International Journal of Social Psychiatry

Armed conflicts and natural disasters can cause significant psychological and social challenges for affected populations. Displaced populations are extremely heterogeneous in terms of culture, language, and experiences of crises. Current diagnostic criteria is insufficient when evaluating the symptoms and treatment of mental health issues across contexts.

This scoping review presents information about cultural idioms of distress across displaced populations. The review includes aspects of etiology, symptomology, and proposed intervention methods.

I conducted a Boolean search of academic and grey literature for studies that described cultural idioms of distress among displaced populations. Results were analyzed using thematic analysis and grounded theory.

A shared sense of injustice, spirit possession, and karma are common etiologies for mental distress among displaced populations. Symptoms include somatic complaints, ‘thinking a lot’, and interpersonal challenges such as social isolation and a fear of others. Potential interventions are likely on a community-level, including the generation of community mechanisms for conflict-resolution, reconciliation, and culturally grounded healing rituals.

It is vital to understand the ways displaced communities conceptualize their mental health in order to develop appropriate culturally grounded interventions. Understanding the etiology, symptoms, and proposed interventions can inform and improve humanitarian aid delivery of mental health and psychosocial support services.

Medical students, interns, and residents have higher rates of depression than the general population, according to previous literature.

The objectives of this paper were to determine the rate of depression and its severity in a group of Egyptian residents of Ain Shams University hospitals.

This is a cross-sectional comparative study that took place in El-Demerdash Hospital from March 1, 2019 to September 1, 2020, with 220 Egyptian residents of Ain Shams University Hospitals participating.

The socioeconomic stress scale had a statistically significant relationship with depression scores (p value = .008) and suicide scores (p-value = .010), according to the findings. Additionally, there was a statistically significant relationship between suicide scores and depression scores (p-value = .001). The relationship between obstetrics and gynecology and high suicide risk was statistically significant (p value = .010), with obstetrics and gynecology having the highest percentage of high suicide risk (10 out of 19 residents, 52.63%), followed by pediatrics with 4 out of 11 residents (36.36%).

The pediatrics department had the highest percentage of residents who were depressed, while the obstetrics and gynecology department had the highest suicide risk. Feeling underpaid, disruption of home life, having insufficient time, being concerned about keeping skills up to date, and having a large volume of work were also found to be the most stressful aspects of residency.

Mental health is essential to students’ academic success as well as their ability to participate fully and meaningfully throughout all aspects of their lives and throughout their lifespan.

This study aims to determine the psychological health status of Moroccan nursing and technique health students. In doing so, it also seeks to compare differences based on sociodemographic factors.

A multicenter cross-sectional study with a convenience sample was conducted with 2,054 participants in the academic year of 2018/2019. A set of socio-demographic information were collected, and The General Health Questionnaire-12 (GHQ-12) was used.

The mean GHQ-12 score was 4.33 ± 2.61, and 58.7% respondents scored 4 and above in the GHQ-12 scores and thus were considered to be in psychological distress. Students’ psychological distress was associated with female gender (60.4% for female compared to 52.4% for men, p = .003); living in parental residence (61.6% compared to 54.7% living away parental residence; p = .02 ), the second and the third training level year respectively (64.6%; 59.2%) compared to first-year (55.2%, p = .001), and midwifery and nursing students (61.6%; 60.3%) as compared to technique health students (43.6%, p = .001).

It appears that a substantial number of students have psychological distress and this is likely to have negative effects on students’ educational attainment and wider wellbeing.

Covert administration of medication (CoAdM) by caregivers to persons with severe mental illness (SMI) is a commonly observed medication delivery practice in India.

This study aims to examine different medication delivery practices adopted by caregivers to provide care to SMI at times of medication refusal.

This study was conducted at the outpatient department between April 2019 and November 2019. A semi-structured questionnaire was used to interview the caregivers of persons with SMI to assess medication delivery practices.

