International Journal of Social Psychiatry

Relabeling has been proposed as a strategy to reduce the stigma associated with mental illnesses. Previous studies have shown that changing the names of psychiatry clinics has led to reduced feelings of being stigmatized among patients. In Taiwan, terms other than ‘psychiatry’ (in Chinese, jīng shén kē) are more commonly used in the names of psychiatry clinics. The term ‘psychosomatic clinics’ is widely used instead.

This study investigated the characteristics of psychiatry clinic names in order to better understand the role of clinic names in primary care settings.

Relevant data were extracted from an open database maintained by the government of Taiwan. These data included the names of community psychiatry clinics and hospital-based psychiatry clinics, population size and the degree of urbanization in the area served by each clinic.

At the time of this study, there were 254 community psychiatry clinics and 190 hospital-based psychiatry clinics in Taiwan. Only 18.9% of the community clinic names included the term ‘psychiatry’. Additionally, 14.6% of community clinic names and 28.4% of hospital-based clinic names included the term ‘psychosomatics’. The regions in which clinics without ‘psychiatry’ in their names were located had significantly larger populations and higher levels of urbanization than the regions in which clinics with ‘psychiatry’ in their names were located.

A low prevalence of the term ‘psychiatry’ in community psychiatry clinic names was found in Taiwan. The stigma associated with psychiatry and other socio-cultural factors are hypothesized to explain this phenomenon.

Knowledge about subjective perceptions and explanatory models has the potential to inform clinical evaluation and lead to development of patient-friendly treatment models in medically unexplained physical symptoms (MUPS).

To collect qualitative data about explanatory models in MUPS.

A cross-sectional observational study was done among patients with MUPS presenting over a 2-year period to a specialty psychosomatic clinic. The Short Explanatory Model of Illness interview was used to gather qualitative data about explanatory models which were subsequently recoded using standard manuals.

A total of 123 subjects were evaluated. The nature of symptoms was most commonly reported as ‘non-specific’ (n = 102, 82.9%) but of moderate to severe intensity (n = 87, 73.8%). Getting cured or showing improvement was the most common expectation from treatment (n = 58, 47.9%). Moderate to severe impact of symptoms was reported on work output (n = 100, 84%), emotional life (n = 85, 71.4%) and physical mobility (n = 59, 49.1%). A considerable proportion was either dissatisfied (n = 61, 50%) or frankly unhappy (n = 38, 31.4%) with treatment received.

There is a need to re-calibrate the clinical approach to people with MUPS to enhance treatment satisfaction. Our findings could assist in evolving culturally sensitive conceptualizations of illness and in developing patient-centred models for therapy in MUPS patients.

Available occupational therapy assessment scales focus on specific areas of functioning. There is a need for comprehensive evaluation of diverse aspects of functioning in people with mental illness.

To develop a comprehensive assessment scale to evaluate diverse aspects of functioning among people with mental illness and to assess its validity and reliability.

Available instruments, which evaluate diverse aspects of functioning in people with mental illness, were retrieved. Relevant items, which evaluate specific functions, were selected by a committee of mental health experts and combined to form a comprehensive instrument. Face and content validity and feasibility were assessed and the new instrument was piloted among 60 patients with mental illness. The final version of the instrument was employed in 151 consecutive clients, between 18 and 60 years of age, who were also assessed using Global Assessment of Functioning (GAF), Occupational Therapy Task Observation Scale (OTTOS), Social Functioning Questionnaire (SFQ), Rosenberg Self Esteem Scale (RSES) and Pai and Kapur Family Burden Interview Schedule (FBIS) by two therapists. The inter-rater reliability and test–retest reliability of the new instrument (Vellore Occupational Therapy Evaluation Scale (VOTES)) were also evaluated.

The new scale had good internal consistency (Cronbach’s alpha = .817), inter-rater reliability .928 (.877–.958) and test–retest reliability .928 (.868–.961). The correlation between the general behaviour domain (Pearson’s Correlation Coefficient [PCC] = −.763, p = .000), task behaviour (PCC = −.829, p = .000), social skills (PCC = −.351, p = .000), intrapersonal skills (PCC = −.208, p = .010), instrumental activities of daily living (IADL) (PCC = −.329, p = .038) and leisure activities (PCC = −.433, p = .005) scores of VOTES with the corresponding domains in the scales used for comparison was statistically significant. The correlation between the total score of VOTES and the total scores of OTTOS, SFQ and RSES was also statistically significant suggesting convergent validity. The correlation between the total score of VOTES with the total score of FBI is not statistically significant, implying good divergent validity.

VOTES seems to be a promising tool to assess overall functioning of people with mental illness.

In Japan, psychiatrists have noted two different types of depression, traditional/melancholic depression and ‘modern-type’ depression (MTD). Although both the modern and the traditional types of depression overlap in regard to symptoms, these are two distinct syndromes, which can lead to confusion for Japanese people.

This study aims to examine impressions of two types of depression using vignettes and clarify the differences in perceptions of the two types.

