bluuebunny/crossref_metadata_2025 huggingface dataset:
The Royal College of Psychiatrists Physician Associate Inceptorship Programme: Developing Educational Programmes to Support the Integration of This New Role in Psychiatric Services
Authors: Mahajan Pranav , Crimlisk Helen , Kenworthy Chris
Published: June 2022

Aims

Physician associates (PAs) are becoming more commonplace in psychiatric services in the UK to help address long term workforce difficulties. In 2019, the NHS Long Term Plan detailed a commitment to transforming mental health care in England recognising that services were not meeting current or future increase in demand. Health Education England's (HEE) report, Stepping Forward to 2020/21: The Mental Health Workforce Plan for England, described a longer-term strategy to expand the mental health workforce, including recruiting 5,000 people into ‘new roles’ including physician associates. The NHS Mental Health Implementation Plan 2019/20–2023/24 stated an aim of recruiting 140 PAs to the workforce over five years in addition to the requirements specified in the HEE report. HEE and the Royal College of Psychiatrists (RCPsych) have sought to support the integration of PAs into psychiatric teams through the development of the Inceptorship programme. The aim was to develop a bespoke training programme for PAs to bridge the gap between university and working in mental health to be rolled out nationally.

Methods

Since 2018, Sheffield Health and Social Care Trust (SHSC) have been providing an Inceptorship Programme for PAs at the trust. Unlike with trainee doctors, there was no curriculum that could be followed. The programme covers the aetiology, diagnosis and management of common psychiatric problems, communication skills and reflective practice. This programme has provided the basis for the RCPsych Inceptorship Programme supported by HEE.

Results

The SHSC programme has been well received by the 11PAs that have been through the programme, with all PAs recommending other mental health organisations take a similar approach. There have been many additional benefits of the sessions. They allow PAs to gain peer support and it has been a forum to raise issues which often arise when integrating new roles into pre-existing MDTs.

Conclusion

The RCPsych Inceptorship Programme is a PA specific educational programme. It is an important tool in addressing the gap between variable mental health experience as a student (which is limited to a 3-week placement and is variable in content) and working in a psychiatric setting. RCPsych and HEE recommend that all mental health organisations employing PAs implement an inceptorship programme based on the work carried out at SHSC. These should comprise of regular, protected sessions that provide PAs with bespoke mental health training to support their integration into psychiatric multidisciplinary teams. HEE have agreed to provide funding to help organisations facilitate it.
Curriculum Development: A National Curriculum for Physician Associates in Mental Health
Authors: Mahajan Pranav , Crimlisk Helen , Wildbore Ellie , Tatt-Smith Paris , Roth Tony
Published: June 2022

Aims

Physician associates (PAs) are becoming more commonplace in psychiatric services in the UK to help address long term workforce difficulties. The 2019 NHS Long Term Plan detailed a commitment to transforming mental health care in England recognising that services were not meeting current or future increase in demand. Health Education England's (HEE) report, Stepping Forward to 2020/21: The Mental Health Workforce Plan for England, described a longer-term strategy to expand the mental health workforce, including recruiting 5,000 people into ‘new roles’ including physician associates. The NHS Mental Health Implementation Plan 2019/20–2023/243 stated an aim of recruiting 140 PAs to the workforce over five years in addition to the requirements specified in the HEE report. A curriculum for PAs working in mental health would set out the competencies required to work in mental health services.

Methods

The curriculum was developed by the National Collaborating Centre for Mental Health (NCCMH). The work was overseen by an expert reference group, comprising experts in training PAs in mental health, PAs, researchers and experts by experience, all selected for their expertise in research, training and service delivery.

Results

The overarching aims and objectives of the curriculum was to convey a practical understanding of the attitudes, knowledge and skills that underpin the role, thus enabling PAs to offer effective and value-driven support to patients.

The completed curriculum has been arranged into seven modules: Knowledge, Professional/Legal Issues, Engagement and Communication, Diagnostic Assessment and Treatment Planning, Interventions, Managing the Interface of Mental and Physical Health and Team Working. This reflects the expected roles and responsibilities of PAs working in mental health.

Conclusion

HEE and the Royal College of Psychiatrist have recommended all mental health organisations implement an educational programme for new PAs. The curriculum will inform the training requirements for PAs and standardise the training they receive from mental health organisations. It should support the work of PA supervisors and peer coordinators, and those delivering education and training to them. The curriculum will be a dynamic document and work will be needed to adapt it as the role changes, for example with incoming regulation and potential prescribing rights that follow.
An Evaluation of the Impact of Psychiatry-Based High-Fidelity Simulation Training for Undergraduate Medical Students in the West Midlands
Authors: Navaratnarajah Sambavi , Wheeldon Helen , Brickstock Amanda , Barrow Emma
Published: June 2022

Aims

Simulation (sim) is an excellent but underused tool suited to key skills in psychiatry such as communication, managing agitated patients and exploring the mental-physical health interface. Access to complex psychiatric patients has always been challenging and this has been exacerbated by the current COVID-19 pandemic. This has further increased fear amongst students creating another barrier to engaging with psychiatric patients. Our aim of the study was to evaluate the use of simulation within psychiatry as the literature in this field is underrepresented compared to other medical specialities. We hope to advocate its use in future undergraduate training.