A total of 300 caregivers were interviewed. CoAdM was practiced in 96 (32.0%) persons with SMI at least once during their lifetime, and other strategies used were pleading (n = 105, 35.0%), lying (n = 10, 3.3%), and threatening (n = 154, 51.4%). Logistic regression showed that male gender (OR 4.75; CI 1.37–16.46), absent insight (OR 10.0; CI 2.01–47.56), and poor adherence to medication (OR 4.75; CI 1.31–16.92) were significantly associated with CoAdM in the last 1 year. Caregivers perceived significant improvement in self-care (Z = −4.37, p < .01), interpersonal (Z = −7.61, p < .01), work (Z = −5.9, p < .01), family functioning (Z = −7.82, p < .01) difficult behavior (Z = −8.27, p < .01), and dependency (Z = −6.34, p < .01) in persons with SMI with use of CoAdM.

CoAdM was given to one in three persons with SMI at some point in their lives. Male gender, absent insight and poor adherence were predictive of CoAdM in the last 1 year. Caregiver perceived improvements in self-care, work, interpersonal, family functioning, problem behaviors, and dependency after CoAdM. Policies need to be evolved to serve all stakeholders while keeping these practices in mind.

Students are one of the most vulnerable groups to suicide. Before the COVID-19 pandemic, a Bangladeshi study was conducted assessing their suicide patterns regarding gender-based associations. But how has the pandemic changed the Bangladeshi students’ suicide patterns is not studied yet, which is investigated herein. Besides, for the first time, this study provides GIS-based distribution of suicide cases across the country’s administrative district.

As Bangladesh has no suicide surveillance system, this study utilized media reporting suicide cases following the prior studies. A total of 127 students’ suicide cases from March 2020 to March 2021 were finally analyzed after eliminating the duplicate ones, and data were synthesized following the prior studies. Arc-GIS was also used to distribute the suicide cases across the administrative district.

Results revealed that female (72.4%; n = 92/127) was more prone to die by suicide than males. About 42.5% of the cases were aged between 14 and 18 years (mean age 16.44 ± 3.512 years). The most common method of suicide was hanging (79.5%; n = 101), whereas relationship complexities (15.7%), being emotional (12.6%), not getting the desired one (11%), conflict with a family member (9.4%), academic failure (9.4%), mental health problem (8.7%), sexual complexities (6.3%), scolded or forbidden by parents (3.9%) were the prominent suicide causalities. In respect to gender and suicide patterns, only the suicide stressor was significantly distributed, whereas the method of suicide was significantly associated with GIS-based distribution. However, a higher number of suicide cases was documented in the capital (i.e. Dhaka) and the northern region than in its surrounding districts.

The findings reported herein are assumed to be helpful to identify the gender-based suicide patterns and suicide-prone regions in the time of the COVID-19 pandemic to initiate suicide prevention programs of the risky students.

The COVID-19 pandemic and the associated containment policies have led to negative mental health consequences in the general population.

This study investigated the association between perceived social support and depressive symptoms in Korea.

Data from the Korea Community Health Survey conducted from August to November 2020 was used for this cross-sectional study. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9) and perceived social support was assessed based on the number of contacts that participants had identified as being available in case participants needed isolation due to COVID-19 exposure. This study included the general adult populations aged 19 years and older. The relationship between the perceived social support and depressive symptoms was analyzed using multivariable liner regression analysis. Subgroup analysis was conducted based on income.

Analysis of the data obtained from 225,453 participants indicated that PHQ-9 scores were highest in the group with ‘no’ perceived social support, followed by ‘low’, ‘middle’, and ‘high’ perceived levels of social support. Compared to individuals with ‘high’ perceived social support, those with ‘middle’ (β: .10, p-value <.001), ‘low (β: .07, p-value .010), and ‘no’ (β: .34, p-value <.001) perceived levels of social support showed poorer depression scores. The magnitude of the relationship found was particularly strong in the low-income group.

During the COVID-19 pandemic, individuals’ depression scores varied according to their perceived level of social support. Strategies that address the need of vulnerable individuals are required to reduce the potentially negative mental health consequences of the pandemic.

Few studies demonstrated the impairment of perceived emotional intelligence ‘EI’ among depressed patients. This study aimed to assess the perceived EI in a group of depressed patients, and its association with different clinical characteristics.

Forty-five patients diagnosed with depression were assessed by the Hamilton Depression Rating Scale and compared to 45 controls that were assessed by the Arabic version of General Health Questionnaire to exclude Psychiatric disorders. The Arabic version of Trait Meta-Mood Scale (TMMS) is used to evaluate EI in both groups.

