Mental Health Sciences Research Articles

THEOLOGY AND SCIENCE OF MENTAL HEALTH AND WELL‐BEING

AbstractThe approach to mental health and well‐being taken here illustrates the complementary perspectives approach and assumes that there are useful and intersecting contributions from science (including medicine) and from religion and spirituality. What counts as poor mental well‐being depends on the interaction of relatively objective criteria with culturally contingent value judgments. I then discuss theological perspectives on depression, including a consideration of sources of hope and tolerance of dysphoria, and argue that depression can be part of a spiritual journey. I then look at the relationship between psychosis and religion, including the work of Isabel Clarke, arguing that a spiritual approach to psychosis can complement a medical approach. Finally, I present a pastoral case study illustrating the interface between neurological and spiritual aspects of the sense of presence. A religious perspective can challenge and complement current assumptions about mental health in a potentially fruitful way.

Of mice and mental health: facilitating dialogue and seeing further.

The science of mental life is critical for understanding both how we function, and impairments in our functioning. However, understanding the causal mechanisms underlying mental health disorders and developing new treatments are challenges too great to be solved by any individual approach. There is a growing awareness that translational research-from laboratory to patient and back again to animal models-will be critical for the improved understanding and treatment of mental health disorders. The motivation and intention to pursue translational approaches is therefore strong in mental health research, but critically, opportunities for interaction between basic scientists and clinicians are relatively limited, and vary depending on the institution in which researchers are working. This has promoted the development of a 'culture gap' between basic and clinical scientists that limits interaction and sharing of knowledge. Here, we provide 14 examples of contemporary translational research and call for an increased collaborative approach to mental health research that spans clinical diagnoses, levels of analysis and bridges between basic to clinical mental health sciences, including, but not limited to, psychology and neuroscience. What is needed is an inclusive and integrated approach, bringing together scientists working at all levels of enquiry with clinicians providing insights on what works (and what does not). To stimulate the much-needed innovation in therapeutic techniques, an analysis of component parts is critical. Our approach suggests simplifying complex behaviours into distinct psychological components. Asking collaboratively driven scientific questions about dysfunction will also benefit our fundamental understanding of mental life.This article is part of a discussion meeting issue 'Of mice and mental health: facilitating dialogue between basic and clinical neuroscientists'.

Managing cardiovascular disease risk in patients with severe mental illness

Managing cardiovascular disease risk in patients with severe mental illness

From neuroscience to evidence based psychological treatments – The promise and the challenge, ECNP March 2016, Nice, France

This ECNP meeting was designed to build bridges between different constituencies of mental illness treatment researchers from a range of backgrounds with a specific focus on enhancing the development of novel, evidence based, psychological treatments. In particular we wished to explore the potential for basic neuroscience to support the development of more effective psychological treatments, just as this approach is starting to illuminate the actions of drugs. To fulfil this aim, a selection of clinical psychologists, psychiatrists and neuroscientists were invited to sit at the same table. The starting point of the meeting was the proposition that we know certain psychological treatments work, but we have only an approximate understanding of why they work. The first task in developing a coherent mental health science would therefore be to uncover the mechanisms (at all levels of analysis) of effective psychological treatments. Delineating these mechanisms, a task that will require input from both the clinic and the laboratory, will provide a key foundation for the rational optimisation of psychological treatments. As reviewed in this paper, the speakers at the meeting reviewed recent advances in the understanding of clinical and cognitive psychology, neuroscience, experimental psychopathology, and treatment delivery technology focussed primarily on anxiety disorders and depression. We started by asking three rhetorical questions: What has psychology done for treatment? What has technology done for psychology? What has neuroscience done for psychology? We then addressed how research in five broad research areas could inform the future development of better treatments: Attention, Conditioning, Compulsions and addiction, Emotional Memory, and Reward and emotional bias. Research in all these areas (and more) can be harnessed to neuroscience since psychological therapies are a learning process with a biological basis in the brain. Because current treatment approaches are not fully satisfactory, there is an imperative to understand why not. And when psychological therapies do work we need to understand why this is the case, and how we can improve them. We may be able to improve accessibility to treatment without understanding mechanisms. But for treatment innovation and improvement, mechanistic insights may actually help. Applying neuroscience in this way will become an additional mission for ECNP.

