bluuebunny/crossref_metadata_2025 huggingface dataset:
The Biotechnology Revolution: A Primer for Pharmacists
Authors: Tolstoi Linda G. , Smith Cassandra L.
Published: January 2018

The Human Genome Project, an international effort, is ushering in an era of molecular medicine with newer and better approaches to the prevention, diagnosis, and treatment of human genetic diseases. Biotechnology, or genetic engineering, can be defined as the alteration of cells or biological molecules for specific applications. Biotechnology has contributed — and will contribute — to many major medical advances. To respond to the biotechnology revolution in health care, pharmacists must become familiar with this new field. With a state-of-the-art understanding of disease processes and drug effects, pharmacists will be ideally prepared to educate patients about disease states and the roles of old and new drugs in treatment plans.
Septra RS?
Authors: Dunn Eddie B. , Wolfe Jonathan J.
Published: January 2018

Hospital Pharmacy welcomes contributions to this column. Articles originally published in pharmacy department newsletters are reprinted here. Material is selected because of its educational value to pharmacists or because it demonstrates the type of information of interest to newsletter readers. If you wish to have your newsletter material considered for publication in this column, mail a copy—along with a computer disk containing the document—to Neil M. Davis, Editor-in-Chief, Hospital Pharmacy, 1143 Wright Drive, Huntingdon Valley, PA 19006-2721.
The organisation of mental health services in post-war Bosnia and Herzegovina
Authors: Sinanovic Osman , Avdibegovic Esmina , Hasanovic Mevludin , Pajevic Izet , Sutovic Alija , Loga Slobodan , Ceric Ismet
Published: January 2018

Bosnia and Herzegovina (BH) is located on the western part of the Balkan Peninsula. It has an area of 51 210 km2 and a population of 3 972 000. According to the Dayton Agreement of November 1995, which ended the 1992-95 war, BH comprises two ‘entities’ - the Federation of Bosnia and Herzegovina (FBH) and the Republic of Srpska (RS) - and the District of Brcko. The administrative arrangements for the management and financing of mental health services reflect this. The FBH, with 2 325 018 residents, is a federation of 10 cantons, which have equal rights and responsibilities. The RS has 1 487 785 residents and, in contrast, a centralised administration. Brcko District has just under 80 000 residents.
Peru: mental health in a complex country
Authors: Rondon Marta B.
Published: January 2018

Peru is a land of mixed cultures, multiple ethnic heritages and severe economic inequities. Its history goes back thousands of years, from accounts of the first inhabitants of the continent to the impressive Inca Empire, the rich Viceroyalty of Peru and the modern republic, which boasts one of the highest economic growth rates in South America. Yet, in spite of such complex cultural development, or perhaps because of it, 21st-century Peruvians have substantial difficulties establishing a national identity and recognising each other as members of the same community.
Chronic poverty, wars and mental health: the East African perspective
Authors: Kigozi Fred , Ssebunnya Joshua
Published: January 2018

Globally, poverty has been noted to be a high risk factor for mental disorder. Although there is limited information on the baseline prevalence of mental disorders in low- and middle-income countries, the known risk factors for poor mental health, such as poverty and violence, afflict many of these areas (Miller, 2006). It is clear that poverty and the mental health consequences of war and displacement significantly hinder the achievement of the Millennium Development Goals (Njenga et al, 2006).
Mental health in Zambia - challenges and way forward
Authors: Ngungu Jedrin , Beezhold Julian
Published: January 2018

Zambia, previously called Northern Rhodesia, was a colony of Great Britain until 1964, when it gained independence and changed its name. It is a landlocked country located in southern Africa and shares its borders with Zimbabwe, Namibia, Botswana, Mozambique, Malawi, Tanzania, Congo and Angola. It has an area of 752 612 km2, about three times the size of Britain, but a population of only 12 million.
The relationship between socio-economic status and mental health funding, service provision and national policy: a cross-national study
Authors: Shah Ajit
Published: January 2018

A recent editorial in International Psychiatry (Cox, 2008) described the importance of a new initiative by the Lancet (Horton, 2007) to promote the development and delivery of mental health services and treatments in low-and middle-income countries (LMICs). This initiative was supported by a series of outstanding papers (Chisholm et al, 2007; Jacob et al, 2007; Patel et al, 2007; Saraceno et al, 2007; Saxena et al, 2007).
Mental health services in Mexico
Authors: Berenzon Shoshana , Sentíes Héctor , Medina-Mora Elena
Published: January 2018

Mexico is a culturally, socially and economically heterogeneous country, with a population of over 100 million. Although it is regarded as a country with a medium–high income according to World Bank criteria, inequality continues to be one of its main problems. In addition to this, the country is going through a difficult period. Large parts of the population face economic insecurity, as a result of which feelings of despair, fear and impotence are common. It is hardly surprising, then, that mental disorders should constitute a major public health problem: depression is the main cause of loss of healthy years of life (6.4% of the population suffer from it), while alcohol misuse is the 9th (2.5%) and schizophrenia the 10th (2.1%) most common health problem (González-Pier et al, 2006).
Author's reply
Authors: Zigmond Tony
Published: January 2018

