World Psychiatric Association Research Articles

Psychiatry as a career choice: determinants of attraction towards psychiatry among final year medical students in a Nigerian university

Background: Despite an increase in the overall number of medical students, the shortage of psychiatry trainees in Nigeria and worldwide reflects diminishing interest in psychiatry among medical students. The study examined the degree and factors influencing attraction towards psychiatry as a career choice. Method: A cross-sectional study of 71 final-year medical students who enrolled at the Usmanu Danfodiyo University Sokoto State (UDUS), Northwest Nigeria between 2006/07 and 2013/14 academic session were interviewed in 2021 while in 600 level. The questionnaires were adapted from similar studies. Results: The ATP-30 revealed a high prevalence of negative attitudes towards psychiatry, the degree of preference for psychiatry as a career option was classified as low and high. Almost half (47.9%) of the participants had a low degree of preference for psychiatry as a career choice. Most (92.9%) of the participants rated job satisfaction (p<0.001) and intellectually challenging (86.7%) (p<0.001) poorly, as negative influences for not being attracted towards psychiatry as a career choice. A low proportion (8.5%) of the participants selected psychiatry as their most preferred area of specialization. Generally, the majority (85.7%) viewed psychiatry as not attractive. Among the participants, the majority perceived psychiatry as unattractive. Students' misconceptions about job satisfaction and the negative view of not being intellectually challenging were the associated factors for the negative views towards psychiatry. Conclusion: There is a need for strategy and policy to promote interest in psychiatry early in medical school and residency programs as recommended by the World Psychiatric Association.

The world's psychiatrists update their position on Workforce mental health.

Aside from personal impacts, costs to employers and national economies of mental health can be measured in trillions of dollars. With volatility, uncertainty, complexity and ambiguity increasingly describing the new normal workplace, the need for evidence-based interventions for sustained mental health at work to be developed, evaluated and implemented by specialists in psychiatry and occupational health could not be greater, nor an updated position statement on work and mental health from the World Psychiatric Association.

Carter Center releases 2024 journalism resource guide for mental health reporting

The Carter Center on March 6 released a new “Journalism Resource Guide for Mental Health Reporting,” a news release stated. The guide — developed in part with funding from the National Institute for Health Care Management and in partnership with the World Psychiatric Association and the International Center for Journalists, is available in English and Spanish and provides up‐to‐date statistics, resources and guidance on how to report on mental health issues accurately and sensitively. “Our new resource guide reflects what we've learned from more than 250 of our mental health journalism fellows and the increased demand for mental health media coverage to be treated with sensitivity,” said Karen Ladley, senior associate director for the Rosalynn Carter Fellowships for Mental Health Journalism. “The guide also integrates consequences and challenges posed by the COVID‐19 pandemic, when depression and anxiety rates rose about 25% in the first year, according to the World Health Organization.”

World Psychiatric Association position statement on mental health and the death penalty

World Psychiatric Association position statement on mental health and the death penalty

Evidentiary Significance of Routine EEG in Refractory Cases: A Paradigm Shift in Psychiatry.

Over the past decade, the Diagnostic and Statistical Manual's method of prescribing medications based on presenting symptoms has been challenged. The shift toward precision medicine began with the National Institute of Mental Health and culminated with the World Psychiatric Association's posit that a paradigm shift is needed. This study supports that shift by providing evidence explaining the high rate of psychiatric medication failure and suggests a possible first step toward precision medicine. A large psychiatric practice began collecting electroencephalograms (EEGs) for this study in 2012. The EEGs were analyzed by the same neurophysiologist (board certified in electroencephalography) on 1,233 patients. This study identified 4 EEG biomarkers accounting for medication failure in refractory patients: focal slowing, spindling excessive beta, encephalopathy, and isolated epileptiform discharges. Each EEG biomarker suggests underlying brain dysregulation, which may explain why prior medication attempts have failed. The EEG biomarkers cannot be identified based on current psychiatric assessment methods, and depending upon the localization, intensity, and duration, can all present as complex behavioral or psychiatric issues. The study highlights that the EEG biomarker identification approach can be a positive step toward personalized medicine in psychiatry, furthering the clinical thinking of "testing the organ we are trying to treat."