The Science of Mental Health as Applied to Self, Politics and Social Policy

How do we improve the mental health? What can government do? What can the caring social institutions do? Can a person help themselves? How do we reduce the incidence of depression, anxiety, suicide, and family violence? How do we understand the aetiology of our psychic states and how do we use that to help people? Is it even legitimate to ask the question can better science make a difference to our mental health? This paper explores proof of the spiritual model of humanity and what it will mean to adopt it as the foundation of people’s understanding of themselves and adopt it as the scientific foundation of all appropriate social policy.

Innovative telementoring for addiction management for remote primary care physicians: A feasibility study

Objective:Addiction is a growing public health problem which affects the person, the whole family, and society. The primary care physician (PCP) is often the first point of contact in the health care and can play a significant role in the early detection and intervention. It is well established that early intervention is associated with better outcomes. In the formal medical training, PCPs receive no formal training on drug addiction management. In this pilot study, we developed an innovative telementoring model and looked at feasibility as well as acceptability among remote PCPs on drug addiction management.Materials and Methods:The telementoring model consists of both synchronous and asynchronous components. The synchronous component consists of National Institute of Mental Health And Neuro Sciences (NIMHANS) academic center Hub and remote district level primary care physician Spokes, and is implemented by using low-cost multipoint videoconference based tele-ECHO (Extension for Community Healthcare Outcome) clinics. During the tele-ECHO clinics, held fortnightly, the remote PCPs used Internet-enabled smartphones to connect as well as present the patient case summaries to the multidisciplinary expert team of NIMHANS HUB. The asynchronous component consists of mobile-based ubiquitous e-learning integrated to a course completion certificate. We evaluated this innovative telementoring program on participant engagement, learning, confidence, and satisfaction. A pre-post design and e-learning assignments were used to measure the outcomes.Results:Of the proposed 21 tele-ECHO clinics, 11 were held till the end of August 2017. All the PCPs were able to virtually join at least one tele-ECHO clinic. Out of 38 participants, two participated in all the tele-ECHO clinics and 47.36% (n = 18) attended more than six (>60% of total) tele-ECHO clinics. About 76.31% (n = 29) of the PCPs presented 41 patient case summaries. Among 38 PCPs, a cumulative of 89.47% completed three e-Learning assignments. The majority of participants (80%) used smartphone with 4G connections to join the tele-ECHO clinics. There was a significant change in knowledge gained over the time duration of 1-month (3.00 ± 0.86, P < 0.001) and 3-month (3.16 ± 0.90, P < 0.001) assessments compared to the baseline (1.77 ± 1.02). About 32.25% (n = 10) reported improved confidence level in managing a case of substance use disorder on a 10-point scale.Conclusion:It has been feasible to connect an academic hub, i.e., NIMHANS to the PCPs of 36 remote districts of Bihar and conduct multipoint videoconference-based tele-ECHO clinics. The results indicate high participant retention. The learners are comfortable in adapting new technology-based learning as evidenced by high rate of e-learning assignment completion. These findings suggest that this new innovative learning model using technology can be an important modality for effective training to address management of drug addiction.

Open science in mental health research

Open science in mental health research

The Psychological Flexibility Model from a cultural perspective: an interpretative analysis of two Native American healing rituals

ABSTRACTWhile the growth of Acceptance and Commitment Therapy and its underlying construct, psychological flexibility, has been supported by numerous studies, it has received little attention from sociocultural disciplines. With the aim of considering the transdiagnostic Psychological Flexibility Model from a cultural perspective and from an interdisciplinary approach combining both Psychology and Anthropology, this article proposes an interpretative theoretical analysis of two Native American healing rituals: sweat lodge ceremonies and peyote ceremonies. Drawing from the fieldwork of Calabrese among the Navajo and Wilson among the Lakota Sioux, both healing rituals are interpreted and compared in light of the six processes of psychological flexibility. While recognising the adaptability of the model outside the cultural sphere of Western mental health sciences, the article concludes with two remarks: the relevance of the sociocultural construction of values and a potential connection between psychologica...

