International Journal of Social Psychiatry (INT J SOC PSYCHIATR)

Publications in this journal

• Article: Depressive symptoms and culture in Chinese patients.

  Jikun Wang, Xudong Zhao
  International Journal of Social Psychiatry 05/2013; 59(3):307.
• Article: Effects of a question prompt sheet on active patient behaviour: A randomized controlled trial with depressed outpatients.

  Johannes Hamann, Nikolaos Maris, Paraskevi Iosifidou, Rosmarie Mendel, Rudolf Cohen, Petra Wolf, Werner Kissling
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  ABSTRACT: BACKGROUND: A deeper engagement into medical decision-making is demanded by treatment guidelines for patients with affective disorders. There is to date little evidence on what facilitates active behaviour of patients with depression. In general medicine 'question prompt sheets' (QPSs) have been shown to change patients' behaviour in the consultation and improve treatment satisfaction but there is no evidence for such interventions for mental health settings. AIMS: To study the effects of a QPS on active patient behaviour in the consultation. METHODS: Randomized controlled trial (involving N = 100 outpatients with depression) evaluating the effects of a QPS on patients' behaviour in the consultation. RESULTS: The QPS showed no influence on the number of topics raised by patients (p = .13) nor on the external rater's perception of 'Who made the decisions in today's consultation?' (p = .50). CONCLUSIONS: A QPS did not change depressed patients' behaviour in the consultation. More complex interventions might be needed to change depressed patients' behaviour within an established doctor-patient dyad. Patient seminars addressing behavioural aspects have been shown to be effective in other settings and may also be feasible for outpatients with affective disorders.
  International Journal of Social Psychiatry 04/2013;
• Article: Art promoting mental health literacy and a positive attitude towards people with experience of mental illness.

  Eugen Koh, Bradley Shrimpton
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  ABSTRACT: BACKGROUND: Exhibitions of art by people with experience of mental illness are increasingly being staged to improve awareness of mental health issues in the general community and to counter the stigma of mental illness. However, few exhibitions have incorporated research to ascertain their actual effectiveness. METHOD: This paper reports the results of a study that considered the responses of 10,000 people after they viewed exhibitions of art produced by people with experience of mental illness. These works were selected from the Cunningham Dax Collection, one of the world's most extensive collection of artworks by people with experience of mental illness and/or psychological trauma. RESULTS: More than 90% of respondents agreed with three propositions that the exhibitions helped them: (1) gain a better understanding of mental illness; (2) gain a more sympathetic understanding of the suffering of people with mental illness; and (3) appreciate the ability and creativity of people with mental illness. CONCLUSION: The results suggest that exhibitions can successfully promote mental health literacy and contribute to positive attitudes towards people with experience of mental illness. This paper explores these findings and raises questions about how the presentation of artworks in an exhibition influences their effectiveness in mental health promotion.
  International Journal of Social Psychiatry 04/2013;
• Article: Does training practice nurses to carry out physical health checks for people with severe mental illness increase the level of screening for cardiovascular risk?

  Sheila Hardy, Philippa Hinks, Richard Gray
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  ABSTRACT: BACKGROUND: Compared to the general population, people with severe mental illness (SMI) have a higher risk of developing cardiovascular disease (CVD). Authors of clinical guidelines advise annual screening for CVD risk factors with appropriate lifestyle counselling. There are seven recommended elements of this health check: blood pressure, body mass index (or waist circumference), blood glucose, serum cholesterol, diet advice, exercise recommendations and smoking cessation guidance. AIM: To establish whether training practice nurses increases the proportion of patients with SMI who are screened for CVD risk factors and given lifestyle advice in primary care. METHOD: A before-and-after audit of 400 patients on the SMI registers in five primary care centres in Northampton, England. RESULTS: Following the training, the proportion of patients with SMI who received all elements of the health check significantly increased (pre-training: n = 33, 8%, 95% CI = 6-11; post-training: n = 60, 15%, 95% CI = 12-19; RR = 1.82, 95% CI = 1.22-2.72, p = .01). CONCLUSION: Training practice nurses about CVD prevention in people with SMI may be effective in increasing the proportion of patients in this group who receive a comprehensive health check.
  International Journal of Social Psychiatry 04/2013;
• Article: Income inequality and schizophrenia: Increased schizophrenia incidence in countries with high levels of income inequality.