Bringing together the World Health Organization's QualityRights initiative and the World Psychiatric Association's programme on implementing alternatives to coercion in mental healthcare: a common goal for action.

Stakeholders worldwide increasingly acknowledge the need to address coercive practices in mental healthcare. Options have been described and evaluated in several countries, as noted recently in major policy documents from the World Health Organization (WHO) and World Psychiatric Association (WPA). The WHO's QualityRights initiative promotes human rights and quality of care for persons with mental health conditions and psychosocial disabilities. A position statement from the WPA calls for implementation of alternatives to coercion in mental healthcare. We describe the engagement of both the WHO and WPA in this work. We discuss their mutual aim to support countries in improving human rights and quality of care, as well as the differences between these two organisations in their stated goals related to coercion in mental healthcare: the WHO's approach to eliminate coercion and the WPA's goal to implement alternatives to coercion. We outline and critically analyse the common ground between the two organisations, which endorse a similar range of rights-based approaches to promoting non-coercive practices in service provision, including early intervention in prevention and care and other policy and practice changes. Advocacy and action based on an agreed need to find practical solutions and advances in this area have the power to build consensus and unify key actors. We conclude that persons with lived experience, families, mental health professionals and policy makers are now coming together in several parts of the world to work toward the common goals of improving quality, promoting human rights and addressing coercion in mental health services.

WPA Digitalization in Mental Health and Care: Empirical Report on Action Plan and Related Activities

AbstractDigital health is increasingly gaining momentum in psychiatry, contributing to better public mental health. The World Psychiatric Association (WPA) is committed to capacity building and training in global mental health and care by integrating competencies and resources, including digital means. The WPA Action Plan Working Group on Digitalization in Mental Health and Care supports the promotion and implementation of digital health in mental health care worldwide. The Working Group is active in producing and improving evidence, data acquisition, policy development, education, and implementation of digital mental health and care. The Working Group has recently completed a survey shared with all 145 WPA member societies to draw a baseline account of the availability, use, and impact of digital health globally. The survey covered questions on digitalization in general and mental health care regarding the status and spectrum of digital tools and programs used in each represented country. The survey, supported by the WPA President, Staff, and 18 Zonal Representatives, was completed by member societies from all WPA/World Health Organization (WHO) regions. Findings will help ensuring accessibility, equity, and progress in country-adapted upscaling of digital mental health and care. Survey results, together with our newly developed WPA official position statement on digitalization, provide clear priorities and targeted interventions that will guide WPA to support the development and implementation of digital mental health and care to transform health systems worldwide, improve professional collaboration, promote mental health, prevent stigma, and ensure universal mental health coverage.

The World Psychiatric Association Telepsychiatry Global Guidelines

AbstractPsychiatry is the branch of medicine that deals with the causation, prevention, diagnosis, and treatment of mental and behavioral disorders. Telepsychiatry, in the form of live interactive videoconferencing, has emerged as a promising approach to improve access to mental health care, particularly in underserved populations across the world. However, the use of telepsychiatry also raises unique clinical, ethical, legal, and technological challenges. Pre-pandemic, the vast majority of mental health professionals had little to no experience with telepsychiatry, so they were forced to quickly adapt to the use of telepsychiatry to continue provide ongoing care to patients or new services. To address these challenges, the World Psychiatric Association (WPA) developed Telepsychiatry Global Guidelines in 2020 via outreach to and input from as many countries as possible, with intent to support all countries with intent to specifically assist low- and middle-income countries in adopting and establishing telepsychiatry services amid the COVID-19 outbreak. The guidelines make suggestions for clinical practice, technological challenges, education and training, research, and specific populations and settings, with an emphasis on international and cross-cultural dimensions. The WPA guidelines specifically emphasize the importance of providing cultural fit to patient-centered care, ensuring confidentiality and security of patient information, and ongoing evaluation and quality improvement. The guidelines offer an appendix with a comprehensive collection of tools, templates, and resources. The guidelines highlight the importance of collaboration between policymakers, clinicians, and patients in the development and implementation of telepsychiatry programs.

