About Journal

Global Psychiatry is a single-blind peer-reviewed, open access journal that publishes original scientific articles, systematic reviews and meta-analyses in all areas of psychiatry and mental health from all over the globe.  The main mission of Global Psychiatry is to advance global mental health by making relevant scientific knowledge globally accessible. We are convinced that all variations and subspecialities of psychiatry and mental health care have a global common ground and can learn from each other and that a journal with a global approach can benefit all mental health professionals, carers...
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Journal Information

Publisher: Global Psychiatric Association

Email:  globalpsychiatry@gmx.com

Editor-in-chief: Professor Christopher Paul Szabo

Online ISSN: 2451-4950

Artificial intelligence-based models for augmenting media reporting of suicide: challenges and opportunities

Ramdas Ransing; Vikas Menon; Sujita Kumar Kar; S.M. Yasir Arafat

GLOBAL PSYCHIATRY, 2021, Volume 4, Issue 2, Pages 123-129
DOI: 10.52095/gp.2021.3037.1017

The sensationalised and harmful content of media reporting of suicide is a modifiable risk factor for suicide and suicidal behaviour. Although the World Health Organization (WHO) has published guidelines for responsible media reporting of suicide to prevent suicide contagion, the uptake of these recommendations across media outlets remains limited due to several barriers such as the motivation of stakeholders, inadequate training of media personnel, and a lack of real-time monitoring by the government. In this report, we suggest that artificial intelligence (AI) based models, can be used to address barriers to guideline adherence and improve the quality of media reporting. It is our understanding that the development and implementation of AI-based models or tools can assist in improving adherence to suicide reporting guidelines. We propose a hybrid model that incorporates steps that can be taken at different levels of the media news communication cycle. The algorithmic approach can help in simultaneously processing large amounts of data while also facilitating the design of article structures and placement of key information recommended by media reporting guidelines. The potential benefits of the AI-based model to the various stakeholders and the challenges in implementation are discussed. Given the positioning of responsible media reporting of suicide as a key population-level suicide prevention strategy, efforts should be made to develop and evaluate AI-based models for improving the quality of media reporting in different national or international settings. 

The prevalence of body dysmorphic disorder in the community: a systematic review

Anton Minty; Gavin Minty

GLOBAL PSYCHIATRY, 2021, Volume 4, Issue 2, Pages 130-154
DOI: 10.52095/gp.2021.8113

Objective:  Body dysmorphic disorder (BDD) is an underdiagnosed condition among the general population with significant associated morbidity and mortality. Symptoms of BDD include worrying excessively about a particular part of the body, repeatedly checking oneself in the mirror and attempting to cover up particular areas of the body.
Aim: To determine the prevalence of BDD within the global population. To perform a further subgroup analysis to identify groups that have a higher prevalence than the general population. To assess the modalities of diagnosis BDD and its relative abundance.
Methods: A systematic review using the PubMed database using the search criteria ‘BDD’ or ‘body dysmorphic disorder’ and ‘prevalence’ or ‘incidence’ from 1 January 1990 to 1 January 2020. 591studies were found, 81 of which were eligible and included in the study. Prevalence was calculated for the global population and subgroups, student, dermatology, surgical and psychiatric patients.
Results: The ranges of prevalence within studies were as follows; within the general population, the prevalence of BDD ranged from 0.5-3.2% (n=8). It was 1.3-5.8% (n=8) in student cohorts, 4.9- 21.1% (n=12) in general dermatology cohorts, 1.3%-5.8% (n=8) in a student population, 0-54.3% (28) in psychiatric cohorts and 2.9- 57% (n=15) in cosmetic surgery cohorts.
Conclusion: Studies found had low heterogenicity. However, there was variation in diagnostic criteria and methods of data collection. This study shows that a significant number of people suffer from BDD. Due to the fact that people with BDD often don’t seek help, this number is likely an underestimation. This study identified subgroups of the population that have a higher prevalence of BDD. Targeted screening of individuals in high-risk cohorts, as well as further clinician education, may be of benefit to help aid early recognition and diagnosis. Additionally, structured clinical interviews for DSM (the Diagnostic and Statistical Manual of Mental Disorders), also known as SCID, were the most common and appear to be more effective than normal interviews at identifying individuals with BDD.