Sir: I am a little surprised by Professor Sugarman's letter, as my editorial does not condemn, categorically or otherwise, the detention of people who are competent but mentally ill. Furthermore, I am not aware (I accept this may be my ignorance) of any country having a law which permits treatment of, to use Professor Sugarman's example, infectious diseases, in the face of capacitous refusal (my editorial refers, at this point, to treatment rather than detention). It is certainly not permitted in England and Wales.
Increasing rates of suicide across cultures
Authors: Skuse David
Published: January 2018

Suicide, especially among young people, appears to be increasing in prevalence in diverse countries and cultures. The reasons for this worrying trend remain obscure. Here we present commentaries on suicidal trends in three countries.
Perspectives on suicide in Africa
Authors: Ndosi N. K.
Published: January 2018

Suicide is a serious worldwide health problem, particularly among youths. It is defined as the intentional act of killing oneself. Analytically, the suicidal act entails: the wish to kill, the wish to be killed and the wish to die. People who die by suicide know what they are doing and are aware of the consequences of their actions. A completed suicidal act is a complex phenomenon associated with psychological, biological and social factors. It follows severe exhaustion under a continuing assault of stressors when the suicidal individual is no longer able to cope with and to restore homeostasis. In order to categorise a case as a suicide, legal authorities demand unequivocal evidence of intent.
Alcohol misuse among young people
Authors: Skuse David
Published: January 2018

Recently, the UK government expressed concern about the rising tide of antisocial behaviour among young people who, in certain areas of the country, were habitually engaging in acts of minor delinquency – often fuelled by drink. On the other hand, legislation was introduced to make it legal for premises that sell alcohol to remain open longer, up to 24 hours a day. This latter arrangement has courted considerable controversy. For example, the British Medical Association commented that any extension to licensing hours requires a programme of research, after its introduction, to look at its health consequences - both acute and chronic.
Alcohol: younger people's favourite substance
Authors: Bailey Sue , Williams Richard
Published: January 2018

On 10 January 2006, ITV2, a UK television channel, ran a 90-minute programme calledBritain's Youngest Boozers.It claimed that one in three younger people are binge drinkers and that one in six is dependent on alcohol. The comments in interviews with adolescents and families were stark and worrying. Although the age parameters were not clear at the start of the programme, it focused on those aged up to 25 years and presented enormously serious concerns about the changed patterns of drinking among Britain's younger people.
Psychiatry in Afghanistan
Authors: Ventevogel Peter , Nassery Ruhullah , Azimi Sayed , Faiz Hafizullah
Published: January 2018

Afghanistan's historic strategic position between the great civilisations of India, Persia and Central Asia has made it from the very beginning both a crossroads for trade and cultural exchange and an almost continuous battlefield. In the years since the Soviet invasion in 1979 the country has become the stage of an ongoing complex humanitarian emergency. The period of Soviet occupation was characterised by massive human rights violations. The Soviet army and its allies were involved in indiscriminate bombardments and targeted executions, while themujahedeenwere involved in guerrilla warfare. The USSR was forced to withdraw in 1989 and the remnants of Afghanistan's communist regime were defeated in 1992.
Profile of psychiatry in Japan
Authors: Akiyama Tsuyoshi
Published: January 2018

During the Edo period in Japan (1603–1867), people with mental illness were not excluded from society. Upon the introduction of European psychiatry around the 1870s, Japanese society became more discriminatory, however. In 1900 a primary law was introduced to regulate the custody of patients. In 1919 another law was approved to facilitate the establishment of public psychiatric hospitals. In 1950 the Mental Hygiene Law was enacted to prohibit home custody. However, these regulations did not assure quality of care or protect service users' rights. Also, after the Second World War, many private psychiatric hospitals were built, but this expansion of the sector was not well thought out or well coordinated. In Japan, the government regulates the private health sector only insofar as it sets standardised fees for treatments and carries out basic quality assurance.
Social aspects of ethno-psychopharmacology: an Arab perspective
Authors: Okasha Tarek A.
Published: January 2018

Some 7000 years ago Egyptians believed in one God, the after-world and that our worldly deeds would be balanced in the day of judgement. This led James Breasted to consider that the emergence of Egyptian culture marked the dawn of conscience (Breasted, 1934; Okasha & Okasha, 2000).
Migration and mental health in Canada: can government policy help?
Authors: Kisely Stephen
Published: January 2018

Canada admits more than 220 000 immigrants every year and this is reflected in the statistic that 18% of the population was born abroad (Beiser, 2005). However, government policy emphasises the admission of healthy immigrants rather than their subsequent health. Immigrants do not show a consistently elevated rate of psychiatric illness, and morbidity is related to an interaction between predisposition and socio-environmental factors, rather than immigrationper se. These factors include forced migration and circumstances after arrival, such as poverty, limited recognition of qualifications, discrimination and isolation from the immigrant's own community. For instance, in Canada more than 30% of immigrant families live below the official poverty line in the first 10 years of settlement (Beiser, 2005).
Worldviews
Authors: Gray Alison J.
Published: January 2018