Patients with depression showed significantly lower EI scores in the three parts of TMMS (repair, clarity and attention) compared to the controls (p < .001). Patients showed significant difference in clarity subscale (p = .005) and attention regarding severity of depression (p < .001). Clarity of feelings was significantly higher in patients who suffered more than two episodes (p = .012). Depressive patients with suicidal attempts showed significantly lower scores of repair (p = .044) and attention (p = .016) subscales. There were no significant differences of TMMS subscales between patients with and without suicidal ideation, sleep disturbance and somatic symptoms.

The current study demonstrates impaired perceived EI among patients with depression that is correlated with symptom severity and suicidal attempts.

Previous studies have demonstrated the positive effects of film screening for raising awareness and improving treatment in various clinical groups. This study not only focused on film screening but also paid special attention to pre-screening group analysis to explore the effectiveness of group movie analysis on mothers with schizophrenic sons.

The present study was conducted using a quasi-experimental design with pre-test and post-test and a control group. The research population included all mothers with schizophrenic sons who had enrolled in the Iranian Society Supporting Individuals with Schizophrenia in Tehran in 2021. The participants were 30 mothers with schizophrenic sons who were selected based on the inclusion criteria and were randomly assigned to intervention and control groups. The participants in the intervention group attended 12 film therapy analysis sessions (one session per week). The data were collected using the Connor-Davidson Resilience Scale (CD-RISC). Statistical analyses were performed using the analysis of covariance (ANCOVA).

The results showed a significant difference between the mean scores of resilience for the participants before (M = 28.89) and after the film therapy analysis intervention (M = 52.56, F = 6.15, p = .0001).

Film therapy analysis was effective in improving the resilience of mothers with schizophrenic sons. It seems that movie screening with the group analysis afterward contributed to sharing the experiences of caring for the sick child and creating a sense of empathy in mothers. Thus, group movie analysis can be used as a suitable option to reduce the psychological distress of mothers with schizophrenic sons and improve their quality of life.

To assess and compare the changes in disability scores associated with Bipolar Depression (BD) and Unipolar Depression (UD) over 1 year.

A longitudinal study was taken up in adults diagnosed with unipolar or bipolar depressive disorder with current depressive episode. Diagnosis was made according to Schedule for Clinical Assessment in Neuropsychiatry. Severity scoring was done using Hamilton’s Depression (HAM-D) rating scale and Hamilton’s Anxiety (HAM-A) rating scale. Disability was assessed using Indian Disability Evaluation and Assessment Scale (IDEAS) and London handicap Scale (LHS) at baseline, 6 and 12 months.

Sixty participants were recruited (42 UD and 18 BD). No significant differences were seen in socio-demographic parameters, except higher education levels and males being overrepresented in UD. Significant differences at baseline were seen in HAM-D (p = .001) and HAM-A (p = .003) scores. The extent of disability was seen to correlate with severity of illness only in case of BD at baseline. No significant differences were seen in the IDEAS scores at baseline. IDEAS score improved at each follow-up assessment (p < .001). LHS showed significant improvement over time in UD (p < .001), but not BD (p = .076). Percentage individuals meeting cut-off for benchmark disability (>40%) were comparable at baseline but were significantly more in the BD at 12-months (p = .049).

Disability in psychiatry occurs equally amongst unipolar and bipolar depressive disorders and tends to improve over time, although the level of improvement may differ. It may not always correspond to severity of illness. These factors should be considered while certifying disability.

Recovery in mental illness is not synonymous with cure. Personal recovery approach consider recovery as a process and not as an outcome. This approach takes into account the subjective meaning of recovery by assessing how a person has learned to accommodate and live with an illness.

To study the personal meaning of recovery among persons with schizophrenia.

This article presents the findings of a qualitative study about what ‘recovery’ means to persons with schizophrenia. A semi structured interview schedule was prepared based on literature review and expert opinion. Twenty participants who met the inclusion criteria and personally consider themselves recovering/recovered from schizophrenia were selected for the in-depth qualitative interviews. Data was analyzed using Interpretative Phenomenological Analysis (IPA). Meaning of recovery from each participant’s perspective was recorded.