Methods

We developed 3 simulated scenarios for fourth year medical students; these involved identifying lithium toxicity and steroid-induced psychosis in ward settings and conducting an A&E risk assessment. The scenarios were developed following feedback from a focus group of foundation doctors on their psychiatry rotations. Data were collected pre- and post-simulation from a cohort of psychiatry students in this academic year. We assessed confidence levels in 7 domains using a 10-point Likert scale and obtained qualitative data to give context to the data collected.

Results

81 and 83 students respectively completed the pre and post questionnaires. Quantitative data found that the student's confidence in all domains improved from pre to post simulation training. For example, confidence in performing a risk assessment improved from M = 4.12 to M = 7.04 and in making a basic management plan from M = 3.43 to M = 6.72. Qualitative data looked at skills gained, empathy and how the scenarios related to clinical practice. Key themes found improvements in de-escalation skills, handing over and self-reflection.

Conclusion

The study supports the evidence that high-fidelity simulation is an important education tool in psychiatry. As facilitators, we feel that confidence scores improved due to the debrief. The standard tool often used is the diamond debrief however we found we had to adapt this model due to fourth year students not having developed sufficient skills to reflect on complex psychiatric scenarios. Therefore, an adjusted debrief was developed featuring technical knowledge and constructive feedback. In the future, we hope to explore the long-term benefits of simulation and its impact on clinical practice.
Balint Group Sessions for Medical Students, a Pilot Study
Authors: Ros Annette , Older Abby , Gaynor Eleanor , Shittu Bayode , Bu Christopher , Sullivan Kathia
Published: June 2022

Aims

Core trainees in psychiatry all complete a year of Balint group sessions. These sessions are invaluable, as improved awareness of our own thoughts and feelings is a crucial part of our development as clinicians. We considered that it may have been helpful to have started these sessions at an earlier stage of medical training, for example, in medical school.

Methods

We approached the University of Liverpool School of Medicine and proposed a pilot Balint programme with 4th year medical students rotating through psychiatry in Cheshire Wirral Partnership Trust.

Sessions were conducted in 4-week blocks, corresponding with the students’ psychiatry rotations. To allow sufficient time for all students to contribute in each hour-long session, groups were limited to a maximum of 7 students. Each group was allocated 2 facilitators and was conducted on Microsoft Teams because of COVID-19-related restrictions. Facilitators had fortnightly supervision with a consultant psychotherapist.

At the end of each 4-week block, anonymous feedback was collected. Small alterations were made to the programme during the course of the pilot in response to attendance rates, punctuality and feedback.

Results

18 (approximately 50%) of the students from the first 3 cohorts submitted feedback:

•

All said the experience helped them reflect more on their interactions with patients and colleagues and improved their insight into how others think/feel in caring for patients.

•

94% said they enjoyed it; they thought they would use the skills they had developed; and they would participate again in future if given the option.

•

83% said 4 sessions was ‘just right’, 11% said ‘not enough’ and 6% said ‘maybe too much’;

•

72% rated their overall experience of the programme as ‘excellent,’ 17% as ‘good,’ 11% as ‘fair’.

Free-text feedback was positive. Students valued the opportunity to reflect on the emotions and interpersonal dynamics experienced in clinical scenarios. Critical feedback was mostly around a preference to have sessions face-to-face and a desire to have more sessions.

As facilitators, the experience has helped us increase our reflective capacity and gain confidence in leading, managing group dynamics and setting boundaries.

Conclusion

Student experience of the Balint programme was positive for the majority. From a facilitator perspective, we found the experience rewarding and beneficial for professional development. Currently only approximately 1/3 students rotate through this trust and can therefore benefit from the sessions. This pilot study provides supporting evidence for extending the scheme to all 4th year Liverpool University medical students.
Learning Needs Assessment of Multidisciplinary Staff Working Within the Memory Assessment Services – Survey Study
Authors: Sameem Hafeesa , Ahmed Raja Adnan
Published: June 2022

Aims

To assess the learning needs of the memory team multidisciplinary (MDT) staff working in South East Wales, in relation to diagnosis of dementia, types of dementia, anti-dementia medications and risk associated with dementia.

