Psychiatry Course Research Articles

Hamlet and psychiatry intertwined.

This article considers selected landmarks in the history of psychiatry and their impact on Hamlet productions, including Burton's Anatomy of Melancholia, Emil Kraepelin's manic-depression, Freud's oedipal complex and R.D. Laing's 'divided self'. Additionally, this article considers the way Shakespeare's Hamlet has influenced the course of psychiatry. The linkages between psychiatry and Hamlet have existed since the 17th century, and perhaps Shakespeare's Hamlet should have a place on every psychiatrist's shelf.

Disease modifying effects of antipsychotic drugs in schizophrenia: a clinical and neurobiological perspective.

Disease modifying effects of antipsychotic drugs in schizophrenia: a clinical and neurobiological perspective.

Advances in clinical pharmacy education in Germany: a quasi-experimental single-blinded study to evaluate a patient-centred clinical pharmacy course in psychiatry

BackgroundThe pharmacy profession has shifted towards patient-centred care. To meet the new challenges it is necessary to provide students with clinical competencies. A quasi-experimental single-blinded teaching and learning study was carried out using a parallel-group design to evaluate systematically the benefits of clinical teaching in pharmacy education in Germany.MethodsA clinical pharmacy course on a psychiatric ward was developed and implemented for small student groups. The learning aims included: the improvement of patient and interdisciplinary communication skills and the identification and management of pharmaceutical care issues. The control group participated only in the preparation lecture, while the intervention group took part in the complete course. The effects were assessed by an objective structured clinical examination (OSCE) and a student satisfaction survey.ResultsThe intervention group achieved significantly better overall results on the OSCE assessment (46.20 ± 10.01 vs. 26.58 ± 12.91 of a maximum of 90 points; p < 0.0001).The practical tasks had the greatest effect, as reflected in the outcomes of tasks 1–5 (34.94 ± 9.60 vs. 18.63 ± 10.24 of a maximum of 60 points; p < 0.0001). Students’ performance on the theoretical tasks (tasks 6–10) was improved but unsatisfying in both groups considering the maximum score (11.50 ± 4.75 vs. 7.50 ± 4.00 of a maximum of 30 points; p < 0.0001). Of the students, 93% rated the course as practice-orientated, and 90% felt better prepared for patient contact. Many students suggested a permanent implementation and an extension of the course.ConclusionsThe results suggest that the developed ward-based course provided learning benefits for clinical skills. Students’ perception of the course was positive. Implementation into the regular clinical pharmacy curriculum is therefore advisable.

Impact of a Nursing in Psychiatry Course on Students' Attitudes Toward Mental Health Disorders

Negative attitudes toward patients with mental illnesses are not uncommon among health professionals, and lead to poorer quality and outcomes of care. Because attitudes are formed early in life, the current study aimed to investigate if teaching psychiatry in secondary school nursing students (i.e., adolescents) changes attitudes toward three prevalent psychiatric disorders: schizophrenia, posttraumatic stress disorder (PTSD), and depression. A pilot quasi-experimental study was conducted with 51 fourth-year students in secondary nursing school who completed a questionnaire regarding attitudes toward these disorders on the first and last day of their Nursing in Psychiatry course. Results show that the stigma attached to all three disorders was significantly reduced after students completed the course. Students attached greater stigma to schizophrenia than PTSD, and to PTSD than depression, before and after the course. The study indicates that education in psychiatry helps reduce negative attitudes toward PTSD, schizophrenia, and depression. [Journal of Psychosocial Nursing and Mental Health Services, 56(3), 45-51.].

Mental illness stigma among medical students and teachers.

Medical school curriculum contributes to future doctors' attitude formation towards people with mental illness. The purpose of this study was to compare stigmatizing attitudes between medical students and faculty, analyse stigmatizing attitudes among students from different years of study and identify factors predicting stigma. A cross-sectional study with the use of scales measuring attitudes and social distance was designed. Online questionnaires were distributed to all students and teachers at a medical faculty in the Czech Republic. The response rate was 32.1% ( n = 308) among students and 26.7% ( n = 149) among teachers. Teachers had a greater prevalence of stigmatizing attitudes than students. Increased tolerant attitudes in students were detected after the fourth year, that is, following introduction to psychiatry. Preferred specialization in psychiatry and attending two psychiatry courses predicted more tolerant attitudes. Among both students and teachers, men possessed more stigmatizing attitudes towards people with mental illness. Age was an important predictor of stigmatizing attitudes among teachers. Educators should pay closer attention to the role of medical psychology and communication training implementation, which may be beneficial to improving skills and increasing medical students' self-esteem and feeling of competence throughout their psychiatry rotation.

