Psychiatric Education Research Articles

Psychiatry for all: enhancing medical practice and patient outcomes through psychiatric education for all doctors

This article emphasizes the importance of studying psychiatry for all medical professionals. Psychiatry deals with mental, emotional, and behavioural disorders, and a strong understanding of the field leads to more holistic, effective, and empathetic patient care. Key reasons for doctors to study psychiatry include adapting a biopsychosocial model of care, early identification and intervention for psychiatric disorders, improved health outcomes, better communication skills, combating stigma surrounding mental health, multidisciplinary collaboration, personal growth and self-care, and a more comprehensive approach to chronic illness management. Integrating psychiatry into medical education prepares doctors for the challenges they will face in their careers, ultimately improving the quality of patient care. The practice of offering internships in psychiatry, as seen in countries like UK and Australia, should be encouraged globally to create a cohort of doctors knowledgeable in the basics of psychiatry, ultimately reducing the impact of a shortage of psychiatrists and improving overall healthcare.

Addressing the Maternal Mental Health Crisis Through a Novel Tech-Enabled Peer-to-Peer Driven Perinatal Collaborative Care Model

Addressing the Maternal Mental Health Crisis Through a Novel Tech-Enabled Peer-to-Peer Driven Perinatal Collaborative Care Model

Psychometric Properties of a Safety Culture Index among Mental Health Workers in Ghana

Safety culture among mental health workers is essential, especially in developing countries where workplace safety seems neglected. However, few studies have provided detailed psychometric analyses of convenient safety instruments with practical relevance for the healthcare industry in the Sub-Saharan African context. We sampled 574 (54.4 % females, 45.6 % males) mental health workers from three Specialist Psychiatric Teaching Hospitals in Ghana. Initially, we collected data using adapted items from Edkins and Coakes’ 25-item Airline Safety Culture Index (ASCI). Consequently, we conducted a Confirmatory Factor Analysis (CFA) using the Diagonally Weighted Least Squares estimator. We also used the item reduction analysis (Gradual Response Model) to reduce the adapted 25-item scale to 11 items (Modified Safety Culture Index, MSCI- 11). Finally, we conducted reliability analyses (alpha and omega) for the MSCI-11. We observed that the data in the CFA showed adequate fit indices [χ2 (df = 44, N = 574) = 223.752, p < 0.001; CFI = 0.975; TLI = 0.968; RM- SEA = 0.084 (CI 90 % 0.074- 0.096); SRMR = 0.063]. The MSCI- 11 is parsimonious and has good reliability estimates [α = 0.853 (95 % CI 0.835 – 0.870) and ω = 0.853 (95 % CI 0.837- 0.087)]. Future studies should use additional cross-validation in other high-risk jobs to generalise the new scale.

Association of Disease Duration and Duration of Olanzapine Use with Blood Sugar, Blood Pressure, BMI, and Lipid Profile among Schizophrenic Patients in Iraq

Background: The association of olanzapine with hyperglycemia, an elevated lipid profile, and high blood pressure was early recognized after its approval and has become of increased concern. Objective: To determine the association of olanzapine use with blood sugar levels, lipid profiles, and blood pressure in hospitalized Iraqi patients with schizophrenia. Methods: A cross-sectional study involving 50 hospitalized patients with schizophrenia who met the Diagnostic and Statistical Manual of Mental Disorders (DSM)-V diagnostic criteria and had taken olanzapine for at least two years was carried out between November 2022 and February 2023 at two facilities in Baghdad, Iraq (Ibn Rushd Psychiatric Teaching Hospital and Al Rashad Hospital for Mental Health). Blood pressure, fasting blood sugar, and serum lipid profile (triglycerides [TG], high-density lipoprotein [HDL], low-density lipoprotein [LDL], and very-low-density lipoprotein [VLDL]) were measured at baseline and after olanzapine use. Results: Olanzapine significantly increases fasting blood glucose (P< 0.001). After using olanzapine, both systolic and diastolic blood pressures significantly increased. It significantly increased the levels of cholesterol, triglycerides, and VLDL (P<0.001). Moreover, HDL levels were drastically lowered. The current investigation found no significant link between the patient's waist circumference and current weight and the length of their illness or olanzapine use. In addition, there was no association between the duration of olanzapine use and blood sugar, blood pressure, or lipid profiles. Conclusion: Different doses and durations of olanzapine use in Iraqi schizophrenic patients are associated with a negative impact on glycemic control, blood pressure, and lipid profiles.