Systemic Racism, Ethnic Discrimination, and Children’s Mental Health: Fostering Global Conversations

Children and adolescents globally are particularly vulnerable to the unfortunate consequences of ethnic discrimination and systemic racism. These impacts not only synergize with other adverse early life experiences but also permeate all psychosocial domains, especially mental health, leading to detrimental shifts in their life trajectory. While terms like ethnic discrimination and systemic racism have been unconsciously used for centuries outside of North America, their interpretation has predominantly relied on a cultural lens, neglecting to acknowledge their profound impact on children's mental well-being. This paper aims to discuss the mental health implications of systemic racism within various social systems and raise awareness of its dire outcomes for children and adolescents. Additionally, it will focus on recommendations by early career psychiatrists (ECPs) who advocate for change in social systems within their own cultures. In 2020, the Global Mental Health Think Tank was established by a diverse, multidisciplinary, and online-based network of ECPs affiliated with the World Psychiatric Association’s ECP section. These ECPs and co-authors are internationally practicing adult and child and adolescent psychiatrists, and physician-scientists. Discussions among authors highlighted three main areas of concern: a) trauma and related disorders within the context of ethnic discrimination, b) discrimination against minorities in education systems, and c) discrimination of minorities in maternal health. Another noteworthy observation was the scarcity of literature on this topic globally, highlighting the need for increased system-based qualitative studies and interventions that align with each region’s respective culture.

Politicization of psychiatry and the improvement of ethical standards in the 1970s.

The Code of Ethics for Psychiatry adopted by the World Psychiatric Association in 1977, also known as the Declaration of Hawaii, was a milestone in the development of ethical standards in psychiatry. The impetus for the development of the code came primarily from the politicization of psychiatry, first discovered in the USSR, and later in other countries of the socialist camp, such as Romania, Yugoslavia, and the People's Republic of China. The purpose of this article is to trace reasons for the lack of consolidation among Western psychiatrists against the politicization of psychiatry and their efforts to improve the ethical standards in this medical field. We analyzed unpublished documents from the Archive of the German Association for Psychiatry, Psychotherapy and Psychosomatics, the private archives of the West German psychiatrists Gerd Huber and Walter von Baeyer as well as research works. To examine these sources, we implemented the historical-critical method. The World Psychiatric Association made efforts to collect, analyze and discuss materials concerning psychiatric ethics in order to create the Code of Ethics for Psychiatry and establish an Ethical Committee. In general, the reaction of Western psychiatrists to the information about the internment of dissidents in psychiatric hospitals was restrained and focused on attempts to solve the issue together with the Soviet colleagues. The international policy of détente of the time as well as collisions between different medical concepts and ethical dimensions did not allow Western psychiatrists to condemn cases of politicization of psychiatry without proir clarification of the situation. The efforts of the World Psychiatric Association in the ethical field improved the ethical standards for psychiatry.

Human rights promotion and the ‘Geneva impasse’ in mental healthcare: scoping review

The World Psychiatric Association recently emphasised that the protection of human rights in mental healthcare was a 'central concern'. This paper examines recent literature on human rights and mental healthcare. To (a) outline how international human rights law distinguishes between the protection and promotion of human rights; and (b) explore the literature on promoting human rights in mental healthcare which avoids what has been termed the 'Geneva impasse' between those who argue that compulsory care and treatment can never comply with human rights law and those who argue that they can if certain conditions are met. The following doctrinal methodology was used: (a) identification and detailed analysis of international human rights conventions and commentaries; (b) identification of key literature on human rights and mental healthcare; and (c) critical analysis of key issues emerging from the literature. Much of the literature on human rights and mental healthcare focuses on whether restrictions on compulsory care are required to meet the requirements of United Nations Conventions. There is an emerging literature identifying measures to promote the right to the enjoyment of the highest attainable standard of mental health. There has been a focus on protecting the rights to liberty and equality before the law for mental health patients. The nascent literature on promoting human rights in mental healthcare could mark a way forward beyond the 'Geneva impasse' that has dominated public debate in recent years.

PUBLIC MENTAL HEALTH: AN AGENDA FOR ACTION.

