019 were included. Most studies used cross-sectional designs to investigate MHL. Findings indicate that most Malaysians have stigmatizing attitudes towards mental health problems. Participants in the included studies endorsed multifactorial explanations of mental health issues with a dominance of supernatural and religious aetiologies. Likewise, the commonest barrier was considering sources other than professional sources of mental-health services. Presence of adequate knowledge and considering providers as competent facilitated help-seeking. Additionally, there was considerable heterogeneity in studies and a lack of standardized measures assessing MHL.

Conclusions

There is an increase in studies on MHL in Malaysia. A few of these studies, based on experimental design, have shown positive effects. Researchers, practitioners, and policymakers should develop standardized measures and interventional studies based on all the components of MHL.

马来西亚的心理健康问题呈上升趋势。本研究旨在对马来西亚的心理健康素养(MHL)进行系统审查。方法于2020年2月检索Medline、Embase、ERIC/Proquest、ScienceDirect、Pubmed、PsycINFO、CINAHL、Scopus、EBM Reviews - Cochrane Central Register of Controlled Trials、Ovid Emcare和纳入研究的参考文献列表。无论研究设计如何,评估MHL的至少一个主要组成部分的研究,包括(1)与心理健康问题相关的知识和(2)耻辱感。作为次要发现,该审查还综合了与寻求精神卫生服务的促进因素和障碍有关的结果。根据研究设计,每项研究的质量都通过检查表进行评估。结果纳入1995 - 2019年间发表的46项研究。大多数研究采用横断面设计来调查MHL。调查结果表明,大多数马来西亚人对精神健康问题持污名化态度。被纳入研究的参与者赞同以超自然和宗教病因为主的心理健康问题的多因素解释。同样,最常见的障碍是考虑专业以外的心理健康服务来源。具备足够的知识并认为提供服务的人有能力,有助于寻求帮助。此外,研究中存在相当大的异质性,缺乏评估MHL的标准化措施。结论马来西亚对MHL的研究有所增加。其中一些基于实验设计的研究显示出了积极的效果。研究人员、从业人员和政策制定者应根据MHL的所有组成部分制定标准化措施和干预性研究。
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引用次数: 12
期刊
Asia‐Pacific Psychiatry
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