Virtual Reality Simulation for Suicide Risk Assessment Training: Prevalence of Adverse Effects.

Virtual reality (VR) simulation is changing the landscape of simulation-based medical education. Immersive VR allows users to interact with a computer-generated environment and digital avatars using a VR headset and controllers. However, current literature regarding the use of immersive VR simulation in psychiatric medical education is sparse. This study describes its use and considerations regarding tolerability. At a mental health hospital in Canada, two immersive VR suicide risk assessment (SRA) case simulations were developed. These simulations have participants interview VR patients to characterize their suicide risk, offering a novel and safe way to engage healthcare providers in SRA training. Regarding user tolerability of these VR simulations, the Simulator Sickness Questionnaire (SSQ) was administered to participants after the simulation to characterize any motion sickness symptoms experienced. Of the 22 participants in this study, the overall SSQ scores demonstrated good tolerability of the VR SRA, with the majority of participants reporting no or minimal simulator sickness symptoms. Moreover, the majority of participants reported being satisfied with this training and that the VR SRA simulation enhanced their learning experience. These study findings are novel, given the current dearth of data regarding the use of immersive VR in simulation-based psychiatric medical education. Further studies exploring the educational effectiveness of VR SRA in simulation-based psychiatric medical education are indicated.

Predicting Patients Requiring Treatment for Depression in the Postpartum Period Using Common Electronic Medical Record Data Available Antepartum

Depression requiring treatment in the postpartum period significantly impacts maternal and neonatal health. Although preventive management of depression in pregnancy has been shown to decrease the negative impacts, current methods for identifying at-risk patients are insufficient. Given the complexity of the diagnosis and interplay of clinical/demographic factors, we tested whether machine learning techniques can accurately identify at-risk patients in the postpartum period. This is a retrospective cohort study of the NIH Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be, which enrolled 10,038 nulliparous people. The primary outcome was depression in the postpartum period. We constructed and optimized 4 machine learning models using distributed random forest modeling and 1 logistic regression model on the basis of the NIH Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be dataset. Model 1 utilized only readily obtainable sociodemographic data. Model 2 added maternal prepregnancy mental health data. Model 3 utilized recursive feature elimination to construct a parsimonious model. Model 4 further titrated the input data to simplify prepregnancy mental health variables. The logistic regression model used the same input data as Model 3 as a proof of concept. Of 8,454 births, 338 (4%) were complicated by depression in the postpartum period. Model 3 was the highest performing, showing the area under the receiver operating characteristics curve of 0.91 (±0.02). Models 1-3 identified the 9 variables most predictive of depression hierarchically, ranging from depression history (highest), history of mental health condition, recent psychiatric medication use, BMI, income, age, anxiety history, education, and preparedness for pregnancy (lowest). In Model 4, the area under the receiver operating characteristics curve remained at 0.79 (±0.05). Postpartum depression can be predicted with high accuracy for individual patients using antepartum information commonly found in electronic medical records. In addition, baseline mental health status and sociodemographic factors have a larger role in the postpartum period than previously understood.

Pathways to care for substance use treatment among tribal patients at a psychiatric hospital: A comparative study.