Association of perceived isolation and resilience with self-rated mental health among undergraduate medical students in Nepal during the COVID-19 pandemic

Rakesh Singh; Pragya Rai; Madhusudan Subedi; Babita Singh; Moses Chicco Banda Aron; Chandra Bahadur Sunar; SM Yasir Arafat; Sharika Mahato

GLOBAL PSYCHIATRY, 2021, Volume 4, Issue 2, Pages 155-164
DOI: 10.52095/gp.2021.1392.1015

Background:  The COVID-19 pandemic has devastatingly affected the entire world and destroyed the equilibrium of every sphere of life. Like other groups of people, medical students of Nepal have been facing the conditions of lockdown and social isolation that have arisen because of the pandemic.
Objective: We aimed to see the relationship of perceived isolation and resilience with self-rated mental health among undergraduate medical students in Nepal.
Materials and methods: A web-based online survey was carried out in July 2020 using a semi-structured questionnaire in Google form. Data analysis was performed in SPSS vs 20. Ordered logistic regression analysis was performed to examine the effects of perceived isolation, resilience and background characteristics on self-rated mental health.
Results: Out of 515 participants, 44.9% were male.31.4% reported having fair/poor mental health status and 21.9% reported feeling stressed often due to the COVID-19 pandemic. An increment of 1SD in perceived isolation is associated with about a 5% reduction in the odds of having better mental health (exp (−0.048) = 0.95; p=0.026). Similarly, an increment of 1SD in resilience is associated with about 13% lower odds of having better mental health (exp (−0.149) = 0.862 ; p<0.001).
Conclusion: This study is an early step towards the assessment of perceived isolation and mental health among undergraduate medical students amid the COVID-19 pandemic in Nepal. There is a need to conduct regular counselling sessions and strengthen the coping skills of medical students duringthe pandemic.

Association of executive function, craving and precipitants of relapse in alcohol use disorder: A cross-sectional study

Zaryab Alam; Sujita Kumar Kar; Pronob Kumar Dalal

GLOBAL PSYCHIATRY, 2021, Volume 4, Issue 2, Pages 165-172
DOI: 10.52095/gp.2021.3236.1018

Objective:  Alcohol use disorder (AUD) is a global health concern. Patients with AUDs often relapse. Various psychosocial factors, as well as cognitive factors, determine relapse. Failure of response inhibition is often associated with relapse. This study aimed to evaluate the association of craving and relapse precipitants with executive function in AUD.
Materials and methods: The study was conducted in the outpatient setting of a tertiary care hospital in North India (between September 2017 to August 2018) on patients with AUD, who presented with a recent relapse.
A total of 46 adult patients with AUD, who relapsed after a quit attempt were enroled in the study. Cross-sectional assessment of relapse precipitants (by using relapse precipitant inventory), craving (by using the obsessive-compulsive drinking scale (OCDS)), and executive function (EF) (by using the Wisconsin Card Sorting Test (WCST)) was done along with various socio-demographic and clinical variables.
Results: The mean age of onset of alcohol use was 21.48±4.25years and the mean duration of alcohol use was 15.13±7.70 years. The average number of relapses in the study population was 3.59±2.06. There is a significant positive correlation between a negative mood state (as a relapse precipitant) and total relapse score with craving. There is a significant association of relapse and craving with deficits of EF (perseverative and non-perseverative errors). Similarly, lessened cognitive vigilance also significantly correlate with EF deficits resulting in a relapse of AUD.
Conclusion: There is a close association of craving, and relapse with deficits of EF, in AUD. Craving and relapse in AUD may be the result of deficits in EF. Future research addressing the cognitive deficits may help in the prevention of craving and relapse.

Suicidal behavior during COVID-19 pandemic in Iraq: An analysis of newspaper reports

Araz Ramazan Ahmad; Ayoob Kareem Saeed; Vikas Menon; Sheikh Shoib; S.M. Yasir Arafat

GLOBAL PSYCHIATRY, 2021, Volume 4, Issue 2, Pages 173-179
DOI: 10.52095/gp.2021.3686.1025

