共查询到20条相似文献,搜索用时 15 毫秒
1.
DINESH BHUGRA SUSHAM GUPTA KAMALDEEP BHUI TOM CRAIG NISHA DOGRA J. DAVID INGLEBY JAMES KIRKBRIDE DRISS MOUSSAOUI JAMES NAZROO ADIL QURESHI THOMAS STOMPE RACHEL TRIBE 《World psychiatry》2011,10(1):2-10
The purpose of this guidance is to review currently available evidence
on mental health problems in migrants and to present advice to clinicians
and policy makers on how to provide migrants with appropriate and accessible
mental health services. The three phases of the process of migration and the
relevant implications for mental health are outlined, as well as the specific
problems of groups such as women, children and adolescents, the elderly, refugees
and asylum seekers, and lesbian, gay, bisexual and transgender individuals.
The concepts of cultural bereavement, cultural identity and cultural congruity
are discussed. The epidemiology of mental disorders in migrants is described.
A series of recommendations to policy makers, service providers and clinicians
aimed to improve mental health care in migrants are provided, covering the
special needs of migrants concerning pharmacotherapies and psychotherapies. 相似文献
2.
Adults with severe mental illness have extraordinarily high rates of co-occurring
substance use disorders, typically around 50% or more, which adversely affect
their current adjustment, course, and outcome. Separate and parallel mental
health and substance abuse treatment systems do not offer interventions that
are accessible, integrated, and tailored for the presence of co-occurrence.
Recent integrated interventions for this population have the specific goal
of ameliorating substance use disorder and the general goal of improving adjustment
and quality of life. The authors overview the current research and offer guidelines
related to mission and philosophy, leadership, comprehensive reorganization,
training, specific programs, and quality improvement. 相似文献
3.
GRAHAM THORNICROFT ATALAY ALEM RENATO ANTUNES DOS SANTOS ELIZABETH BARLEY ROBERT E. DRAKE GUILHERME GREGORIO CHARLOTTE HANLON HIROTO ITO ERIC LATIMER ANN LAW JAIR MARI PETER McGEORGE RAMACHANDRAN PADMAVATI DENISE RAZZOUK MAYA SEMRAU YUTARO SETOYA RANGASWAMY THARA DAWIT WONDIMAGEGN 《World psychiatry》2010,9(2):67-77
This paper provides guidance on the steps, obstacles and mistakes to avoid
in the implementation of community mental health care. The document is intended
to be of practical use and interest to psychiatrists worldwide regarding the
development of community mental health care for adults with mental illness.
The main recommendations are presented in relation to: the need for coordinated
policies, plans and programmes, the requirement to scale up services for whole
populations, the importance of promoting community awareness about mental
illness to increase levels of help-seeking, the need to establish effective
financial and budgetary provisions to directly support services provided in
the community. The paper concludes by setting out a series of lessons learned
from the accumulated practice of community mental health care to date worldwide,
with a particular focus on the social and governmental measures that are required
at the national level, the key steps to take in the organization of the local
mental health system, lessons learned by professionals and practitioners,
and how to most effectively harness the experience of users, families, and
other advocates. 相似文献
4.
VIKRAM PATEL MARIO MAJ ALAN J. FLISHER MARY J. DE SILVA MIRJA KOSCHORKE MARTIN PRINCE WPA Zonal Member Society Representatives 《World psychiatry》2010,9(3):169-176
The treatment gap for people with mental disorders exceeds 50% in all countries
of the world, approaching astonishingly high rates of 90% in the least resourced
countries. We report the findings of the first systematic survey of leaders
of psychiatry in nearly 60 countries on the strategies for reducing the treatment
gap. We sought to elicit the views of these representatives on the roles of
different human resources and health care settings in delivering care and
on the importance of a range of strategies to increase the coverage of evidence-based
treatments for priority mental disorders for each demographic stage (childhood,
adolescence, adulthood and old age). Our findings clearly indicate three strategies
for reducing the treatment gap: increasing the numbers of psychiatrists and
other mental health professionals; increasing the involvement of a range of
appropriately trained non-specialist providers; and the active involvement
of people affected by mental disorders. This is true for both high income
and low/middle income countries, though relatively of more importance in the
latter. We view this survey as a critically important first step in ascertaining
the position of psychiatrists, one of the most influential stakeholder communities
in global mental health, in addressing the global challenge of scaling up
mental health services to reduce the treatment gap. 相似文献
5.