Methods

An online anonymised survey was designed and distributed via email among memory team MDT staff of 3 different health boards of the South East Wales area which included Aneurin Bevan University Health Board, Cwm Taf Morgannwg University Health Board and Cardiff and Vale University Health Board.

The survey was designed to gather information about their understanding of the common type of dementia, treatment with medication, indications and cautions related to medications, the potential side effects and risks associated with Dementia. The survey had a mixture of `Likert Scale` format with free text segments where their opinion was sought in their own words.

Results

Twenty-one (21) staff members responded to the survey. The majority (16) were psychiatric nurses, rest were psychologists and support workers.

Thirteen (13) staff members reported they feel confident in identifying subtypes of dementia whereas the rest reported they can benefit from additional knowledge. Majority of staff felt they understood the indications of anti-dementia medication side effects of medications and risks associated with Dementia but do not fully understand the contra-indications and cautions related to anti-dementia medications.

Participants suggested that regular teaching, lectures and updates should be arranged especially targeting the diagnostic criteria, medication and risk assessment. Sessions providing bite-size information on a regular basis to build on their knowledge base were suggested.

Participants also suggested shadowing doctors and consultants in memory clinics as a useful tool to improve their knowledge base.

Conclusion

MDT staff working with memory teams are at the front line of screening, assessments and providing help and treatment to patients and their families. It is important to make sure our staff are equipped with evidence-based accurate knowledge and training.

This survey study indicated that MDT staff working within the memory team appreciate more training and helped identify the specific areas and mode of teaching required.

Prescription of medication may be seen as a doctor's responsibility but we need to ensure our MDT staff has up to date knowledge of types of medications used, their indications, contra-indications, monitoring requirements, and side effects.

Regular teaching, online modules and experience of shadowing with doctor's clinics should be offered to all the MDT staff.
OpenMinds on Mental Health Literacy: A Reflective Journey of a Medical Student
Authors: Selvakumar Jashan , Loo Jiann Lin , Ohn May Honey
Published: June 2022

Aims

As a medical student from a local university, the first author undertook a mental health education course, i.e. OpenMinds at the King's College University. The aim of the course is to improve literacy about key mental health issues that children and adolescents face and the stigma against mental illnesses. Upon completion of training, a medical student will be able to lead intervention workshops to share the mental health knowledge with local school audiences on these issues, promote early detection of mental illnesses among the audiences and their peers with the aim of improving health-seeking behaviour by providing information of where to access help to reduce the duration of untreated illness. This article is aimed to describe the personal reflective experience of a medical student and the lessons learnt.

Methods

The OpenMinds course was an eight-week workshop on important mental health topics such as depression, anxiety, coping strategies and psychosis. This was followed by a session on effective teaching detailing various techniques including maintaining children's concentration, increasing engagement by utilising different learning techniques, safeguarding and maintaining well-being during conversations about difficult and sensitive topics.

Results

After attending the OpenMinds educational workshop, the first author had delivered three workshops (one primary school and two secondary schools) as part of the bigger organising team from the other university. Overall, the verbal feedback from the local schools on the workshops was positive (Kirkpatrick's evaluation outcome level one). The challenge faced was virtual teaching due to the COVID-19 pandemic which meant not being able to read facial expressions or body language while delivering information. This limitation could be mitigated by having a trained teacher moderating the sessions on-site and making sure the workshops ran smoothly. Online lessons emphasised the use of technology which was proven to be useful as videos and other audiovisual aids had the ability to keep the children engaged and provide different sources of learning concurrently.

Conclusion

Having participated in this course, the first author has learned teaching skills and a better way of communicating mental health issues to vulnerable audiences. Although face-to-face workshops are still not possible at the time of writing, the first author is keen to set up an OpenMinds branch at his university and be able to share with his fellow colleagues these skills in the future.
Young Academician Network (YAN) Project: Creating a Sustainable Ecosystem of Training for Early-Career Healthcare Student Researchers
Authors: Loo Jiann Lin , Selvakumar Jashan , Ali Sahar , Ohn May Honey
Published: June 2022

Aims

A lot of healthcare students are interested to have early involvement in research and one of the common obstacles is getting access to a mentor who can help them venture into academic work. Therefore, the Young Academician Network (YAN) project has been conceptualised in November 2020 after an opportunistic email communication between a medical student and a psychiatrist registrar, with the vision of creating a sustainable ecosystem of mentoring in research. This article is aimed to elucidate the journey of the YAN project and the lessons learned after a year.