Mental disorders accounts for at least 20-25% of global disease burden. This could be due to a combination of most lifetime mental disorder arising before adulthood, and broad range of impacts across health, education, employment, social relationships, crime, violence, and stigma. Poor mental wellbeing has a similar range of impacts. It is a pity that crises such as COVID-19 are likely to further increase prevalence of risk of mental disorder, relapse of mental disorder and poor mental wellbeing across all populations. The public mental health conceptual framework brings together many perspectives into a comprehensive agenda for future action. Public mental health (PMH) takes a population approach to sustainably reduce mental disorder and promote mental wellbeing through provision of population required levels of PMH interventions. This approach does acknowledges that a wide range of determinants across individual, family & community levels contribute positively or negatively to mental health and well-being. Taking public mental health as a conceptual framework, the World Psychiatric Association’s Action Plan for 2020-23 also defines emerging needs and priorities, from a worldwide perspective, in some specific areas of public mental health. Given that globally, only a minority with mental disorder receive any treatment, there is an outstanding need to promote and practice mental health as public mental health.

JOURNEY OF ORGANIZING WPA THEMATIC CONGRESS

How the Journey Started? "Hey, Majid, why are you not taking any dessert?" asked Prof. Afzal Javed,1 the President of World Psychiatric Association. "No. Thank you, Sir. I want to maintain my weight," I answered. "You know there is another good strategy to control your weight. Why don't you organise a WPA Thematic Congress in Karachi!" intervened Prof. Nasar Sayeed Khan, a former President of Pakistan Pakistan Psychiatric Society.2 This was almost two years ago in Lahore, while I was enjoying dinner in the company of these esteemed colleagues. The next evening at the Fountain House Lahore3 dinner, the three of us had the same idea. This is how the seed for organising a WPA Thematic Congress in Karachi was planted. The following day, we conducted an unofficial meeting to plan the first-ever WPA Thematic Congress in Karachi. To think it all began there…!

How to implement evidence-based practice to prevent and reduce coercion in psychiatry

AbstractThe UN Convention on the rights of people with disabilities (UN CRPD) raised awareness of the need to find alternatives to coercion in the process of care for people with mental illness and/or mental impairment. In order to promote the application of the CRPD the World Psychiatric Association (WPA) has undertaken to produce a document listing possible alternatives to coercion and proposed to the General Assembly of the WPA to support the recommendations of that document by a WPA Position Statement on the matter.The presentation will discuss the suggestions included in the Position Statement and in the review of options to reduce coercion in the WPA materials.Disclosure of InterestNone Declared