The results indicate factors that patients deem important for their recovery are, absence of symptoms, regaining functioning, being able to work, having adequate emotional stability and not being on medicines. The findings are examined in the background of the previous studies and suggestions for clinical practice and research is also discussed.

Recovery is far more than remission of symptoms. Persons with mental illness has their own criteria of recovery, which could be very distinct from the clinical definition. Current study findings can help in identifying meaning of recovery through the perspectives of persons with mental illness and in developing and implementing recovery-oriented services.

Relapse in People Living with Schizophrenia (PLS) has several reasons and recognizing these can increase the effectiveness of treatment interventions. Formal and informal caregivers are an informed source to reduce relapse in PLS.

This study explores the caregivers’ perspective in Iran on the factors affecting relapse in PLS.

A total of 28 caregivers (16 formal caregivers and 12 informal caregivers) of PLS were enrolled in our qualitative study. A content analysis was conducted using individual and group, semi-structured in-depth interviews with informal and formal caregivers of PLS. This study was conducted in a hospital, three universities, and a non-governmental organization in Tehran, Iran.

The majority (69%) of the participants were females. About half of the informal caregivers were over 60 years old and about 40% of the formal caregivers were in the age range of 30 to 40 years. The average number of years of work for informal caregivers was 17.6 years and the average of work experience among the formal caregivers was 14.1 years. Seven key dual themes were identified from data: ‘awareness-stigma’, ‘social support-social exclusion’, ‘treatment adherence-treatment discontinuation’, ‘holistic approach – one-dimensional approach’, ‘supported employment-social dysfunction’, ‘emotional management in family – family with high emotional expression’, and ‘access to treatment-treatment gap’.

The results of this research can help practitioners and policymakers to enable evidence-based practices to reduce relapse in PLS by emphasizing and acting on factors identified in our analyses.

To qualitatively characterize the experience, impact and needs of informal family caregivers around the communication of a diagnosis of schizophrenia.

In all, 13 informal family caregivers were recruited. All were parents. Semi-structured interviews were used to explore their experience of the diagnosis of schizophrenia, the impacts of the diagnosis and the needs related to the diagnosis around its communication. Interviews were recorded, transcribed, codes generated and mixed deductive–inductive thematic analysis undertaken.

Participants described receiving the diagnosis of schizophrenia for their relative as a devastating experience, although some nuanced the experience with a sense of relief of finally naming the disorder and getting access to care. Caregivers’ experience and representations prior to hearing the diagnosis played an important role in the way the ‘news’ was internalized. The communication of the diagnosis constituted a starting point for acceptance of the reality of the illness in participants. Numerous unmet needs around the communication of the diagnosis were reported by participants, including personnalized support, specific explanations about the disorder and guidance on their role as caregiver.

A specific attention must be given to the communication of the diagnosis of schizophrenia to the informal family caregivers. Information giving must be early, comprehensive, personalized and embedded into tailored education and support programmes for caregivers to facilitate illness acceptance and adaptation.

In August 2014, the Islamic State in Iraq and Syria (ISIS) attacked the Sinjar district and destroyed several villages and towns and killed several individuals.

In this study, the Yazidi young women who survived the ISIS attack were encouraged to express their lived experiences through paintings following participation in a 6-month art-based intervention program.

A total of 13 Yazidi Kurdish females aged 18 to 25 years (Mean: 21.7 years) were invited to participate in an art-based (drawing and painting) course for 6 months in 2018. They were invited to draw or paint images that portrayed their lived experiences of attack and capture by the ISIS. Qualitative research situated within feminist methodology was used with the young women in this study. The interviews were analyzed using the descriptive content analysis method.

The paintings and narratives of the participants were constructed into three main themes: fear and traumatic experiences; feeling of hopelessness; and freedom and hope. During the attack and capture, due to the escape, rape, and horrific treatments by the ISIS fighters, the young women were traumatized severely. They were sold as a sex slave by the ISIS fighters. The participants still had severe anxiety and psychological challenges after being free from the capture. However, despite their traumatic experiences and feeling of hopelessness, most of them were hoping for freedom and a better future.

