Norman Sartorius

Association for the improvement of mental health programmes

Objective: To identify the COVID-19 impact on well-being/mental health, coping strategies and risk factors in adolescent worldwide. Method: Anonymous online multi-national/language survey in the general population (representative/weighted non-representative samples, 14-17years), measuring change in well-being (WHO-5/range=0-100) and psychopathology...

There is no multi-country/multi-language study testing a-priori multivariable associations between non-modifiable/modifiable factors and validated wellbeing/multidimensional mental health outcomes before/during the COVID-19 pandemic. Moreover, studies during COVID-19 pandemic generally do not report on representative/weighted non-probability sample...

The international human rights framework was adopted by the United Nations in 1948 through the Universal Declaration of Human Rights, followed by the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights in 1966. There was no specific mention of the right of people with disabilit...

In this section, we explore issues that arise during application of the Convention on the Rights of the Persons with Disabilities (CRPD) in mental health care through a discussion of case histories modelled on real-life stories in clinical practice. We brought together psychiatrists, persons who experienced mental illness and persons who provided f...

The United Nations Convention on the Rights of Persons with Disabilities (CRPD) is a landmark international treaty based on the central idea of respect for the inherent dignity of every human being. We explored issues that arise in the application of the CRPD in mental health care through case histories modelled on real-life stories in clinical pra...

This study aimed to determine the degree of family relations and associated socio-demographics characteristics, clinical/physical and mental disorders in type 2 diabetes mellitus in a Kenyan diabetes clinic. This study was part of a large multicentre study whose protocol and results had been published. It took place at the outpatient diabetes clini...

Objectives: Anxiety disorders are significant predictors of suicidality and are proposed to be independent risk factors for suicide attempts. They are common in people with type 2 diabetes (T2DM) and are associated with longer duration of diabetes and poorer treatment outcomes. The aim was to examine associations between anxiety disorders and suici...

Background Diabetes mellitus and depression are serious common diseases, and the number of people with both conditions is rising steadily. Depression in people with diabetes mellitus results in poorer prognosis through different mechanisms. On the other hand, the presence of diabetes in individuals with depression increases functional impairment th...

International studies measuring wellbeing/multidimensional mental health before/ during the COVID-19 pandemic, including representative samples for >2 years, identifying risk groups and coping strategies are lacking. COH-FIT is an online, international, anonymous survey measuring changes in well-being (WHO-5) and a composite psychopathology P-score...

Background For better disease management and improved prognosis, early identification of co-morbid depression in diabetic patients is warranted. the WHO-5 well-being index (WHO-5) has been used to screen for depression in diabetic patients, and its Chinese version (WHO-5-C) has been validated. However, its psychometric properties remain to be furth...

Background Stigma related to mental illness (and its treatment) is prevalent worldwide. This stigma could be at the structural or organizational level, societal level (interpersonal stigma), and the individual level (internalized stigma). Vulnerable populations, for example, gender minorities, children, adolescents, and geriatric populations, are m...

Progress in promoting mental health, preventing mental illness, and improving care for people affected by mental illness is unlikely to occur if efforts remain separated from existing public health programs and the principles of public health action. Experts met recently to discuss integrating public health and mental health strategies in the south...

The concepts of human rights, social justice, and social determinants of health are inextricably intertwined with public health. Globally, attention is increasingly being paid to the connections between social determinants and the challenges of sustainability, well‑being, and justice. Social factors and socioeconomic inequities are among the root c...

Background For better disease management and improved prognosis, early identification of co-morbid depression in diabetic patients is warranted. the WHO-5 well-being index (WHO-5) has been used to screen for depression in diabetic patients, and its Chinese version (WHO-5-C) has been validated. However, its psychometric properties remain to be furth...

The European Journal of Psychiatric Trainee is the official journal of the European Federation of Psychiatric Trainees. It is a fully open-access peer-reviewed scientific journal which will prioritize work by psychiatric trainees while also publishing a wide range of papers on mental health by other authors from diverse professional backgrounds. T...