Common human questions include ‘Why are we here?’ and ‘How should we live?’ The search for meaning, purpose and values is fundamental to most religions and philosophies. In the UK these views used to be derived from a shared Judaeo-Christian faith. People defined themselves as accepting or rebelling against the faith community. In postmodern times we no longer trust in meta-narrative and there is no consensus on how to deal with existential issues, nor on how to label and map the territory; some would deny that the territory even exists.
Psychiatrists are stakeholders in improving access to controlled medicines
Authors: Scholten Willem
Published: January 2018

Medicines made from substances that are controlled under the international drug control treaties (‘controlled medicines’) are out of reach for the majority of patients around the world. Seya et al (2011) demonstrated that 5.5 billion people (83% of the world's population) live in countries with little or no access to opioid analgesics, 250 million (4%) have moderate access and only 460 million people (7%) have adequate access. Insufficient data are available for 430 million (7%). If the need for treatment of moderate to severe pain were to be satisfied adequately, the global consumption of strong opioid analgesics would go up from 231 tonnes of morphine-equivalents to 1292 tonnes.
Mental health legislation in Nigeria: current leanings and future yearnings
Authors: Ogunlesi Adegboyega O. , Ogunwale Adegboyega
Published: January 2018

Nigeria's current mental health legislation stems from a lunacy ordinance enacted in 1916 that assumed the status of a law in 1958. The most recent attempt to reform the law was with an unsuccessful Mental Health Bill in 2003. Currently, though, efforts are being made to represent it as an executive Bill sponsored by the Federal Ministry of Health. The present paper reviews this Bill, in particular in light of the World Health Organization's recommendations on mental health legislation.
Self-burning in Iraqi Kurdistan: proportion and risk factors in a burns unit
Authors: Mohammad Amin Nazar M. , Hamah Ameen Nashmeel Rasool , Abed Reem , Abbas Mohammed
Published: January 2018

To determine the rate of self-burning among all burns patients admitted to the Burns and Plastic Surgery Centre at Sulaimani University in Iraqi Kurdistan and to identify the risk factors and motives, all burns patients, aged 8 years and over, admitted between 1 September 2009 and 30 April 2010 were surveyed. Of the 200 patients interviewed, 54 (27%) reported self-burns and 146 (73%) reported accidental burns. The risk factors for self-burning included mental illness, female gender and younger age. Almost two-thirds of those who reported self-burns (32, 60.4%) had intended to kill themselves. The most commonly cited reasons for the act were family problems (24, 44%) and marital problems (13, 24%). Burns in the self-burning group were more severe and were associated with a higher mortality rate (34, 63%) than in the accidental burns group (29, 20%).
Non-communicable diseases and the mental health gap: what is to be done?
Authors: Ganju Vijay
Published: January 2018

The increasing evidence base for cost-effective interventions and a fledgling advocacy effort have given momentum to mental health becoming a global priority. The contention of this editorial is that we are at a tipping point if we can exploit the opportunities that will be afforded to mental health professionals and advocates in the next year or two. The missing links are the development of consensus among mental health stakeholders, the formation of coalitions and partnerships with both advocates and policy-makers, and the mobilisation of a stronger advocacy effort built around consumer and family member ‘voice’ and empowerment.
Scaling up in Europe: learning from diversity
Authors: Muijen Matt
Published: January 2018

Over the past decade, attention has increasingly focused on the need to increase the capacity of mental health services. The World Health Report 2001 – Mental Health: New Understanding, New Hope (World Health Organization, 2001) set the agenda, advocating the development of community-based mental health services. The case for scaling up, inspired by the World Health Organization's vision of ‘no health without mental health’, was powerfully argued first in the Lancet series in 2007 (Prince et al, 2007) and again in the Lancet in 2011 (Eaton et al, 2011). The forthcoming Global Mental Health Action Plan, requested in a resolution by member states of the World Health Organization at the 2012 World Health Assembly, is a great opportunity to formulate objectives and targets for countries, and to analyse experiences from around the world. The forthcoming European Action Plan builds on this, customising actions for European countries.
Global representation in psychiatric research
Authors: Zhang Michael , Hedges Dawson W. , Brown Bruce L.
Published: January 2018

To monitor global representation in the psychiatric literature, we compared publication rates in the ten psychiatric journals with the highest impact factors in 1998 and 2008 by world regions. In both 1998 and 2008, North America, Northern Europe, Western Europe and Oceania produced the majority of psychiatric research papers published in these journals, despite representing only a small fraction of the world's population. This suggests that much of the world's population continues to be underrepresented in highly influential psychiatric journals.
Using the lever of parity of esteem between mental and physical health to close the mental health gap -a call for action
Authors: Bailey Sue , Thorpe Lucy , Smith Greg
Published: January 2018

This paper provides a six-point definition of what parity of esteem for mental health means in practice. It highlights examples of the current disparity between mental and physical health and the importance of redressing this. The significance of securing a legislative basis for parity in England is discussed. The authors make a call for action, and pose six questions for international readers to consider and respond to.
Risk-taking, revictimisation and perpetration of sexual violence in ten southern African countries
Authors: Andersson Neil
Published: January 2018

