Image Of Psychiatry Research Articles

Methods for and Use of Functional Magnetic Resonance Imaging in Psychiatry.

Functional magnetic resonance imaging (fMRI) is a noninvasive technique for measuring brain activity that uses MRI to measure the blood oxygen level dependent (BOLD) signal. Over the 30+ years since the technique was first described (Ogawa et al. 1990), BOLD-fMRI has uncovered much about the organization and function of the human brain and is now beginning to fulfill its promise as a tool for diagnostic and prognostic biomarker of psychiatric conditions. In this chapter, we will first describe the neurophysiology, basic physics, and image processing of the technique. We will then discuss three broad applications of the technique with an emphasis on both best practices and future uses for psychiatric biomarkers.

Image of psychiatry and psychic illness during the COVID-19 pandemic: social media monitoring

BackgroundExperts indicate that despite the demand there was no increase in referrals to Moscow psychiatric services in 2020. Among contributing factors are image/public perception of psychiatry and psychiatric diseases that are heavily influenced by social media.MethodsMore than 700 thousand social media messages of Muscovites matching relevant keywords (January-August, 2020) were downloaded using specialized software. Alongside with quantitative analysis, qualitative analysis was performed on a random subsample of 401 messages and respective images.ResultsOur analysis allowed combining messages into 6 groups and the biggest one was “Frivolous attitude to psychiatry”. In these messages, psychiatric terms are mainly used as means of stigmatization, to insult the opponent, even in cases when person is “guilty” of liking the “wrong” ideology, politicians or fashion. This heavily stigmatizes seeking help in official psychiatric facilities. People discuss numerous psychiatric diagnoses but at the same time they do not distinguish between types of psychiatric services (even in- and outpatient facilities). In the overall majority of messages people rely not on their personal experience, but on their thoughts based on e.g. stigmatizing pieces of art. This often leads to highly incompetent statements. COVID-19 references were very few in the subsample (<4%) but it should be highlighted that sometimes information gaps are filled with esoteric and conspiracy theories which do not promote seeking help in official psychiatric facilities either.ConclusionsAnalysis showed high level of stigmatization of the service in social media, which can distract people from seeking help when needed. It can be recommended to create appropriate social media monitoring system to find main topics for informational interventions and monitor the effectiveness of such interventions.Key messages Psychiatry and psychic illness are highly stigmatized in social media.Social media monitoring can help in destigmatization of psychiatric care.

Wizerunek psychiatry, psychologa i psychoterapeuty w mediach. Analiza polskich tygodników opinii

Introduction: The image of psychiatry and psychiatrists in film, press and news media is presented in a negative way. Psychiatrists are shown as unethical, unprofessional, ineffective and generallybringing harm to their patients, although they are shown as better educated and more intelligent than psychologists. Existing literature on the image of psychiatrists concerns mainly fictional characters and skips the Polish context. The aim of the study was to find out how psychiatry and mental health experts are presented in Polish opinion weeklies. Material and methods: An analysis of psychiatrist’simage was carried out using competent judges method. A database of 208 articles from year 2013 was created. The articles were chosen from the magazines“Angora”, “Do Rzeczy”, “Gazeta Polska”, “Gośc Niedzielny”, “Newsweek Polska”, “Polityka”, “Sieci”, “Wprost”, using keywords related to psychiatry, psychology and psychotherapy.Two independent judges conducted the analysis using a questionnaire created for the purpose of this study, assessing the content of the articles on three five-step dimensions: (1) Competence, (2) Positive role, (3) Ethics. Results: The average overall assessment of the image of psychiatrists, psychologists and psychotherapists oscillated around the value of 3.5, indicating the neutrality of the image. No statistically significant differences were found in the assessment of the level of competence, a positive assessment of the role and ethics between specialists. 53% of the articles presented psychiatrists in a positive way, 40% in a neutral way, and 6% in a negative way. Among psychologists, the image was positive in 60%, in 27% it was neutral, and in 13% - negative. In the case of psychotherapists, the frequencies is by analogy 33%, 52% and 15%. Conclusions: The image of psychiatrists, psychologists and psychotherapists in the analyzed articles was positive or neutral. There was no significant difference between representation strategies of each profession. The comparison of the obtained results with the analyses presented in the literature shows that the image of mental health experts is systematically improving.