Hermeneutics, Neuroscience and Psychiatry

Hermeneutics, Neuroscience and Psychiatry Michael T. H. Wong, MBBS, MD, MA, MDiv, PhD, FRCPsych, FRANZCP, FHKAM (bio) Hermeneutic practice in mental health has been a theme in Philosophy, Psychiatry, & Psychology (PPP) since its very beginnings. In this essay I argue that hermeneutics, the theory and practice of interpretation, promotes therapeutic interaction between mental health professionals, patients and their family. Why does this patient present in such a way at this particular point in time? The distressing symptoms are there. The changes in behavior are obvious. Impairments of functions are hurting. A mental illness clearly runs in the family. There were early losses of loved ones, physical abuse at home, bullying by peers and self-medication with drugs and alcohol. Three in four adults with a mental illness first experienced that before they turned 24. The brain goes through major reorganization during adolescence and early adulthood. If synaptic pruning went wrong, psychoses emerged. When stresses activated the hypothalamic–pituitary–adrenal axis the elevated cortisol level impacted the size and function of the hippocampus and amygdala in the genetically vulnerable; anxiety, depression, bipolar, and personality disorders developed. The patient needs a voice/language to describe all these experiences and events and the psychiatrist needs a discourse to make sense of them. Eisenberg laments the swings between "brainlessness" and "mindlessness" in psychiatry. Engel argues for a "biopsychosocial" discourse. The major challenge for psychiatry is how to organize clinical information of different nature (categories, dimensions, narratives; i.e., objective vs. subjective, personal vs. interpersonal) into a coherent and comprehensible account for us all. Mental illnesses are not only neuropsychiatric spectrum disorders but also dysfunctions of social relationship and environmental/ecological adaptation. Psychiatry as a clinical neuroscience per se lacks the semantics to address the rich interactions between the physical, psychological, social, cultural, and spiritual in the illness experience of our patients. Explanation in the diagnostic formulation (objective scientific discourse on cause and effect) and understanding in the patient narrative (subjective ordinary everyday discourse on significance and meaning) are irreducible to each other (Wong, 2018). They instead interact with one another to achieve an integrative formulation, not through merging different discourses into a single assertion/monologue but via the dialectic/dialogue of "explaining more in order to understand better," as Ricoeur puts it, and between "the whole and the parts," as Schleiermacher highlights. This "therapeutic hermeneutic circle" of "explanation vs understanding" and "the whole vs the parts" includes symptoms behavior function and life events. It correlates between bio-psychosociocultural-spiritual dimensions/perspectives and does not reduce them to any particular/single [End Page 13] stance. The whole integrates the parts and the parts enrich the whole. It explains but does not explain away. It understands through an articulation of meaning and significance. This discourse is a multilayered (bio-psycho-social-cultural-spiritual) personal narrative that formulates diagnosis and care in a correlative (linking different voices/discourses) and non-reductive (no particular voice/discourse is prejudiced against) manner that is comprehensible to us all (Wong, 2021). PPP will be an excellent forum for discussing clinical hermeneutics in the future. In this digital era of social media and virtual reality, hermeneutics has the never-ending task to tackle the unprecedented challenges to meaning illness and health posed by polarizing discourses. Michael T. H. Wong Michael T.H. Wong, MBBS, MD, MA, MDiv, PhD, FRCPsych, FRANZCP, FHKAM, is Hon Clinical Professor, Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, HKSAR, China. Michael is Chair, Section of Philosophy & Humanities in Psychiatry, World Psychiatric Association. He is an Organizational Partner & International Lead with The Collaborating Centre for Values-Based Practice in Health and Social Care, St Catherine's College Oxford. He is Advisor to the Chinese Health Foundation of Australia. References Wong M. T. H. (2018). Ricoeur and the third discourse of the person: From philosophy and neuroscience to psychiatry and theology. London: Lexington Books. Google Scholar Wong, M. T. H. (2021). Values, meanings, hermeneutics and mental health. In Stoyanov, D., Fulford, K. M. W. F., Stanghellini, G., Van Staden, W., & Wong, M. TH. (Eds.), International perspectives in values-based mental health practice: Case studies and commentaries (pp. 341–349...

Non-invasive neurostimulation in OCD – implications for widescale application.

AbstractBrain-imaging findings implicate aberrant cortico-striatal neurocircuitry in the underlying pathology of OCD, so representing a potential treatment target. Ablative neurosurgery or deep brain (invasive) stimulation (DBS) of tracts or nodes within this circuitry is sometimes found to improve OCD, possibly by enhancing information-processing functions. Non-invasive neurostimulation, targeting superficial cortical nodes within cortico-striatal circuitry, is a safer and more acceptable alternative, with potential for scaling up and applying to a larger patient population, earlier in the course of illness.Repetitive transcranial magnetic stimulation (rTMS) is the form of neuromodulation studied most in OCD. The orbitofrontal cortex (OFC), dorsolateral prefrontal cortex and supplementary motor area (SMA) have been identified as promising targets. The effect is larger for those not resistant to SSRI or failing to respond to only one SSRI trial. Thus, r-TMS may be best implemented earlier in the care pathway. rTMS is also relatively costly, involves specialist technical equipment and staff, and cannot be delivered in patients’ homes.Transcranial direct current stimulation (tDCS) involves applying a low-amplitude (1-3mA) electric current to the brain via electrodes placed on the scalp. Compared with rTMS, tDCS tends to electrically modulate a more diffuse and superficial brain area, but it could represent a preferable option for patients with common mental disorders such as OCD, as it is cheaper, portable, simple and safe to use. In a recent randomised controlled feasibility study, the L-OFC represented the optimal target based on clinical changes. Further investigation of tDCS in OCD is warranted, to determine the optimal stimulation protocol, longer-term effectiveness and brain-based mechanisms of effect. If efficacy is substantiated, home-based approaches represent a rational next step.Disclosure of InterestN. Fineberg Grant / Research support from: In the past three years I have received research funding from the NIHR, COST and Orchard; . I have additionally received financial support to attend meetings from the British Association for Psychopharmacology, European College for Neuropsychopharmacology, Royal College of Psychiatrists, International College for Neuropsychopharmacology, World Psychiatric Association, International Forum for Mood and Anxiety Disorders, American College for Neuropsychopharmacology. In the past I have received funding from various pharmaceutical companies for research into the role of SSRIs and other forms of medication as treatments for OCD., Consultant of: payment for expert advisory work on psychopharmacology for the Medicines and Healthcare Products Regulatory Agency, royalties from Oxford University Press and an honorarium from Elsevier for editorial work., Paid Instructor of: payment for lectures for the Global Mental Health Academy.