This paper reports the results of a cross-sectional survey of 11- to 16-year-old school-going youths in ten southern African countries. The survey instrument recorded both the experience of coerced sex and the perpetration of forced sex. There were prominent school and community risk factors for increased risk-taking behaviours, revictimisation and the perpetration of sexual violence. This supports the idea that the local culture can reinforce the antisocial consequences of sexual abuse of boys and girls. There was a suggestion that the school environment can compound the effects of child sexual abuse in terms of conscious knowledge, high-risk behaviour, the risk of revictimisation and disdain for the safety of others.
Mental health law in Qatar
Authors: Abou-Saleh Mohammed T. , Ibrahim Mohamed Abdelalaim
Published: January 2018

This article provides a brief outline of mental health services in Qatar, historical notes on the use of informal traditional conventions under common law for the care under compulsory conditions of people who are mentally ill and information on the ongoing development of the Mental Health Law and its key provisions in the context of the new National Mental Health Strategy.
Mental health in Latin America and the Caribbean
Authors: Rodriguez Jorge J.
Published: January 2018

Mental illnesses are a growing health problem and reducing the treatment gap in Latin America and the Caribbean is a great challenge. Evaluations conducted by the Pan American Health Organization (PAHO) and World Health Organization (WHO) have shown that the responsiveness of health services is still limited. Nonetheless, from an evaluation of how mental health reform has progressed in the region following the historical benchmark of the Caracas Declaration (1990), it is clear that – despite the limitations, shortcomings and challenges – significant progress has been made in most countries. This paper briefly reviews this progress.
Mental health reform in Fiji and opportunities for training assistance
Authors: Deva M. Parameshvara
Published: January 2018

Fiji inherited a British colonial healthcare system. In 2010 the long dormant mental health law was replaced by the Mental Health Decree (MHD), which set up divisional mental health units for the purpose of managing mental health problems outside of the old asylum. The Ministry of Health recruited an overseas consultant to help improve training. Under the MHD, stress management wards, stress management clinics and stress management day centres have been set up, to decentralise and deinstitutionalise psychiatric care. These are on the whole doing reasonably well and have good client acceptance.
The draft Mental Health Act in Sudan
Authors: Saeed Mahmoud , Sultan Saoud , Ali Abdelazim
Published: January 2018

At a workshop in 2012 in Khartoum, attended by Sudanese psychiatrists based in both the UK and Sudan, as well as psychologists, social workers and lawyers from Sudan and elsewhere, a draft Mental Health Act for Sudan was approved; it is due to be submitted to the Sudanese Parliament. We give a summary of the draft Act and outline some of the areas that need further discussion.
Medical and nursing students' attitudes to people with mental illness in Nigeria: a tale of two teaching hospitals
Authors: Iheanacho Theddeus , Stefanovics Elina , Makanjuola Victor , Marienfeld Carla , Rosenheck Robert
Published: January 2018

This study compared beliefs about and attitudes to mental illness among medical and nursing students at two teaching hospitals in Nigeria with very different levels of psychiatric instructional capacity. Factor analysis of responses to a 43-item self-report questionnaire identified three domains: social acceptance of people with mental illness; belief in non-superstitious causation of mental illness; and stress, trauma and poverty as external causes of mental illness, with entitlement to employment rights. Students at the hospital with a larger, functioning psychiatry department had significantly higher scores on all three factors. Culturally enshrined beliefs and attitudes about mental illness are not uncommon among medical trainees. The availability of psychiatric education and services may have a positive effect on beliefs and attitudes.
Prisoner mental health in the USA
Authors: Bark Nigel
Published: January 2018

The mental health of prisoners in the USA is affected by American history: Dorothea Dix's 1830s campaign; the Civil War and slavery; presidential interventions; the Great Depression; and the introduction of Medicaid and the Affordable Care Act. In 1934, the ratio of prisoners to mental hospital patients was 0.4; now, it is 3:1, with states varying from 10:1 to 1:1. Those states with the highest ratios also have the highest rates of imprisonment and the lowest expenditures on mental health. Litigation is likely to improve mental health services in prisons and to keep people who are mentally ill out of prisons.
A novel prison mental health in-reach service in Somaliland: a model for low-income countries?
Authors: Handuleh Jibril I. M. , Mclvor Ronan J.
Published: January 2018

Prison in-reach mental health services are reasonably well developed in advanced economies, but virtually nonexistent in low-and middle-income countries. We describe the development of a small prison in-reach project in Somaliland, a self-declared independent state which has experienced conflict and poverty in equal measure. After careful planning and cooperation with local agencies, the service provides sessional input to a regional prison, including assessment and treatment of a wide range of psychiatric conditions. The project has had some unexpected benefits, which are described. The success of the project reflects the effectiveness of collaboration between local stakeholders and international agencies, and could be used as a model for the development of in-reach services in other low-income countries.
Is there a resumption of political psychiatry in the former Soviet Union?
Authors: van Voren Robert
Published: January 2018

