Psychiatric Research Project Research Articles

Negative association of perceived risk and willingness to participate in innovative psychiatric research protocols

Psychiatric researchers grapple with concerns that individuals with mental illness may be less likely to appreciate risks of research participation, particularly compared to people not suffering from mental illness. Therefore, empirical studies that directly compare the perspectives of such individuals are needed. In addition, it is important to evaluate perspectives regarding varied types of research protocols, particularly as innovative psychiatric research protocols emerge. In this pilot study, respondents with a mood disorder (n = 25) as well as respondents without a mood disorder (n = 55) were recruited using Amazon's Mechanical Turk (MTurk) platform. These respondents were surveyed regarding four psychiatric research projects (i.e., experimental medication [pill form]; non-invasive magnetic brain stimulation; experimental medication [intravenous infusion]; and implantation of a device in the brain). Regardless of health status, respondents rated the four research protocols as somewhat to highly risky. The brain-device implant protocol was seen as the most risky, while the magnetic brain stimulation project was viewed as “somewhat risky”. Respondents, on average and regardless of health status, rated their willingness at or below “somewhat willing.” Respondents were least willing to participate in the brain-device implant protocol, whereas they were “somewhat willing” to participate in the magnetic brain stimulation protocol. Trust in medical research was negatively associated with perceived risk of research protocols. Perceived risk was negatively associated with willingness to participate, even when adjusting for potential confounders, suggesting that attunement to risk crosses diagnostic, gender, and ethnic categories, and is more salient to research decision-making than trust in medical research and dispositional optimism. The findings of this study may offer reassurance about the underlying decision-making processes of individuals considering participation in innovative neuroscience studies.

Recruitment to psychiatry in the Czech Republic: ‘Waiting for resuscitation’?

Recruitment to psychiatry is becoming a serious obstacle in providing first-class mental health treatment in many countries worldwide. We attempt to address this burning issue by examining medical student's attitudes towards psychiatry and factors influencing their career choice in the Czech Republic. In 2010, 71 students in their last year of medical school at the First Faculty of Medicine, Charles University, Prague were recruited in this quantitative cross-sectional online study. From the sample, 16% (n = 11) of students were considering psychiatry as a career path. An important factor in choosing psychiatry as a career path was personal/family presence of mental illness. Longer experience with psychiatry placement also contributed to the choice of psychiatry, as well as participation in elective courses or psychiatric research projects. Students considering psychiatry were less systematic compared to the group not considering psychiatry. Low reported levels of recruitment to psychiatry present a problematic issue in the Czech Republic. To make psychiatry more appealing to medical students, proactive steps by the relevant stakeholders need to be implemented. These strategies should include steps such as allocating more time for psychiatry in the medical curriculum, better quality of lectures, and the inclusion of additional elective courses.

Recruitment problems in psychiatry: just a matter of more exposition?

Recruitment problems in psychiatry: just a matter of more exposition?

Études criminologiques et psychiatriques au Japon

CRIMINOLOGICAL AND PSYCHIATRIC STUDIES IN JAPAN Criminological development in Japan is largely the work of the Japanese Association of Criminology, founded in Tokyo in 1913. The year 1935 saw the debut of the publication Acta criminologia?: et medicinee legalis japonica. After an interruption of several years caused by the second world war, society made great strides, and important research could then be undertaken. There are now three State institutes of criminology in Japan: the General Research Institute of Forensic Medicine at the Tokyo University of Medicine and Dentistry, the Institute of Research, Practical and Clinical Training at the Ministry of Justice, and the Institute of Encephalographie Research of the University of Tokyo. Among the most important criminological and psychiatric research projects are: 1) Study of twins: Led by Yoshimasu, this could be considered as one of the most brilliant contributions of Japanese criminology to science. It is based on the rate of concordance between homozygotic and heterozygotic twins. For a clearer understanding of the phenomenon of concordance between the two partners, Yoshimasu used the following factors: age at first offence, age at the time of research, and number of relapses. The results of his analysis show a lesser rate of agreement than that of foreign studies, nevertheless this rate increased perceptibly after the second world war, which is explained by the influence of environment. 2) Research on recidivism by means of analysis of the life curve: In 1951, Yoshimasu discovered a new method for analyzing the criminal careers of recidivists (this method is defined in English as «the criminal life curve» and in German, die kriminelle Lebenskurve). It comprises three indices: a) age at the time of first offence: before or after 25 years; b) the type of offence: classified in accordance with the kind of crime, the sequence of crime and the kinds of crimes committed during any one episode, i.e. one, the same or different; c) interval between the offences: sequence, remission, intermission, suspension. Later on, various studies were added to this research. 3) Characteristics of various crimes: The studies undertaken dealt with homicidal women, homicidal girls, mass murderers (Massenmo'rder). These studies showed interesting results, because there is an intimate relationship between patricide and the family environment in the traditional Japanese atmosphere. Other researchers were interested in arsonists, sex criminals, persistent embezzlers, recidivists in crimes of violence. 4) Research on juvenile delinquency: In this field, Japan may well be proud of having several pioneers. We stressed the importance of the psychopathic personality, as much as the sheer asymmetry of psychic and physical maturity. 5) Criminality of the mentally disturbed with encephalitis due to anti-rabies vaccination: Studies undertaken after the massacre of 12 employees of the Teikoku Bank of Tokyo revealed that subjects suffering from this malady have a deviated personality of a mythomanie type with Korsakov's syndrome. Other studies show a seat of demyelinized fibres. Treatment could thus be applied to effectively fight this illness. 6) Amphetamine drug addiction and criminality: This problem took on the dimensions of a national crisis after the second world war, when amphetamine drug addiction rose to 200 000. The work undertaken on this problem revealed psychopathic personalities characterized by hyperthymic tendencies, hysterics, explosiveness or instability, as explained by Kurt Schneider. 7) Reactions to penal institutions and disciplinary infractions: With regard to these, a new method called infractiologie was used. It is concerned with the actual relationship which exists between crimes committed in society and infractions committed within the penal institution.