Highly Cited Publications Output by India in Clinical Pharmacology during 2000-14: A Scientometric Assessment

Objectives: The main objective of this research is to identify highly cited papers in clinical pharmacology and to analyze their publication and citation data to study their citation characteristics, and understand what role contributing authors, participating research organizations as well as international collaborative countries play in Indian clinical pharmacology research. Design: The publications output of Indian clinical pharmacology papers published during 2000-14 were screened in Scopus database and highly cited papers, with at least 100 citations since publication, were identified and shortlisted for their bibliometric analysis. The statistics cover collaboration across authors, institutions, foreign participating countries in the publication of highly cited papers. To assess comparative contributions of authors/ organizations, a new indicator, the Major Contributor Index ( MCI ), was used. Citation trends for all papers, as well as for top papers, are presented. Results: A total of 76 highly cited articles, constituting 1.45% share of world highly cited papers output and 0.75% share of India’s publications output, were published by India in clinical pharmacology output during 2000-14. This study covered only those papers that received at least 100 citations since publication. In recent years, top-cited articles have reached their citation peak in the early years of their citation life cycle, but have shown a more-rapid decreasing trend compared to top-cited articles from past decades. These 76 highly articles have received 14059 citations, with an average citation per paper of 184.99. The leading Indian organizations participating in highly cited research papers were All India Institute of Medical Sciences, New Delhi (7 papers), Panjab University, Chandigarh (6 papers), Jadavpur University, Kolkata (5 papers), National Institute of Mental Health & Allied Sciences, Bangalore, Aligarh Muslim University, Annamalai University, Banaras Hindu University, Varanasi, Sathyabama University, Guru Jambeshwar University, Hisar, Post Graduate Institute of Medical Education & Research, Chandigarh, Institute of Life Sciences, Bhubaneswar and Drug Research & Development Center, Kolkata (2 papers each).The leading authors were S.K. Bhattacharya (3 papers), J.K. Grover, S.P. Yadav, S. Garg, A.K. Singla, A.Garg, S. Ghosal, A. Bhattacharya, S. Khanna, A. Bhattacharya, S. Praveen and S.K.Sahoo (2 papers each). The leading international collaborative countries were USA (10 papers), Germany and U.K. (3 papers each), Japan, Russia Federation, Belgium and Canada (2 papers each). The MCI varied among leading organizations, as well as among individual authors. Conclusions: The output of highly cited papers by Indian authors in clinical pharmacology is still not significant given the fact that 208 authors contributed only one paper each once in 15 years, 11 contributed two papers each once in 15 years, and 1 contributed three papers once in 15 years. India still ranks 10th highest country with 1.45% share to the world output of highly cited papers compared to 61.41% share by USA. The quality of research in clinical pharmacology in India is though growing significantly over time, but there is very little evidence of corresponding growth in publication rate of highly cited papers in India. Key words : Clinical pharmacology, India, Highly Cited Papers, Major Contributed Organizations, Authors, International Collaboration, Bibliometrics, Scientometrics.

The Value of Electronic Medical Record Implementation in Mental Health Care: A Case Study.

