bluuebunny/crossref_metadata_2025_split huggingface dataset:
The mental health challenges of immigration
Authors: Mollica Richard F. , Kirschner Kathia E. , Ngo-Metzger Quyen 
Published: April 2012

Abstract
In 2007 it was estimated that there were 38.1 million foreign-born people living in the United States (U.S. Census Bureau, 2007). Since 1975, the United States has resettled approximately 2.6 million refugees (Office of Refugee Resettlement, 2008). Most immigrants and refugees come to escape poverty, mass violence, and/or political/religious oppression. Since 1960 there has been a continuous increase in immigrants coming from Latin America (from 9.4 % in 1960 to 53.6 % in 2007) and Asia (from 5.1 % in 1960 to 26.8 % in 2007). In Europe a similar trend is taking place: the European Union (EU) estimates that 28.8 immigrants currently live in the EU. By the end of 2008, the United Nations High Commissioner for Refugees (UNHCR; 2008 ) estimated that there were more than 10 million refugees under its mandate and about 26 million conflict- induced displaced persons worldwide. According to the UNHCR, ‘The year 2008 saw the mass movement of people within and beyond their borders, uprooted by conflict, calamity or searching for opportunity’ (UNHCR, 2008). Patterns of both conflict and human displacement are becoming increasingly more complex. The increase in diversity of immigrant/refugee population from developing countries to the so-called developed countries has increased and poses new challenges to the field of community health and mental health care.
In this chapter we will focus on describing the barriers encountered by highly traumatized immigrants and refugees from culturally diverse backgrounds and provide a model that addresses this population’s specific health and mental health problems and barriers to care.
Early interventions for people with psychotic disorders
Authors: Power Paddy , McGorry Pat 
Published: April 2012

Abstract
Early intervention (EI) in psychosis has established itself as a cornerstone of service provision in psychosis over the last two decades. It is the latest in a line of key developments in the management of psychotic disorders over the last 60 years, following the introduction of antipsychotic medication, de-institutionalization, community care, and more effective psychosocial interventions. It borrows from principles that have emerged over the last few decades in other areas of medicine, social care, and education. Its focus is on early detection, prevention, and intervention in young people with emerging first-episode psychosis. It has become a social movement in its own right, developing its own national and international associations (e.g. the International Early Psychosis Association) World Health Organization-endorsed principles (Bertolote and McGorry, 2005), and attracting considerable political, media, and community support.
This explosion of interest in EI over the past two decades has prompted governments in many developed countries to adopt the EI model, with some promoting it as a top priority for mental health service planning (Appleby, 2009). Countries such as United Kingdom, Canada, Australia, and New Zealand have committed to national roll-outs of these services. This has been further supported by recent economic evaluations highlighting the substantial health savings involved (McCrone et al., 2008; Mihalopoulos et al., 2009).
The field is now moving into other forms of serious mental illness, not only in conditions typically affecting young people but even into old age psychiatry (Naismith et al., 2009). However, questions remain regarding the long-term benefits of a focus on early intervention (Bertelsen et al., 2008; Craig, 2003; Gafoor et al., 2010; Pelosi, 2009) and there is much to discover about the true extent of its merits. There is still uncertainty about the ideal model. EI services wrestle with the dilemma of whether they are for all age groups or specifically for young people, whether they are extensions of child and adolescent mental health services, or young adult services, or both, whether they are limited to non-affective psychoses or all forms of serious mental illness, and whether they are best provided independently of generic services or embedded as subcomponents of these services.
Day hospital and partial hospitalization programmes
Authors: Schene Aart H. 
Published: April 2012