After the outbreak of the Ukrainian crisis in the spring of 2014, the former Soviet Union again became front-page news. The sequence of events led to an atmosphere reminiscent of the Cold War. In Russia itself it led to a hunt for ‘national traitors’ and ‘foreign agents’ and observers both inside the country and abroad fear a return to Soviet-style repression. For the outside world this may come as a surprise, but human rights activists have been ringing the alarm bells for a few years. Ever since Vladimir Putin took power, the human rights situation has deteriorated. One of the warning signs was the return of the use of psychiatry for political purposes, to ‘prevent’ social or political activism or to ostracise an activist.
The mental health of military veterans in the UK
Authors: Burdett Howard , Greenberg Neil , Fear Nicola T. , Jones Norman
Published: January 2018

Risk factors for poor mental health among UK veterans include demonstrating symptoms while in service, being unmarried, holding lower rank, experiencing childhood adversity and having a combat role; however, deploy ment to a combat zone does not appear to be associated with mental health outcomes. While presentation of late-onset, post-service difficulties may explain some of the difference between veterans and those in service, delayed-onset post-traumatic stress disorder (PTSD) appears to be partly explained by prior subthreshold PTSD, as well as other mental health difficulties. In the longer term, veterans do not appear to suffer worse mental health than equivalent civilians. This overall lack of difference, despite increased mental health difficulties in those who have recently left, suggests that veterans are not at risk of worse mental health and/or that poor mental health is a cause, rather than a consequence, of leaving service.
Psychiatry in the Republic of Belarus
Authors: Golubeva Natallia , Naudts Kris , Gibbs Ayana , Evsegneev Roman , Holubeu Siarhei
Published: January 2018

The Republic of Belarus (ROB) covers 207 600 km2 and has a population of about 10 million (Ministry of Statistics and Analysis, 2005). It was a member state of the former Soviet Union until it gained independence in 1991. Belarus is located between Poland, Lithuania and Latvia in the west, Russia in the east, and Ukraine in the south. Seventy-two per cent of the population live in an urban environment and 28% in rural areas. The average life span for men is 63 years and for women 75 years (Ministry of Public Health, 2005).
Psychiatry in the Sultanate of Oman
Authors: Al-Sinawi Hamed , Al-Adawi Samir
Published: January 2018

The Sultanate of Oman is located in the south-east of the Arabian Peninsula. It has a distinctive history and subcultures. Its seafaring tradition has endowed the country with various ethnic and linguistic groups, with Arabic being a dominant language and Ibadhi being the dominant sect of Islam (Al-Nami, 1971). Oman in the 1970s saw rapid development, triggered by the discovery of oil, which took place under enlightened new political leadership.
Sudanese refugees: sufferings and suggested management
Authors: Loza Nasser , Hasan Nael
Published: January 2018

Egypt and the Sudan have historically provided a continuum of social and cultural exchange. With the Nile valley providing the only route between the Mediterranean and sub-Saharan Africa, Egypt became the natural host for Sudanese refugees.
Traditional healers in East Africa
Authors: Ndetei David M.
Published: January 2018

Since time immemorial, people from East Africa, and beyond, depended on traditional healers for treatment of all types of disorders, including those related to mental health. Even today, the use of traditional healers is common, despite the introduction of modern drugs. Alternative medicine is growing fast all over the world.
European service perspectives for people with intellectual disabilities and mental health problems
Authors: Holt Geraldine , Costello Helen , Bouras Nick
Published: January 2018

Services for people with intellectual disabilities, in the UK as elsewhere, have changed dramatically over the last 30 years; deinstitutionalisation has probably been the largest experiment in social policy in our time. The vast majority of people with intellectual disabilities, their families and carers have benefited from having a better quality of life as a result of deinstitutionalisation. However, much still needs to be done to integrate this population more into society and to ensure they are offered the appropriate supports to meet their needs.
A re-evaluation of the yield from national surveys of mental health
Authors: Kessler Ronald C. , Üstün T. Bedirhan
Published: January 2018

Having spent a considerable amount of time thinking about the uses of large-scale descriptive psychiatric epidemiological needs assessment surveys in our capacity as co-directors of the World Health Organization's World Mental Health Survey Initiative, we agree with many of the conclusions of Henderson and Andrews. Most importantly, we agree:

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that among the most important benefits of these surveys have been their political value in documenting high prevalence and high disability

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that the time has come to expand the focus to study causes.
Cultural psychiatry, diversity and political correctness in a shrinking world
Authors: Cox John L.
Published: January 2018

It is perhaps unusual for an academic journal like the Lancet to spearhead a ‘movement’ to advocate the scaling up of mental health services in low-income countries. Yet at the movement's launch in London in November 2007, attended by representatives from World Health Organization (WHO), the World Bank, donor agencies, as well as the World Psychiatric Association (WPA) and the Royal College of Psychiatrists, it was clear that a seminal series of papers, published in September of last year, was of the utmost importance for world psychiatry and for our planet. The five papers in the series ‘Global Mental Health’ had the following titles: ‘No health without mental health’; ‘Resources for mental health: scarcity, equity, and inefficiency’; ‘Treatment and prevention of mental disorders in low-income and middle-income countries’; ‘Mental health systems in countries: where are we now?’; and ‘Barriers to improvement of mental health services in low-income and middle-income countries’ (Lancet, September 2007, vol. 370, nos 9590–9593).
Mental health services in sub-Saharan Africa
Authors: Skuse David
Published: January 2018