BackgroundElectronic medical records (EMR) have been implemented in many organizations to improve the quality of care. Evidence supporting the value added to a recovery-oriented mental health facility is lacking.ObjectiveThe goal of this project was to implement and customize a fully integrated EMR system in a specialized, recovery-oriented mental health care facility. This evaluation examined the outcomes of quality improvement initiatives driven by the EMR to determine the value that the EMR brought to the organization.MethodsThe setting was a tertiary-level mental health facility in Ontario, Canada. Clinical informatics and decision support worked closely with point-of-care staff to develop workflows and documentation tools in the EMR. The primary initiatives were implementation of modules for closed loop medication administration, collaborative plan of care, clinical practice guidelines for schizophrenia, restraint minimization, the infection prevention and control surveillance status board, drug of abuse screening, and business intelligence.ResultsMedication and patient scan rates have been greater than 95% since April 2014, mitigating the adverse effects of medication errors. Specifically, between April 2014 and March 2015, only 1 moderately severe and 0 severe adverse drug events occurred. The number of restraint incidents decreased 19.7%, which resulted in cost savings of more than Can $1.4 million (US $1.0 million) over 2 years. Implementation of clinical practice guidelines for schizophrenia increased adherence to evidence-based practices, standardizing care across the facility. Improved infection prevention and control surveillance reduced the number of outbreak days from 47 in the year preceding implementation of the status board to 7 days in the year following. Decision support to encourage preferential use of the cost-effective drug of abuse screen when clinically indicated resulted in organizational cost savings.ConclusionsEMR implementation allowed Ontario Shores Centre for Mental Health Sciences to use data analytics to identify and select appropriate quality improvement initiatives, supporting patient-centered, recovery-oriented practices and providing value at the clinical, organizational, and societal levels.

Mental Disorders are Not Real: Using Skepticism and Critical Thinking to Challenge Key Myths in the Science of Mental Health

This review aims to identify and correct several prevalent misunderstandings about mental health and mental disorders which are potentially damaging to society. Organized into themes around four myths about mental disorders, this discussion provides readers with helpful information and references to other useful readings to support their skepticism and critical thinking about psychopathology. The four myths identified here are that mental disorders are unimportant, are solely biomedical entities, are only treatable with medication or CBT, and are real. In each case, the author makes a reasoned argument to the contrary, culminating in a discussion about how mental disorders are actually not real, but are nevertheless very important considerations. Throughout the discussion several logical fallacies are introduced (e.g., confusing correlation with causation, the nominal fallacy, the reification fallacy), as well as brief historical notes on the field of psychology (e.g., varying treatment modalities, schools of thought around treatment impactfulness, and problems with language progression in research).

Healing the Spirit: Exploring Sexualized Trauma and Recovery among Indigenous Men in Toronto.

Colonial policies in Canada have led to social disruption and intergenerational trauma across Indigenous nations, contributing to high rates of sexualized violence within many communities. While mental health and social science discourse has identified the harmful impacts of violence against Indigenous women in Canada, there continues to be a lack of focus on the unique mental health needs of Indigenous men in this regard. This article reviews the results of a nationally funded research study which looked at the mental health and healing needs of Indigenous men in Toronto who have experienced sexualized trauma. This study followed Indigenous protocols for research and was conducted in partnership with Anishnawbe Health Toronto, a culture-based community health center. The methodology utilized a narrative inquiry and interviewed six community men about their recovery journeys and ten community healers and counselors about recovery through a gendered lens. The results explore the discourses that contribute to the social construction of masculinity(ies) and the impacts of these social norms on help-seeking behaviors. These results inform culturally appropriate and gender-relevant mental health service provision for Indigenous male clients recovering from sexualized trauma.

T29 - GSK-3b 50 T/C Polymorphism And Lithium Maintenance Treatment In Bipolar Disorder