Recent advances in the use of imaging in psychiatry: functional magnetic resonance imaging of large-scale brain networks in late-life depression.

Advances in neuroimaging have identified neural systems that contribute to clinical symptoms that occur across various psychiatric disorders. This transdiagnostic approach to understanding psychiatric illnesses may serve as a precise guide to identifying disease mechanisms and informing successful treatments. While this work is ongoing across multiple psychiatric disorders, in this article we emphasize recent findings pertaining to major depression in the elderly, or late-life depression (LLD), a common and debilitating neuropsychiatric illness. We discuss how neural functioning of three networks is linked to symptom presentation, illness course, and cognitive decline in LLD. These networks are (1) an executive control network responsible for complex cognitive processing, (2) a default mode network normally deactivated during cognitive demanding when individuals are at rest, and a (3) salience network relevant to attending to internal and external emotional and physiological sensations. We discuss how dysfunction in multiple networks contributes to common behavioral syndromes, and we present an overview of the cognitive control, default mode, and salience networks observed in LLD.

La web TV, un outil de communication au service de la qualité des soins

The Web TV of the EPSM Lille-Métropole is an innovative communication tool in mental health. Aiming to change the image of psychiatry among users as well as professionals, these programmes, posted online, enable viewers to see the care provided by mental health professionals. They are also an opportunity for those involved to get to know each other better to improve the way they work together.

Images of psychiatry: Attitude survey of teaching medical specialists of India.

Context:Attitude of teaching medical specialists shapes those of future doctors. Region-specific data on teaching medical specialists’ attitudes toward psychiatry (ATP) are lacking from India.Aims:This study aimed to assess the attitudes of teaching medical specialists toward psychiatry and its association with sociodemographic profile and career stage.Settings and Design:This is a cross-sectional descriptive survey.Materials and Methods:Attitude towards psychiatry (ATP) was assessed from 188 specialists from All India Institute of Medical Sciences (AIIMS) Bhubaneswar and AIIMS Jodhpur using modified ATP scale-30.Statistical Analysis:Descriptive statistical analysis was done using SPSS version 16.0. Associations of ATP with sociodemographic status, career stage, and family history of psychiatric illness were done using logistic regression analysis.Results:Overall response rate was 81.68%, and gender (confidence interval [C.I.]: 2.026–7.410, P = 0.000) and super-specialization (C.I.: 2.167–19.479, P = 0.021) were independent significant predictors for difference in attitudes. Female gender and super-specialization were associated with better attitudes. Ninety percent of participants had favorable attitude toward psychiatric illness. Four-fifth felt psychiatric patients to be as human as other patients and found psychiatric treatments effective. More than half felt that psychiatry does not stand among the three most exciting specialties and psychiatrists get less work satisfaction. Only one third said that they would have liked to be a psychiatrist.Conclusions:Attitudes were favorable toward patients and psychiatric interventions whereas unfavorable toward psychiatry as a discipline.

Image of psychiatric hospitals among general population in 2015, views from four countries