Background: Suicide is a major public health issue that has been under-researched in Iraq, particularly during the COVID-19 pandemic.
Aim: The study aimed to assess the characteristics, methods, and risk factors of suicidal behavior in Iraq during the COVID-19 pandemic.
Methods: We searched the news reports between April and May 2021 on Google using the term “suicide news in Iraq. We included online newspaper reports of suicidal behavior in Iraq that were published from January 2020 to April 2021.
Results: A total of 156 reports was studied. The majority of reports were published in the Arabic language (59%). Among the newspapers, the majority of the reports were published in the Nalia Radio and Television (NRT) and the shafaqnews (11.5% each). The mean age of the suicidal attempts was 27.69 (±13.78) years ranging from 10-65 years. The majority were male (57.7%), married (18%), student (9.6%), and urban habitant (64.74%). Hanging (31.4%), firearms (22.4%), and fall from height were the leading methods of suicide and familial disharmony (12.8%), mental disorder (9.6%), financial constraints (5.1%), marital discord (3.2%), COVID-19 related factors [like being infected, quarantined] (3.2%) were the leading cause of proximally related factors of suicidal attempts.
Conclusion: The present study suggests that of all suicides during the COVID-19 pandemic in Iraq, the majority are that of young, married, employed males. Furthermore, interpersonal and financial stressors are possible risk factors for suicide in this period.

Association of social stigma of COVID-19 with work satisfaction, burnout and fatigue among health care workers in Nepal

RAKESH SINGH; Madhusudan Subedi; ChandraC Bahadur Sunar; Smriti Pant; Babita Singh; Bigya Shah; Sharika Mahato

GLOBAL PSYCHIATRY, 2021, Volume 4, Issue 2, Pages 180-190
DOI: 10.52095/gp.2021.3838.1027

Background: Stigma towards the patient of coronavirus disease (COVID-19) has been reported in various media reports, including negative behaviour among health care workers (HCWs) towards COVID-19 patients. Moreover, the negative behaviour of HCWs towards COVID-19 patients could affect the professional quality of life of these HCWs.
Objective: We aimed to assess stigma related to COVID-19 patients among HCWs and explore its impact on their professional quality of life during COVID-19 pandemic in Nepal.
Methods: An online cross-sectional study was carried out among 421 HCWs (health assistants 35.6%, nurses 33%, doctors 23.3% and paramedics 8.1%), 52.7% female, working in health facilities in Nepal. The measures included background characteristics, stigma in terms of - discrimination towards COVID-19 patients, acceptance of COVID-19 patients and fear of COVID-19, and professional quality of life in terms of - work satisfaction, burnout and fatigue. Descriptive and inferential statistics were utilised to analyze the data in SPSSvs20.
Results: While around two-third of the study participants showed discriminating attitude towards COVID-19, a half showed negative attitude towards acceptance of COVID-19 patients, and a fifth reported attitude of fear of COVID-19.
Multivariable regression analysis indicated that while presence of fear of COVID-19 was associated with low satisfaction, low burnout, and low fatigue; attitude of acceptance of COVID-19 patients was associated with low burnout and low fatigue; and attitude of discrimination towards COVID-19 patients was associated with only low satisfaction.
Conclusion: Strategies directed towards - reducing fear and discrimination towards COVID-19 patients, and enhancing positive attitude of acceptance towards COVID-19 patients among HCWs, and thus, creating enabling environment for reducing their burnout and fatigue, and increasing work satisfaction are recommended.

The socioeconomic burden and disability linked with mental illnesses: findings from the National Mental Health Survey of India 2015-16 in Uttar Pradesh

Sujita Kumar Kar; Eesha Sharma; Vivek Agarwal; Shivendra Kumar Singh; Pronob Kumar Dalal; Gopalkrishna Gururaj; Girish N Rao

GLOBAL PSYCHIATRY, 2021, Volume 4, Issue 2, Pages 191-200
DOI: 10.52095/gp.2021.3586.1024


BACKGROUND: Mental health problems can lead to a substantial disability, financial loss, and a caregiver burden globally. The national mental health survey of India (NMHS) 2015-16 attempted to estimate the disability and socio-economic impact of mental morbidities in India and the representative state level. This paper reports the socio-economic impact and disability due to mental morbidity in Uttar Pradesh, India, by NMHS-2015-16, which will help the policymakers address the mental healthcare needs of the community.
METHODS: This was a cross-sectional study done in the community setting. The investigators estimated socio-economic impact due to mental morbidities by using a structured questionnaire and applying the Sheehan Disability Scale.
RESULTS: A total of 3,508 adults were interviewed, of which 282 individuals had a lifetime prevalence of mental health problems (excluding tobacco use disorder). Disability was reported: 27.3% at work, 31.9% in family life and 28.4% in social settings. Disability due to mental health problems were more evident in those with common and severe mental illnesses. The median monthly expense for the illness was found to be about 1,000 rupees INR (10 GBP). The individuals with mental health issues found in this study had 10 days of absentism from work and 20 days of reduced efficiency in work in the past 30 days.
Conclusion: Disabilities related to mental health illness are having significant socio-economic impact across India. There is a need for early intervention and more adequate addressing of these issues across the national mental health policy and programming arena.