A Brief History of Lithium Treatment in Psychiatry.

The history of lithium as a psychiatric medication is marked by its serendipitous discovery, its lengthy path to US Food and Drug Administration approval, and controversy surrounding its current status in bipolar disorder treatment. Without doubt, the discovery of lithium as a psychotropic agent forever changed the course of psychiatry. The drug's fascinating, and sometimes contentious, history is reviewed here.

Workplace stress among non-doctor trainees in psychiatric rehabilitation

Mental health care settings have long been associated to a specific and long-standing emotional involvement, eventually determining professional stress and burnout in psychiatrists. However, recent evidence demonstrated that also non-doctor mental health workers may be at high risk of developing job dissatisfaction. Previous studies also suggested that the longer exposure to psychiatric settings the higher the levels of burnout. We report here data from a survey conducted among first-year students of rehabilitation courses in psychiatry (n = 44) and logopedics (n = 39), before and after the first exposure to an health care environment over a 6-month term. We investigated their psychological wellbeing and risk of psychiatric morbidity (by means of GHQ-12), levels of burnout (with the Maslach Burnout Inventory) and knowledge about mental health (by means of the MAKS schedule). The two groups were comparable as for the main socio-demographic characteristics as well as for their knowledge about mental health before training. We found a significant difference between students in mental and general health care, with significantly higher emotional exhaustion and depersonalization and lower personal accomplishment levels in the former group, after 6-month training. Such changes were significantly correlated to variations in knowledge about mental health issues and risk of psychiatric morbidity. The implementation of a specific peer support group was perceived as extremely useful by the majority of the students (96%) and had a positive impact on their burnout levels and psychological wellbeing.Disclosure of interestThe author has not supplied his declaration of competing interest.

Empathy and attitudes towards mental illness among Italian medical students

ABSTRACTThere is a growing interest regarding the attitudes of medical students towards people with mental illness, since discrimination and stigma may affect healthcare workers and education should be aimed to improve empathy and attitudes at medical school level. A cross-sectional study was conducted at medical schools in Rome and Foggia (Italy). We recruited 339 medical students who completed an anonymous self-report questionnaire including sociodemographic data, the 40-item Community Attitudes toward the Mentally Ill scale (CAMI) and the 60-item Baron Cohen’s Empathy Quotient. The questionnaires were administered before and after the yearly academic course of psychiatry. This study shows a significant improvement in some CAMI items and total score after the yearly academic course of psychiatry among medical students, especially among those who had personal experience with mentally ill people (including the training in a psychiatric ward). Female students reported higher empathy quotient and CAMI score...

Development of a Diverse Learning Experience for Diverse Psychiatry Resident Needs: A Four-Year Biological Psychiatry Curriculum Incorporating Principles of Neurobiology, Psychopharmacology, and Evidence-Based Practice.

ObjectiveA clinically relevant approach to patient care grounded in neurobiological constructs and evidence based practice which emphasizes a relevant psychopharmacology is needed to optimally train psychiatry residents.MethodsWe implemented a biological psychiatry course that now incorporates neurobiology, psychopharmacology, and evidence-based practice in conjunction with a Research Domain Criteria (RDoC) perspective. A survey launched prior to course implementation and following each class session, served as the outcome metric of residents' attitudes toward the new curriculum and followed a baseline attitudinal survey designed to evaluate the program.ResultsGreater than 90% of the psychiatry residents at Duke University who took the attitudinal survey agreed or strongly agreed with needing a course that helped them develop an understanding of neurobiology, psychopharmacology, and evidence-based practice concepts. Most residents also indicated a less than adequate understanding of the neurobiology and psychopharmacology of psychiatric disorders prior to sessions.ConclusionOur biological psychiatry curriculum was associated with enthusiasm among residents regarding the incorporation of neurobiology, psychopharmacology, and evidence-based practice into course topics and discussions. A biological psychiatry curriculum with integrated neurobiology and psychopharmacology built on an evidence base approach is possible, well-received, and needed in training of future psychiatrists.