This study showed that the Yazidi young females still experienced psychological challenges burdens even 3 years after the traumatic day. However, the participants showed their resilience through feeling hopeful for freedom and a better future.

Traumatic life events (TLEs) are one of the most robust environmental risk factors for the onset of first-episode psychosis (FEP).

To explore TLEs in FEP patients and healthy controls (HC), to analyze gender differences and to examine whether TLEs were associated with sociodemographic, clinical and psychofunctional variables in all FEP sample and split by age.

Descriptive and cross-sectional study. Three hundred and thirty-five FEP and 253 HC were recruited at 16 Spanish mental health research centers. The Traumatic Experiences in Psychiatric Outpatients Questionnaire was administered.

We found a higher number of TLEs in FEP than in HC, and the proportion of individuals with three or more TLEs was significantly higher in the FEP group. No differences were found in terms of gender and age. There was no relationship between total number of TLEs and psychotic symptomatology and functional outcomes.

The number and cumulative TLEs should be taken into account in the detection, epidemiology and process of recovery in FEP.

Suicidality among youth is one of the most challenging public health issues. A thorough understanding of the risk factors that contribute to youth suicidality is necessary. The main aim of the study is to estimate the proportion of suicidality and understand factors associated with suicidality amongst clients attending youth mental health promotion clinics in Karnataka, India.

A retrospective cross-sectional case record analysis was performed utilising data from real-time digitised management information system specifically developed for the programme. All case records of clients aged 15 to 35 years who received mental health promotion (MHP) services between January 2017 and December 2020 across 30 districts of Karnataka were included in this analysis. Multivariate logistic regression analysis was performed with suicidality among clients as outcome. Socio-demographic characteristics, issues reported, feelings/emotions that indicate underlying mental health issue/crisis, being aware of suicidality among friends and family and personal habits (smoking/chewing tobacco and drinking alcohol) were considered potential exposure variables.

Overall proportion of suicidality among youth presenting to youth mental health promotion clinics in Karnataka was 3.5% (357/10,340). Among factors associated with suicidality, the strongest association was found among those clients who reported attempted suicide among friends (AOR 8.94; 95% CI 5.95–13.45), family members (AOR 5.50; 95% CI 3.66–8.29), being anxious (AOR 4.90; 95% CI 3.43–6.99), inability to trust anyone (AOR 4.07; 95% CI 2.75–6.03), had issues of Gender, Sex and Sexuality (AOR 3.16; 95% CI 1.93–5.17) and relationship issues (AOR 2.77; 95% CI 2.05–3.73).

The results alert all institutions, organisations and departments that cater to services and development of youth, to be sensitive towards risk factors of suicidality. The study advocates youth mental health promotion clinics to be equipped with measures/interventions to identify and manage such risk factors. This study has implications for Youth mental health promotion in India and other similar South-East Asian countries.

The COVID-19 pandemic has led to important changes in the approach to patients worldwide. Different agencies have proposed and implemented telemedicine-based care services in order to ensure access to health care for all people.

The aim of this study was to determine the satisfaction of patients using the Telepsychiatry service offered by the Department of Psychiatry of the Hospital de Clínicas (National University of Asunción, Paraguay).

A cross sectional and descriptive study has been conducted. Participants were recruited through a phone-based survey. Satisfaction with Telepsychiatry has been measured with an adapted version of a satisfaction survey in Teleneurology. As a complement, psychiatrists from the Hospital de Clínicas were also interviewed about their rate of satisfaction with Telepsychiatry.

A total of 530 patients were included, 51.3% of whom were women. The consultation satisfaction scale ranged between 2.15 and 4.30 with a mean score of 3.02 ± 0.32. Cronbach’s alpha for the scale was .897, indicating a good internal consistency. Patients’ satisfaction was higher for the perception of Telepsychiatry and lower for the doctor-patient relationship. Of the physicians, 87.5% were satisfied with the Telepsychiatry service.

The satisfaction overall score indicates patients’ general satisfaction with the quality of care in Telepsychiatry, mainly regarding the perception of health care. and lower satisfaction with the doctor-patient relationship. Nine out of 10 psychiatrists felt satisfied with the Telepsychiatry service and considered that the degree of patient’s satisfaction was acceptable during the Telepsychiatry consultation.