Methods

The word YAN originates from the Mandarin word for “research”, which is the theme for the project. The mission is to train healthcare student research leaders who will be able to lead their juniors into the field of research. It began with a weekly hourly online meeting between the student and registrar with the agenda of brainstorming research ideas, reflections from the previous meeting, reviewing the progress of tasks, and discussions of topics that were relevant to research. All explored research topics were discussed based on SMART (specific, measurable, achievable, relevant and time-bound) goals to ensure they were feasible since there was no external funding involved.

Results

The YAN project had successfully published one full article in a peer-reviewed journal and two proceedings in an international congress within a year. Meanwhile, there are two ongoing projects with abstracts produced for submission to different international conferences. The lack and restriction of resources led to the promotion of creativity rather than stunted growth of the project. The main challenge of the project was the difficulty in meeting the dateline due to the busy timetable of different members. Other challenges included the difficulty of striking a balance between vision and reality.

Conclusion

As this is a not-for-profit initiative, a high level of motivation is required to keep the project moving forward. Although the number of participants has not grown significantly, this pilot project has at least shown its feasibility without any funding support. There is a plan for further expansion of the project to recruit more members once the foundation of this project has been established with an adequate number of publications. A more structured and systematic evaluation of this project is needed to provide vital information for further improvement of this project.
Recognizing Early Deterioration in Elderly Care Home Setting - a Snapshot
Authors: Varvari Ioana , Nirodi Pratibha
Published: June 2022

Aims

Our aim is to measure the baseline physical and mental health early deterioration recognition of carers in the care home setting in Harrogate, North Yorkshire. This is part of a larger undergoing quality improvement project that looks at improving elderly care in care homes in the region by implementing a training package.

Methods

The approach was to contact local authorities, in this case, the NHS clinical commissioning group North Yorkshire to identify a struggling care home. We then engaged the care home and designated a leader to coordinate the project. We collected common themes by using focus groups with both carers and our professionals which led to the creation of a 16-item questionnaire covering deterioration literacy. Finally, we electronically and anonymously surveyed the carers (December 2021) and analysed the data via Google Forms.

Results

We had 22 responses out of 30 possible. As an overview, 100% felt confident in recognizing deterioration, however, 31.8% don't feel confident in managing deterioration. 90.9% need tools to aid recognition, from which 45.5% find tools confusing. Only 50% feel confident to appropriately escalate the incident, from which 36.4% did not know when or to whom to escalate and 13.6% were not sure if escalation was needed but will refer to secondary care regardless. 27.3% think their escalation process needs improvement. When it comes to deterioration themes, 4.6% don't feel confident in identifying confusion, 13.6% feel their knowledge on confusion could be improved and 9.1% don't know how to identify, manage, or escalate confusion. 22.7% don't feel confident in identifying mobility decline and 9.1% don't know how to manage this accordingly. 9.1% feel like their knowledge of skin changes needs improvement. 22.7% feel that their confidence in identifying toilet habits could be improved and 4.5% don't know how to manage or escalate these changes. In terms of carers’ mental health, 50% and 13.6% have mild and moderate anxiety, respectively.

Conclusion

Deterioration recognition in the elderly is currently a hot topic. Recent studies highlight the need to improve deterioration management to minimize inappropriate referrals and admissions and unnecessary infection exposure of a vulnerable elderly individual. Our results show that besides improving the theoretical knowledge we also must think about a clear escalation process, an easy-to-read deterioration tool, and managing carers' anxiety as part of the training package.
Mental Health Status of High School Students in Khartoum State, Sudan During the COVID-19 Pandemic: A Cross-Sectional Study
Authors: Altamih Randa , Elmahi Osman
Published: June 2022

Aims

This study sought to assess mental health status of high school students in Khartoum State, to evaluate the participants’ adherence to COVID-19 preventive measures and to identify factors associated with commitment to COVID-19 guidelines and mental health status during the COVID-19 pandemic.

Methods

This was a descriptive, cross-sectional and institution-based study. 364 post-primary students in 10 schools were selected by multistage stratified cluster sampling. Mental health status was evaluated using the General Health Questionnaire (GHQ-12). Chi-square testing was used to identify influencing factors of mental health status and commitment to practicing COVID-19 preventive measures.

Results

A median commitment score of 2/5 was achieved. 70.8% of students in this study demonstrated low commitment (< 50%) to practicing COVID-19 preventive guidelines. Commitment to COVID-19 preventive measures was significantly associated with gender (p = 0.047), academic year (p = 0.033) and post-primary schools attended by the participants (p < 0.001). 36.5% of the participants’ GHQ-12 scores demonstrated severe psychological distress (GHQ-12 > 20/36). A mean GHQ-12 score of 18.4 and median of 19 was achieved, indicating moderate to severe psychological distress. GHQ-12 scores were significantly associated with incidence of COVID-19 infection among family members (p = 0.016).