The perceived stigma associated with COVID-19: Findings from a community survey in India

Sudha Mishra; Sujita Kumar Kar; Deblina Roy; S.M. Yasir Arafat

GLOBAL PSYCHIATRY, 2021, Volume 4, Issue 2, Pages 201-207
DOI: 10.52095/gp.2021.4064.1029

BACKGROUND: Stigma related to coronavirus disease 2019 (COVID-19) can be a potential barrier in the prevention of the disease. The current study aimed to measure COVID-19-related stigma among the people of India.
METHODS: A cross-sectional online survey was conducted using a semi-structured questionnaire regarding the socio-demographic background and perceived stigma towards COVID-19, using a convenient sampling technique.
RESULTS: A total of 405 responses were received. The respondents’ mean age was 25.6 ±8 years with an age range of 18-76 years, and 52.5% were male. Among the respondents: 60 believed that they would be judged negatively by other people if they disclose their COVID status; 59% believed that if the COVID-19 status of a person is reported to their employer, they are likely to lose their jobs;70% reported that they would feel uncomfortable with patients with COVID-19 infection; 67% thought that developing COVID-19 can make them isolated from society.
CONCLUSION: Perceived stigma was found in the form of fear of being negatively judged and fear of losing their job after disclosing their COVID-19 status. The study warrants an urgent need for stigma reduction strategies which are focused on education and awareness concerning COVID-19.

There is a substantial global burden of perioperative anxiety in the paediatric population – a systematic review

Iona Minty; Millicent Banks

GLOBAL PSYCHIATRY, 2021, Volume 4, Issue 2, Pages 208-217
DOI: 10.52095/gp.2021.1181.1014

Objective: Perioperative anxiety is described as an uncomfortable, tense or unpleasant mood at any point in the surgical journey. It can alter the way patients’ deal with the surgical experience and think about surgical treatments in the future. This systematic review aims to investigate the methods of diagnosing perioperative anxiety and assess the prevalence of the condition within the global paediatric population undergoing operations.
Materials and methods: The systematic review was conducted in accordance with the PRISMA Checklist (a 27-item checklist to address introduction, methods, results and discussion with a systematic review). Medline and Scopus databases were searched. Two independent reviewers determined which papers were suitable for inclusion. Inclusion was determined by the mention of prevalence of operative-related anxiety, in a population under 18 years old and patients that were undergoing an operation in a hospital setting. Initially, 48 papers were found and, after screening, a total of 12 eligible studies were included. Data was extracted on the method of diagnosis of anxiety, the prevalence of perioperative anxiety, the time of assessment and the age of the cohort. Cochrane bias assessment was used to assess the presence of types of bias in randomised control trials (RCTs) included and the risk of bias in non-randomised studies of interventions tool in each non-RCTs.
Results: 83% (n=10) studies used the modified Yale Preoperative Anxiety Scale (mYPAS) for diagnosis.‌‌ The overall average prevalence of perioperative anxiety in each paediatric cohort undergoing surgery was 42.1% (95% CI 30.5 - 53.7). There was not sufficient evidence to support a relationship between the age of the patient groups, the time of the anxiety assessment and the prevalence of the perioperative anxiety.
Conclusion: Paediatric anxiety remains a significant factor affecting over a third of all children who undergo operations. The vast majority of papers used the mYPAS for diagnosis although there is still some debate about the most appropriate diagnostic tool. Further studies are needed to assess the factors influencing perioperative anxiety and to evaluate the impact of perioperative anxiety on the patient experience and recovery.

A Cross-sectional study of prevalence and predictors of psychological distress during COVID-19 pandemic among the Indian population

Vivian Kapil Venugopal; Natarajan Shanmugasundharam; Rohith Khanna Deivasigamani; Ashly Shibu; Mithun Prasad Vivekanandam; Ravindran Ottilingam Somasundaram; Karthik MS; Sathianathan Ramanathan; Ramya Revathi Rajagopal; Zubaida Sultana Shujaath Ali; Suresh Kumar Munirathinam

GLOBAL PSYCHIATRY, 2021, Volume 4, Issue 2, Pages 218-229
DOI: 10.52095/gp.2021.3858.1028

Objectives: To assess the prevalence of psychological distress and identify the predictors and factors associated with the distress during the onset of COVID-19 pandemic among Indian population.