The effect of an elective psychiatry course on pharmacy student empathy

IntroductionWhile a number of published studies have evaluated the impact of pedagogical methods on pharmacy student stigma and attitudes toward patients with mental illness, the current study is the first to compare a psychiatry elective course to traditional lecture on pharmacy student empathy toward patients with mental illness. Materials and methodsAll third-year pharmacy students at one pharmacy school enrolled in the Pathophysiology/Therapeutics III course and prior to enrollment in an Advanced Psychiatry elective course, were invited to complete a survey containing the Jefferson Scale of Empathy Health Professions Student Version (JSE-HPS). Demographic variables including age, gender, family history of mental illness, and previous experience in mental health hospitals were also collected. The same survey instrument (JSE-HPS with demography) was administered after traditional lecture/prior to psychiatry elective and at the conclusion of the Advanced Psychiatry elective. ResultsThe survey was completed by 60% (N = 41) of students prior to traditional lecture, 45% (N = 31) after traditional lecture and 88% (N = 14) after the psychiatry elective. Mean empathy scores increased from 109.32 pre-lecture to 112.86 post-lecture (p = 0.162 vs. pre-lecture) and 120.00 post-elective (p = 0.001 vs. pre-lecture). ConclusionThe teaching methods employed in the psychiatry elective course, including media, contact-based education and an auditory hallucination simulator, lead to an increase in pharmacy student empathy toward patients with mental illness. Pharmacy educators should continue to explore novel ways to increase pharmacy student empathy toward patients with mental illness.

Differences in attitudes towards mental illness and psychiatry among medical students, before and after the academic course of psychiatry

BackgroundStigma towards mental illness and psychiatry have a major impact on psychiatric patients’ quality of life; in particular, prejudicial beliefs make it more difficult for future doctors to send patients to mental health services, leading to a delay of necessary care.AimsOur aim is to evaluate the stigma towards mental illness and psychiatry, in a sample of Italian medical students. We studied the differences between the first-year students who have not attended the academic course in psychiatry, compared to the senior students who have attended the psychiatric lectures.MethodsWe tested 113 medical students, using the following questionnaires:– Attitudes Towards Psychiatry (ATP 30);– Community Attitudes Towards Mental Ill (CAMI);– Perceived Discrimination Devaluation Scale (PDD), to assess the discrimination towards mental illness perceived in society;– Baron-Cohen's Empathy Quotient (EQ), to measure empathy.ResultsAmong the 113 students, 46 have already attended the academic course of psychiatry and CAMI scores were less stigmatizing as total score (P = 0.014) and in authoritarianism subscale (P = 0.049), social restriction (P = 0.022) and ideology of mental health in the community (P = 0.017). However, there were no statistically significant differences in empathy, perceived discrimination in the society and stigmatization of psychiatry.ConclusionsThe 67 students who have not attended the academic course of psychiatry are more stigmatizing, considering psychiatric patients as inferior people that require coercive attitudes, socially dangerous and that should be treated faraway from the community. Studying psychiatry is therefore useful to reduce, in the future doctors, these prejudices toward mentally ill patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Suicide prevention in pharmaceutical education: Raising awareness with inspiring stories.

Suicide rates are high in high-income countries like Canada and the United States, where 10 to 12 people per 100 000 commit suicide every year. In the United States, in 2011 there were 73.3 emergency room visits per 100 000 people for suicide attempts with prescription drugs. The latter were also involved in 13% of completed suicides between 1999 and 2013. In most cases, these drugs were distributed by members of our profession who could not predict this outcome. This led us to create an initiative to teach pharmacy students how to prevent suicide. A literature review and online search were performed to find documentation about pharmacists' commitment to the cause, but very little information exists. Thus, a training session was developed for third-year pharmacy students that includes basic statistics, arguments for involving pharmacists in suicide prevention, role-playing, tools to evaluate suicide risk, thoughtful verbatims of interview techniques, and case studies. It is delivered during the mental health theme of the psychiatry course. In 5 years, around 1150 students have participated in the course, of whom approximately 950 are now practicing pharmacists. This intervention may have prevented some suicides, although the impact is impossible to measure. The objective of this paper is to describe the creative process of designing a suicide prevention training session for pharmacy students, while inspiring a mental health sensitive readership to this noble cause. This article does not provide guidelines on how to replicate this initiative, nor does this article replace proper training on suicide prevention.