  Jonathan K Burns, Andrew Tomita, Amy S Kapadia
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  ABSTRACT: BACKGROUND: Income inequality is associated with numerous negative health outcomes. There is evidence that ecological-level socio-environmental factors may increase risk for schizophrenia. AIMS: The aim was to investigate whether measures of income inequality are associated with incidence of schizophrenia at the country level. METHOD: We conducted a systematic review of incidence rates for schizophrenia, reported between 1975 and 2011. For each country, national measures of income inequality (Gini coefficient) along with covariate risk factors for schizophrenia were obtained. Multi-level mixed-effects Poisson regression was performed to investigate the relationship between Gini coefficients and incidence rates of schizophrenia controlling for covariates. RESULTS: One hundred and seven incidence rates (from 26 countries) were included. Mean incidence of schizophrenia was 18.50 per 100,000 (SD = 11.9; range = 1.7-67). There was a significant positive relationship between incidence rate of schizophrenia and Gini coefficient (β = 1.02; Z = 2.28; p = .02; 95% CI = 1.00, 1.03). CONCLUSIONS: Countries characterized by a large rich-poor gap may be at increased risk of schizophrenia. We suggest that income inequality impacts negatively on social cohesion, eroding social capital, and that chronic stress associated with living in highly disparate societies places individuals at risk of schizophrenia.
  International Journal of Social Psychiatry 04/2013;
• Article: Standardization of the MARISTAN scale to measure needs in people with schizophrenia and related psychoses.

  Sandra Saldivia, Francisco Torres-González, Ariadne Runte-Geidel, Pamela Grandon, Miguel Xavier, Helen Killaspy, Dinarte Ballester, Claudio Antonioli, Roberto Melipillan, Emiliano Galende, Jose Miguel Caldas, Michael King
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  ABSTRACT: OBJECTIVE: Existing measures of needs in severe mental illness have been developed mainly from professionals' viewpoints and are Eurocentric. Our aim was to standardize a measure of the needs of people with schizophrenia across several cultures and based on users' own viewpoints. METHOD: An instrument to measure needs, based on qualitative data on users', carers' and professionals' views, was tested in 164 people with schizophrenia or related psychoses in six countries. Participants underwent face-to-face interviews, one third of which were repeated 30 days later. Principal axis factoring and Promax rotation evaluated scale structure; Horn's parallel combined with bootstrapping determined the number of factors; and intra-class correlation assessed test-retest reliability. RESULTS: The instrument contained four factors: (1) health needs; (2) work and leisure needs; (3) existential needs; and (4) needs for support in daily living. Cronbach's α for internal consistency was 0.81, 0.81, 0.77 and 0.76 for factors 1-4 and 0.81 for the scale as a whole. Correlation between factors was of moderate range for the first three factors (0.41-0.50) and low for the fourth factor (0.14-0.29). Intra-class correlation coefficient for test-retest reliability was 0.74 (0.64-0.82) for the whole scale. Mean item score on needs for support in daily living was lower than for the other factors. CONCLUSIONS: The MARISTÁN Scale of Needs evaluates needs from the patient perspective and it is a valid instrument to measure the needs of people with severe mental illness across cultures.
  International Journal of Social Psychiatry 04/2013;
• Article: Psychiatry, homeless patients and welfare reforms: Historical links and chains.