Background Bipolar Disorder is a chronic debilitating mental illness requiring long term medications. Bipolar disorder also has heritability of 80%, thus probably indicating an underlying genetic etiology. Glycogen Synthase Kinase (GSK) is a serine/threonine kinase. GSK3-b is an essential element of the Wnt/beta-catenin pathway. GSK-3B gene has been mapped to chromosome 3q13.3, a potential susceptibility locus for bipolar disorder. GSK-3B 50 T/C single nucleotide polymorphism (SNP) falls into the effective promoter region (nt − 171 to + 29) of the GSK-3B gene and the presence of T allele is noted to increase the transcriptional activity. GSK-3B is also directly inhibited by Lithium which is widely used in the prophylaxis of Bipolar Disorder. Earlier Studies have also found a positive correlation between Mutant C allele carriers of 50 T/C SNP and better response to Lithium. Methods 441 patients with Diagnosis of Bipolar Disorder according to DSM-IV were recruited from all patients attending Outpatient Services of National Institute of Mental Health and Neurological Sciences (NIMHANS). The diagnosis was confirmed using Clinical Interview and MINI 5.0.0. Genotype analysis for 189 patients selected was done for GSK-3B -50 T/C using PCR-RFLP method. Treatment response has been assessed using “Retrospective Criteria of Long Term Treatment Response in Research Subjects with Bipolar Disorder” for 95 patients for whom NIMH life charts were available Results Of all the 441 patients who were selected for the study, demographic analysis was done with the mean age at onset being 21.40 years (SD- 6.940). Lifetime psychotic symptoms were noted among 377 subjects. The genotype Frequencies for the GSK-3B 50 T/C polymorphism CC-25.9%, TC-47.6%, TT-26.5% for 189 patients, did not deviate significantly from Hardy-Weinberg equilibrium. Of the patients who were C allele carriers (N=78) there were 14 subjects who were poor responders (score less than or equal 3) and 64 subjects who were good responders (score >3).However this difference was not significant(p>0.05,Spearman’s correlation p>0.05). No statistically significant correlation was found between GSK-3B 50 T/C SNP and the clinical parameters that were studied including age at onset(n=186), and presence of psychotic symptoms(n=186) (all p>0.05) Discussion The study did not duplicate the favorable response to Lithium among patients who carry C allele in GSK-3B 50T/C SNP using a well validated scale to assess lithium response like “Retrospective Criteria of Long Term Treatment Response in Research Subjects with Bipolar Disorder” scale probably owing to difference in the allelic frequencies in the studied population. In a previous study by Benedetti et al,2008 among 60 Caucasian subjects had CC- 5%, TC-40%, TT-55% which significantly varies with the frequencies noted in the studied population. The limitation being that study was under-powered to assess the allelic association and a larger study is being completed currently. The study though did not find any positive association of GSK-3B 50 T/C with other clinical parameters that were studied. No other previous studies have looked into the association between the studied SNP and clinical parameters of Bipolar Disorder in this population. We are also in the process of doing gene expression analysis from cell lines (lymphoblastoid, induced pluripotent) derived from patients with this SNP to obtain further insights into the mechanism of Lithium in bipolar disorder.

Advancing Evidence-Based Assessment in School Mental Health: Key Priorities for an Applied Research Agenda.

Evidence-based assessment (EBA) is a critically important aspect of delivering high-quality, school-based mental health care for youth. However, research in this area is limited and additional applied research on how best to support the implementation of EBA in school mental health (SMH) is needed. Accordingly, this manuscript seeks to facilitate the advancement of research on EBA in SMH by reviewing relevant literature on EBA implementation in schools and providing recommendations for key research priorities. Given the limited number of published studies available, findings from child and adolescent mental health and implementation science research are also included to inform a robust and comprehensive research agenda on this topic. Based on this literature review, five priorities for research on EBA in SMH are outlined: (1) effective identification of assessment targets, (2) appropriate selection of assessment measures, (3) investigation of organizational readiness for EBA, (4) study of implementation support for EBA, and (5) promotion of EBA data integration and use. Each priority area includes recommended directions for future research. A comprehensive and robust research agenda is warranted to build the science and practice of implementing EBA in SMH. Specific directions for this agenda are offered.

Update on Obstructive Sleep Apnea: Implications for Neuropsychiatry.

Update on Obstructive Sleep Apnea: Implications for Neuropsychiatry.

Woman focused smoking cessation programming: a qualitative study.