According to the national mental health survey, substance use disorders (SUDs) are prevalent in 22.4% of the population above 18 years, whereas the same is 26% among the tribal population. The treatment gap is also high in substance-addictive disorders. Our study aimed to compare the severity of substance use, pathways to psychiatric care, and treatment-seeking behavior among the tribal and non-tribal populations. The study was conducted at a tertiary psychiatric teaching institute in India. It was a cross-sectional comparative study. Patients fulfilling the International Classification of Disease 10 diagnostic criteria of mental and behavioral disorders due to substance use, with active dependence, were taken without comorbidity. Forty patients in tribal and non-tribal groups were recruited with consecutive sampling. The samples were assessed with a semi-structured interview schedule, addiction severity index, attitudes toward help-seeking, and pathways-to-care. Excessive substance use median was for 7.00 (± 5.00) years in tribal and 6.00 (± 4.00) years in non-tribal; in tribal, substance intake was younger than non-tribal (P = 0.167), and general health-care system more distance than the non-tribal (P < 0.001). Around 65% of the persons with SUD never consulted their general practitioner and primary health-care facilities. Alcohol severity was higher in the tribal population than in the non-tribal population. The cannabis and opioid severity was high in the non-tribal population. Help-seeking behavior was deficient in both groups. Most of the substance abuse tribal and non-tribal populations reach healthcare very late and do not consider it as a health issue initially. The major reason for the delayed pathway is a lack of awareness about mental health care facilities and stigma in both populations. The stigma is high in non-tribal communities compared to the tribal community. There is a need to improve the identification and treatment of alcohol morbidity in primary care.

Assessing attitudes of fourth year medical students towards psychiatry and mental illness.

Research revealed a high prevalence of negative attitudes towards psychiatry and mental illness among medical students prior to formal psychiatric education. Anti-stigma interventions at the medical student level have been postulated to reduce the risk of negative attitudes, which may drive stigmatization impacting recruitment into training posts and overall medical care. To determine the prevalence of negative attitudes towards psychiatry and mental illness in a sample of fourth-year medical students prior to formal psychiatric teaching. To ascertain possible sociodemographic correlations with findings. The University of the Witwatersrand. A cross-sectional, quantitative, descriptive study was conducted using the Mental Illness: Clinicians' Attitudes Scale 2 questionnaire and a socio-demographic questionnaire. Of the total scores, 97.2% participants fell below the median potential score of 56, reflecting a low prevalence of stigmatising attitudes. The African cohort expressed less interest in psychiatry (P=0.0017), compared to other race cohorts (ranging from 92.1% to 100.0%). This study revealed a low prevalence of negative and stigmatising attitudes towards psychiatry and mental illness. Of statistical significance, was a relative difference in attitudes towards psychiatry and mental illness in different race cohorts (P=0.0017); however, overall race cohorts showed a low prevalence of negative and stigmatising attitudes towards psychiatry. This study creates awareness of the impact factors on attitudes of medical students towards mental illness and specialization in psychiatry.

Consumer Involvement in Psychiatric Nursing Education: An Analysis of South Korean Students’ Experiences

This study examined the experiences of South Korean nursing students in a psychiatric nursing class with consumer involvement. Data on 98 nursing students were collected in June 2021 and analysed using content analysis of participants’ journals. Our qualitative study design adheres to the COREQ checklist for qualitative studies. Four main categories and subcategories were identified: (1) reflection, (2) learning, (3) preparation for the future, and (4) requirements. The findings demonstrated that applying consumer involvement to psychiatric nursing education is an innovative and effective strategy to correct negative prejudices among nursing students against people with mental illness.

Comments on the position UEMS paper “Maintaining Human Rights and recovery principles when Coercive Practices are considered”

AbstractProf. dr. sc. Slađana Štrkalj Ivezić, psychiatrist, University psychiatric hospital Vrapče, CroatiaThe aim is to present the importance of educating psychiatrists to acquire competencies relate to knowledge, attitudes and behavior in holistic understanding of patients, implementation of principles of recovery and respect for human rights and use of alternative interventions to coercion in order to eliminate or reduce coercive practice such as involuntary hospitalizations and coercive measures. All the necessary competences such as clinical assessment, skills to form therapeutical relationship and application of evidence base interventions that can prevent or significantly reduce the use of coercive measures: de-escalation; availability of a comfort room with sensory modulation; a trained response team; joint crisis intervention, advance directives and successful multimodal strategies will be presented including the elimination of potential environmental triggers of aggression in the hospital setting. The training and education of psychiatrists on human rights, recovery and alternatives to coercive practice can abolish or significantly reduce coercion.Disclosure of InterestNone Declared