Abstract
Partial hospitalization (PH) as a treatment modality for psychiatric disorders has evolved over more than 60 years now. PH fills the wide gap between inpatient or full-time hospitalization (FTH) on the one hand and outpatient or community mental health care on the other. For patients, carers, and professional staff, PH has the potential to offer more than low-frequency outpatient visits while at the same time it prevents the disadvantages of a hospital admission.
In this chapter I discuss some of the main issues regarding the current status and the future development of PH: history, development, conceptual issues and definition, different types of PH programmes, (cost-) effectiveness of PH in comparison with FTH and outpatient treatment, selection criteria, treatment models, and therapeutic factors. In the last section I review the place of this component in the total of psychiatric services.
Programmes to support family members and caregivers
Authors: Drapalski Amy L. , Dixon Lisa B. 
Published: April 2012

Abstract
Most individuals with schizophrenia or other serious mental illnesses have regular contact with family members and these family members often provide substantial support and assistance to their ill relative (Chien et al., 2006; Hackman and Dixon, 2008; Resnick et al., 2005). Although providing support to a relative with mental illness is often rewarding on many levels, caring for a relative with a mental illness can also be extremely demanding and can lead to feeling of being overwhelmed, frustrated, worried, and depressed. Oftentimes, limited knowledge of mental illness, mental health treatments, and the mental health service system coupled with the increased demands associated with taking on a caregiver role can contribute to significant family stress, distress, and burden. In turn, this increased burden may impede a family’s ability to continue to provide the support and assistance that their ill relative may need to help effectively manage an illness and achieve recovery goals. Several programmes have been developed in an effort to address the varying needs and preferences of family members and caregivers of individuals with serious mental illness. This chapter aims to discuss the potential impact of mental illness on the family and its relationship to family needs, to highlight the basic tenets or principles of effective family programmes, and to describe several prominent family interventions and outline the evidence for their effectiveness.
Managing co-occurring physical disorders in mental health care
Authors: Cimpean Delia , Drake Bob 
Published: April 2012

Abstract
Individuals with serious mental illness (SMI) have increased rates of medical comorbidity. The most common serious medical conditions in this population include cardiovascular disease, cardiovascular risk conditions (obesity, hyperlipidaemia, type 2 diabetes), and blood-borne viral infections. The cluster of cardiovascular risk factors that includes high body-mass index (BMI), high blood pressure, high blood sugar and cholesterol, sometimes called metabolic syndrome, is found in 35 % to 63 % of people with schizophrenia and is associated with a fivefold increase in risk of diabetes and twofold increased cardiovascular risk.
As consequences of high rates of medical comorbidity, people with SMI have greatly reduced physical functioning, are vulnerable to early institutionalization in nursing homes, experience worse mental health outcomes, and ultimately, high levels of early mortality, especially cardiovascular mortality. Indeed, on average, people with SMI have 30-year shorter lifespans compared to people of the same age without mental illness (Dickey et al., 2002; Miller et al., 2006).
Morbidity, disability, and early mortality observed in people with SMI are outcomes that resemble that of people 20 years older in the general population. In other populations with premature aging or ‘weathering’, chronic pervasive socioeconomic stress was associated with increased allostatic load, measured by several cardiovascular, metabolic, and inflammatory biomarkers (Bird et al., 2010; Geronimus et al., 2006). Similarly, people with SMI are subjected to pervasive stress, such as poverty, unemployment, homelessness, and overt or subtle chronic stigma and discrimination. Over the course of a lifetime, psychological and physiological response to pervasive stress and the high effort required for coping, produce premature aging of people with SMI. This underlines the importance of coupling socioeconomic measures to the health improvement programmes to address the high medical burden and early mortality of people with SMI.
Treatment pressures, coercion, and compulsion
Authors: Szmukler George , Appelbaum Paul S. 
Published: April 2012