Narrative Formulation Revisited: On Seeing the Person in Mental Health Recovery

Narrative Formulation RevisitedOn Seeing the Person in Mental Health Recovery Anna Bergqvist (bio) The use of narrative in mental health contexts models consciousness as something necessarily embodied, as already part of the world, in an inherently value-laden and perspectival way. As such narrative presents a powerful tool for critical reassessment and reevaluation of preconceived ideas in relating to difficult concepts in clinical interactions. Narrative structures can reveal psychological differences between persons in a way that matters for the provision of effective treatment and management. As emphasized by Solomon (2015), narrative reasoning is also motivated by distinctly first-personal concerns that are operative in the practitioner–client relationship. I maintain that the dynamics of that interpersonal relationship are part and parcel of what it means to address the patient's needs to be seen as a person in humanistic empathetic care—without thereby reducing truth to an individual person's perspective to encourage positive transformation.1 The notion of empowering narratives to encourage positive change is a core concept behind the emphasis on the critical role of empathy in explaining human development and psychoanalytic change within the self-psychology tradition but is also key to recovery-based models of the significance of person-centered quality of life in medicine more generally. This is defined in mental health as recovering a good quality of life as determined by the values of (by what matters or is important to) the individual concerned (Allott, Loganathan, & Fulford, 2002; Fulford, 1989, 2004; Fulford, Peile, & Carroll, 2012). The importance of strengths in this regard was reflected for example in the UK government program on values-based mental health assessment. The 3 Keys program, as it was called (National Institute for Mental Health in England, NIMHE, and the Care Services Improvement Partnership, 20082) identified three shared 'keys' to good practice in mental health assessment: three things that were identified in a wide-ranging consultation as being important alike by health professionals of all kinds and by 'service users' thus understood as patients and carers (Fulford, Duhig, Hankin, Hicks, & Keeble, 2015a; Fulford, Dewey, & King, 2015b). The third of these keys was defined in [End Page 7] the subsequently published Good Practice Guidance, as "a person-centred focus that builds on the strengths, resiliencies and aspirations of the individual service user as well as identifying his or her needs and challenges" (NIMHE, 2008: 6); and the guidance included a number of real-life case examples of best recovery practice reflecting this aspect of mental health care (Slade et al., 2014). What my (Bergqvist, 2018, 2020, 2022, forthcoming) account adds to this claim is that while such choices are revelatory or expressive of a distinctly first-personal stance, they do not constitute or determine selfhood and self-interpretation in a fixed way. Moreover, the reason is that one can also adopt a second-personal stance on one's own experience and address oneself, where the relationship between the first- and the second-personal narrative perspective on experience and self-understanding is itself a dynamic and open-ended evaluative process. Anna Bergqvist Anna Bergqvist is Reader in Philosophy at Manchester Metropolitan University since 2021, and has been Postgraduate Research Coordinator and AHRC North West Doctoral Pathway Consortium Lead for Philosophy since 2020. I was elected to a Visiting Fellowship at St Catherine's College University of Oxford for Michaelmas Term 2021. Her service to the profession out with the University includes acting as Secretary of the World Psychiatric Association (WPA) Section for Philosophy & Humanities in Psychiatry (October 2020 – present), Executive Committee Member of the Royal College of Psychiatry (RCPsych) SIG in Philosophy (February 2020 – present) and External Examiner, University of Liverpool (November 2019 – present, 4-year tenure). She is also Director of the Values-based Theory Network at St Catherine's Collaborating Centre for Values-based Practice at the University of Oxford, and Member of its Whiteness and Race Equality Network. Her approach to philosophy bridges the disciplines of moral philosophy, moral psychology and philosophy of psychiatry to improve lives through her reputable expertise in moral perception and co-production as a mechanism for change. Notes 1. Here I side with Goldie (2012) and Solomon (2015), who...