Not The Ghost in The Machine: Transforming Patient Data into E-Learning Cases Within A Case-Based Blended Learning Framework For Medical Education

Emergent challenges in medical education support an implementation of trans-disciplinary case-based learning. We propose a case-based blended learning framework, synergistically combining textbook, e-learning cases and a simulated patient course in medical education. A novel server system architecture allows patient data to be automatically transferred from the Vienna General Hospital to the Medical University of Vienna, and then imported into an e-learning template, in which online MCQ questions can be generated. We present one example of a transferred, imported and completed anxiety disorder e-learning case, currently implemented in the pre-clinical psychiatry course. This framework facilitates the creation of up to date teaching content, while addressing difficulties in transforming declarative knowledge into procedural-knowledge and -skill, (background knowledge into clinical reasoning) especially in domains which profit from a structured learning approach in creating a close link in understanding between functional morphology and clinical presentation.

APA Offers Online Course Focusing on Recovery

Back to table of contents Previous article Next article Association NewsFull AccessAPA Offers Online Course Focusing on RecoveryVabren WattsVabren WattsSearch for more papers by this authorPublished Online:15 Sep 2014https://doi.org/10.1176/appi.pn.2014.9b3AbstractThe new Recovery to Practice course is designed to help psychiatrists and mental health professionals foster a deeper relationship with patients, say the course developers.In August, APA launched the website of Recovery to Practice (RTP), an online continuing medical education course centered on recovery-oriented care.“There has been a push for transformation of our behavioral health care system to become a more person-centered kind of care,” commented Wesley Sowers, M.D., director of the Center for Public Service Psychiatry at Western Psychiatric Institute and Clinic in Pittsburgh and a member of the RTP curriculum advisory committee. “This new project,” he explained to Psychiatric News, “will allow patients to take control of their lives and have a directive roll in recovery.”The course was co-developed by APA and the American Association of Community Psychiatrists to equip psychiatrists and other mental health care providers with the “knowledge and tools to provide care in a manner that respects the person, engages them as an active participant in decision making, and engenders hope in achieving their goals,” according the course description.The RTP consists of nine modules, each ranging from 20 to 40 minutes, that address specific aspects of recovery-oriented practice via narrated slides, video clips from experts, and case vignettes. APA designates a maximum of 1 AMA PRA Category 1 credit per module. These are the module:Introduction to Recovery-Oriented Care Engagement and Welcoming Environment Person-Centered Planning and Shared Decision MakingPeer Supports in RecoveryThe Role of MedicationHealth- and Wellness-Focused CareDeveloping Living Skills and Natural SupportsCulturally Appropriate CareTrauma-Informed CareThough there has been much focus on the biological and technical aspects of treatment for mental disorders over the past decade, Sowers said that once implemented in practice, the principles learned from the RTP course will show that the “human” aspects of treatment are just as important in healing as treatments that may be considered more “advanced.”The course can help psychiatrists develop “better and deeper relationships” with patients, Sowers stressed. “By engaging with [patients] in a humanistic way, we will recognize their potential for growth and getting back to a satisfying and productive life.”Funding for the course was provided by the Substance Abuse and Mental Health Services Administration’s Recovery to Practice Initiative, which awarded five-year contracts, each valued at $350,000, to six national mental health organizations “to develop and implement training curricula that promote greater awareness, acceptance, and adoption of mental health recovery principles and practices among mental health providers.” ■The Recovery-Oriented Care in Psychiatry course can be accessed here. Enroll now in 9 part series to provide psychiatrists with a basic understanding of recovery from mental illness and substance use disorders. ISSUES NewArchived