IntroductionIn recent years, numerous studies about the image of psychiatry have been conducted. However, to our knowledge, a significant part of psychiatry has been very little explored: the vision of psychiatric hospitals (PsH). For instance, “PsH” on google images reveals a long list of frightening pictures of ravaged places.Objectives/AimsWith such an image spread by the medias, we wanted to evaluate the vision of PsH and treatment modalities among general population in 2015, in 4 countries: France, Spain, England, and Brazil.MethodsAn online survey in 4 languages has been sent via facebook and emails. Two hundred and fifteen responses were collected during September 2015: 178 French, 11 Spanish, 17 Brazilians, 9 English.ResultsThirty-nine percent of participants consider PsH as a place of care, and 16% as an asylum. There were differences among countries: for example, asylum is more represented in France than Spain. Regarding patients admitted in PsH, they are not all dangerous (90%), nor all irresponsible (94%) and have specifics rights (66%). Concerning diseases: delirium, bipolar disorders, and perversity are to be treated in PsH, while depression, addiction, and autism are to be cured in psychiatric structures other than hospital. Moreover, 2% of participants believe abuses are common practice, whereas a majority consider therapeutic activities instead.ConclusionsThese results are quite different from the studies based on the perception of mental illness and patients. Here, on the overall, they are quite encouraging. So, PsH could lead the path on the improvement of the image of psychiatry.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The negative image psychiatry from a sociological perspective

The negative image of psychiatry is not only due to unfavourable communication with the media, but is basically a problem of self-conceptualization. It results both from unjustified prejudices of the general public, mass media and health care professionals and of own unfavourable coping with external and internal concerns.Issues related to negative stereotypes of psychiatry include overestimation of coercion, associative stigma, lack of public knowledge, need of simplification of complex mental issues, problem of the continuum between normality and psychopathology, competition with medical and non-medical disciplines, and psychopharmacological treatment.Issues related to psychiatry's own contribution to being underestimated include lack of a clear professional identity, lack of biomarkers supporting clinical diagnoses, limited consensus about best treatment options, lack of collaboration with other medical disciplines and low recruitment rates among medical students.Much can be improved to achieve a positive self-concept, however, psychiatry will remain a profession with an exceptional position among the medical disciplines which should be seen as its specific strength.Disclosure of interestThe author has not supplied his declaration of competing interest.

The negative image of psychiatry in the medical community

It is a very unfortunate matter of fact that mental problems and diseases are matter to societal stigmatization. In the slipstream psychiatry has a negative image in the public eye. Fighting stigma should be at the core of all professionals involved in mental health care. Self-reflection should be a primary reaction of any psychiatrist when confronted with a sensitive issue like stigmatization and negative image. It is painful to realize that the negative image of psychiatry is also present to the community to which psychiatrists belong, namely the medical community. This is strange and hurting. Psychiatrists (then closely linked to neurology) have, worldwide strongly contributed to the birth and strengthening of medical associations. Yet psychiatrists have estranged themselves from the medical community, thus, in my view, contributing themselves to stigma on patients with mental conditions and the negative image of psychiatry. So time for action, starting by self-awareness of psychiatrists that they are medical specialist, urging oneself as a psychiatrist to behave as a medical specialist by relating to colleagues in a helpful way and keeping one's own medical knowledge and skills up to standards. Psychiatrists have so much to offer in helping their colleagues in somatic medicine.Disclosure of interestThe author has not supplied his declaration of competing interest.

Pioneering ambient mass spectrometry imaging in psychiatry: Potential for new insights into schizophrenia

Understanding the molecular basis of schizophrenia is essential for disease management, and several molecular biology tools have been employed for this purpose. Mass spectrometry, which is used mostly in proteomic and metabolomic studies, is one such tool. Here, we present the first psychiatric study to use mass spectrometry imaging (MSI) with desorption electrospray ionization (DESI). Preparation of samples for use with DESI-MSI is remarkably simple and quick and preserves the spatial distribution of analytes. By using this tool, we found differences in the phospholipid content in schizophrenia postmortem brains. These results validate both the role of phospholipids in schizophrenia and the value of this MS tool in furthering the understanding of the molecular aspects of the disease.

Malaysian medical students' perceptions of a film to promote psychiatry as a career.