Conclusion

Over one-third of high school students in Khartoum State demonstrated moderate to severe psychological distress as a result of the COVID-19 pandemic, which was significantly associated with first-degree family members having a confirmed COVID-19 diagnosis. Commitment to preventive measures set by the General Directorate of Global Health was significantly associated with gender and academic year. A lesser psychological impact could be achieved through timely health education, expression of confidence in professional healthcare providers and perception of sound health status, together with consistent public health campaigning.
Does the Presence of Psychiatric Symptoms in Adolescents With Special Educational Needs at Certain Time Points in Earlier Life Predict Functional Outcome Later On?
Authors: Bansal Neha , Mizen Lindsay , Stanfield Andrew
Published: June 2022

Aims

This study analyses the progression of psychiatric symptoms over time of young people with special educational needs (SEN). The aims of this study were: 1) To examine whether the presence of psychiatric symptoms in earlier life are more likely to impact functional outcomes in later life in those with SEN; 2) Whether the presence of psychiatric symptoms in adolescence predicts functional outcomes in early adult life.

Methods

Data were obtained from the Edinburgh Study of Comorbidity (ESC) which was a longitudinal follow-up study of adolescents with SEN. This study had ethical approval from the Multicentre Research Ethics Committee for Scotland. It involved head teachers of 99 schools around Scotland identifying pupils aged 13–22 years whom they would estimate as functioning in the borderline to mild intellectual disability range (estimated IQ between 50–80) and were therefore receiving special educational assistance.

Adolescents with SEN were assessed with the Clinical Interview Schedule (CIS) to evaluate the presence of psychiatric symptoms. A total of 247 individuals with SEN were recruited to the study. They completed the CIS at baseline (T1), 1–2 years later (T2) and 6 years later (T3). At T3, the participants also completed the World Health Organisation Disability Assessment Schedule 2.0 (WHO-DAS) to measure the degree of functional impairment. Correlation statistical analyses were carried out to find whether there was a significant relationship between CIS and total WHO-DAS scores.

Results

There was a statistically significant correlation between total WHO-DAS score with slowness and anxiety symptoms (p values 0.008 and 0.024 respectively) measured on the CIS at T1. None of the symptoms measured on CIS at T2 had a statistically significant correlation with total WHO-DAS score. With the symptoms that were significant, after application of a Bonferroni correction, none of the symptoms measured on CIS had a statistically significant correlation at any time point with total WHO-DAS score.

Conclusion

Our results show that there is some evidence that anxiety and slowness in adolescence are associated with greater functional impairment in young adulthood. However, further research is required to confirm this relationship. Our data highlight the potential value of identification and treatment of psychiatric symptoms in early adolescence.
The Effect of the COVID-19 Pandemic on Young People With OCD
Authors: Bennett Sharna
Published: June 2022

Aims

The full impact of the ongoing COVID-19 pandemic is yet to be determined, but it is likely to have had a significant influence on the development of young people, especially those with mental health conditions such as Obsessive Compulsive Disorder (OCD). This study aims to investigate the change in symptoms and whether these were linked to COVID-19/lockdown, as well as the treatment and support received.

Methods

The Mood and Anxiety team for West Kent were contacted to request patients with a diagnosis of OCD. A total of 16 patients were included (12–18 years, 63% female), as they were known to services prior to March 2020. Data were retrospectively collected by searching electronic notes between September 2018 and October 2021 to identify patient demographics, OCD symptoms and severity (and whether this had been affected by COVID-19/lockdown), and if they were receiving medication and therapy. It was noted whether questionnaires had been completed, and how frequently patients were contacted by CAMHS.

Results

75% of young people reported increasing OCD symptoms after March 2020. Of the patients who reported an increase in symptoms, nearly half (47%) explicitly attributed this to either the COVID-19 pandemic or lockdown. Prior to March 2020, 31% of patients were receiving medication for OCD, this increased to 69% of patients between March 2020 and September 2021. 31% of patients were undergoing therapy for OCD prior to March 2020, and over the following 18 months, 50% were receiving therapy, with the remainder of patients on the waiting list. The most common therapy was CBT. Prior to March 2020, 13% of patients had completed questionnaires relevant to OCD, which increased to 44% between March 2020-Septermber 2021. Patients were contacted more frequently via CAMHS post-March 2020 (62.5% vs 25%), but the method of contact switched to mainly remote methods.