Spanish Medical Students’ Attitudes and Views towards Mental Health and Psychiatry: a Multicentric Cross-Sectional Study

The aim of this study is to investigate the attitudes towards mental illness and psychiatry among fifth year Spanish medical students. The study included 171 students from three medical schools located in different areas of Spain: Cádiz; UCA (n = 113), Madrid; San Pablo-CEU (n = 22), and Barcelona; UAB (n = 36). They responded, prior to their undergraduate medical course in psychiatry, to the AMI questionnaire to measure the attitudes towards mental illness and to Balon's adapted questionnaire to investigate their view towards psychiatry. The students (93.4 %) had a positive attitude towards mental illness (AMI). Attitudes towards psychiatry were fairly positive with a few negative views, specifically regarding the role of psychiatrists (items 11 and 13) and the prestige of the specialty (item 16). There were some statistically significant differences between the three medical schools in the perception of psychiatry as a medical discipline. A better attitude towards mental illness was associated with a better view of the overall merits of psychiatry. Findings suggest that Spanish medical students do not have a negative attitude towards mental illness and they have a good perception of psychiatry, although there are still some misconceptions about this specialty. These student's attitudes could favor an appropriate management of patients suffering from mental illness.

Psychiatrist-Anthropologist Studies Drug Addiction and Recovery

Psychiatrist-Anthropologist Studies Drug Addiction and Recovery

Conversation with Charles P. O'Brien

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The development of a model of training in child psychiatry for non-physician clinicians in Ethiopia.

BackgroundThe lack of trained mental health professionals has been an important barrier to establishing mental health services in low income countries. The purpose of this paper is to describe the development and implementation of child psychiatry training within a graduate program in mental health for non-physician clinicians in Ethiopia.MethodsThe existing needs for competent practitioners in child psychiatry were identified through discussions with psychiatrists working in Ethiopia as well as with relevant departments within the Federal Ministry of Health Ethiopia (FMOHE). As part of a curriculum for a two year Master of Science (MSC) in Mental Health program for non-physician clinicians, child psychiatry training was designed and implemented by Jimma University with the involvement of experts from Addis Ababa University (AAU), Ethiopia, and Ludwig-Maximillian’s University, (LMU), Germany. Graduates gave feedback after completing the course. The World Health Organization’s (WHO) Mental Health Gap Action Program (mhGAP) intervention guide (IG) adapted for Ethiopian context was used as the main training material.ResultsA two-week child psychiatry course and a four week child psychiatry clinical internship were successfully implemented during the first and the second years of the MSC program respectively. During the two week psychiatry course, trainees learned to observe the behavior and to assess the mental status of children at different ages who had a variety of mental health conditions. Assessment of the trainees’ clinical skills was done by the instructors at the end of the child psychiatry course as well as during the subsequent four week clinical internship. The trainees generally rated the course to be ‘very good’ to ‘excellent’. Many of the graduates have become faculty at the various universities in Ethiopia.ConclusionChild psychiatry training for non-physician mental health specialist trainees was developed and successfully implemented through collaboration with other universities. The model of institutional collaboration in training mental health professionals in the context of limited resources provides a useful guide for other low income countries where there is scarcity of psychiatrists.

EPA-1157 – The influence of medical student gender and drug use on the detection of addiction in patients

Introduction Little is known about medical students’ interest in their training on drug addiction, their personal experience of consumption and whether these aspects influence the detection of addiction in patients. Objectives To study the interest of medical students enrolled on the psychiatry course in the area of addictions, and evaluate the influence of such interest, a history of personal consumption and gender on the detection of addiction in patients. Aims&Methods Voluntary participation was offered to all students from academic years 2008–2009 to 2012–2013. Of the 505 potential students, 336 questionnaires were collected, of which 71.13% were female. Results Of the respondents, 88.5% considered that drug dependence issues are important to their professional future and 63% that the approach to drug-related diseases is important. A total of 34% of the students had already assessed addicted patients in their previous clinical training. The students report consuming alcohol(69%), cigarettes(19.5%) and illegal drugs(15.8%). The female students consumed fewer illegal drugs than the men(p0.022) and more frequently considered that the list of topics to be covered was appropriate(p0.021). The male students consumed more illegal drugs more frequently(p 0.005), knew more consumers(p 0.023), and those who drink alcohol consumed more illegal drugs than women(p Conclusions Consumption among medical students may have a normalizing role on consumption and prevent the detection of addicts. It is important to educate and raise awareness on drugs, as this may influence detection. The focus should be particularly on the male group.