We aimed to evaluate perceptions of a Royal College of Psychiatrists promotional film among Malaysian medical students. Year 3 (n=108) and Year 5 (n=108) students completed separate standard measures of attitudes to psychiatry: the ATP 30 and Balon scales, respectively. A questionnaire was also administered recording students' socio-demographic information, career preferences, perceptions of the film's effectiveness and its influence on career choice. Quantitative and qualitative analyses of responses were performed. The overall response rate was 95.5%. Mean career preference ranking for psychiatry was higher for Year 5 than for Year 3 (p=0.025). For most Year 3 (64.8%) and Year 5 (58.3%) respondents the film conveyed a positive image of psychiatry. Fewer perceived it as influencing career choice: 31.4% for Year 3 and 27.2% for Year 5. Higher scores on both attitudinal scales correlated positively with increasing likelihood of students rating the film positively (Year 3: p=0.000; Year 5: p=0.003). Thematic content analysis suggested possible socio-cultural influences on students' perceptions. Despite conveying a positive image of psychiatry, promotional films may have limited impact in changing students' attitudes towards psychiatry and in increasing interest in psychiatry as a career.

Images of psychiatry and psychiatrists.

ObjectiveThis study surveyed medical teaching faculty to determine their attitudes toward psychiatry and psychiatrists.MethodWe conducted a multisite survey of a probability sample of 1057 teaching medical faculty members from 15 academic teaching centers in the United Kingdom, Europe, and Asia stratified by early, middle, and late career stage. The average response rate across countries was 65%.ResultsThe outstanding findings were that 90% of respondents considered that psychiatrists were not good role models for medical students, 84% thought psychiatric patients were unsuitable to be treated outside of specialized facilities, and 73% thought psychiatric patients were emotionally draining. We noted statistically significant differences by country, gender, career stage, and specialty.ConclusionThese results highlight why recruitment into psychiatry is problematic in many countries and suggest that greater attention should be given to improving the perception of psychiatrists as good role models and the efficacy of psychiatric treatments.

Improving the image of psychiatry and psychiatrists: Results of a French national survey

BackgroundA decline of recruitment into psychiatry has been observed in low and high income countries. It has been suggested that the negative image of psychiatrists may play a role in this issue. Thus, one mission of the AFFEP (French National Association of Psychiatric Trainees) is to improve the image of psychiatry and to fight the related stigma.ObjectiveThis study aimed to highlight prejudices about psychiatric trainees.MethodsThis study is a descriptive cross-sectional survey conducted toward French residents specialized in psychiatry, anaesthesia, neurology, paediatrics, orthopaedic surgery or general medicine, between June and July 2013. An invitation email and an anonymous web-based auto-questionnaire were sent to the residents through their national associations mailing-lists. AFFEP local representatives also disseminated the survey to psychiatric trainees. The survey, hosted by the MODALISA software was made of four sections:– sociodemographic data;– school records;– prejudices from the other specialities towards psychiatric trainees;– professional identity.A statistical analysis was performed using MODALISA in order to describe and compare the data.ResultsOne thousand two hundred and ninty-six trainees participated in the study, including 760 psychiatrists, 253 residents in general practice, 123 anaesthetists, 60 neurologists, 57 paediatrics and 43 orthopaedics. 56% of the participants think that psychiatrists are odd trainees with previous history of mental health, 42% consider they are not doctors, and 37% describe them as lazy persons. Comparisons of personal history cases did not show any significant difference between psychiatric trainees and non-psychiatric trainees (12.6% vs. 9,3%, P = 0.074). Besides, the results show that almost all psychiatric trainees (95%) are happy becoming a psychiatrist.ConclusionsThese results suggest that prejudices about psychiatric trainees exist and are wrong. They will allow to work on the image of psychiatry and psychiatrists, to communicate about the great satisfaction of the psychiatric trainees and to break down old “cliché”.