Within the continent of Africa, mental health services are relatively undeveloped. In the sub-Saharan countries of Malawi, Kenya and Nigeria, similar problems are faced by dedicated psychiatrists who are struggling to create and sustain an educational, management and political structure for psychiatry.
Psychiatry in Brunei Darussalam
Authors: Sabri Reehan , Kudlebbai Ajmal-Khan
Published: January 2018

Brunei Darussalam occupies a sliver of land on the northwest coast of the island of Borneo with a geographical area of just 5765 km2 (Government of Brunei, 2004). It is divided into the four districts: Brunei-Muara, Temburong, Tutong and Belait. Two-thirds of the land is covered by lush tropical rainforest and the climate is perpetually warm and humid. It is ruled by Sultan Hassan Al-Bolkiah, the head of a dynasty which has governed Brunei for 650 years.
Nepal: trying to reach out to the community
Authors: Shyangwa Pramod M. , Jha Arun
Published: January 2018

Sandwiched between India and China, Nepal is a small landlocked lower-middle-income country in South Asia. Once a peaceful country, it is striving to overcome the legacy of a 10-year Maoist rebellion, a royal massacre and continuing political chaos. Nepal has been in dispute with neighbouring Bhutan over the repatriation of hundreds of thousands of refugees in several camps in Nepal. In addition, the country experiences frequent natural disasters (floods and landslides) and faces several environmental challenges, including deforestation and a population explosion in southern Nepal.
A longitudinal study of psychosocial adjustment and community reintegration among former child soldiers in Sierra Leone
Authors: Betancourt Theresa S.
Published: January 2018

The forceful conscription of children (both boys and girls) into armed forces has been documented in at least 86 countries (Coalition to Stop the Use of Child Soldiers, 2008). Research suggests that these children may be at heightened risk of psychological and social problems (Wessells, 2009; Blattman & Annan, 2010). However, there is little information on the long-term effects of child soldiers' wartime experiences.
Perceptions of and attitudes to alcohol use among Pakistani medical students
Authors: Imran Nazish , Haider Imran Ijaz , Sohail Atif , Zafar Mohsan , Bhatti Muhammad Riaz
Published: January 2018

Studies worldwide have reported alarming rates of alcohol misuse among medical students (Webb et al, 1996; Kuo et al, 2002; Akvadar et al, 2004). These reports are surprising as well as of extreme concern, as medical professionals are supposedly more educated on the harmful effects of excessive alcohol consumption. The majority of studies exploring the knowledge and attitudes of medical students regarding alcohol have been from the USA and the UK, with only few from lower-income countries and the Islamic world (Kumar & Basu, 2000; Akvadar et al, 2004).
Personality profiles of patients with alcohol and drug misuse in a Nigerian treatment facility
Authors: Adamson T. A. , Onifade P. O. , Ibikunle O. I. , Somoye E. B.
Published: January 2018

Drug dependence treatment in Nigeria is at an early stage of development. The first ‘stand alone’ drug dependence treatment in-patient unit in Nigeria, the Drug Addiction Treatment Education and Research (DATER) unit, Aro, Abeokuta, Nigeria, was established in 1983. Prior to this, patients with drug dependence received care along with other patients in psychiatric wards and traditional healing homes (United Nations International Drug Control Programme, 1998). Currently, there is no national body in Nigeria actively involved in regulating or facilitating good practice in drug dependence treatment.
Public mental health services in Mumbai
Authors: Akhuly Ajanta , Kulkarni Mrinmoyi
Published: January 2018

Mumbai, India's largest city, also has the distinction of being the most populous city in the world. The association between urbanisation and mental illness has been widely documented (Harpham & Blue, 1995, especially pp. 41–60). Mumbai is characterised by dense slums housing large migrant populations facing stressful lives. The state of publicly funded mental health facilities in Mumbai has special significance in this context, since they are the only resource available to a large economic ally vulnerable section of the population. The objective of the present study was to evaluate the public mental health services in Mumbai and to identify areas for improvement.
The new Ghana mental health bill
Authors: Osei Akwasi O. , Roberts Mark , Crabb Jim
Published: January 2018

In Ghana, the main burden of ill-health, as in many sub-Saharan countries, consists of communicable disease, illnesses due to inadequate nutrition and poor reproductive health. As these conditions are tackled, other diseases, such as mental disorders and substance misuse, are also becoming the focus of development efforts. In Ghana, it has been estimated that there are 2166 000 individuals experiencing a mild to moderate mental disorder, with a further 650000 suffering from a severe mental disorder, out of a population of 21.6 million (World Health Organization, 2007). In 2003, the country's mental health workforce consisted of 9 psychiatrists (only 4 of whom worked in mental health services), 451 nurses and 160 community psychiatric nurses (World Health Organization, 2003). Currently there are just 5 consultant psychiatrists in active service in the public sector and 11 retired psychiatrists. As just under 33 000 individuals are seen each year in Ghana by mental health services, there is an estimated treatment gap of 98% (World Health Organization, 2007). Most mental healthcare is undertaken at the three large psychiatric hospitals, in the south of the country. This is reflected in the ratio of out-patient attendance to admission, which is 4.64 for mental health, compared with 14.6 for all health conditions (Ghana Health Service, 2005).
Global mental health – problem and response
Authors: Ghodse Hamid
Published: January 2018