Background: Pharmacoepidemiological studies of clozapine use to treat bipolar disorder (BD), especially in Asia, are rare, although they can provide insights into associated clinical characteristics and support international comparisons of indications and drug dosing. Methods: We examined the prevalence and clinical correlates of clozapine treat...

Objective: Mood stabilizers are psychotropic drugs mainly used to treat bipolar disorder in the acute phase or for maintenance therapy to prevent relapse. In clinical practice, mood stabilizers are commonly prescribed for conditions other than bipolar disorder. This study investigated the distribution of mood stabilizer prescriptions for different...

Background: Protecting all human rights of people with mental health conditions is globally important. However, to facilitate practical implementation of rights, it is often necessary to decide which of these rights should be given priority, especially when they conflict with each other. Aims: The aim of the Priorities of Human Rights and Mental...

Background: The Collaborative Outcome study on Health and Functioning during Infection Times (COH-FIT; www.coh-fit.com) is an anonymous and global online survey measuring health and functioning during COVID-19 pandemic. The aim of this study was to test concurrently the validity of COH-FIT items and the internal validity of the co-primary outcome,...

Introduction: Drug-induced extrapyramidal syndrome (EPS) remains a major problem in clinical psychiatry. This study aimed to examine the factor structure of drug-induced extrapyramidal symptoms observed in patients with schizophrenia and assessed using the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS). Methods: The participants were 1478 p...

Psychiatry has always been characterized by a range of different models of and approaches to mental disorder, which have sometimes brought progress in clinical practice, but have often also been accompanied by critique from within and without the field. Psychiatric nosology has been a particular focus of debate in recent decades; successive edition...

Introduction The European Psychiatric Association (EPA) Summer School allows psychiatric trainees and early career psychiatrists (ECPs) from all over Europe to meet, network, and learn together. After the 2020 edition being cancelled due to COVID-19, the 10th edition in 2021 focused for the first time on research and was conducted remotely. Object...

The European Psychiatric Association (EPA) Summer School is an intensive program which has been organised for 10 years now by the EPA Committee on Education and allows selected psychiatric trainees and early career psychiatrists (ECPs) from all over Europe to meet, network, and learn together. After the 2020 edition being cancelled due to COVID-19...

The global pandemic of COVID-19 has forced people to restrict their outings. In Japan, self-restraint behavior (SRB) has been requested by the government, and some of those decreasing their outings may shift to pathological social withdrawal; hikikomori. The purpose of this study was to examine the risk factors of hikikomori conducting an online pr...

Psychotic symptoms are rarely concurrent with the clinical manifestations of depression. Additionally, whether psychotic major depression is a subtype of major depression or a clinical syndrome distinct from non-psychotic major depression remains controversial. Using data from the Research on Asian Psychotropic Prescription Patterns for Antidepress...

Aims Schizophrenia is a major mental disorder with a wide range of psychiatric symptoms. This study explored the structure of psychiatric symptoms of schizophrenia using network analysis in a large representative Asian sample based on a survey of clinical features and treatment used in schizophrenia patients across 15 countries/territories in Asia....

The augmentation of clozapine with electroconvulsive therapy (ECT) has been an optimal treatment option for patients with treatment- or clozapine-resistant schizophrenia. Using data from the Research on Asian Psychotropic Prescription Patterns for Antipsychotics survey, which was the largest international psychiatry research collaboration in Asia,...

Introduction: The European Psychiatric Association (EPA) Summer School allows psychiatric trainees and early career psychiatrists (ECPs) from all over Europe to meet, network, and learn together. The 10th session of the EPA Summer School focused for the first time on research and was conducted online. Methods: The program of the 2021 Summer School...

Despite human rights and employment equity legislation, people with mental illnesses face a number of barriers to employment. Because of stigma, not only is it difficult to get a job, but it is also difficult to keep a job. Yet, employment is a key factor promoting social inclusion and recovery for people with mental illnesses. Employers’ knowledge...

Since World War II there has been a long history of activities designed to protect the human rights of people with mental and substance use disorders. This chapter examines initiatives to reduce stigma and promote social equity for people with mental and substance use disorders. It begins with a broad view of human rights legislation from organizat...