MARC DE HERT DAN COHEN JULIO BOBES MARCELO CETKOVICH‐BAKMAS STEFAN LEUCHT DAVID M. NDETEI JOHN W. NEWCOMER RICHARD UWAKWE ITSUO ASAI HANS‐JURGEN MÖLLER SHIV GAUTAM JOHAN DETRAUX CHRISTOPH U. CORRELL 《World psychiatry》2011,10(2):138-151
Physical disorders are, compared to the general population, more prevalent
in people with severe mental illness (SMI). Although this excess morbidity
and mortality is largely due to modifiable lifestyle risk factors, the screening
and assessment of physical health aspects remains poor, even in developed
countries. Moreover, specific patient, provider, treatment and system factors
act as barriers to the recognition and to the management of physical diseases
in people with SMI. Psychiatrists can play a pivotal role in the improvement
of the physical health of these patients by expanding their task from clinical
psychiatric care to the monitoring and treatment of crucial physical parameters.
At a system level, actions are not easy to realize, especially for developing
countries. However, at an individual level, even simple and very basic monitoring
and treatment actions, undertaken by the treating clinician, can already improve
the problem of suboptimal medical care in this population. Adhering to monitoring
and treatment guidelines will result in a substantial enhancement of physical
health outcomes. Furthermore, psychiatrists can help educate and motivate
people with SMI to address their suboptimal lifestyle, including smoking,
unhealthy diet and lack of exercise. The adoption of the recommendations presented
in this paper across health care systems throughout the world will contribute
to a significant improvement in the medical and related psychiatric health
outcomes of patients with SMI. 相似文献
6.
In the first decade of this new millennium, health professionals are faced with a rapidly increasing need for child mental health services and changing models of service provision. This gives us a unique opportunity to make provision for services where it has not been available before, or to improve upon the existing services. This paper examines the challenges and opportunities while attempting to integrate child mental health services to primary care. 相似文献
7.
The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management 下载免费PDF全文
Sexual dysfunction often accompanies severe psychiatric illness and can be due to both the mental disorder itself and the use of psychotropic treatments. Many sexual symptoms resolve as the mental state improves, but treatment‐related sexual adverse events tend to persist over time, and are unfortunately under‐recognized by clinicians and scarcely investigated in clinical trials. Treatment‐emergent sexual dysfunction adversely affects quality of life and may contribute to reduce treatment adherence. There are important differences between the various compounds in the incidence of adverse sexual effects, associated with differences in mechanisms of action. Antidepressants with a predominantly serotonergic activity, antipsychotics likely to induce hyperprolactinaemia, and mood stabilizers with hormonal effects are often linked to moderate or severe sexual dysfunction, including decreased libido, delayed orgasm, anorgasmia, and sexual arousal difficulties. Severe mental disorders can interfere with sexual function and satisfaction, while patients wish to preserve a previously satisfactory sexual activity. In many patients, a lack of intimate relationships and chronic deterioration in mental and physical health can be accompanied by either a poor sexual life or a more frequent risky sexual behaviour than in the general population. Here we describe the influence of psychosis and antipsychotic medications, of depression and antidepressant drugs, and of bipolar disorder and mood stabilizers on sexual health, and the optimal management of patients with severe psychiatric illness and sexual dysfunction. 相似文献
8.
Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice,policy and research agendas 下载免费PDF全文
Nancy H. Liu Gail L. Daumit Tarun Dua Ralph Aquila Fiona Charlson Pim Cuijpers Benjamin Druss Kenn Dudek Melvyn Freeman Chiyo Fujii Wolfgang Gaebel Ulrich Hegerl Itzhak Levav Thomas Munk Laursen Hong Ma Mario Maj Maria Elena Medina‐Mora Merete Nordentoft Dorairaj Prabhakaran Karen Pratt Martin Prince Thara Rangaswamy David Shiers Ezra Susser Graham Thornicroft Kristian Wahlbeck Abe Fekadu Wassie Harvey Whiteford Shekhar Saxena 《World psychiatry》2017,16(1):30-40
Excess mortality in persons with severe mental disorders (SMD) is a major public health challenge that warrants action. The number and scope of truly tested interventions in this area remain limited, and strategies for implementation and scaling up of programmes with a strong evidence base are scarce. Furthermore, the majority of available interventions focus on a single or an otherwise limited number of risk factors. Here we present a multilevel model highlighting risk factors for excess mortality in persons with SMD at the individual, health system and socio‐environmental levels. Informed by that model, we describe a comprehensive framework that may be useful for designing, implementing and evaluating interventions and programmes to reduce excess mortality in persons with SMD. This framework includes individual‐focused, health system‐focused, and community level and policy‐focused interventions. Incorporating lessons learned from the multilevel model of risk and the comprehensive intervention framework, we identify priorities for clinical practice, policy and research agendas. 相似文献
9.
Kristian Wahlbeck 《World psychiatry》2015,14(1):36-42
Public mental health deals with mental health promotion, prevention of mental disorders and suicide, reducing mental health inequalities, and governance and organization of mental health service provision. The full impact of mental health is largely unrecognized within the public health sphere, despite the increasing burden of disease attributable to mental and behavioral disorders. Modern public mental health policies aim at improving psychosocial health by addressing determinants of mental health in all public policy areas. Stigmatization of mental disorders is a widespread phenomenon that constitutes a barrier for help-seeking and for the development of health care services, and is thus a core issue in public mental health actions. Lately, there has been heightened interest in the promotion of positive mental health and wellbeing. Effective programmes have been developed for promoting mental health in everyday settings such as families, schools and workplaces. New evidence indicates that many mental disorders and suicides are preventable by public mental health interventions. Available evidence favours the population approach over high-risk approaches. Public mental health emphasizes the role of primary care in the provision of mental health services to the population. The convincing evidence base for population-based mental health interventions asks for actions for putting evidence into practice. 相似文献
10.
Assessing the outcomes of interventions in mental health care is both important and challenging. The aim of this paper is to advance the field of outcomes research by proposing a taxonomy of the decisions that clinicians and researchers need to consider when evaluating outcomes. Our taxonomy has eight components, framed as decisions: Whose outcome will be considered? Which scientific stage is being investigated? What outcome domain(s) matter? What level of assessment will be used? Will clinical and/or recovery outcomes be assessed? Whose perspective will be considered? Will deficits and/or strengths be the focus? Will invariant or individualized measures be preferred? We propose a future focus on understanding what matters most to people using mental health services, and on the use of measures rated by service users as the primary approach to evaluating outcome. 相似文献
11.