Interoceptive awareness and the insula - Application of Neuroimaging Techniques in Psychotherapy

Interoceptive awareness is defined as the awareness of stimuli originating inside one's own body such as the heartbeat. The emergence of new brain imaging techniques like functional magnetic resonance imaging (fMRI) or magnetic resonance spectroscopy (MRS) has increased our knowledge of neural substrates underlying interoceptive awareness. In particular, the bilateral brain structure of the insula has been identified as a key region involved in interoceptive processes in healthy populations. In line with prominent theories of human emotion, the insula has an important function in connecting interoceptive awareness with affective experience. This connection hinging on the insula between interoception and emotional processing is suggestive of an involvement of the insula in mood disorders such as major depressive disorder (MDD). Multilayered deficits in the insula cortex of depressed individuals such as abnormal function, biochemistry, and anatomy support this hypothesis. The aim of the present article is a) to describe the importance of the insula for the interplay between interoception and emotional processing and b) how this might be figured into psychotherapeutic treatment of depressed patients using new imaging techniques like real-time fMRI. The article begins with a brief introduction about neuroanatomical settings of the insula (I. Introduction- Neuroanatomical background of the insula). Afterwards, early behavioral studies to investigate interoceptive awareness are described (II. A step Back-First attempts to investigate interoceptive awareness), followed by a description of more recent imaging studies outlining neural mechanisms underlying interoceptive awareness and emotional processing in the insula (III. The insula as key region involved in functional interoception and emotion.) Throughout, the article addresses the question of why the investigation of individuals suffering from depression might provide novel insights into the neural underpinnings of interoceptive awareness and its link to abnormal behavior (IV. Why study interoceptive awareness in depressed participants?). Following the description of a selected study that combines for the first time functional results of interoception (using fMRI) with biochemical results of the insula (using MRS) (V. Neuroimaging in interoceptive awareness combining fMRI and MRS - A specific study), the article concludes with a perspective outlining the potential for using imaging techniques like real-time fMRI to enhance neural activity in the insula during interoceptive awareness. This approach potentially leads to faster recovery in depressed patients and might be the first therapeutic application of functional imaging in psychiatry (VI. Perspectives: Neurofeedback in major depression using real-time fMRI).

EPA-0096 – Psychiatry in films: stigmatising or educating?

Why films? Films are powerful medium, art, entertainment, an industry and an instrument of social change, it is also a ruthless commercial enterprise, driven by populism and low cunning:’follow the money’ is the first rule of movie psychiatry. Over the years the image of psychiatry in films has struggled and, from an early start, the role of psychiatry was unfortunately often used for shock value. The incorrect portrayal of patients as either incurable or violent has been a recurrent theme, and psychiatrists have been depicted as incompetent, controlling or downright nasty. No wonder psychiatry is still affected by stigma! However, some authors have advocated that films can actually be useful learning tools for medical students and psychiatric trainees to teach them about certain aspects of psychiatry: watching a film is useful when learning about mental state examination, how to reach a diagnosis, doctor-patient interactions and personality disorder. Films can be used in teaching different subjects, including psychology (Fleming et al, 1990), developmental psychopathology (Nissim-Sabat, 1979), and individual and couple therapy (Hesley & Hesley, 2001). Fritz (1979) has argued that films, through their visual imagery, are closely related to dreams and therefore more likely to attune with the viewers’ unconscious and primary process thinking. A disadvantage of using films can be the distortion and stigmatising portrayal of mental illness (Levine, 2000).

EPA-1737 – Addressing the recruitment crisis in psychiatry: a cross-sectional study on the delegates who attended the doctors academy future excellence international medical summer school