Anti-stigma advocates have made good use of “older” technologies such as television, movies, radio, theater, and printed materials, to name a few. Newer digital technologies are increasingly viewed as a panacea for mental health promotion and stigma reduction. Not only can they reach vast audiences, but they are also cost-effective, relatively easy...

Healthcare systems, including healthcare providers, have been consistently identified as major contributors to mental illness–related stigma at both interpersonal and system levels. Stigma occurring within health systems is particularly impactful to people who have a mental illness and their family members because it occurs at a time when they are...

The news and entertainment media have produced some of the most sensitive, educational, and award-winning material on mental illnesses and the mentally ill. They also have created a vast store of negative imagery with some of the most malignant depictions of madness and horrifying descriptions of psychiatrists and psychiatric treatments. The fact t...

This book draws on more than 25 years of experience developing and evaluating anti-stigma programs to reduce negative and unfair treatment experienced by people with a mental or substance use disorder. It builds on a previous edition, Paradigms Lost: Fighting Stigma and the Lessons Learned , that identified new approaches to stigma reduction. This...

Despite the importance of school settings for anti-stigma education, school officials and teachers are often reluctant to offer mental illness–related programs to students for fear of reprisals from parents or unexpected negative emotional reactions from students who, they fear, may be triggered by the content. In addition to worrying about how men...

This chapter provides a non-technical summary of how to build an anti-stigma program. It is intended to help local groups through the process of setting up an anti-stigma program. It draws on the authors’ experiences working with international, national, and local anti-stigma groups and is intended to broadly serve as a “how-to” resource. The advic...

This chapter summarizes some of the most important lessons learned from past research and practice. It highlights key approaches to successful stigma reduction, both the principles and practices. It reflects on successful anti-stigma programming and considers novel ways of operating. The state of the art in anti-stigma programming described in the...

A wide range of substances have been stigmatized, including tobacco, alcohol, prescription drugs (such as opioids), and illicit drugs. Public health officials want to stigmatize substances to limit their use, while at the same time they work to destigmatize people with drug dependencies to promote help-seeking and greater social acceptance. Particu...

Since the early 1970s, epidemiological studies have consistently documented a high prevalence of mental illnesses in the population. But it was not until researchers developed the disability-adjusted life-year and applied this internationally that the full public health burden of mental illnesses became known. Stigma is a key driver of inequities i...

This chapter summarizes the key points and guiding principles for anti-stigma programming. It provides a high-level summary of the important points to keep in mind when developing anti-stigma programming and outlines our model of “enlightened opportunism,” which allows programs to seize opportunities that appear for targeted anti-stigma interventio...

In the history of medicine, few conditions other than mental illnesses have cast such a pall on an individual, their family, health providers, health systems, and health research. In addition to having serious consequences for one’s social identity, having a mental illness or substance use disorder results in structural inequities that impinge on o...

At its essence, mental illness–related stigma is a cultural phenomenon, created by such factors as shared beliefs, values, and expectations about what constitutes normal, abnormal, and mentally disordered behavior. Stigma has been generally described as being universal. Yet, more recent research shows that it can vary considerably by time and place...

This book draws on more than 25 years of experience developing and evaluating anti-stigma programs to reduce negative and unfair treatment experienced by people with a mental or substance use disorder. It builds on a previous edition, Paradigms Lost: Fighting Stigma and the Lessons Learned, that identified new approaches to stigma reduction. This v...

Objectives: Pre–electroconvulsive therapy (ECT) evaluation is an essential part of ECT preparation, a standard treatment in the psychiatric field. However, no routine pre-ECT evaluation has been published so far. This preliminary study aimed to explore different practices in pre-ECT evaluation across European countries. Methods: The data were colle...

Background: Because use and dosing of mood stabilizers (MSs) to treat bipolar disorder (BD) patients in Asia are not well documented, we examined prevalence and clinical correlates of treatment of Asian BD patients with relatively high doses of MSs. Methods: We conducted a pharmacoepidemiological survey across 13 Asian countries and territory in...