According to the World Health Organization, 450 million people in the world currently suffer from some form of mental or brain disorder, including alcohol and substance misuse. Within this huge number, 121 million people suffer from depression, and more than 800 000 people die by suicide each year, with young people accounting for well over half of these. Projections from 1990 to 2020 suggest that, in future, the proportion of the global burden of all disease accounted for by mental and brain disorders will increase to 15%.
Impact of trauma on Palestinian children's mental health: lessons from the Gaza studies
Authors: Vostanis Panos
Published: January 2018

Children exposed to violence are at high risk of developing a range of mental health problems, predominantly post-traumatic stress disorder (PTSD) and depression (Yule, 1999). Children in war zones can be affected not only directly but also indirectly, for example through their basic health needs not being met, the loss of family members, disruption of social networks, internal displacement and their parents’ responses.
Italian psychiatry – 25 years of change
Authors: Fioritti Angelo , Bassi Mariano , de Girolamo Giovanni
Published: January 2018

Italian psychiatry is probably more debated than known in the international arena. Law 180 of 1978, which introduced a radical community psychiatry system, has drawn worldwide attention and debate, with comments ranging from the enthusiastic to the frankly disparaging (Mosher, 1982; Jones et al, 1991). More recently, this interest was marked by a well-attended symposium ‘Lessons Learned from Italian Reforms in Psychiatry’ held at the 2003 annual meeting of the Royal College of Psychiatrists in Edinburgh.
Psychiatry for tomorrow's doctors: undergraduate medical education
Authors: Ghodse Hamid
Published: January 2018

The importance both of undergraduate education in forming the knowledge base for the next generation of doctors and of their continuing professional development is widely acknowledged. The changes that are occurring to the undergraduate medical curriculum in many countries are therefore likely to have a long-term effect, although their specific effect on psychiatric teaching and the future of psychiatry is not yet apparent. This is of particular significance in the context of a continuing crisis in the recruitment and retention of mental health professionals in general, and of psychiatrists in particular, when the need to attract doctors into the specialty has never been greater (Sierles & Taylor, 1995).
Introduction
Authors: Saxena Shekhar
Published: January 2018

Country profiles provide summary information on mental health policy, services, training and research in the country, along with key references for more details. The aim is to give a bird's eye view of the situation within about 1500 words. It is hoped that this will not only increase the reader's awareness of distant and often forgotten countries, but also provide an opportunity for learning from others’ experiences. The profiles can also open possibilities for further dialogue and even collaboration.
Psychiatry in Jordan
Authors: Takriti Adnan
Published: January 2018

Jordan, one of the most recently established countries in the Middle East, was part of the Ottoman Empire. It was declared a political entity known as Transjordan under the mandate of the British government in 1923, until it gained independence and was declared a Kingdom in 1946. In 1950, Transjordan and the West Bank were united and assumed the current name of the Hashemite Kingdom of Jordan. The next major change for the Kingdom came in 1967, when the occupation of the West Bank and Gaza Strip by Israeli forces caused a massive influx of migrants to the East Bank.
The International Fellowship Programme: some personal thoughts
Authors: Holsgrove Gareth J.
Published: January 2018

The International Fellowship Programme (IFP) was launched in 2003 under the name of the International Fellowship Scheme, its title being changed in 2004 because it was causing confusion to US doctors, who interpreted the word ‘scheme’ as having Machiavellian implications.
Mental healthcare in South Korea
Authors: Suh Guk-Hee
Published: January 2018

The Korean peninsula is located between China and Japan. After the Second World War, the Republic of Korea was established in the southern half of the Korean peninsula. South Korea has a total area of 98 480 km2 and a population of 48 598 175 (July 2004 estimate). The per capita gross domestic product (GDP), in terms of purchasing power parity, is US$17 700 (2003 estimate) (Central Intelligence Agency, 2004). The illiteracy rate (among those aged over 15 years) is 1.9% (0.7% for males and 3% for females) (2003 estimate). Life expectancy at birth is 75.6 years (72.0 years for males and 79.5 years for females) and the infant mortality rate is 7.2 per 1000 births (2004 estimate). The unemployment rate is 3.4% (2003 estimate). The proportion of the population aged 65 and over is currently 8.7% (2004 estimate) (Korea National Statistics Office, 2003). Over 40% of the total Korean population (i.e. some 20 million) lives in Seoul and its vicinity. South Korea is highly urbanised and modernised. Besides central government, local government is based on seven metropolitan cities and nine provinces.
Psychiatry and geriatric psychiatry in Romania
Authors: Tataru Nicoleta
Published: January 2018