Methods: An online cross-sectional study with a semi-structured questionnaire was used to assess the psychological distress using the General Health Questionnaire (GHQ-12) among Indians. Descriptive statistics and prevalence of psychological distress were calculated. Chi-square test was done to find the association between the independent variables and psychological distress. Factors that are significantly associated with psychological distress were further analysed using multiple logistic regression analysis to identify the predictors.

Results: 846 responses were obtained with mean age 32 years (32.45 ± 11.44). 35% (n=290) had significant psychological distress with mean GHQ-12 score of 2.37. Factors associated were age (p=0.002), family members having COVID symptoms (p=0.017), lockdown distress (p=0.0001), source of health information (p=0.041), perception that information by social media increased fear (p=0.0001), likelihood of family contracting COVID-19 (p=0.022), pattern of food consumption (p=0.0001) and worry about financial burden during lockdown (p=0.0001). By logistic regression analysis, we found increased odds of developing psychological distress among the participants aged less than 40 years (OR=1.49, C.I=1-2.249,p=0.050); people who felt distressed due to the lockdown situation (OR= 2.31, C.I=1.694-3.162, p=0.0001); individuals whose fear increased due to social media information (OR=1.55, C.I= 1.144-2.113, p=0.005) and participants whose food pattern increased during the lockdown period (OR=1.41, C.I=1.035-1.923, p=0.029).

Conclusions: Nearly 1/3rd of the participants were in a state of psychological distress which transcended topographical barriers with factors such as being less than 40 years of age, accessing health information through social media, pattern of food consumption being increased and being in lockdown situation as predictors of psychological distress.

Academic psychiatry journals in South Asian countries: most from India, none from Afghanistan, Bhutan and the Maldives

S.M. Yasir Arafat; Syeda Ayat-e-Zainab Ali; Tamkeen Saleem; Debanjan Banerjee; RAKESH SINGH; Anuradha Baminiwatta; Sheikh Shoib

GLOBAL PSYCHIATRY, In Press
DOI: 10.52095/gp.2021.4395.1036

Background
As journals play a crucial role in the dissemination of knowledge, reviewing the psychiatry journals would illustrate the mental health research status.

Aims
We aimed to identify and assess the academic journals in psychiatry from South Asian countries.
Methods
We searched on Google to identify the currently functioning psychiatry journals from South Asian countries. We used “psychiatry journals in South Asia”, “mental health journals in South Asia” as search terms. We also searched by individual country names (Afghanistan, Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka).

Results
A total of 19 psychiatry journals were identified and reviewed from five countries; one each from Bangladesh, Nepal, Pakistan, and Sri Lanka while 15 journals from India. Only three journals (15.8%) are indexed in PubMed, four journals (21%) in Scopus, and one in Web of Science inclusively. Major indexation was only found in the journals of India. Indian Journal of Psychiatry appears to be the oldest and currently leading mental health journal in the region.
Conclusions
The review revealed that South Asia has a noticeable deficit in a high-quality academic research publishing system in psychiatry on its own despite the region caters to about a quarter of the global population.

Increased risk for mental disorders and suicide during the COVID-19 pandemic. Position statement of the Section on Suicidology and Suicide Prevention of the European Psychiatric Association.

Marco Sarchiapone; Jorge Lopez-Castroman; Carla Gramaglia; Enrique Baca-Garcia; Francesca Baralla; Maria Luisa Barrig&oacute;n; Silvia Bartollino; Julian Beezhold; Julio Bobes; Raffaella Calati; Narc&iacute;s Cardoner; Erminia Colucci; Philippe Courtet; Lavinia Duica; Christine Dunkley; Laura Dunkley; Ricardo Gusm&atilde;o; Catarina Jesus; Fabrice Jollant; Alexandr Kasal; Anisur Khan; Philip Jules Simon Michielsen; Peter Osvath; Stephen Palmer; Nuhamin Petros; Mihai Pirlog; Anna Plaza estrada; Pilar Saiz; Jos&eacute; Carlos Santos; Alexandra Tubiana Potiez; Christina Van Der Feltz-Cornelis; Tereza Vitcheva; Petr Winkler; Patrizia Zeppegno

GLOBAL PSYCHIATRY, 2021, Volume 4, Issue 1, Pages 4-19
DOI: 10.52095/gp.2021.8114

