World Psychiatric Association Research Articles

Improving mental health response in earthquake-prone regions: recommendations following the recent earthquake in Türkiye

We are members of Students’ Education, Empowerment and Development in Mental Health, a group of medical students and psychiatrists from around the globe under the Psychiatry, Medicine and Primary Care Section of the World Psychiatric Association. In this article, we put forward recommendations to help improve the mental health response in disaster-prone regions such as Türkiye. We recommend a three-step multi-tiered mental health response system that could significantly help to address the immediate, short-term and long-term mental health needs of communities directly affected by a disaster. The recommendation draws from the relevant literature and, most importantly, from our lived experiences of living in earthquake-prone countries.

Mental healthcare for older adults among countries in World Psychiatric Association Zone 10

Mental healthcare for older adults among countries in World Psychiatric Association Zone 10

Introduction to the World Psychiatric Association Digital Mental Health Special Edition: Evidence, Implementation, Guidelines, and Policy

Introduction to the World Psychiatric Association Digital Mental Health Special Edition: Evidence, Implementation, Guidelines, and Policy

“V.M. Bekhterev Review of Psychiatry and Medical Psychology” — History of the First Psychiatric Journal in Russia

The article presents the historical facts oт the creation of the first psychiatric journal in Russia (1896). The organizer of the journal and its first editor-in-chief was V.M. Bekhterev. After his death in 1927, the journal was named after him. It had been published until its closure in 1930. For various reasons, some of which are discussed in the article, the journal has not been published for six decades. The organizational difficulties of registering printed materials that existed at that time are also described. Nevertheless, they were overcome, and in 1990 the USSR State Press Committee issued the Order «On the resumption of publication of the journal...». The journal received a Registration Certificate and was assigned to almost the highest group of central journals. All financing was assigned to the Leningrad branch of the publishing house «Medicine», and the journal was printed in the fabulous in modern reality figure of 20,000 copies per month.After the collapse of the USSR in 1991, this Order ceased to be valid, and the whole thing had to be started all over again. Nevertheless, the first issue of the journal was published in 1991. Its release has been expected not only in Russia, but also abroad. The first issue included a welcoming speech by the President of the World Psychiatric Association, Jorge Alberto Costa e Silva, which attracted even more attention towards the journal. In 1992, the American Psychiatric Association published an English-language digest of the journal in the United States. For some time the journal was also published in Paris (1998-2000) and in Moscow (2004-2011). Currently, the journal is published by its founder, the V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology in St. Petersburg and is one of the most renowned journals in the field of psychiatry and medical psychology in Russia.

Geopsychiatry: Climate change, migration, and mental health.

Geopsychiatry, a newly emerging discipline within psychiatry, examines the influence of geopolitical determinants on mental health and mental illness. Geopolitical determinants include conflict and wars, global austerity, climate change, public health crises (such as the coronavirus disease 2019 (COVID-19)), and migration. This study focuses on the two significant areas of climate change and migration. Climate change can affect mental health directly or indirectly in a variety of ways, including chronic (global warming) and acute (heat waves and environmental disasters) events. Certain groups of migrants, including migrating children, older migrants, refugees, and asylum seekers, are particularly vulnerable to developing psychiatric disorders. The convergence of climate change and migration is significantly complicating the already highly difficult situation for mental health services worldwide, particularly in low- and middle-income countries where access to care is limited. Despite this, the majority of studies examining mental health impacts of these events originate from high-income countries, and there is still a lack of effective preventive and treatment strategies. In 2023, the World Psychiatric Association (WPA) set up a Special Interest Group on Geopsychiatry with a clear and explicit aim to summarize current evidence and propose strategies to tackle geopolitical challenges on mental health. The Special Interest Group aims to support regional and local groups across all psychiatric disciplines and stakeholders dedicated to building local consensus, prioritizing research, crafting policies, and collating and sharing good clinical practices. With such significant effort, we can expand our understanding and collaboration on geopsychiatry and make changes to the care of people with geopolitical and mental health challenges around the globe.

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.

Norman Sartorius: The Mental Health Crusader Who Simply Won’t Stop

Abstract Professor N. Sartorius, MD, PhD, FRCPsych, previously the Director of the Mental Health Program of the World Health Organization and President of the World Psychiatric Association and of the European Psychiatric Association, now serves as President of the Association for the Improvement of Mental Health Programs, a nongovernmental organization located in Geneva, Switzerland. Professor Sartorius holds several professorial positions in Europe, the USA, and elsewhere. He has published more than 500 papers in peer-reviewed journals and authored, co-authored, edited, or co-edited more than 120 books. However, more than all these, Professor Sartorius will be remembered by posterity as a relentless crusader for mental health and against stigma toward mental illness. Professor Sartorius has focused his sustained attention on the reduction of the stigma of mental illness, on the comorbidity of mental and physical disorders, and on support to carers of people with mental disorders. He has been particularly interested in the education of young professionals and conducted leadership and professional skills courses in some 60 countries involving more than 3000 psychiatrists early in their careers. In this interview, he briefly but importantly talks about the phases of his life, work, passion, vision, and mission, and leaves important messages for future generations.