Abstract
In the last half of the 20th century and beginning of the 21st century, psychiatrists and other mental health clinicians became increasingly sensitive to the effects and implications of treatment that was not fully consensual. The number of psychiatric inpatients declined by more than two-thirds during that period. Many countries have tightened their procedures and standards for involuntary commitment (Appelbaum, 1997; Dressing and Salize, 2004). Mental health systems have worked harder to protect patients’ liberty interests, and to avoid circumstances in which non-consensual treatment occurs.
Nonetheless, the nature of mental illness — with patients frequently manifesting denial of their disorder or of a need for care — and the public’s concerns about the propensity of mentally ill persons to injure others or themselves, will probably make it impossible for non-consensual treatment ever to be abandoned completely. Indeed, with the movement to community care, new mechanisms for exerting pressures on patients have developed in services such as Assertive Community Treatment (ACT) (Stein and Santos, 1998). A major focus of ACT — usually targeted at persons with chronic mental illness who are thought likely to drift away from care — is to prevent defaulting from treatment, since loss of contact is likely to lead to relapse and readmission to hospital. Treatment is brought assertively to the patient making disengagement difficult. ‘Compliance’ or ‘adherence’ with medication is often a central issue. In the background also remains the possibility of compulsory admission to hospital.
This chapter has three aims:
To outline a spectrum of treatment pressures in contemporary practice, drawing ethically relevant distinctions between them
To consider when the exercise of such treatment pressures can be justified
To suggest approaches aimed at reducing the need for treatment pressures in community mental health services.
Public attitudes towards people with mental illness
Authors: Link Bruce , Angermeyer Matthias C. , Phelan Jo 
Published: April 2012

Abstract
The increase in research about public knowledge, attitudes, and beliefs concerning mental illnesses is a prominent fact. From just a small number of path-breaking studies in the 1950s and 1960s (Cohen and Struening, 1962; Cumming and Cumming, 1957; Nunnally, 1961; Star, 1955) the field has grown to become an enormous literature that has used multiple measures and multiple methods in studies conducted in a vast array of populations (Link et al., 2004; Thornicroft 2006; Thornicroft et al., 2009). We seek to capture the essence of this body of work by reviewing the core questions it has assessed. We follow this brief review by posing two questions. The first asks why it is important to study knowledge, attitudes, and beliefs (KABs) and turns our attention to KABs as representations of cultural conceptions of mental illness. We argue that KABs are elements of a cultural context that influences how people think about and respond to mental illnesses and that this influence expands beyond the narrow individually-based model that asks whether individual attitudes are good predictors of individual behaviours. To exemplify this point we highlight the importance of cultural conceptions for modified labelling theory and for the creation and sustenance of structural stigma. The second question asks how we can capture changes in KABs towards mental illnesses and leads us to consider the importance of studies that monitor trends in KABs over time.
Reducing stigma and discrimination
Authors: Thornicroft Graham , Mehta Nisha 
Published: April 2012

Abstract
The term stigma (plural stigmata) was originally used to refer to an indelible dot left on the skin after stinging with a sharp instrument, sometimes used to identify vagabonds or slaves. The resulting mark led to the metaphorical use of ‘stigma’ to refer to stained or soiled individuals who were in some way morally diminished. In modern times stigma has come to mean ‘any attribute, trait or disorder that marks an individual as being unacceptably different from the “normal” people with whom he or she routinely interacts, and that elicits some form of community sanction’ (Goffman, 1963 ).
There is now a voluminous literature on stigma (Corrigan, 2005; Link et al., 1999 ; Mason, 2001 ; Sartorius and Schulze, 2005 ). The stigma of mental illness is the subject of many hundreds of scientific papers (Pickenhagen and Sartorius, 2002). The most complete model of the component processes of stigmatization has four key components (Link and Phelan, 2001 ): 1) labelling, in which personal characteristics are signalled or noticed as conveying an important difference; 2) stereotyping, which is the linkage of these differences to undesirable characteristics; 3) separating, the categorical distinction between the mainstream/normal group and the labelled group as in some respects fundamentally different; 4) status loss and discrimination: devaluing, rejecting, and excluding the labelled group. Interestingly, more recently the authors of this model have added a revision to include the emotional reactions which may accompany each of these stages (Link et al., 2004 ).
We shall consider later what needs to be done to allow people with mental illnesses a full opportunity for social participation. First of all we need to have a clear map to know where we are and where we want to go.
Stigma theories have not been enough to understand the feelings and experiences of people with mental illness, nor to know what practical steps are needed to reverse social exclusion (Social Exclusion Unit, 2004). Rather stigma can be seen as an overarching term that contains three important elements:
◆ Problems of knowledge (ignorance)
◆ Problems of attitudes (prejudice), and
◆ Problems of behaviour (discrimination).
In terms of social psychology, these are referred to as the cognitive, affective, and behavioural domains (Dovidio et al., 2000), and each will now be discussed.
Funding of mental health services
Authors: Chisholm Dan , Knapp Martin 
Published: April 2012