Extracting data in file-based forensic psychiatric research: Some methodological considerations

This article explores possibilities and problems of the use of file-based data in forensic psychiatric research. Attention is paid to methodological problems with regard to data quality, operationalization of information into variables, and procedures for reliable data extraction, including interrater reliability assessments. We report on experiences from an ongoing Swedish forensic psychiatric research project based on complete forensic psychiatric investigation records, the National Police Register and the National Hospital Discharge Register. We conclude that when forensic psychiatric investigation records and population-based registers are combined, various factors for research can be extracted reliably. However, contrary to expectations, several categories of variables could not be consistently extracted. Examples of both types of variables are provided.

IRBs under the microscope.

IRBs Under the Microscope Jonathan D. Moreno (bio) The spring and summer of 1998 were seasons in the sun for institutional review board (IRB) aficionados. Rarely have the arcana of the local human subjects review panels been treated to so much attention in both the executive and the legislative branches of government, not only at the federal but also at the state level. And it looks as if the attention will continue for some time. The spate of interest is due to a series of coincidences: a powerful House of Representatives subcommittee held hearings after its chairman learned about the IRB system during a previous session on research in underdeveloped communities; the Department of Health and Human Services’s Inspector General (DHHS-IG) released a report on IRBs; the National Institutes of Health (NIH) Office of Extramural Research completed a report on clinical trial monitoring; the National Bioethics Advisory Commission (NBAC) readied a report on research involving persons with mental disorders; the states of Maryland and New York completed studies of research with subjects who lack decision-making capacity; and advocacy groups protested a psychiatric research project involving inner city children. Underlying these proximate causes for the IRB blitz is a growing realization that the already considerable clinical trial enterprise will expand significantly over the next few years. Congress is talking about giving the politically popular NIH half again the budget it currently receives, which in turn will stimulate more commercially supported research. The director of the National Cancer Institute is considering a five-fold increase in the number of subjects enrolled in oncology studies over the next several years. Phase I cancer studies are among the most ethically sensitive, so IRBs will have more work cut out for them if this goal is reached. Adding to the rush of interest in IRBs are the government’s recent apology to the survivors of the syphilis study in Tuskegee, continuing congressional dissatisfaction with the way the Pentagon handled its vaccine distribution during the Gulf War, and the controversy about AZT trials in developing countries. On the Hill Congressman Christopher Shays, the moderate Connecticut Republican who has developed an interest in human research issues, convened hearings on human [End Page 329] subjects research and the IRB system on 11 June 1998. Shays chairs the House Government Reform/Human Resources Subcommittee. The committee’s ranking minority member is Edolphus Towns of Brooklyn, NY, who shares Shays’s interest in this area. The immediate rationale for the hearings was the release that day of the DHHS-IG report, Institutional Review Boards: A Time for Reform. The subtitle was changed from A System in Jeopardy apparently after some people in DHHS expressed reservations about its seemingly alarmist tone, but the IG staffers who testified before Shays’s subcommittee insisted that they stood behind the message that the IRB system is in trouble if considerable reforms are not undertaken. Among the factors in the research environment cited as support for the bleak forecast: managed care, commercialization, multi-site trials, high IRB workloads, minimal IRB oversight of approved studies, conflicts of interest, insufficient training of IRB members and investigators, and lack of IRB self-studies (DHHS-IG 1998). As is normally the case for congressional oversight hearings, the first panel of witnesses consisted of executive branch officials, including Eric Meslin, Executive Director of the National Bioethics Advisory Commission, and Gary Ellis, Director of the Office for Protection from Research Risks (OPRR). Shays pressed Ellis on the extent to which OPRR conducts on-site investigations of complaints about abuse of human subjects. Admitting that on-site investigations are rare, Ellis suggested that the agency is inadequately staffed to follow up on complaints as quickly as it might wish. The members of Congress who were present at the hearings generally expressed concern about the DHHS-IG’s findings. The second panel that day, which Shays was unable to attend, set a different tone. Four of the panelists—Paul Appelbaum of the University of Massachusetts at Worcester, Robert Levine of Yale University, Angela Bowen of the Western IRB (a private clinical trials review firm), and I—were invited as authorities on the current condition of the IRB system. Bert Spilker...