The participants, 206 Japanese undergraduates, were presented with two vignettes, one describing a patient with traditional-type depression and the other describing a patient with MTD, and then were asked to answer questions regarding their perceptions of the patient. In order to control covariates (i.e. perceived severity and dysfunction of depression), analyses of covariance with repeated measures were administered.

People generally had more negative perceptions of the patient with MTD. For example, when the protagonist was the patient with MTD, people were more likely to avoid and less motivated to support the patient. Large differences were also found in causal attribution to internal and controllable causes.

Negative impressions of the patient with MTD may be partly explained by causal attribution to internal and controllable factors.

Self-management of bipolar disorder (BD) is challenging for many individuals.

Interviews were used to assess perceived barriers to disease self-management among 21 high-risk patients with BD. Content analysis, with an emphasis on dominant themes, was used to analyze the data.

Three major domains of barriers emerged: individual barriers (psychological, knowledge, behavioral and physical health); family/community-level barriers (lack of support and resources); and provider/healthcare system (inadequate communication and access to care).

Care approaches providing social and peer support, optimizing communication with providers and integrating medical and psychiatric care may improve self-management of BD in this vulnerable population.

We examined the long-term effects of parental divorce timing on depression using longitudinal data from the Korean Welfare Panel Study.

Depression symptoms were measured using the 11 items of Center for Epidemiologic Scale for Depression (CES-D-11), and we categorized parental divorce timing into ‘early childhood’, ‘adolescent’ and ‘none’.

Although participants who experienced parental divorce during adolescence exhibited a significantly higher CES-D-11 score (p = .0468), ‘early childhood’ participants displayed the most increased CES-D-11 score compared to the control group (p = .0007). Conversely, among participants who were unsatisfied with their marriage, those who experienced parental divorce in early childhood showed lower CES-D-11 scores, while ‘adolescent period’ participants exhibited significantly higher CES-D-11 scores (p = .0131).

We concluded that timing of parental divorce exerts substantial yet varied effects on long-term depression symptoms and future marriage satisfaction.

Gatekeeper training for community facilitators, to identify and respond to those at risk of suicide, forms an important part of multi-level community-based suicide prevention programmes.

This study examined the effects of gatekeeper training on attitudes, knowledge and confidence of police officers in dealing with persons at risk of suicide.

A total of 828 police officers across three European regions participated in a 4-hour training programme which addressed the epidemiology of depression and suicidal behaviour, symptoms of depression, warning signs and risk factors associated with suicidal behaviour, motivating help-seeking behaviour, dealing with acute suicidal crisis and informing bereaved relatives. Participants completed internationally validated questionnaires assessing stigmatising attitudes, knowledge about depression and confidence in dealing with suicidal persons pre- and post-training.

There were significant differences among countries in terms of previous exposure to suicidal persons and extent of previous training. Post-training evaluation demonstrated significant improvements in stigmatising attitudes, knowledge and confidence in all three countries.

The consistently positive effects of gatekeeper training of police officers across different regions support inclusion of this type of training as a fundamental part of multi-level community-based suicide prevention programmes and roll-out, nationally and internationally.

Duration of untreated psychosis (DUP) has been considered as a poor prognostic factor for psychotic disorder. Several studies have been investigating different predictors of DUP in Western countries, while in Egypt only a few studies have examined various predictors of DUP.

To study DUP in Egyptian patients with psychotic disorders and to investigate how certain illnesses, patient, socio-cultural risk factors and help-seeking behaviour are correlated with prolonged DUP.

The sample included 100 patients with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) diagnosis of psychotic disorder were selected and interviewed to assess DUP. They were interviewed using the Structured Clinical Interview for DSM-IV axis I disorders (SCID-I), Positive and Negative Syndrome Scale (PANSS) and Global Assessment of Functioning (GAF) scale.

Mean (±standard deviation (SD)) of DUP was found to be 36.93(±45.27) months. DUP was correlated with various sociodemographic and clinical variables. Following log transformation of DUP, correlation with PANSS scores was done and revealed highly significant statistical relation of DUP to PANSS negative and PANSS positive scores. In linear regression analysis, it was found that age of patients, the age of onset, residence, being illiterate, the insidious mode of onset, negative family history of psychiatric disorder and the severity of illness as indicated by PANSS are among DUP predictors.

Longer DUP results from multiple patient- and illness-related factors. This has many implications in targeting early intervention with specific consideration to cultural factors.

T. S. Eliot’s The Waste Land and A. Ginsberg’s Howl are two landmark poems of the 20th century which have a unique way of dealing with emotional suffering.

(a) To explore the interplay between emotional suffering, conflicting relationships and societal perceptions; (b) to show the therapeutic effect of the writing process; (c) to analyse the portrayal of ‘madness’; and (d) to discuss, in contemporary psychiatric terms, the ‘solutions’ offered by the poets.

Qualitative research with a narrative, hermeneutic approach.

Against the background of wartime/genocide and postwar disillusionment, close relationships are projected onto societal perceptions. Concepts of (self-)control, compassion, empowerment and self-efficacy are offered as solutions to overcome feelings of despair.

In a time of perceived societal and environmental crises, both poems help us understand people’s fears and how to counteract them. Besides biological approaches, the narrative approach to the suffering human being has not lost its significance.