In March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic. The Section on Suicidology and Suicide Prevention of the European Psychiatric Association (EPA) wants to raise awareness about the potential increase in mental health disorders and suicides as a result of the socio-economic impact of the COVID-19 pandemic, and of the necessary restrictive measures adopted worldwide to contain its spread. Even if fear, worries and symptoms of anxiety, depression and stress can be considered a natural response to this global crisis, some individuals are overexposed to its potential negative effects, such as healthcare workers, COVID-19 and psychiatric patients, prisoners, members of the LGBTQ+ community, migrants (including migrant workers), ethnic minorities and asylum seekers and internally displaced populations. Nevertheless, social support, resilience, a supportive work environment and other protective factors may buffer the impact of this crisis on mental health. These unprecedented times are calling for unprecedented efforts. Evidence-based and coordinated actions to prevent the risk of increased mental health disorders and suicide are needed. However, most of the data about COVID-19 impact on mental health comes from online surveys using non-probability and convenience sample in which females are often over-represented. For this reason the quality of future research should be also improved.

How to measure the impact of the COVID-19 pandemic on quality of life: COV19-QoL –the development, reliability and validity of a new scale

Selman Repišti; Nikolina Jovanović; Martina Rojnić Kuzman; Sara Medved; Stefan Jerotić; Emina Ribić; Tihana Majstorović; Silvana Markovska Simoska; Ljubisha Novotni; Miloš Milutinović; Biljana Blazevska Stoilkovska; Tamara Radojičić; Ivan Ristić; Mirjana Zebić; Tamara Pemovska; Manuela Russo

GLOBAL PSYCHIATRY, 2020, Volume 3, Issue 2, Pages 201-210
DOI: 10.2478/gp-2020-0016

Objective: The primary objective of this paper is to present a short measure of perceptions on the impact of the COVID-19 pandemic on quality of life, along with analysis of its reliability and validity in non-clinical and clinical samples.
Methods: The scale was named The COV19 – Impact on Quality of Life (COV19-QoL) and it consists of six items presented in the form of a 5-point Likert scale. The items (i.e. statements) cover main areas of quality of life with regard to mental health. The scale was administered to 1346 participants from the general population in Croatia (the non-clinical sample) and 201 patients with severe mental illness recruited from four European countries (Bosnia and Herzegovina, Montenegro, North Macedonia and Serbia), constituting the clinical sample. The clinical sample was part of the randomised controlled trial IMPULSE funded by the European Commission. Data on age and gender were collected for both samples, along with psychiatric diagnoses collected for the clinical sample.
Results: Main findings included a high internal consistency of the scale and a moderate to strong positive correlation among participants’ scores on different items. Principal component analysis yielded one latent component. The correlation between participants’ age and their results on COV19-QoL was negligible. Participants’ perceived quality of life was the most impacted domain, whereas mental health, personal safety and levels of depression were the least impacted domains by the pandemic.
Discussion: The COV19-QoL is a reliable and valid scale which can be used to explore the impact of COVID-19 on quality of life. The scale can be successfully used by researchers and clinicians interested in the impact of the pandemic on people experiencing various pre-existing mental health issues (e.g. anxiety, mood and personality disorders) as well as those without such issues.

Protocol for a process evaluation of a cluster randomised controlled trial to improve psychosocial treatment of patients with psychotic spectrum disorders: the IMPULSE trial

Tamara Pemovska; Nikolina Jovanović; Tamara Radojičić; Aliriza Arënliu; Alma Džubur-Kulenović; Antoni Novotni; Lidija Injac-Stevović; Nađa P. Marić; Stojan Barjaktarov; Jill J Francis

GLOBAL PSYCHIATRY, 2021, Volume 4, Issue 1, Pages 20-30
DOI: 10.52095/gp.2020.1407