Andrew Wooyoung Kim Amber D. Rieder Christine E. Cooper-Vince Bernard Kakuhikire Charles Baguma Emily N. Satinsky Jessica M. Perkins Allen Kiconco Elizabeth B. Namara Justin D. Rasmussen Scholastic Ashaba David R. Bangsberg Alexander C. Tsai Eve S. Puffer 《American journal of physical anthropology》2023,182(1):19-31
Objectives
This study aimed to examine the intergenerational effects of maternal adverse childhood experiences (ACEs) and child mental health outcomes in rural Uganda, as well as the potentially mediating role of maternal depression in this pathway. Additionally, we sought to test the extent to which maternal social group membership attenuated the mediating effect of maternal depression on child mental health.Methods
Data come from a population-based cohort of families living in the Nyakabare Parish, a rural district in southwestern Uganda. Between 2016 and 2018, mothers completed surveys about childhood adversity, depressive symptoms, social group membership, and their children's mental health. Survey data were analyzed using causal mediation and moderated-mediation analysis.Results
Among 218 mother–child pairs, 61 mothers (28%) and 47 children (22%) showed symptoms meeting cutoffs for clinically significant psychological distress. In multivariable linear regression models, maternal ACEs had a statistically significant association with severity of child conduct problems, peer problems, and total child difficulty scores. Maternal depression mediated the relationship between maternal ACEs and conduct problems, peer problems, and total difficulty, but this mediating effect was not moderated by maternal group membership.Conclusions
Maternal depression may act as a potential mechanism linking maternal childhood adversity with poor child mental health in the next generation. Within a context of elevated rates of psychiatric morbidity, high prevalence of childhood adversity, and limited healthcare and economic infrastructures across Uganda, these results emphasize the prioritization of social services and mental health resources for rural Ugandan families. 相似文献12.
Wallcraft J Amering M Freidin J Davar B Froggatt D Jafri H Javed A Katontoka S Raja S Rataemane S Steffen S Tyano S Underhill C Wahlberg H Warner R Herrman H 《World psychiatry》2011,10(3):229-236
WPA President M. Maj established the Task Force on Best Practice in Working with Service Users and Carers in 2008, chaired by H. Herrman. The Task Force had the remit to create recommendations for the international mental health community on how to develop successful partnership working. The work began with a review of literature on service user and carer involvement and partnership. This set out a range of considerations for good practice, including choice of appropriate terminology, clarifying the partnership process and identifying and reducing barriers to partnership working. Based on the literature review and on the shared knowledge in the Task Force, a set of ten recommendations for good practice was developed. These recommendations were the basis for a worldwide consultation of stakeholders with expertise as service users, families and carers, and the WPA Board and Council. The results showed a strong consensus across the international mental health community on the ten recommendations, with the strongest agreement coming from service users and carers. This general consensus gives a basis for Task Force plans to seek support for activities to promote shared work worldwide to identify best practice examples and create a resource to assist others to begin successful collaboration. 相似文献
13.
L Hackett L Theodosiou C Robson F Spicer R Lever 《Mental health in family medicine》2011,8(3):173-179
Background In a time of limited resources and the need for cohesive services, understanding levels of need and prevalence is key. Manchester has a diverse range of cultures and socio-economic groups; national data is valuable but not always representative of local need.Aim To assess the prevalence of mental health needs in secondary school pupils in Manchester.Method Parents and teachers in three secondary schools were invited to complete the Strengths and Difficulties Questionnaire (SDQ) and a tool examining unmet needs.Results Initially, 560 pupils were chosen. Having excluded families that opted out, 503 questionnaires were distributed. Teachers returned 200 questionnaires and parents returned 127. Higher than average levels of need were identified with teachers reporting that 18% of pupils scored abnormally on the SDQ. Parent rates were also higher than the national average at 13.4%.Discussion Parents and teachers wanted children to be seen at home and at school, the need for consultation and outreach from mental health into schools is emphasised. 相似文献
14.
A meta‐review, or review of systematic reviews, was conducted to explore the risks of all‐cause and suicide mortality in major mental disorders. A systematic search generated 407 relevant reviews, of which 20 reported mortality risks in 20 different mental disorders and included over 1.7 million patients and over a quarter of a million deaths. All disorders had an increased risk of all‐cause mortality compared with the general population, and many had mortality risks larger than or comparable to heavy smoking. Those with the highest all‐cause mortality ratios were substance use disorders and anorexia nervosa. These higher mortality risks translate into substantial (10‐20 years) reductions in life expectancy. Borderline personality disorder, anorexia nervosa, depression and bipolar disorder had the highest suicide risks. Notable gaps were identified in the review literature, and the quality of the included reviews was typically low. The excess risks of mortality and suicide in all mental disorders justify a higher priority for the research, prevention, and treatment of the determinants of premature death in psychiatric patients. 相似文献
15.