  Walid Khalid Abdul-Hamid, Kamaldeep Bhui
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  ABSTRACT: The birthplace of the specialty of psychiatry was in the asylum, which was created to divert patients from workhouses where the most disadvantaged and destitute people with mental illness were to be found. The current welfare reforms are endangering the welfare and livelihood of the most disadvantaged of our patients. These reforms in the authors' opinion are related more to the historical cycle of societal attitude to homeless people than to seeing them as the undeserving poor. This is particularly true since the current economic crisis was not caused by the poor, so it is very unfair that our poorest patients should suffer most as a result of the welfare reforms.
  International Journal of Social Psychiatry 04/2013;
• Article: Patients' and carers' perception of needs in a Polish sample.

  Magdalena Cialkowska-Kuzminska, Blazej Misiak, Andrzej Kiejna
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  ABSTRACT: BACKGROUND: The assessment of patients' needs is an essential element of psychiatric health care planning and evaluation. Not much interest has been paid to the study of psychiatric patients' needs in Poland so far. AIMS: To assess the relation between inpatients' and their key carers' perception of needs in a Polish sample. METHODS: Out of 324 inpatients invited to take part in the study, 60 sets were finally included. Patients and their carers were examined by means of CANSAS to rate patients' and carers' perception of needs. RESULTS: The mean number of general needs indicated by patients themselves was 7.11 (± 2.98), and those indicated by carers equalled 9.53 (± 3.92). The more unmet needs identified by the patient, the more met and general needs of the patient identified by their carer (r = .27, p = .03; r = .38, p = .02, respectively). The more general needs perceived by the patient themself, the higher the indicator of unmet and general needs scored by their carer (r = .32, p = .01; r = .39, p = .001, respectively). CONCLUSIONS: There is a significant association between the inpatients' and their carers' perception of needs. Patients' perspective should serve as a high priority in developing treatment plans.
  International Journal of Social Psychiatry 03/2013;
• Article: A recovery journey for people with personality disorder.

  Heather Castillo, Shulamit Ramon, Nicola Morant
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  ABSTRACT: BACKGROUND: The study investigates the process of recovery for people diagnosed with personality disorder, a client group that suffers significant social exclusion known to impact on demand for health and other public services. It aims to examine efforts that attempt to reverse this social exclusion as an aspect of the recovery process. AIM: and METHOD: The following study aims to (1) explore what recovery means to people with personality disorder; (2) develop a conceptual model of recovery in personality disorder; and (3) evaluate the contribution of the setting (The Haven) to recovery practice. The study uses a Participatory Action Research (PAR) design. Data was collected from 66 participants by focus groups and individual interviews.Findings: A map based on thematic analysis of data collected during the study is proposed of the recovery journey for people with this diagnosis, shown as a pyramid that represents a hierarchy of progress, from building trust through stages of recovery to social inclusion. CONCLUSION: The findings offer contributions to knowledge in terms of the service design and propose a new model of recovery in personality disorder. This is defined as a journey of small steps highlighting recovery as a process rather than a goal, leading to the emergence of the new concept of transitional recovery.
  International Journal of Social Psychiatry 03/2013;
• Article: Explaining the 'immigration advantage' and the 'biculturalism paradox': An application of the theory of demoralization.

  John M de Figueiredo
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  ABSTRACT: BACKGROUND: : Recent immigrants have better mental health than the natives ('immigration advantage'). Biculturals have better mental health than the monoculturals ('biculturalism paradox'). MATERIAL: : Mexican immigrants have lower rates of psychopathology than the US population. This is less true for Cubans and not true for Puerto Ricans. The 'advantage' also occurs in other groups. Biculturals have better mental health and endorse both cultures. DISCUSSION: : The theory of demoralization predicts that borrowing values from both cultures and applying them judiciously are more conducive to mental health than indiscriminately subscribing to either culture. CONCLUSION: : The findings are consistent with the theory of demoralization.
  International Journal of Social Psychiatry 03/2013;
• Article: Gender differences in referral pathways and admissions to a psychiatric intensive care unit in a county psychiatric hospital in the UK.