Climate change and mental health. Position paper of atask force of the DGPPN

Climate change and the resulting higher frequency of extreme weather events have a direct negative impact on mental health. Natural disasters are particularly associated with an increase in the prevalence of depression, anxiety and posttraumatic stress disorder. Indirect consequences of climate change, such as food shortages, economic crises, violent conflicts and forced migration, additionally represent severe psychological risk and stress factors. Climate anxiety and solastalgia, the distress induced by environmental change, are new psychological syndromes in the face of the existential threat posed by the climate crisis. Accordingly, asustainable psychiatry must prepare for increasing and changing demands. The principles of psychiatric treatment need to focus more on prevention to reduce the overall burden on the healthcare system. Waste of resources and CO2 emissions in psychiatric treatment processes as well as infrastructure must be perceived and prevented. Psychiatric education, training and continuing education concepts should be expanded to include the topic of climate change in order to comprehensively inform and sensitize professionals, those affected and the public and to encourage climate-friendly and health-promoting behavior. More in-depth research is needed on the impact of climate change on mental health. The DGPPN becomes asponsor and aims for climate neutrality by 2030 by committing to climate-friendly and energy-saving measures in the area of finance, in relation to the DGPPN congress as well as the DGPPN office.

Teaching Professional Boundaries in Psychiatric Nursing: Resource Development

A standard of practice in psychiatric nursing pertains to the ability to maintain professional boundaries within a nurse-patient relationship. Nursing students are inexperienced in maintaining nurse-patient relationships and are at risk of crossing professional boundaries. Research regarding boundary instruction and available resources is needed to guide educators. Psychiatric nurse educators (n = 11) and psychiatric nurses (n = 9) were interviewed to determine what resources psychiatric nursing educators use to teach professional boundaries to undergraduate students. Following the interviews and preliminary analysis, eight participants also attended a focus group. Participants reported resources such as textbooks were useful for defining professional boundaries. Participants also described case studies as a resource available to help operationalize boundaries in psychiatric nursing practice. Resources should be developed to address changes in care provision and technology to include cultural competence and guidelines for the use of social media. [J Nurs Educ. 2023;62(2):97-100.].

A Review of Chronic Pain with Depression and/or Anxiety Comorbidities in the Indian Population

Chronic pain and psychiatric conditions often coexist with shared risk factors and a reverse causal link. Depression and anxiety comorbidities are associated with increased pain intensity, less favorable response to treatments, and higher medical costs. The management of psychiatric comorbidities in chronic pain conditions is less explored in India. This paper aims to review the current literature landscape of comorbid depressive and/or anxiety disorders with chronic pain conditions in the Indian populations and identify need gaps for future research. A literature search on MEDLINE database and other sources conducted from January 2010 through March 2020 retrieved 84 shortlisted eligible articles and their findings were synthesized into a narrative review. There was a high prevalence of comorbid depression and anxiety with chronic pain observed across multiple pain etiologies and population groups in the Indian setting. Women had a higher burden of psychiatric comorbidities in chronic pain conditions compared with men. Poor socioeconomic conditions and pain severity were important risk factors that predisposed individuals to psychological distress. There was limited data on evidence-based management of chronic pain and comorbid depression or anxiety for Indian populations. Barriers toward effective pain management in India occur at the level of patients, physicians, or healthcare systems; some of these challenges relate to patient’s health-seeking behavior, stigma associated with psychiatric treatment, physician awareness, and education, and access to pain medications. Future initiatives are needed toward building an evidence base for effective management of pain and comorbid psychiatric conditions in India.