Handy Hints on Completing a Psychiatric Research Project: 8. On Publishing, Conventions and Gifts

(1995). Handy hints on completing a psychiatric research project: 8. On publishing, conventions and gifts. Australasian Psychiatry: Vol. 3, No. 3, pp. 176-177.

Handy Hints on Completing a Psychiatric Research Project: 7. On Analysis and Finding the Analytic Line

Handy Hints on Completing a Psychiatric Research Project: 7. On Analysis and Finding the Analytic Line

Handy Hints on Completing a Psychiatric Research Project: 6. On Holidays, Data Sneets, Computers and Consultants

Handy Hints on Completing a Psychiatric Research Project: 6. On Holidays, Data Sneets, Computers and Consultants

Handy Hints on Completing a Psychiatric Research Project: 5. On Forms, Notebooks and Copies

Handy Hints on Completing a Psychiatric Research Project: 5. On Forms, Notebooks and Copies

Handy Hints on Completing a Psychiatric Research Project: 4. On Protocols and Ethics

(1994). Handy hints on completing a psychiatric research project: 4. On protocols and ethics. Australasian Psychiatry: Vol. 2, No. 4, pp. 171-172.

Handy Hints on Completing a Psychiatric Research Project: 3. On Reading the Literature

Handy Hints on Completing a Psychiatric Research Project: 3. On Reading the Literature

Handy Hints on Completing a Psychiatric Research Project: 2. On Surveys and Experiments

Handy Hints on Completing a Psychiatric Research Project: 2. On Surveys and Experiments

Handy Hints on Completing a Psychiatric Research Project: 1. On Mentors and Ideas

Handy Hints on Completing a Psychiatric Research Project: 1. On Mentors and Ideas

The Roles of Social work in Psycho-Biological Research

Social Workers have an opportunity to utilize their skills in the arena of psychiatric research. Traditional areas of social work functions, including working with patients, families, groups, complicated systems, and interdisciplinary teams, as advocate, therapist, mediator, and manager, are all necessary for the successful implementation of psychiatric research projects with human subjects. The repertoire of social work skills can enhance the successful operation of research involving bio-psycho-pharmacological or neurobiological trials.

Informed consent in psychiatric research: Preliminary findings from an ongoing investigation

Preliminary findings from an investigation of informed consent processes in four psychiatric research projects (two being carried out at a university medical center and two at a public psychiatric hospital) are reported. Study methods include the systematic observation of investigator/subject information disclosure sessions using audio and videotape, as well as the use of standardized interaction rating forms and subject understanding interviews. In an attempt to determine if subjects' understanding of research can be improved through increased subject education, several modes of information disclosure are compared. Partial results from the public psychiatric hospital portion of the investigation suggest low subject understanding in many areas with subjects often demonstrating difficulty differentiating between treatment and biomedical research. Subjects' problematic understanding of research purposes and methodology was compounded by investigator disclosures which often emphasized the therapeutic, personalistic and nonresearch-oriented aspects of the project. Nevertheless, even when information disclosures were significantly improved, subject understanding in many cases continued to be low— suggesting that additional factors aside from the quality of investigator disclosure are involved in psychiatric subjects' comprehension and understanding of research. The implication of these findings for informed consent, regulation of biomedical research and the protection of human subjects are discussed.

Psychiatry in New Britain

A psychiatric research project has been instituted in the Rabaul district of New Britain. A case report of a psychotic patient is presented as a basis for understanding psychiatric illness in the indigene. The role of traditional beliefs in illness are outlined and, although western beliefs and scientific medicine are gaining ground, the treatment of the mentally ill involves an active role for traditional healers. A hospital-oriented service may only be efficacious for more disturbed deviant individuals.