Conclusion

Overall, there was an increase in OCD symptoms during the pandemic, with a proportion of patients identifying either COVID-19 or lockdown as contributing factors. The number of patients receiving both psychological and pharmacological therapy for OCD increased. There were low numbers of patients completing questionnaires for OCD, which would be a useful way to identify changes in symptoms across patients. Contact from mental health services increased during the pandemic, although this shifted to virtual formats. This suggests that CAMHS need to prepare for the possible increasing need for services due to the pandemic and provide support targeted to those with OCD.
A Retrospective Analysis of Pattern of Mental Health Problems in COVID-19 Patients in a Tertiary Care Hospital in India
Authors: Thirugnanam Jwalamukhi Chidambaram , Jose Ringhoo Theresa
Published: June 2022

Aims

A. To investigate the nature of liaison psychiatry consultations for COVID-19 patients in a tertiary care hospital in India B. To assess pattern and prevalence of mental health disorders and management, in COVID-19 patients in a tertiary care hospital in India.

Methods

Retrospective chart-based study

Data from medical records of 1600 confirmed COVID-19 patients was studied and charts of 368 patients among that who, during their in-patient stay for COVID-19 treatment in Lourdes Hospital, Kochi (September 2020 - December 2021), received liaison psychiatry consultation was selected for retrospective analysis

Results

Psychiatric consultations were sought for 23%(368) patients with COVID-19 (1600) during the study period. The most common symptoms of mental health problems for referral were sleep disturbance (74.9%), agitation/restlessness, increased tension (50.3%), depressive symptoms like low mood, loss of interest (11.1%) and psychotic symptoms like talking to self, hearing voices, suspiciousness (8%). Liaison psychiatry consultation was most sought-after for critically ill patients (69.2%), with disturbed behaviour as the most common presenting complaint. Psychiatric diagnoses included in the spectrum of delirium (39.3%), sleep disorders (33.3%), anxiety (15.5%), depression (7.1%) and psychosis (4.8%). In terms of psychiatric treatments, 95.9% of patients who received psychiatric consultation were treated with psychotropic medications, including non-benzodiazepine sedative-hypnotic agents (54.8%), anti-psychotic (26.2%), benzodiazepines (22.6%) and antidepressant (10.7%). The symptoms of 61% of patients had improved and they were prescribed medications to continue the treatment on discharge.

Conclusion

A significant proportion of hospitalized COVID-19 patients experienced mental health problems, especially patients in intensive care unit. Data that emerged from this study regarding pattern of mental illness and management options will serve as a template for psychiatrists to liaise with medical teams to treat future patients.
An Explorative Study to Assess the Suicidal Risk Amongst Infertile Patients
Authors: Dastidar Baidyanath Ghosh
Published: June 2022

Aims

To assess the psychosocial impact of infertility amongst female infertile patients including suicidal risk/ suicidal ideation in the given study population.

Methods

A total of 300 women attending the Obstetrics and Gynecology out patients department of a tertiary hospital in Kolkata, India were selected by simple random sampling. 100 fertile women attending the routine ante natal clinic were selected as cases and 100 infertile women seeking fertility treatment were selected as controls. 100 women didn't follow up with the study. The following questionnaires were administered to both case and control group- BAI, BDI, SCL-90-R, SF-36, MINI and socio demographic proforma ; by trained clinic psychologist .

The raw scores & adjusted scores were analysed statistically by SPSS using the following tests, independent t test, chi square test and Z test.

Results

The results of the MINI scale indicate that up to 25% of the infertile cohort suffer from suicidal risk/ suicidal ideation which is statistically significant in comparison to the control group.

The other psychosocial parameters are also statistically significant in the case in comparison to the control population.

Conclusion

Although the psychosocial impact of infertility has been well researched and documented. Few studies have been conducted globally which assess suicidal risk amongst infertile patients.

Our results corroborate earlier studies such as the Danish administrative population-based registry study by Trille Kristina Kjaer et al which found a causative link between infertility and suicidal risk.

Further research is needed in this direction.
An Explorative Study to Assess the Neuropsychiatric Impact of COVID-19
Authors: Dastidar Baidyanath Ghosh
Published: June 2022

Aims

To assess the neurocognitive and psychiatric impact of SARS-CoV-2 in COVID-19 recovered patients in a district COVID hospital in West Bengal, India.

Methods

A total of 300 COVID-19 recovered patients who had suffered from SARS-CoV-2 and admitted at a district COVID hospital in West Bengal were selected by simple random sampling method. Informed consent was obtained from these patients. Subsequently a questionnaire based interview was conducted by trained clinical psychologist. The following scales were administered BDI (Depression), BAI, HAM A(Anxiety), SF 36 (Quality of Life), SCL 90 (Psychopathology), Addenbrooks scale (Neuro Cognitive impairment), socio demographic proforma which included vaccination status, pulmonary involvement and medical interventions.

The data were analysed by SPPS and compared with matched control group and the following statistical tools were used - independent t test, spearman's rho, chi square test, linear regression analyses and z test.