Assessment Of Nurses' Knowledge About Ethical And Legal Issues Of Mental Health Nursing At Psychiatric Teaching Hospitals

Assessment Of Nurses' Knowledge About Ethical And Legal Issues Of Mental Health Nursing At Psychiatric Teaching Hospitals

Assessment of Depression in Mothers of Children with Cerebral Palsy

Background: Mothers of children with various degrees of impairment may bear a high amount of stress. Children with chronic medical disorders lead their moms to experience sadness, mental distress, and behavior problems. Aim: To determine the frequency of depression in mothers of children with cerebral palsy. Methodology: This cross sectional study was conducted in OPD of Neurology and Development Department, Children's Hospital Lahore in six months after the approval of synopsis August 20, 2020 till Feb 20, 2020. After taking written informed consent, 196 CP children's mothers were enrolled. Demographic information (including name, age) was also recorded. After admission to hospital detailed history and thorough clinical examinations were carried out to reach the provisional diagnosis. Results: The mean age of children was 6.65±2.23 years with age range of 3 and 10 years. There were 109(55.6%) male and 87(44.4%) female cases with higher male to female ratio. The mean age of mothers was 37.92±7.69 years with age range of 25 and 50 years. There were 115(58.7%) mothers who had depression and 81(41.3%) mothers did not have depression. There were 81(41.3%) mothers who had normal, 33(16.8%) had mild mood disturbance, 24(12.2%) mothers had borderline clinical depression, 23(11.7%) mothers had moderate depression and 35(17.9%) mother had severe depression. Practical implication: This study identifies a greater risk of depression in mothers of CP children, so by the help of this study we can identify such mothers at follow up of CP children and can give them psychiatric attention which can decrease mental health issues in them and would be beneficial for both the mother and their CP children. Conclusion: Depression among mothers of CP child was higher in this study, so these mothers must be given attention through psychiatric education and mental health programs to reduce their depression at the time of their CP children follow up. Keywords: Depression, care taker, disability, cerebral palsy, mental health

Dependence Severity, Locus of Control, and Readiness to Change in Male Alcoholic Clients: A Correlational Study

Objectives: To assess the level of dependence severity, locus of control, and readiness to change in male alcohol clients and measure the correlation between dependence with a locus of control and readiness to change.&#x0D; Methodology: A descriptive correlational design was conducted in the substance use rehabilitation centers at psychiatric teaching hospitals in Baghdad city from November /2021 to May 2022. The instrument of the study was designed by using sociodemographic, the clinical characteristics of the client, the Short-form Alcohol Dependence Data Questionnaire (SADD), Drinking Related Internal-External Locus of Control Scale: (DRIE), and the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). The data was collected through the use of a semi-structured form and analyzed by Social Package for Statistical Sciences SPSS version 26.0&#x0D; Results: The study showed a highly significant difference in dependence severity with an internal and external locus of control at p-value= .001, a significant reverse relationship between readiness to change among clients with regard to the duration of alcohol use at p-value= .008, and amount of alcohol use per day at p-value=.009. A significant relationship between readiness to change and clients’ level of education, and age of alcoholic clients’ is significant at p-value= .005.and significant relationship between locus of control and monthly income.&#x0D; Conclusions: Alcoholic male clients have a moderate dependence severity of alcohol and moderate external locus of control, low internal locus of control, and high readiness to change.&#x0D; Recommendations: Further research should be conducted on AUD, activating the media’s role to increase community awareness about the harmful effects of alcohol and the possible treatment methods.