Romania is now in a period of transition from communism to democracy. Geographically, Romania, like other Eastern European countries, is on the border between the Western world and the Middle East and Asia; until December 1989 it was behind the ‘Iron Curtain’.
Traditional Chinese medicine in psychiatric practice in Singapore
Authors: Kua Ee Heok , Tan Chay Hoon
Published: January 2018

Around three-quarters of the Singaporean population are of Chinese ethnic origin, and so traditional Chinese medicine is the most widely practised non-Western system of healthcare on the island.
Psychiatry in Venezuela
Authors: Belfort Edgard , González Javier
Published: January 2018

The Bolivarian Republic of Venezuela covers 916 445 km2; to the north is the Caribbean Sea, to the south-east the Amazonian region and the plains of Brazil and Colombia, and to the west the Andes and the Colombian Guajira peninsula. Its estimated population (2004) is 25 226 million, which is concentrated along the north coastal area, where the population density exceeds 200 inhabitants per km2; most of the territory remains almost inhabited (fewer than 6 inhabitants per km2), in particular the border areas. The population is mainly urban: 70% live in cities with more than 50 000 inhabitants.
Establishing a mental health system in the Occupied Palestinian Territories
Authors: Giacaman Rita , Arya Neil , Summerfield Derek
Published: January 2018

What is ‘mental health’ during the societal crisis and upheaval occasioned by war? Perhaps the primary psychological effect of war on victims generally is through their witnessing the destruction of a social world embodying their history, identity, values and roles of everyday life. Such suffering has largely to be resolved collectively, in this same social world, albeit one which has been intentionally weakened. Thus, as the World Health Organization and other authorities confirm, the major thrust of humanitarian interventions must be towards the depleted social fabric and its institutions, for herein lie the sources of resilience and capacity for recovery for all (Kawachi & Berkman, 2000). Beyond that, history has shown that social or political reform is the best medicine, and for victims of oppressive violence this means acknowledgement and justice (Summerfield, 2002).
Some Australian reflections on problems with recruitment into the profession of psychiatry
Authors: Tonge Bruce J.
Published: January 2018

Psychiatry has probably always been the least attractive of the medical specialties. The choice of psychiatry as a career has been consistently low in the English-speaking world over the past 50 years (British Medical Journal, 1973; Feifelet al, 1999; Brockington & Mumford, 2002). Over the past decade there has probably been a further decline in the proportion of medical graduates choosing to train in psychiatry (Sierles & Taylor, 1995; Feifelet al, 1999).
Mental health, illness and communal violence in Northern Ireland
Authors: John Lord Alderdice
Published: January 2018

Many psychologically informed books and papers have been published during the past 30 years that have explored different elements of the Northern Ireland problem. These have ranged from Padraig O'Malley's (1990) fascinating examination of the world of the hunger strikers and their families, to a recent socio-psychological study of sectarianism in young children, which was sponsored by the Community Relations Council (Connolly et al, 2002). The latter careful piece of work demonstrated that while children of three years of age are beginning to identify different cultural symbols, there is not much evidence of sectarian attitudes until about five or six years of age. By this time they have not only begun to recognise and identify with partisan symbols, but also to express deeply antagonistic sectarian attitudes. These are not wholly unexpected findings, but the purpose of good research is to enquire whether things are in fact the way one might expect them to be. When it comes to research on clinical psychiatry there is less material but the most interesting and unexpected finding that emerges from the published work of psychiatrists in Northern Ireland is the limited evidence of any increased violence-related psychiatric illness in the population as a whole.
Brazilian public mental health policy: education and research
Authors: de Toledo Ferraz Marcos Pacheco , Carlini Elisaldo A.
Published: January 2018

Brazil is a country with 170 000 000 inhabitants (census for the year 2000), of whom 138 000 000 live in urban areas. The illiteracy rate, that is, people over 15 years of age who cannot write or read even a simple message, is 13.4%. About 25.6% of the population live on a family income less than half the minimum wage (1999 figures). Brazil's gross internal revenue is R$564 800 per capita (1998 figures, about US$1680 today).
Psychiatry in India
Authors: Patel Vikram , Saxena Shekhar
Published: January 2018

India is a low-income country that is characterised by huge diversity within and between its 35 states and union territories. For example, the infant mortality rate (per 1000 live births) ranges from a low of 16.3 in Kerala to a high of 86.7 in Uttar Pradesh, over a fivefold difference (International Institute for Population Sciences & ORC Macro, 2001). This considerable variation is evident in virtually every aspect of human development in India, and any summary figures are likely to be unrepresentative of most parts of the country. Within the scope of this short article, this important limitation of averages must be recognised at the outset.
SUNDAR: mental health for all by all
Authors: Patel Vikram
Published: January 2018

This article describes the rationale and principles for the SUNDAR approach adopted by Sangath, an Indian non-governmental organisation: to use lay people, with appropriate training and supervision, to deliver psychosocial interventions for a range of mental health conditions. This approach has been evaluated in a number of randomised controlled trials and is now being scaled up. At the core of this innovation is revisiting the questions of what constitutes mental healthcare, who provides mental healthcare and where mental healthcare is provided. In doing so, SUNDAR offers a vision for a mental healthcare system which is empowering, inclusive, equitable and effective.