Transforming a Dumping Site Into a Psychiatric Inpatient Unit in Somalia

Back to table of contents Previous article Next article PerspectivesFull AccessTransforming a Dumping Site Into a Psychiatric Inpatient Unit in SomaliaJibril Handuleh, M.B.B.S.Jibril HandulehSearch for more papers by this author, M.B.B.S.Published Online:1 Nov 2013https://doi.org/10.1176/appi.ajp.2013.13010044AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Above: The new psychiatric unit at the hospital in Borama, Somalia. Left: The doctors and nurses having clinical case discussions after rounds.Somalia is a country in the horn of Africa in a region known for wars, hunger, and droughts. The country has been in a state of chaos since 1991, when the last serving dictator, Siad Barre, was overthrown. According to the World Health Organization, two out of every five people in the country suffer from mental health disorders (1). Qat, or khat, a stimulant containing an amphetamine-like substance, makes the situation worse and is sometimes associated with psychosis (2). Since 2000, British institutions, including King's College London and the charity Tropical Health and Education Trust, have been helping the local Somali people to develop their own services through education of doctors (3). Local graduating health professionals have been given short courses in psychiatry and, through online tutorials, helped from a distance to develop mental health services in Somalia (4, 5).The images shown here come from Borama, a town in northwestern Somalia. Borama has a population of 150,000 and is home to Amoud University Medical School. The local community decided to fund a psychiatric inpatient unit in Borama Hospital, to reduce stigma by integrating psychiatry into the hospital. The Somali diaspora communities in northern Europe, with the backing of the local community leaders, raised enough money to build an inpatient psychiatric unit in Borama Hospital with no international support.The psychiatric unit was built on a former hospital dumping site. Construction began in February 2012, and the unit opened its doors in June 2012. It has 24 beds and an outpatient department.From the Amoud School of Health Sciences, Borama, Somalia.Address correspondence to Dr. Handuleh (jibriil.[email protected]com).Photographs provided by Dr. Handuleh and approved by Borama Hospital and the community. The author thanks everyone who contributes to the services of the unit.References1 World Health Organization: A Situation Analysis of Mental Health in Somalia. http://applications.emro.who.int/dsaf/EMROPUB_2010_EN_736.pdfGoogle Scholar2 Odenwald M, Neuner F, Schauer M, Elbert T, Catani C, Lingenfelder B, Hinkel H, Häfner H, Rockstroh B: Khat use as risk factor for psychotic disorders: a cross-sectional and case-control study in Somalia. BMC Med 2005; 3:5Crossref, Medline, Google Scholar3 Leather A, Ismail EA, Ali R, Abdi YA, Abby MH, Gulaid SA, Walhad SA, Guleid S, Ervine IM, Lowe-Lauri M, Parker M, Adams S, Datema M, Parry E: Working together to rebuild health care in post-conflict Somaliland. Lancet 2006; 368:1119–1125Crossref, Medline, Google Scholar4 Finlayson AE, Baraco A, Cronin N, Johnson O, Little S, Nuur A, Tanasie D, Leather A: An international, case-based, distance-learning collaboration between the UK and Somaliland using a real-time clinical education website. J Telemed Telecare 2010; 16:181–184Crossref, Medline, Google Scholar5 Syed Sheriff R, Whitwell S: An innovative approach to integrating mental health into health systems: strengthening activities in Somaliland. Intervention 2012; 10:59–65Crossref, Google Scholar FiguresReferencesCited byDetailsCited ByHigh variability of the current mental health practices around the globe: Twenty days in the lives of psychiatrists and other mental health care professionals from all over the world18 September 2020 | Global Psychiatry, Vol. 0, No. 0 Volume 170Issue 11 November 2013Pages 1248-1248 Metrics PDF download History Accepted 1 February 2013 Published online 1 November 2013 Published in print 1 November 2013