IN MEMORIAM - PROF. MOHAMMAD SHAFIQUE (1935 - 2022)

We share the news of Professor Mohammad Shafique’s passing with great sorrow. On the 2nd of August, 2022 at his home, our dear mentor and teacher passed away. Dr. Shafique was a pioneer for psychiatry in Pakistan, most notably his contributions were in the KPK province. He was the third Psychiatrist in Pakistan and first in KPK. He was a true Messiah to his patients and a role-model to his students. Like his name, he was the embodiment of kindness and compassion. He paved the way for future psychiatrists of the country by transforming psychiatric teaching and patient care as it was known. Many psychiatrists in Pakistan today have been mentored and taught by Dr. Shafique. He has been regarded as the father of psychiatry in Pakistan. In 1961, he went to England to pursue higher training in the field of Psychiatry, where he trained under Dr. John Hughes and Dr. Andy Wills at St. Cadoc’s Hospital in Cardiff, Wales. He received his Doctor of Psychological Medicine degree and returned to Pakistan in 1964 to accept the post of Medical Superintendent at Dhodial Mental Hospital. He developed it into a fully functional mental hospital and revolutionized psychiatric patient care across KPK by building new foundations for the system to stand on. Later on, he was made the Medical Superintendent of Peshawar Mental Hospital and he established the psychiatric OPD at Lady Reading Hospital. His efforts inside and outside the hospital changed the perspective on mental illness in KPK and across the country.

Psychiatric genetic counseling: A survey of Australian genetic counselors' practice and attitudes.

Genetic counseling plays a critical role in supporting individuals and their families' adaption to psychiatric conditions, addressing the multifactorial nature of these conditions in a personally meaningful and empowering way. Yet data related to the practice and attitudes of Australian genetic counselors about psychiatric genetic counseling (PGC) is limited. This survey investigated the practice of Australian genetic counselors, and their attitudes toward PGC. Genetic counselors (N=393) were invited to participate in an anonymous online survey between March and May 2022. Forty-four genetic counselors (response rate=11%) from Australia and New Zealand responded. No respondents practice in psychiatric genetics as their speciality area; most respondents do not see any patients where the primary indication is a personal and/or family history of psychiatric disorders (91%). Greater than half of respondents (56%) believed there was sufficient evidence to support PGC, and 64% enquire about personal and/or family history of psychiatric disorders, but only 25% provide genetic counseling on this topic. Most respondents do not feel confident providing risk assessments for psychiatric disorders (72%), while the majority expressed interest in attending specialist training (95%), and in incorporating PGC into future practice (77%). Australian genetic counselors would benefit from psychiatric genetic education and training, and establishment of specialized PGC services would address this gap in patient care, while providing opportunities for genetic counselors to gain skills and experience in PGC.

Jeffrey Lyness, M.D., to Become President and CEO of ABPN

Jeffrey Lyness, M.D., to Become President and CEO of ABPN

Relation of Demographic and Impact of Psych educational Program on Anxiety Level in Patient Diagnosed with Generalized Anxiety Disorder in Garmian Psychiatric Center/Kalar

Background and aim: anxiety disorders are among the most frequent psychiatric disorders that nearly one-third of the population is being affected by an anxiety disorder during their life. Psychoeducation has been used as the main anxiety management for patient diagnosed with anxiety disorder. The aim of the study to asses effectiveness of psycho- educational program among patients diagnosed with anxiety. Methodology: A quasi-experimental design was carried out on 82 patients diagnosed with anxiety disorder. The patients attended a knowledge-based psycho-educational program, and anxiety level was measured using the Zang anxiety self-rating scale in pre- post- intervention status . The data was analyzed using the statistical package for social sciences (SPSS) version (23). Result s: this study has demonstrated that anxiety was high among female (67.1%) and high educated (44.9%) comparatively. The study has also indicated that psychoeducation program has significant impact on decreasing the anxiety severity. The percentage of severe anxiety in pre-intervention state was (40.2%), mild and moderate anxiety level was (9.8%) and (50%) respectively, while in post-intervention status, severe anxiety level was (20.7%), mild and moderate anxiety level were (15.9%), (63.4%) respectively. Conclusion: This study concluded that psych-education intervention could significantly reduce level of anxiety among anxiety patients. The impact of a psychiatric education program is primarily due to increased knowledge about anxiety and improved problem-solving skills for anxiety sufferers. Anxiety was observed less frequent in male, single and less educated, while anxiety was more severe comparatively