Mental health disorders significantly contribute to the global burden of disease, however, prevention and treatment programs are often inaccessible in low- and middle-income countries.

The goal of this qualitative evaluation was to examine participants experiences of the healthy community clinic (HCC-MH), an integrated mental health awareness intervention delivered in primary care clinics to Jordanians and resettled Syrians in a border community in Jordan.

Four focus group discussions (FGDs) with Jordanians and Syrians (N = 21) who participated in the HCC-MH were conducted. FGDs examined knowledge, acceptability, and applicability of the intervention. Open coding and the constant comparison method were used to identify themes that emerged from the FGDs.

Six central themes emerged from the data including : (1) awareness; (2) behavior changes; (3) reduction in stigma; (4) connecting physical and mental health; (5) relationships; and (6) coping. Notably, female participants stated participation in the intervention fostered awareness of their own emotional needs, which led to positive lifestyle and behavior changes. Participants also described how the information provided in the intervention normalized emotional distress and aided understanding of the interconnection between physical and mental health. The amplification of healthy coping strategies to reduce stress and distress was also a prominent theme.

Findings are discussed within the cultural and contextual setting of the study, and implications for mental health awareness interventions in complex settings are provided.

While the effect of insecure attachment on depression is well established, findings pertaining to the relationship between specific attachment dimensions (anxious and avoidant) and depression are inconsistent. The role of interpersonal factors underlying this effect has been little explored. ‘Silencing the Self’, a socio-cognitive construct may provide important insights as a mediating pathway from insecure attachment to depression and help resolve the inconsistencies.

The present study explored the mediating effect of self-silencing and the role of gender as a moderator in the relation between insecure attachment orientation (i.e. avoidant and anxious) and depressive symptoms.

Data was collected via an online survey, from 121 adults who were in a relationship. The participants were asked to complete three self-report questionnaires, assessing attachment orientation, silencing the self and depressive symptoms. Moderated mediation analysis was performed using conditional process analysis.

The results indicated that the effect of both insecure attachment dimensions on depressive symptoms was mediated by silencing the self. In addition, gender moderated the association between insecure attachment and self-silencing.

This study adds to the literature on mediating pathways between insecure attachment and depression, and provides a new perspective for therapeutic interventions in the context of depression. It indicates that professionals should focus on current social context and relational schemas of individuals with an insecure attachment, especially women, while treating cases of depression in clinical settings.

This study looked at the bright and dark-side personality profile of distressed and potentially derailing doctors (82% male). The derailing doctors were on average 48.75 years old, and from many specialities, in particular, general practice and surgery.

In all, a group of 77 derailing British doctors, and a control group of 357 doctors completed a valid multi-dimensional test of bright-side (normal) personality (NEO-PI-R) and one of dysfunctional interpersonal themes (sub-clinical personality disorders) (HDS: Hogan Development Survey).

Controlling for sex and age, the derailing doctors were more Neurotic (less resilient), and less Agreeable, Conscientious, Extraverted and Open-to- Experience. They were also more Excitable (Borderline), Sceptical (Paranoid), Cautious (Avoidant), Reserved (Schizoid), Leisurely (Passive Aggressive) and Bold (Narcissistic). Discriminant analysis showed age, Neuroticism, Extraversion, Leisurely and Excitable were, in that order, the greatest personality discriminators between those who did and did not derail.

More research needs to be done on doctor derailment to inform the selection and training of doctors.

One in four families has at least one member with a mental disorder and families are the main caregivers in most patients in low and middle-income countries. Caregivers experience disruption in their routine lives, increased responsibilities, increased need for support, and changes in their network. The role of personal support networks in the health and burden of the caregivers is complex and depends on the context, cultural and socioeconomical variables. In this study, we aimed to investigate the personal support network of caregivers of patients with severe mental illness in Iran.

By using a mixed-methods design, we focused on the structure and composition of caregiver networks, as well as self-perceived caregiver support.

We found that the support network of caregivers was mostly composed of immediate family members whom themselves were selectively chosen as a result of the multidimensional process of interaction between stigma, availability, and the perceived needs of caregivers. The participants mentioned economic and instrumental supports more frequently than emotional support, probably reflecting their unmet basic needs. Advocacy for providing formal systemic supports to caregivers, as well as interventions that expand caregivers personal support network is recommended.