Abstract
Whether it is a case of setting out to develop, reorientate, or just maintain existing levels of community-based mental health services, policy-makers and planners will run up against the inconvenient but inescapable question of resource constraints. How much money will it take, for example, to build up service coverage and capacity, to introduce effective new intervention strategies, to overhaul prevailing modes of service delivery, or to cater for the changing needs of the population? Decisions made at this strategic level of mental health policy and planning exert a powerful influence over the extent to which those people in need of services will actually be able to access and use them, as well as shape the way in which provision is organized and paid for.
Mental health financing is a far-reaching topic that not only addresses the specific question of what services to purchase and how, but also more normative questions around how much should be allocated to (say) community mental health care (e.g. what can be afforded, given the extent of mental health and broader other health needs in the population?), as well as equity issues (e.g. are funding arrangements fair, in the sense that people in need are not prevented from accessing services on financial grounds?). Indeed, alongside meeting the reasonable expectations of service users and actualizing mental health improvements in the population, fair financing does or should represent a key goal of a mental health system (WHO, 2006). In this chapter, we endeavour to cover these diverse questions under a number of central financing themes— resource generation and revenue collection, risk pooling and financial protection, plus resource allocation and purchasing — to highlight key funding issues that need to be considered when planning, implementing, or evaluating community mental health services.
Qualitative research methods in mental health
Authors: Whitley Rob 
Published: April 2012

Abstract
In this chapter I set out to introduce the reader to qualitative research in mental health. I describe its main methods of inquiry, and its underpinning foundational and philosophical principles. I give numerous examples of where qualitative research has been fruitfully employed in community psychiatry. I then describe criteria of rigour which can be used to assess the strength and contribution of any qualitative study in mental health. I believe qualitative research continues to offer interesting insights into the prevention, diagnosis, phenomenology, treatment, management, and understanding of psychiatric disorder. It may also assist resolution of current policy imperatives, such as calls for person-centred care, and more thorough evaluations of service effectiveness.
Understanding and using systematic literature reviews
Authors: Cipriani Andrea , Barbui Corrado 
Published: April 2012

Abstract
Making rapid decisions is a key component of everyday clinical practice. Informed decision-making such as this requires physicians to combine their own clinical expertise and training with high-quality scientific evidence (Guyatt et al., 2000). New scientific knowledge is emerging all the time and all health workers need to update their knowledge continuously. Most busy practising clinicians simply do not have sufficient time to read all the important primary research reports. Over two million articles are published every year in 20,000 biomedical journals (Mulrow, 1994) and even if a clinician restricts his/her reading to high-yield clinical psychiatry journals, he/she would need to read over 5000 articles a year (Geddes et al., 1999). The clinician therefore needs a reliable system of knowledge management, that is, systematic reviews and meta-analyses. In this chapter, we will outline the main features and limitations of systematic reviews and will suggest ways in which further syntheses of primary trial data may yield clinically useful information.
Characterization of Three O-Methyltransferases Involved in Noscapine Biosynthesis in Opium Poppy
Authors: Dang Thu-Thuy T. , Facchini Peter J. 
Published: April 2012