From the beginning to the highest impact factor – the journey of World Psychiatry

AbstractWorld Psychiatry, the official journal of the World Psychiatric Association, was founded in the year 2002. From the very beginning, its aims have been: a) to reach as many psychiatrists as possible worldwide, disseminating information on recent significant clinical, service and research developments, using a language that can be assimilated by most of them; b) to give voice to psychiatrists of all regions of the world, encouraging submission of research papers, commentaries and reports on innovative service modalities. The two main criteria by which an article submitted to the journal is evaluated have been from the beginning: a) its relevance to everyday clinical practice of the average psychiatrist; and b) its usefulness to foster the average psychiatrist’s professional growth. From its first issue, the journal has been freely available online. In the year 2008, World Psychiatry received its first impact factor, that was 3.896. On that same year, the publication of the Spanish edition of the journal was started. The impact factor of World Psychiatry has then increased year after year, up to the value of 79.683 reached in July 2022. For the eighth consecutive year, World Psychiatry has been no. 1 in the Clarivate’s category of Psychiatry, and for the fifth consecutive year no. 1 in the entire Clarivate’s Social Science Citation Index. All the issues of the journal are now freely available both on the PubMed system and on the WPA website. The journal reaches now, in its online or printed edition, more than 60,000 mental health professionals worldwide. One of the main factors explaining the success of the journal is the continuing attempt to identify in advance topics which are going to become very visible in the international literature and relevant to ordinary clinical practice. The journal has been recently praised by the World Health Organization for the representation of members from low/middle income countries in its Advisory Board, which was at that time 32.3%, while among the other top ten psychiatric journals it was 1.9%. Furthermore, every issue of the journal includes contributions from all continents.Disclosure of InterestNone Declared

Older adults’ mental health during humanitarian crisis

IntroductionA humanitarian crisis is defined as a singular event or a series of events that are threatening in terms of health, safety or wellbeing of a community or group of individuals, and require action that is usually urgent and often non-routine. Examples of such crisis are wars, natural disasters, epidemics and forced immigration. There is an urgent need of an international commitment to planning for humanitarian emergencies that include individual and community psychosocial support for older adults with mental health conditions. The current lack of inclusion for these older adults in humanitarian response is dramatic and constitute a clear violation of their Human Rights.ObjectivesThe World Psychiatric Association Section of Old Age Psychiatry and the International Psychogeriatric Association are working together since 2020 to promote the older adults’ Human Rights. Articles, position statements, seminars, sympsoia and congress were produced. The ultimate common goal is to support the adoption of an UN Convention on the Human Rights of the Older Persons that include the promotion and protection of the mental health of these persons.MethodsInput to the Independ Expert on Older Adults at the OHCHR who prepared official repports presented during the UN General Assembly in 2022.Publication of articles, organization of seminars, symposia and congressResultsThe main documents pulblished will be presented as well the template of the next Position statement on Older Adult’s mental health during Humanitarian CrisisConclusionsHumanitarian actors must provide assistance in accordance with the principles of humanity, neutrality and impartiality. Promoting and ensuring compliance with these principles are essential elements of effective humanitarian coordination, in respect of the Human Rights principles, in particular when vulnerable people such older adults with mental health conditions are involved.Disclosure of InterestNone Declared

The new Code of Ethics of the World Psychiatric Association: A fresh look at the ethical issues of the psychiatric profession

This article develops the WPA's new Code of Ethics that was developed in 2020. It succeeds the Declaration of Hawaii of 1977 and the Declaration of Madrid of 1996. The Code is divided into four sections that cover the practice of psychiatry in clinical practice, education, research and publication as well as public mental health. We will discuss the new ethical issues that this Code raises in parallel with the development of psychiatry and psychiatrists’ role in society in recent years.