Results

The results of our study do not indicate any statistically significant differences in the psychosocial parameters (depression, anxiety, psychopathology and quality of life) between case and control group.

Neurocognitive deficits not statistically significant in study population.

Delirium experienced during admission process and vascular insult such as stroke significant in case versus control group.

Conclusion

Our study indicates that COVID-19 does not have any significant psychological or neurocognitive impact.

Our study was one of the few interview based studies conducted on COVID recovered patients.

Certain studies collected data from emergency room case records / meta analysis to suggest that COVID-19 may have a psychological sequel in the long term.

Our study and similar interview based studies contradict this hypothesis.
The Effectiveness of Mindfulness-Based Interventions for Anxiety Disorders in Adults: A Systematic Narrative Review
Authors: Harrison Lisa , Umla-Runge Katja , Hassoulas Athanasios
Published: June 2022

Aims

In recent years there has been accelerated clinical interest in Mindfulness based interventions (MBI's) leading to an upswell in research due the impact of its wide clinical application. Mindfulness Based Cognitive Therapy (MBCT) and Acceptance and Commitment Therapy (ACT) have recently been investigated for the beneficial treatment of anxiety-based disorders in adults. The aim of the current review was to appraise and synthesise findings of studies published within the last decade, in determining the efficacy of MBCT and ACT in treating anxiety disorders in adults, given gaps identified in the existing literature.

Methods

Scoping searches were conducted using MEDLINE, PsycINFO, Emcare, and Cochrane databases. The Synthesis Without Meta-analysis protocol (SWiM) was adopted for this review, in evaluating the efficacy of MBCT and ACT for anxiety disorders in adults. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Standards.

Results

The results of this review suggest that MBCT and ACT are effective therapeutic modalities in improving anxiety in adult populations. The results are, however, tentative. Whilst both MBI's show promise in the treatment of anxiety disorders, with the paucity of existing systematic reviews and methodological flaws within overall primary study design, the results should be interpreted with caution.

Conclusion

The overall therapeutic effectiveness of MBI's has been assessed and the general data support its efficacy. However, a judicious approach is required as results continue to remain inconclusive grounded in the totality of the evidence.

The current review revealed the ongoing methodological concerns encountered in determining the comparative effectiveness of MBCT and ACT for anxiety disorders in adults. Due to the current limited number of comparative studies of mindfulness based with mindfulness informed interventions, it could be suggested that a lack of systematic research is slowly influencing a collective understanding of MBI's being a homogenous group of treatments. The lack of delineation can have an impact on research, clinical practice and policy making. Further high quality research is required to continue to bridge the science practice gap. Without depth of understandings associated with the mechanisms of change and the impact that contextual aspects have on the outcome effectiveness, there are significant implications for practice and patient care. It is of importance that the adaptation and subsequent developments in clinical practice do not outpace the research base to fully understand the mechanisms that make each MBI effective, for which population and diagnoses.
“The Stress of the Situation”: How Do Compounding Experiences of Oppression Impact Emotional Distress Among a Diverse Sample of Internally Displaced People in Colombia?
Authors: Kerrigan Rachel , Burgess Rochelle , Fonseca Laura
Published: June 2022

Aims

Addressing the mental health needs of Internally Displaced People (IDPs) in Colombia has been identified as a public health priority. Women and disabled IDPs are recognised as under-researched populations, with differences in vulnerabilities to displacement and resettlement prospects. This thematic network analysis employs an intersectional approach to consider how compounding experiences of oppression impact emotional distress among IDPs to enable informed and appropriate service provision.

Methods

This is a qualitative analysis of a subset of data collected by the second author and her research team in 2017–18, as part of a larger action research project. Participants were randomly selected from the Victim's register in an industrialised municipality of Colombia. A subsample (n = 20) were invited to participate in life and family histories. Units of analysis were individual (n = 11) and family interviews (n = 9), with a mixture of self-identifying disabled and non-disabled men and women. River and tree of life tools were used to elicit culturally sensitive discussion of significant life events and ongoing distress. NVivo software and hand coding techniques were used to operationalise thematic webs. The analysis employed a grounded approach to thematic network analysis.

Results

Three global themes, each underpinned by several organisational themes, were developed. The first, Environments and contexts of displacement, considers the loss of land and community alongside the myriad of social institutions, legal entitlements, family circumstances, cultural expectations and stigma influencing participants' access to resources. The second, Making sense of it all, represents the emotional and cognitive responses to perceived injustices and eroded trust. The third, Mechanisms for managing distress, represents strategies employed by IDPs at individual and family levels. Relationships between employment status and gendered divisions of labour were noted, suggesting that non-disabled women were able to meet increased domestic and paid work demands following displacement, though this was a considerable source of stress. Concepts around racial, indigenous and class identities were alluded to by several participants but could not be fully developed due to relative scarcity of accounts within the dataset.