Objective: This paper describes the protocol of a process evaluation of a cluster randomised controlled trial designed to evaluate the effectiveness, cost-effectiveness and implementation of a digital mental health intervention, called DIALOG+, in five low- and middle-income countries in Southeast Europe (Bosnia and Herzegovina, Kosovo1, Montenegro, North Macedonia and Serbia). The objectives of the process evaluation are: a) to explore attributes of context that might impact on the implementation of the DIALOG+ intervention; b) to assess intervention fidelity and c) to explore patients’ and clinicians’ retrospective (i.e. experienced) acceptability of the intervention.
Materials and methods: This is a mixed-method process evaluation nested within the cluster randomised controlled trial. We adopted the guidance on process evaluations of complex interventions published by the United Kingdom Medical Research Council. Data collected during and after the trial, but prior to awareness of trial outcomes, include transcripts, questionnaire responses, routinely collected monitoring data and audio-recordings of intervention and control sessions. Data analysis is descriptive and involves triangulation methods to compare findings across countries, stakeholder groups (healthcare provider, patient) and data type (qualitative, quantitative).
Results: This work is part of a larger study entitled ‘Implementation of an effective and cost-effective intervention for patients with psychotic disorders in low and middle-income countries in Southeast Europe’ (IMPULSE). The study is funded by the European Union’s Horizon 2020 research and innovation programme. The IMPULSE trial recruited 81 clinicians and 458 patients. The clinician clusters were randomised to the intervention (six sessions of DIALOG+ over 12 months) or treatment-as-usual arm. Process data collection began in parallel with the trial, starting in April 2019. Data collection and analysis will be completed before the main trial findings are known. Process evaluation findings will be used to interpret the trial results including assessing the effect of context on outcomes.
Conclusion: This process evaluation will explore the context, intervention fidelity and acceptability to contextualise the trial results, help in optimising sustainability of the intervention and inform its future dissemination. The methods described here may also inform the development and implementation of other complex psychosocial interventions in low-resource settings.

Media portrayal of panic buying: A content analysis of online news portals

S.M. Yasir Arafat; Sujita Kumar Kar; Vikas Menon; Marthoenis Marthoenis; Pawan Sharma; Angi Alradie-Mohamed; Srijeeta Mukherjee; Charanya Kaliamoorthy; Russell Kabir

GLOBAL PSYCHIATRY, 2020, Volume 3, Issue 2, Pages 249-254
DOI: 10.2478/gp-2020-0022

Objectives: Media reporting has an influential role in panic buying (PB). We aimed to evaluate the media portrayal of PB during this COVID-19 pandemic.
Methods: We searched, collected, and analysed the news reports from the English media discussing the PB events. The search was done between 23 and 30 May 2020.
Results: A total of 525 news reports were analysed. Approximately half (49.3%) discussed the government action to handle the situation, 36.4% discussed the expert opinion regarding PB, 20.6% discussed the psychology of PB, 21.5% discussed the rumours, and 18.5% suggested remedial measures. Concerning the negative aspects, 96.6% of the titles mentioned panic buying, 75.4% mentioned the cause, and 62.3% mentioned the photos of empty shelves. The media in low–middle-income countries are 1.5 times more likely to include expert opinion (p = 0.03), 2.1 times more likely to discuss rumours regarding PB (p = 0.001), almost thrice more likely to report the cause of PB (p = 0.001), and thrice more likely to mention its impact (p = 0.001).
Conclusion: Media has been portraying more negative aspects of PB. Further, there are variations in reporting patterns between highincome and low–middle-income countries.

Implementing a mental health intervention in low-and-middle-income countries in Europe: is it all about resources?

Jennifer Hunter; Rose McCabe; Jill J Francis; Tamara Pemovska; Emina Ribić; Eldina Smajić Me&scaron;ević; Jon Konjufca; Silvana Markovska Simoska; Biljana Blazevska Stoilkovska; Tamara Radojičić; Selman Repi&scaron;ti; Stefan Jerotić; Ivan Ristić; Mirjana Zebić; Lidija Injac-Stevović; Aliriza Arenliu; Alma Džubur Kulenović; Dashamir Berxulli; Stojan Bajraktarov; Nikolina Jovanović

GLOBAL PSYCHIATRY, 2021, Volume 4, Issue 1, Pages 31-54
DOI: 10.52095/gp.2020.1409