This study aimed to analyze treatment guidelines of 12 SEE countries to identify non-pharmacological interventions recommended for schizophrenia, explore the evidence base supporting recommendations, and assess the implementation of recommended interventions. Desk and content analysis were employed to analyze the guidelines. Experts were surveyed a...

Objective: Pharmacotherapy including mood stabilizers and antipsychotics are frequently used in bipolar disorder (BD); however, the lack of consensus regarding the definition of polypharmacy hinders conducting comparative studies across different settings and countries. Research on Asian Prescription Pattern (REAP) is the largest and the longest l...

Background There are limited data on the role of body image in patients with type 2 diabetes. The purpose of this study was to compare body self-esteem in this group with norms for the general Polish population and to investigate the relationship between body self-esteem and the psychological and clinical characteristics of the course of diabetes....

Background: . High-quality comprehensive data on short-/long-term physical/mental health effects of the COVID-19 pandemic are needed. Methods: . The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is an international, multi-language (n=30) project involving >230 investigators from 49 countries/territories/re...

Mental disorders account for at least 18% of global disease burden, and the associated annual global costs are projected to be US$6 trillion by 2030. Evidence-based, cost-effective public mental health (PMH) interventions exist to prevent mental disorders from arising, prevent associated impacts of mental disorders (including through treatment), an...

The symptom heterogeneity of schizophrenia is consistent with Wittgenstein’s analogy of a language game. From the perspective of precision medicine, this study aimed to estimate the symptom presentation and identify the psychonectome in Asian patients, using data obtained from the Research on Asian Psychotropic Prescription Patterns for Antipsychot...

Background . High-quality comprehensive data on short-/long-term physical/mental health effects of the COVID-19 pandemic are needed. Methods . The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is an international, multi-language (n=30) project involving >230 investigators from 49 countries/territories/regi...

Background Pathways to care studies are feasible and tested means of finding the actual routes taken by patients before reaching proper care. In view of the predominance of nonprofessional service providers and the lack of previous large studies on pathways in Nepal, this multicenter study is needed. The aim of the study was to trace the various pa...

The COVID‐19 pandemic has disrupted scientific gatherings and conferences, opening up opportunities for virtual learning platforms. Realizing the potential of online academic exchanges, the World Psychiatric Association (WPA) also developed virtual avenues and information systems for capacity building of mental health professionals across the world...

Background Patients suffering from severe mental disorders, including schizophrenia, major depression and bipolar disorders, have a reduced life expectancy compared to the general population of up to 10–25 years. This mortality gap requires urgent actions from a public health perspective in order to be reduced. Main text Factors associated with th...

Objective: Recently, rational polypharmacy approaches have been proposed, regardless of the lower risk and cost of monotherapy. Considering monotherapy as first-line treatment and polypharmacy as rational treatment, a balanced attitude toward polypharmacy is recommended. However, the high prevalence of polypharmacy led the Japanese government to e...

Purpose The aim of this study was to assess the structure and validate the Polish version of the Problem Areas in Diabetes (PAID) scale, as the current translations of the original English version significantly vary in their psychometric properties. Patients and Methods Two hundred and sixteen consecutive Polish outpatients were invited to partici...

The European Psychiatric Association (EPA) Summer School is an intensive program which has been organised for 10 years now by the EPA Committee on Education and allows selected psychiatric trainees and early career psychiatrists (ECPs) from all over Europe to meet, network, and learn together. After the 2020 edition being cancelled due to COVID-19...

Background: The COVID-19 pandemic has altered daily routines and family functioning, led to closing schools, and dramatically limited social interactions worldwide. Measuring its impact on mental health of vulnerable children and adolescents is crucial. Methods: The Collaborative Outcomes study on Health and Functioning during Infection Times (C...

Background: Non-pharmacological treatment for schizophrenia includes educational, psychotherapeutic, social, and physical interventions. Despite growing importance of these interventions in the holistic treatment of individuals with schizophrenia, very little is known about their availability in South-East European countries (SEE). Objective: To e...