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.

Alcohol and Substance Abuse in the General Population during the COVID-19 Pandemic: Results of the COMET-G International Study

The global impact of the COVID-19 pandemic on mental health and substance use behaviors has sparked extensive research efforts. The COMET-G international study, organized by the Department of Medicine and the Rectorate of the Aristotle University of Thessaloniki in collaboration with the World Psychiatric Association, delved into these issues. Running from March 2020 to April 2021, the study collected responses from 55,589 individuals across 40 countries. Through a comprehensive questionnaire, participants provided insights into their mental state, attitudes toward the pandemic, and the resultant changes in their personal and daily lives. Findings revealed, among other things, significant patterns of change in substance use, with notable correlations between reduced usage and the severity of lockdown measures among non-binary individuals. Mental health history emerged as a strong predictor of substance use changes, with influences from anxiety disorders, depression, and self-harm. Additionally, family and social dynamics, including economic expectations and household composition, significantly shaped substance use behaviors during lockdowns. Given these findings, the development of comprehensive approaches targeting the adverse effects of the pandemic on individual behaviors and general welfare is crucial.

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."

Comparing the World Psychiatric Association and European Psychiatric Association Codes of Ethics: Discrepancies and shared grounds.

Codes of ethics provide guidance to address ethical challenges encountered in clinical practice. The harmonization of global, regional, and national codes of ethics is important to avoid gaps and discrepancies. We compare the European Psychiatric Association (EPA) and the World Psychiatric Association (WPA) Codes of Ethics, addressing main key points, similarities, and divergences. The WPA and EPA codes are inspired by similar fundamental values but do show a few differences. The two codes have a different structure. The WPA code includes 4 sections and lists 5 overarching principles as the basis of psychiatrists' clinical practice; the EPA code is articulated in 8 sections, lists 4 ethical principles, and several fundamental values. The EPA code does not include a section on psychiatrists' education and does not contain specific references to domestic violence and death penalty. Differences can be found in how the two codes address the principle of equity: the EPA code explicitly refers to the principle of universal health care, while the WPA code mentions the principle of equity as reflected in the promotion of distributive justice. We recommend that both WPA and EPA periodically update their ethical codes to minimize differences, eliminate gaps, and help member societies to develop or revise national codes in line with the principles of the associations they belong to.Minimizing differences between national and international codes and fostering a continuous dialogue on ethical issues will provide guidance for psychiatrists and will raise awareness of the importance of ethics in our profession.

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.

The World Psychiatric Association Telepsychiatry Global Guidelines

Psychiatry 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.

A Whole of Society Response to Depression

The world is failing to tackle the global crisis of depression, a leading cause of avoidable suffering and premature death. Poor understanding of this condition and lack of psychosocial and financial resources are holding back prevention, diagnosis, treatment, and the impact on the economic prosperity of nations. Despite effective strategies for prevention, treatment, and care, not enough is done to avoid and alleviate the suffering and disadvantages linked with depression, and few governments acknowledge the brake that depression places on social and economic development. The recently published report of The Lancet – World Psychiatric Association Commission on depression calls on governments, health-care providers, researchers, people living with depression, and their families to work together. Making depression a priority means taking a public health approach to its prevention and treatment and to recovery from it.

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.

What i have Learned from French Psychiatry

Background: I studied psychiatry in France from 1971 to 1974 as a French government-scholarship student. I became familiar with a history of French psychiatry, the development of chlorpromazine, new movement of community psychiatry away from hospital-centered psychiatry. What I learned in France became the background for my clinical psychiatric practice after returning to Japan. My experience in France was also useful when I later worked at the World Health Organization (WHO), where I remained involved in shaping national policies concerning mental health in Asian countries. The lessons I have learned in France are innumerable. French psychiatry has made a monumental contributions to the world psychiatry. But these facts are not well-known to Asian countries. Methods: Based on my experiences, I would like to introduce several achievements made by French psychiatry. Results: During my studying psychiatry in France, 1971-1974, I learned France being one of birthplaces of psychiatry, witnessed the birth of the World Psychiatric Association (WPA), heard of discoveries of psychotropic drugs, experienced the academic activities at l'Hôpital Sainte Anne, as well as exposed myself to a community mental health center and deinstitutionalization to learn a different way in taking care chronic patients with schizophrenia. Conclusion: My valuable studying experiences in France have had huge influences in my later psychiatric career, such as helping the development of mental health policy in countries of the Western Pacific Region of WHO, doing the research on the use of psychotropic drugs in Asia (REAP), involving in the WPA, and founding the Asian Federation of Psychiatric Associations.