Introduction The Future Excellence International Medical Summer School (FEIMSS) is a 5-day event for medical students held yearly in Manchester, UK. FEIMSS is the largest event of its kind in the world; the 2013 cohort was comprised of 244 students from 40 countries representing 80 universities. Aim To improve the image of psychiatry with 2 short lectures from a consultant and a trainee psychiatrist. Methods Feedback forms were distributed to delegates who attended the psychiatry talks. Answers to questions relevant to the talks were on a Likert-type scale. The sample was comprised of participants representing 11 countries from Japan to Kosovo. Results 25/25 (100%) of the participants responded. The feedback was exceptionally positive. For the,’Did you find the psychiatry talks interesting?’ and,’Does attending FEIMMS improve your understanding and respect for other cultures?’ questions, 23/25 (92%) respondents answered that they agree or strongly agree. Free-text comments were also positive: ’Overall excellent and made me more inclined to psychiatry than I was before and proved to me that psychiatrists are not the boring stereotype!’ Medical student, Czech Republic Conclusions Notwithstanding the limitations of our study (which to our knowledge is the first of its kind on such an ethnically eclectic sample) our results demonstrate that a brief intervention can have positive effects on the perceptions of psychiatry of medical students from diverse cultural backgrounds. We contend FEIMSS provides a platform to recruit medical students into psychiatry from all over the world and enables them to develop cultural competency.

Challenges for trainees in psychiatry and early career psychiatrists

Psychiatry as a discipline will undergo major changes in the coming years. Although changes can be particularly stimulating and challenging from an intellectual, scientific and social viewpoint, the new generations of psychiatrists must be prepared to face these changes and deal with them appropriately. Paradigms which have represented the foundations of psychiatry in the last century now need a major revision. In particular, both trainees in psychiatry and early career psychiatrists need to (1) (re)discover psychopathology, (2) improve mental healthcare through integrated treatments, (3) identify and treat new syndromes, (4) promote an image of psychiatry with patients at the heart of care and as advocates for each other by fighting stigma and promoting the recruitment in psychiatry by medical students. These can be achieved by increasing involvement in institutions and organizations to influence the agenda. In this paper the possible contribution of trainees and early career psychiatrists is discussed and recommendations are made in order to set a new agenda for early career psychiatrists who will still be practising 2–3 decades from now.

Medical students are susceptible to the public image of psychiatry

Mukherjee and colleagues[1][1] concentrate mainly on interventions in medical training, but it is also important to bear in mind that, as members of the public, medical students are constantly exposed to public perceptions and media portrayals of psychiatry. The poor public perception of psychiatry

Clinical application of brain imaging for the diagnosis of mood disorders: the current state of play

In response to queries about whether brain imaging technology has reached the point where it is useful for making a clinical diagnosis and for helping to guide treatment selection, the American Psychiatric Association (APA) has recently written a position paper on the Clinical Application of Brain Imaging in Psychiatry. The following perspective piece is based on our contribution to this APA position paper, which specifically emphasized the application of neuroimaging in mood disorders. We present an introductory overview of the challenges faced by researchers in developing valid and reliable biomarkers for psychiatric disorders, followed by a synopsis of the extant neuroimaging findings in mood disorders, and an evidence-based review of the current research on brain imaging biomarkers in adult mood disorders. Although there are a number of promising results, by the standards proposed below, we argue that there are currently no brain imaging biomarkers that are clinically useful for establishing diagnosis or predicting treatment outcome in mood disorders.

Neural networks in psychiatry

Over the past three decades numerous imaging studies have revealed structural and functional brain abnormalities in patients with neuropsychiatric diseases. These structural and functional brain changes are frequently found in multiple, discrete brain areas and may include frontal, temporal, parietal and occipital cortices as well as subcortical brain areas. However, while the structural and functional brain changes in patients are found in anatomically separated areas, these are connected through (long distance) fibers, together forming networks. Thus, instead of representing separate (patho)-physiological entities, these local changes in the brains of patients with psychiatric disorders may in fact represent different parts of the same ‘elephant’, i.e., the (altered) brain network. Recent developments in quantitative analysis of complex networks, based largely on graph theory, have revealed that the brain's structure and functions have features of complex networks. Here we briefly introduce several recent developments in neural network studies relevant for psychiatry, including from the 2013 special issue on Neural Networks in Psychiatry in European Neuropsychopharmacology. We conclude that new insights will be revealed from the neural network approaches to brain imaging in psychiatry that hold the potential to find causes for psychiatric disorders and (preventive) treatments in the future.