Background: The COVID-19 pandemic has forced people to change their lifestyles, especially with respect to restrictions on going out. Forced quarantine (i.e., lockdown) and self-restraint behavior (SRB), including self-quarantine, are suggested to induce potential negative impacts on public mental health. SRB seems to be related to governmental pol...

PurposeWe aimed to map evidence on the development of mental health care in Central Asia after 1991.Method We conducted a scoping review complemented by an expert review. We searched five databases for peer-reviewed journal articles and conducted grey literature searching. The reference lists of included articles were screened for additional releva...

Background: . High-quality comprehensive data on short-/long-term physical/mental health effects of the COVID�19 pandemic are needed. Methods: . The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is an international, multi-language (n=30) project involving >230 investigators from 49 countries/territories/r...

Methods: A systematic analysis was performed of the medical specialization academic programs of 20 different countries to establish which medical specialties take into account mental health issues in the specialty curricular design and which mental health content these programs address. The criteria that were explored in the educational programs i...

Since the Second World War mental health programmes and psychiatry have made significant advances. Countries, as well as the United Nations, have recognized the magnitude and severity of mental health problems, and numerous national programmes have been launched to deal with them. Technology relating to the treatment of mental disorders has advance...

Drug-induced extrapyramidal syndrome (EPS) remains a major problem in clinical psychiatry. This study aimed to examine the factor structure of drug-induced extrapyramidal symptoms observed in patients with schizophrenia and assessed using the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS). The participants were 1,478 patients with a diagnosis...

The effects of Covid‐19 have been well documented across the world with an appreciation that older people and in particular those with dementia have been disproportionately and negatively affected by the pandemic. This is both in terms of their health outcomes (mortality and morbidity), care decisions made by health systems and the longer‐term effe...

Objective: To assess the prevalence of mental disorders in patients with type 2 diabetes mellitus (DM2) and their relationship with laboratory findings, somatic comorbidities and psychosocial consequences. Material and methods: In the frames of the INTERPRET-DD multicenter 200 T2DM patients from primary care (47 men and 153 women) from the Russi...

Objective To provide an estimate of the effect of interventions on comorbid depressive disorder (MDD) or subthreshold depression in type 1 and type 2 diabetes. Methods Systematic review and meta‐analysis. We searched PubMed, PsycINFO, Embase, and the Cochrane Library for randomized controlled trials evaluating the outcome of depression treatments...

Aims This study evaluated the psychometric characteristics of the Polish version of the PHQ-9 in detecting major depression (MDD) and ‘MDD and/or dysthymia’ in people with and without type 2 diabetes. Methods Participants were randomly selected from a diabetes outpatient facility (N = 216) and from among patients admitted to a medical center and p...

Aim: Diabetic peripheral neuropathy (DPN) is a common, severe microvascular complication of diabetes. Our study was to assess prevalence and risk factors for DPN in subjects with type 2 diabetes from 14 different countries. Methods: A total of 2,733 subjects with type 2 diabetes aged 18–65 years (45.3% men, mean duration of diabetes = 8.8 years) we...

Background.: Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations...

Background: Although an inverse relationship between body mass index (BMI) and Parkinson disease (PD) has been repeatedly reported, to our knowledge, the relationship between BMI and antipsychotic-induced extrapyramidal symptoms (EPS) has rarely been studied in patients with schizophrenia. Our study aimed to evaluate the relationship between BMI a...

Although the association between antipsychotic use and corrected QT interval (QTc) prolongation has been repeatedly confirmed, the relationship has been rarely studied in a practical setting. Using data from the Research on Asian Psychotropic Prescription Patterns for Antipsychotics (REAP‐AP) survey, our study aimed to investigate the prevalence an...

Objective Studies examining coprescription and dosages of mood stabilizers (MSs) with antipsychotics for psychotic disorders are infrequent. Based on sparse extant data and clinical experience, we hypothesized that adjunctive MS use would be associated with certain demographic (e.g., younger age), clinical factors (e.g., longer illness duration), a...