BackgroundSeveral studies of smoking cessation programs in clinical settings have revealed poorer outcomes for women compared to men, including counselling alone or in combination with pharmacotherapy. The objective of the current study was to explore treatment and program structure needs and preferences among female clients in a specialized smoking cessation clinic in an academic mental health and addiction health science centre in order to inform program design so that it meets the needs of female clients.MethodsFour focus groups were conducted with current and former female clients (n = 23, mode age range = 50–59 years old, 56.5 % were still smoking and 43.5 % had quit) who had registered for outpatient smoking cessation treatment. Questions were designed to examine what aspects of the services were helpful and what changes they would like to see to better assist them and other women with quitting smoking. A thematic analysis of the raw data (audio recordings and notes taken during the focus groups) was conducted using a phenomenological theoretical framework.ResultsThemes that emerged indicated that females trying to quit smoking are best supported if they have choice from a variety of services so that treatment can be individualized to meet their specific needs; psychosocial support is provided both one-one-one with health care professionals and by peers in support groups; free pharmacotherapy is available to eliminate financial barriers to use; women-specific educational topics and support groups are offered; the clinic is accessible with evening/weekend hours, options to attend a local clinic, and childcare availability; and communication about clinic services and operation are clear, readily available, and regularly updated.ConclusionsAn ideal smoking cessation program for women includes a women’s centred approach with sufficient variety and choice, free pharmacotherapy, non-judgmental support, accessible services and clear communication of program options and changes. Findings may suggest an actionable list of adaptations that can be adopted by other clinics providing smoking cessation services to women.Electronic supplementary materialThe online version of this article (doi:10.1186/s12905-016-0298-2) contains supplementary material, which is available to authorized users.

Lamotrigine Treatment for Agitation Following Traumatic Brain Injury

Received December 18, 2015; revised January 11, 2016; accepted January 11, 2016. From Department of Psychiatry, University of South Florida College of Medicine, Tampa, FL (WLW, GAS); Departments of Psychiatry and Geriatric Medicine, University of South Florida College of Medicine, Tampa, FL (JTS). Send correspondence and reprint requests to Jonathan T. Stewart, M.D., D.F.A.P.A., A.G.S.F., Mental Health and Behavioral Sciences Service (116A), James A Haley VA Hospital, 13000 Bruce B Downs BLVD, Tampa FL 33612; e-mail: jonathan.stewart1@va.gov Published by Elsevier Inc. on behalf of The Academy of Psychosomatic Medicine. Introduction

A Contribution of Islamic Education on Mental Health Science: A Thinking of Zakiah Daradjat, An Indonesian Islamic Education Expertise

A Contribution of Islamic Education on Mental Health Science: A Thinking of Zakiah Daradjat, An Indonesian Islamic Education Expertise Muh. Mawangir Abstract It can be denied that Zakiah Daradjat is one of Muslim psycholog, but she has great concern on Islamic education. Therefore, her education thought tend to soul education, especially mental health. Education in Zakiah’s thought includes human fully life, not only concern on aqidah, worship or same moral side, but also greater and deeper than that all. The definition of mental health is correlated with children potential i.a. the implementation of seriously harmony among soul functions, and the potential to faced common problems and also avoid anxiety and conflicted. Role of Islamic education on health in Zakiah’s thought is to give counseling on life, as a helper in difficulties, reassuring inner, be able to control moral or as therapy of mental disorder. Full Text: PDF DOI: 10.15640/jisc.v4n1a8

IT-тренинги – новая тенденция в практике помощи больным с психическими расстройствами и их значение для развития социального познания

The emergence and development of social cognition paradigm is a new trend in the science of mental health, which led to a significant modification of training in the direction of greater specialization in training of various skills in the field of social cognition, including with the use of computer technology. The article provides a brief overview of the most well-known foreign computerized training programs, gives idea of skills in social cognition (SC), presents data on the effectiveness of these programs, the possibilities and limitations of application of computer technologies in training SC, and also a number of conclusions about the perspectives of their application.

An Algorithmic Approach to Determine the Etiology of Acute Encephalitis Syndrome (AES) in India

Acute Encephalitis Syndrome (AES) in India Ravi Vasanthapuram, MD1, Padmini Srikantiah MD2, Vijayalakshmi Reddy PhD1, Anita Desai PhD1, Reeta S Mani MD1, Shah Hossain MD2, Lahari Saikia MD3, Amita Jain MD4, Tapan Dhole MD5, Sharon Daves MPH,RD2 and Kayla Laserson ScD2. 1National Institute of Mental Health and Neuro Sciences, Bangalore, India, 2 CDC India Office, New Delhi, India, 3 Assam Medical College, Dibrugarh, India, 4King George Medical University, Lucknow, India and 5Sanjay Gandhi Institute of Post Graduate Medical Education And Research, Lucknow, India.