Most participants of the study were relatively isolated and had a small network of support, mostly composed of immediate family members. Stigma was a serious source of family distress for caregivers and a limiting factor in social relationships.

COVID-19 pandemic has affected all crucial aspects of daily life, including; food security, education, gender relation, mental health, and environmental air pollution, in addition to the impact of the lockdown that had far-reaching effects in different strata of life.

To study the impact of COVID-19 on people with respect to their mental and social suffering and consequences.

This cross sectional study was conducted during the period from November 2020 through August 2021. A sample of 1,000 attendants to four teaching hospitals and eight PHCCs, was collected. The mental and social sequels of COVID-19 were assessed for all participants whether previously infected or not.

Out of the total sample (1,000), 389 had a history of infection with COVID-19. The main mental symptoms reported were depression (67.8%), and anxiety (46.9%), males and females equally reported symptoms of anxiety, while depressive symptoms were reported more among females (59.9%), Fear and worries of the participants about their health and their families’ was the main reason for mental symptoms (94.7%).

Symptoms of depression and anxiety in time of COVID-19 are prevalent. Suspending educational activities was the most social burden that affect people while increase the price of food and cessation of work were the main causes of economic burden.

Patients with severe mental illness (SMI) may be at increased risk for COVID-19-related severe morbidity and mortality. There is limited research on the vaccination rates against COVID-19 in patients with SMI.

The objective of the present study is to explore vaccination rates and co-relations in patients with SMI, attending community mental health services, namely the Mobile Mental Health Units (MMHUs) in rural Greece.

All treatment engaged patients with SMI (schizophrenia-spectrum or bipolar disorder) with two MMHUs (MMHU of Kefalonia, Zakynthos and Ithaca, [MMHU KZI] and MMHU of the prefectures of Ioannina and Thesprotia [MMHU I-T]) in rural Greece were enrolled prospectively over a six-month period. The MMHU I-T had adopted a more proactive approach to patients’ vaccination, by informing patients and caregivers for its benefits.

Data were analyzed for 197 patients with SMI. The overall vaccination rate was 68.5% and did not differ from the respective rates in the general population. There were no differences in vaccination rates among patients attending the two MMHUs, nor among patients with different diagnoses (schizophrenia spectrum disorders or bipolar disorder). Vaccination was not associated with gender, educational level, history of alcohol and substance abuse, illness duration, or number of previous hospitalizations, whereas the effect size of age was moderate. In more than half non-vaccinated patients the refusal to get vaccinated was associated with fears and concerns as well as false beliefs that are encountered in the general population.

In the present sample of treatment-engaged rural patients vaccination rates against COVID-19 appear to be satisfactory. There were no differences in vaccination rates with regard to the interventions that were applied to enhance vaccination. It seems that other forms of intervention should be applied to reluctant patients to modify their attitudes toward vaccination.

While mental disorder is an ‘intrinsically social phenomenon’, social psychiatry has been reportedly declining. Addressing public interests in social psychiatry was among the suggestions to address this decline. In recent years, public interest in social psychiatry can be explored using Google Trends, an increasingly important infodemiological tool.

This study determined changes in global online public interest in social psychiatry from January 2004 to December 2021 using Google search volumes.

Search query using this keyword, ‘Social Psychiatry (Topic)’, was made using the Explore feature of Google Trends. The Region and Time Filters were set to ‘Worldwide’ and January 2004 to December 2021, respectively. Afterward, the search volumes, country ranking, queries, and topics returned by the Google Trends system was described and compared.

There was a generally decreasing trend in search volumes for social psychiatry where it decreased almost 10 times between 2004 and 2021. Only 11 countries were listed in Google Trends’ ranking with the top countries including Austria, Germany, and Switzerland. Search-related topics and queries were about social psychiatry related concepts, related academic discipline, human resources, social interventions, and education activities

The findings suggest that there is a decreasing public interest in social psychiatry. To improve this, social psychiatry can address public expectation through improving its connection with allied social sciences, increasing its educational activities, and expanding its social intervention services.