Conclusion

The thematic networks presented illustrate several compounding and interrelated oppressions faced by IDPs, offering explanation as to how this produces and sustains emotional distress. Participants’ well-founded worries about economic security and childcare alongside concerns for safety and acceptance in host communities require co-ordinated, locally informed responses. Prevention and recovery programmes should consider interventions at a family level, whilst strengthening participants’ self-developed strategies for managing distress.
Insight Into Illness Among Inpatients in a Forensic Service - a Study From Dundrum Hospital as Part of the Dforest Study
Authors: Murray Sean , Davoren Mary , Kennedy Harry
Published: June 2022

Aims

We endeavoured to ascertain if using a specific tool rating insight adds benefit over and above the insight ratings on violence risk assessment or recovery based tools currently in use and to see if they may be helpful in guiding clinical decision making.

Methods

A cross sectional study of 104 forensic in-patients was completed. All current inpatients were rated for self-rated and clinician-rated insight using the VAGUS tool, a validated and reliable measure of insight into psychotic symptoms. All participants completed the self-rated scale independent of the clinician to avoid bias. Patients were also rated with the HCR-20, the Dundrum-3 and Dundrum-4, and the PANSS measures. Patients’ scores on the VAGUS tool and the other tools were compared to ascertain if any correlations could be identified.

Results

Higher scores on the VAGUS tool were associated with a greater degree of insight into psychotic symptoms. Clinician and self-ratings of insight on the VAGUS tool were different from but complimentary to the ratings for insight on the HCR-20 (r = 0.480, p = <0.001), the DUNDRUM-3 (r = 0.491, p = <0.001) and DUNDRUM-4 (r = 0.265, p = 0.041). An inverse relationship between the VAGUS scores and the scores on the PANSS measures (r = 0.452, p = <0.001) was found, correlating lower levels of insight with a higher degree of positive and negative psychotic symptoms. There was also a correlation between greater insight and progress through the care pathway to lower secure wards.

Conclusion

Using a specific tool to rate insight adds benefit over and above the insight ratings on other tools currently in use and may be helpful in guiding clinical decision making in the forensic setting.
Moroccans’ Perception of Addiction: A Cross-Sectional Study on Stigma and Familiarity Dynamics
Authors: M'hamdi Ibrahim , Harbil Afaf , Bensaid Abdessamad , Benchekroun Omar
Published: June 2022

Aims

This study aims to assess the stigmatization of Moroccans towards substance and nonsubstance addictions, as well as to explore its relationship with both demographic factors and addiction familiarity.

Methods

527 Moroccans anonymously participated in a cross-sectional study via an online survey that was distributed on social media. Participants were randomly assigned 2 vignettes describing either substance (Alcohol and Cannabis) or non-substance (Gambling and Social Media) addictions, followed by the Social Distance Scale and the Familiarity Scale.

Results

A total of 527 individuals answered our online questionnaire. The median age of respondents was 27.6 years (std = 15.66). 56% were females and 44% were males. Among the participants 45% were married and 50% were medical students or health professionals.

Using ANOVA and a series of student t-tests, that yielded a p < 0.05, the following results were obtained:

A moderate level of stigma was found towards all addictions, except for social media where no stigma was found (p < 0.05). In contrast, the familiarity level was high with social media addiction and low with the other addictions (p < 0.05).

The women in our study showed higher stigmatization of all addictions, whereas older people (>43 years) showed higher stigmatization of substance addictions only.

Different levels of stigmatization were observed towards the 4 types of addiction; the highest being cannabis addiction and the lowest being social media addiction.

Regarding familiarity with addiction, males were more familiar with all types of addiction. Whereas, younger individuals (<23 years) were the least familiar with substance addiction.

Moroccans’ familiarity levels with different types of addiction were significantly different. Familiarity with social media addiction was the highest whereas familiarity with gambling addiction was the lowest.

Using the Pearson correlation, we found that stigma and familiarity concerning substance addiction were negatively correlated (r=−0,30, p < 0.01). A stronger, yet moderate relationship was found between stigma and familiarity regarding cannabis (r=−0,36, p < 0.01).

Conclusion

It seems that Moroccans stigmatize against most addictions, which was found to be influenced by multiple factors including familiarity level, age, and sex. These findings can be used as a base to create a targeted educational campaign to tackle addiction in our society. No significant conclusions were made concerning whether or not the academic level or the health professional background influenced stigmatization, which raises concerns about the Moroccan academic and medical curricula's representation of addiction.