  Feras Ali Mustafa, Zena Bayatti, Rafey A Faruqui
  International Journal of Social Psychiatry 03/2013; 59(2):188-9.
• Article: Public mental health is about social psychiatry.

  Dinesh Bhugra, Alex Till
  International Journal of Social Psychiatry 03/2013; 59(2):105-6.
• Article: Bully victims and borderline personality symptomatology.

  Randy A Sansone, Joy Chang, Martin Sellbom, Bryan Jewell
  International Journal of Social Psychiatry 03/2013; 59(2):193-4.
• Article: Integrating community mental health within primary care in southern Malawi: A pilot educational intervention to enhance the role of health surveillance assistants.

  Jerome Wright, Stephanie Common, Felix Kauye, Chikayiko Chiwandira
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  ABSTRACT: BACKGROUND: In response to the significant contribution of mental health problems to the global burden of disease, the World Health Organization (WHO, 2008) renewed its call for the integration of mental health services within primary care. The operationalization of this within resource-constrained settings such as rural Malawi, however, presents a challenge, not least the cultural acceptance of approaches to responding to psychological distress. AIM: This study reports on the development, implementation and evaluation of a mental health care training programme for 271 health surveillance assistants (HSAs) designed to overcome such challenges. METHOD: A structured evaluation of the impact of training on HSAs' provision of mental health care was undertaken. RESULTS: RESULT: s demonstrated a statistically significant positive effect on HSAs' knowledge and confidence in providing care and analysis of patient records revealed considerable mental health care and health promotion activity wherein HSAs initiated a new dialogue with the community on mental health and human rights concerns. CONCLUSION: The HSAs' focus on the psychosocial concerns of individuals' 'distress' and 'risk' prepared the way for a practical set of culturally sensitive and therapeutic interventions and offers a potential path towards increasing the capacity of primary care mental health provision that is responsive to local understandings and experiences of distress.
  International Journal of Social Psychiatry 02/2013;
• Article: Psychometric evaluation of the Dutch version of the Mental Health Recovery Measure (MHRM).

  Chijs van Nieuwenhuizen, Greet Wilrycx, Mozhgan Moradi, Evelien Brouwers
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  ABSTRACT: BACKGROUND: During the past decade, the mental health consumer movement has drawn the attention of mental health providers, researchers and policy makers to the concept of recovery. Traditionally, recovery primarily refers to the remission of symptoms. Nowadays, recovery is also regarded in a sense that all individuals, even those with severe psychiatric disabilities, can improve. Accordingly, recovery for people with severe mental illness refers to hope and optimism, empowerment, regained control and increased self-esteem, illness self-management and engagement in meaningful daily activities (Corrigan, Giffort, Rashid, Leary & Okeke, 1999; Jacobson & Greenley, 2001; Leamy, Bird, le Boutillier, Williams & Slade, 2011; van Gestel-Timmermans, Brouwers, van Assen, Bongers & van Nieuwenhuizen, 2012). Little empirical research, however, has been done and instruments to measure recovery are scarce. AIMS: In the current study, the psychometric properties of the Dutch version of the Mental Health Recovery Measure (MHRM) are explored. Convergent and divergent validity of the MHRM was assessed using standardized measures of hope (Hope Herth Index (HHI)), recovery-promoting professional competence (Recovery Promoting Relationships Scale (RPRS)) and general physical health and well-being (RAND Measure of Health-Related Quality of Life (RAND-36)). METHODS: A factor analysis was conducted and Cronbach's α of the MHRM scales was assessed. The construct validity was assessed by computing the intercorrelations of the MHRM, HHI, RPRS and RAND-36. RESULTS: Data were available for 212 patients: 70 patients completed the MHRM, HHI and RAND 36 and 142 filled out the MHRM and RPRS. Exploratory factor analysis resulted in an interpretable three-factor solution. Cronbach's α ranged from 0.86 to 0.94. The convergent validity of the instrument was satisfactory; the divergent validity was less clear. CONCLUSIONS: This study offers evidence to suggest that the Dutch version of the MHRM is a reliable measure (in terms of internal consistency) with a generally acceptable convergent and divergent validity. Further research is needed to clarify the extent to which the MHRM is sensitive enough to capture the individual recovery process of patients.
  International Journal of Social Psychiatry 02/2013;
• Article: Personality disorders in a community sample in Turkey: Prevalence, associated risk factors, temperament and character dimensions.