16.
Rudolf Uher Barbara Pavlova Joaquim Radua Umberto Provenzani Sara Najafi Lydia Fortea Maria Ortuño Anna Nazarova Nader Perroud Lena Palaniyappan Katharina Domschke Samuele Cortese Paul D. Arnold Jehannine C. Austin Michael M. Vanyukov Myrna M. Weissman Allan H. Young Manon H.J. Hillegers Andrea Danese Merete Nordentoft Robin M. Murray Paolo Fusar-Poli 《World psychiatry》2023,22(3):433-448
The offspring of parents with mental disorders are at increased risk for developing mental disorders themselves. The risk to offspring may extend transdiagnostically to disorders other than those present in the parents. The literature on this topic is vast but mixed. To inform targeted prevention and genetic counseling, we performed a comprehensive, PRISMA 2020-compliant meta-analysis. We systematically searched the literature published up to September 2022 to retrieve original family high-risk and registry studies reporting on the risk of mental disorders in offspring of parents with any type of mental disorder. We performed random-effects meta-analyses of the relative risk (risk ratio, RR) and absolute risk (lifetime, up to the age at assessment) of mental disorders, defined according to the ICD or DSM. Cumulative incidence by offspring age was determined using meta-analytic Kaplan-Meier curves. We measured heterogeneity with the I2 statistic, and risk of bias with the Quality In Prognosis Studies (QUIPS) tool. Sensitivity analyses addressed the impact of study design (family high-risk vs. registry) and specific vs. transdiagnostic risks. Transdiagnosticity was appraised with the TRANSD criteria. We identified 211 independent studies that reported data on 3,172,115 offspring of parents with psychotic, bipolar, depressive, disruptive, attention-deficit/hyperactivity, anxiety, substance use, eating, obsessive-compulsive, and borderline personality disorders, and 20,428,575 control offspring. The RR and lifetime risk of developing any mental disorder were 3.0 and 55% in offspring of parents with anxiety disorders; 2.6 and 17% in offspring of those with psychosis; 2.1 and 55% in offspring of those with bipolar disorder; 1.9 and 51% in offspring of those with depressive disorders; and 1.5 and 38% in offspring of those with substance use disorders. The offspring's RR and lifetime risk of developing the same mental disorder diagnosed in their parent were 8.4 and 32% for attention-deficit/hyperactivity disorder; 5.8 and 8% for psychosis; 5.1 and 5% for bipolar disorder; 2.8 and 9% for substance use disorders; 2.3 and 14% for depressive disorders; 2.3 and 1% for eating disorders; and 2.2 and 31% for anxiety disorders. There were 37 significant transdiagnostic associations between parental mental disorders and the RR of developing a different mental disorder in the offspring. In offspring of parents with psychosis, bipolar and depressive disorder, the risk of the same disorder onset emerged at 16, 5 and 6 years, and cumulated to 3%, 19% and 24% by age 18; and to 8%, 36% and 46% by age 28. Heterogeneity ranged from 0 to 0.98, and 96% of studies were at high risk of bias. Sensitivity analyses restricted to prospective family high-risk studies confirmed the pattern of findings with similar RR, but with greater absolute risks compared to analyses of all study types. This study demonstrates at a global, meta-analytic level that offspring of affected parents have strongly elevated RR and lifetime risk of developing any mental disorder as well as the same mental disorder diagnosed in the parent. The transdiagnostic risks suggest that offspring of parents with a range of mental disorders should be considered as candidates for targeted primary prevention. 相似文献
17.