Abstract
Noscapine is a benzylisoquinoline alkaloid produced in opium poppy (Papaver somniferum) and other members of the Papaveraceae. It has been used as a cough suppressant and more recently was shown to possess anticancer activity. However, the biosynthesis of noscapine in opium poppy has not been established. A proposed pathway leading from (S)-reticuline to noscapine includes (S)-scoulerine, (S)-canadine, and (S)-N-methylcanadine as intermediates. Stem cDNA libraries and latex extracts of eight opium poppy cultivars displaying different alkaloid profiles were subjected to massively parallel pyrosequencing and liquid chromatography-tandem mass spectrometry, respectively. Comparative transcript and metabolite profiling revealed the occurrence of three cDNAs encoding O-methyltransferases designated as SOMT1, SOMT2, and SOMT3 that correlated with the accumulation of noscapine in the eight cultivars. SOMT transcripts were detected in all opium poppy organs but were most abundant in aerial organs, where noscapine primarily accumulates. SOMT2 and SOMT3 showed strict substrate specificity and regiospecificity as 9-O-methyltransferases targeting (S)-scoulerine. In contrast, SOMT1 was able to sequentially 9- and 2-O-methylate (S)-scoulerine, yielding (S)-tetrahydropalmatine. SOMT1 also sequentially 3′- and 7-O-methylated both (S)-norreticuline and (S)-reticuline with relatively high substrate affinity, yielding (S)-tetrahydropapaverine and (S)-laudanosine, respectively. The metabolic functions of SOMT1, SOMT2, and SOMT3 were investigated in planta using virus-induced gene silencing. Reduction of SOMT1 or SOMT2 transcript levels resulted in a significant decrease in noscapine accumulation. Reduced SOMT1 transcript levels also caused a decrease in papaverine accumulation, confirming the selective roles for these enzymes in the biosynthesis of both alkaloids in opium poppy.
Structural and Functional Analysis of VQ Motif-Containing Proteins in Arabidopsis as Interacting Proteins of WRKY Transcription Factors
Authors: Cheng Yuan , Zhou Yuan , Yang Yan , Chi Ying-Jun , Zhou Jie , Chen Jian-Ye , Wang Fei , Fan Baofang , Shi Kai , Zhou Yan-Hong , Yu Jing-Quan , Chen Zhixiang 
Published: April 2012

AbstractWRKY transcription factors are encoded by a large gene superfamily with a broad range of roles in plants. Recently, several groups have reported that proteins containing a short VQ (FxxxVQxLTG) motif interact with WRKY proteins. We have recently discovered that two VQ proteins from Arabidopsis (Arabidopsis thaliana), SIGMA FACTOR-INTERACTING PROTEIN1 and SIGMA FACTOR-INTERACTING PROTEIN2, act as coactivators of WRKY33 in plant defense by specifically recognizing the C-terminal WRKY domain and stimulating the DNA-binding activity of WRKY33. In this study, we have analyzed the entire family of 34 structurally divergent VQ proteins from Arabidopsis. Yeast (Saccharomyces cerevisiae) two-hybrid assays showed that Arabidopsis VQ proteins interacted specifically with the C-terminal WRKY domains of group I and the sole WRKY domains of group IIc WRKY proteins. Using site-directed mutagenesis, we identified structural features of these two closely related groups of WRKY domains that are critical for interaction with VQ proteins. Quantitative reverse transcription polymerase chain reaction revealed that expression of a majority of Arabidopsis VQ genes was responsive to pathogen infection and salicylic acid treatment. Functional analysis using both knockout mutants and overexpression lines revealed strong phenotypes in growth, development, and susceptibility to pathogen infection. Altered phenotypes were substantially enhanced through cooverexpression of genes encoding interacting VQ and WRKY proteins. These findings indicate that VQ proteins play an important role in plant growth, development, and response to environmental conditions, most likely by acting as cofactors of group I and IIc WRKY transcription factors.