  Cigdem Dereboy, Halime Senay Güzel, Ferhan Dereboy, Pinar Okyay, Mehmet Eskin
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  ABSTRACT: BACKGROUND: : Data from Turkey on prevalence of personality disorders (PD) in the normal population are sparse. AIMS: : The present study conducted in a community sample aimed to investigate personality disorders in terms of prevalence, associated risk factors and personality dimensions. METHODS: : A stratified sampling procedure allowed us to compose a sample consisting of 774 participants residing in Aydin, Turkey. The DSM-IV and ICD-10 Personality Questionnaire (DIP-Q) and the Temperament and Character Inventory (TCI) were used to assess PDs and personality dimensions, respectively. RESULTS: : Roughly 20% of the participants received a PD diagnosis. Among the individual PD categories, schizotypal and obsessive-compulsive PDs were the most prevalent diagnoses. Participants with PD were more likely to have higher self-directedness and cooperativeness scores. These risk factors and personality dimensions were most strongly associated with the cluster B disorders. CONCLUSION: : New versions of the diagnostic systems should include schizotypal, obsessive-compulsive and cluster B PDs as separate diagnostic categories, and impaired self-directedness as well as cooperativeness as a general diagnostic criterion for the sake of backward and forward compatibility of the research in this field.
  International Journal of Social Psychiatry 02/2013;
• Article: The enduring mental health impact of mass violence: A community comparison study of Cambodian civilians living in Cambodia and Thailand.

  Richard F Mollica, Robert Brooks, Svang Tor, Barbara Lopes-Cardozo, Derrick Silove
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  ABSTRACT: BACKGROUND: No population-based studies have directly compared the long-term health and mental health outcomes of conflict- versus non-conflict-affected communities from the same ethnic background. AIMS: To identify and compare levels of psychiatric morbidity between a traumatized and non-traumatized civilian community; to investigate the long-term impact of mass violence. METHODS: Double-stratified community surveys in Siem Reap and Surin provinces were conducted by highly qualified Cambodian interviewers using culturally validated survey instruments with known psychometric properties. These included Cambodian versions of the Hopkins Symptom Checklist-25, the Harvard Trauma Questionnaire and the Medical Outcome Study Short Form. RESULTS: Siem Reap and Surin respondents experienced 12,266 and 621 major trauma events, respectively; 745 (76.2%) Siem Reap respondents and six (0.6%) Surin respondents reported torture events; 499 (49.5%) Siem Reap respondents and 203 (19.7%) Surin respondents met the clinical threshold for depression (OR 4.01, 95% CI 3.29-4.88); 204 (20.6%) Siem Reap respondents and 23 (2.2%) Surin respondents met the clinical threshold for post-traumatic stress disorder (PTSD) (OR 11.39, 95% CI 7.3-17.7). The MOS physical disability was higher in Siem Reap versus Surin respondents (74 (7.5%) vs 13 (1.3%), χ2 = 47.4 df = 1, p < .001). Health status was poorest among Siem Reap respondents when compared with Surin respondents (mean score 1.59 vs 0.59, respectively; t = 19.85 df = 2018, p < .001). Path analysis reveals that recent and past extreme violence are associated with the health and mental health status of the Siem Reap community. CONCLUSION: After 25 years, the Khmer civilian population that experienced the Pol Pot genocide continues to suffer psychiatric morbidity and poor health.
  International Journal of Social Psychiatry 02/2013;