Perinatal mental health has become a significant focus of interest in recent years, with investment in new specialist mental health services in some high‐income countries, and inpatient psychiatric mother and baby units in diverse settings. In this paper, we summarize and critically examine the epidemiology and impact of perinatal mental disorders, including emerging evidence of an increase of their prevalence in young pregnant women. Perinatal mental disorders are among the commonest morbidities of pregnancy, and make an important contribution to maternal mortality, as well as to adverse neonatal, infant and child outcomes. We then review the current evidence base on interventions, including individual level and public health ones, as well as service delivery models. Randomized controlled trials provide evidence on the effectiveness of psychological and psychosocial interventions at the individual level, though it is not yet clear which women with perinatal mental disorders also need additional support for parenting. The evidence base on psychotropic use in pregnancy is almost exclusively observational. There is little research on the full range of perinatal mental disorders, on how to improve access to treatment for women with psychosocial difficulties, and on the effectiveness of different service delivery models. We conclude with research and clinical implications, which, we argue, highlight the need for an extension of generic psychiatric services to include preconception care, and further investment into public health interventions, in addition to perinatal mental health services, potentially for women and men, to reduce maternal and child morbidity and mortality. 相似文献
18.
Huermann Rosalia; Crook Lyon Rachel E.; Heath Melissa Allen; Fischer Lane; Potkar Kirti 《Dreaming》2009,19(2):85
In this study, 49 public school mental health practitioners (school counselors, school psychologists, and school social workers) completed a survey about working with students’ dreams. The majority of these practitioners reported having at least one student bring up dreams during counseling, more frequently with troubling dreams and nightmares or when coping with grief. Results showed that practitioners were less likely to talk about dreams with students who had been identified with an adjustment disorder, psychosis, or eating disorder; those who were oppositional or ill; and those who struggled with substance abuse problems. Although most practitioners did not feel competent working with children’s dreams and reported minimal training in dream work, they were interested in learning more about children’s dreams and potential uses of dream work in supportive counseling. (PsycINFO Database Record (c) 2010 APA, all rights reserved) 相似文献
19.
Mike Slade Michaela Amering Marianne Farkas Bridget Hamilton Mary O'Hagan Graham Panther Rachel Perkins Geoff Shepherd Samson Tse Rob Whitley 《World psychiatry》2014,13(1):12-20
An understanding of recovery as a personal and subjective experience has emerged within mental health systems. This meaning of recovery now underpins mental health policy in many countries. Developing a focus on this type of recovery will involve transformation within mental health systems. Human systems do not easily transform. In this paper, we identify seven mis‐uses (“abuses”) of the concept of recovery: recovery is the latest model; recovery does not apply to “my” patients; services can make people recover through effective treatment; compulsory detention and treatment aid recovery; a recovery orientation means closing services; recovery is about making people independent and normal; and contributing to society happens only after the person is recovered. We then identify ten empirically‐validated interventions which support recovery, by targeting key recovery processes of connectedness, hope, identity, meaning and empowerment (the CHIME framework). The ten interventions are peer support workers, advance directives, wellness recovery action planning, illness management and recovery, REFOCUS, strengths model, recovery colleges or recovery education programs, individual placement and support, supported housing, and mental health trialogues. Finally, three scientific challenges are identified: broadening cultural understandings of recovery, implementing organizational transformation, and promoting citizenship. 相似文献
20.
Michael B. First Wolfgang Gaebel Mario Maj Dan J. Stein Cary S. Kogan John B. Saunders Vladimir B. Poznyak Oye Gureje Roberto Lewis‐Fernndez Andreas Maercker Chris R. Brewin Marylene Cloitre Angelica Claudino Kathleen M. Pike Gillian Baird David Skuse Richard B. Krueger Peer Briken Jeffrey D. Burke John E. Lochman Spencer C. Evans Douglas W. Woods Geoffrey M. Reed 《World psychiatry》2021,20(1):34-51