Background: There are limited resources for improving mental health care across Europe, especially in Low-and-Middle- Income Countries (LMICs) in South-eastern Europe with fewer specialist staff and less funding. Scaling up psychosocial interventions that utilise available time and resources more effectively could improve care for people with psychosis in these settings. One intervention is DIALOG+, delivered via an app on a tablet computer: patients identify life areas to improve and clinicians use a solution-focussed process to help improve these areas. This intervention was piloted across mental healthcare systems in European LMICs, and focus groups were conducted to explore whether such interventions could use available resources effectively to improve care for psychosis in these settings.
Methods: Eleven focus groups were conducted with clinicians and patients with psychosis who used the intervention over three months during the pilot study, in Bosnia and Herzegovina, Kosovo United Nations Resolution, Montenegro, North Macedonia and Serbia. The Theoretical Domains Framework (TDF), which describes factors affecting engagement with healthcare interventions, structured topic guides and guided analysis. Codes from the data were mapped onto the TDF, analysed to identify barriers and facilitators, translated into English and checked for inter-rater reliability.
Results: 25 clinicians and 23 patients participated in focus groups. Clinicians’ barriers included limited time for sessions and difficulties working with acutely psychotic patients. Patients’ barriers were burden of greater concentration when engaging with DIALOG+ and feeling tense or disturbed during the sessions. Facilitators included motivation to use DIALOG+, positive opinions shared by others, perceived benefits for practice and improving clinician-patient conversations, relationships and care.
Conclusions: Barriers to using psychosocial interventions could be overcome even if resources cannot be increased. Despite limited time and other barriers to using DIALOG+, perceived benefits to practice and clinician-patient relationships suggest that psychosocial interventions can use available resources effectively to improve care for psychosis.

How to measure the impact of the COVID-19 pandemic on quality of life: COV19-QoL –the development, reliability and validity of a new scale

Selman Repišti; Nikolina Jovanović; Martina Rojnić Kuzman; Sara Medved; Stefan Jerotić; Emina Ribić; Tihana Majstorović; Silvana Markovska Simoska; Ljubisha Novotni; Miloš Milutinović; Biljana Blazevska Stoilkovska; Tamara Radojičić; Ivan Ristić; Mirjana Zebić; Tamara Pemovska; Manuela Russo

GLOBAL PSYCHIATRY, 2020, Volume 3, Issue 2, Pages 201-210
DOI: 10.2478/gp-2020-0016

Objective: The primary objective of this paper is to present a short measure of perceptions on the impact of the COVID-19 pandemic on quality of life, along with analysis of its reliability and validity in non-clinical and clinical samples.
Methods: The scale was named The COV19 – Impact on Quality of Life (COV19-QoL) and it consists of six items presented in the form of a 5-point Likert scale. The items (i.e. statements) cover main areas of quality of life with regard to mental health. The scale was administered to 1346 participants from the general population in Croatia (the non-clinical sample) and 201 patients with severe mental illness recruited from four European countries (Bosnia and Herzegovina, Montenegro, North Macedonia and Serbia), constituting the clinical sample. The clinical sample was part of the randomised controlled trial IMPULSE funded by the European Commission. Data on age and gender were collected for both samples, along with psychiatric diagnoses collected for the clinical sample.
Results: Main findings included a high internal consistency of the scale and a moderate to strong positive correlation among participants’ scores on different items. Principal component analysis yielded one latent component. The correlation between participants’ age and their results on COV19-QoL was negligible. Participants’ perceived quality of life was the most impacted domain, whereas mental health, personal safety and levels of depression were the least impacted domains by the pandemic.
Discussion: The COV19-QoL is a reliable and valid scale which can be used to explore the impact of COVID-19 on quality of life. The scale can be successfully used by researchers and clinicians interested in the impact of the pandemic on people experiencing various pre-existing mental health issues (e.g. anxiety, mood and personality disorders) as well as those without such issues.

Increased risk for mental disorders and suicide during the COVID-19 pandemic. Position statement of the Section on Suicidology and Suicide Prevention of the European Psychiatric Association.

Marco Sarchiapone; Jorge Lopez-Castroman; Carla Gramaglia; Enrique Baca-Garcia; Francesca Baralla; Maria Luisa Barrig&oacute;n; Silvia Bartollino; Julian Beezhold; Julio Bobes; Raffaella Calati; Narc&iacute;s Cardoner; Erminia Colucci; Philippe Courtet; Lavinia Duica; Christine Dunkley; Laura Dunkley; Ricardo Gusm&atilde;o; Catarina Jesus; Fabrice Jollant; Alexandr Kasal; Anisur Khan; Philip Jules Simon Michielsen; Peter Osvath; Stephen Palmer; Nuhamin Petros; Mihai Pirlog; Anna Plaza estrada; Pilar Saiz; Jos&eacute; Carlos Santos; Alexandra Tubiana Potiez; Christina Van Der Feltz-Cornelis; Tereza Vitcheva; Petr Winkler; Patrizia Zeppegno

GLOBAL PSYCHIATRY, 2021, Volume 4, Issue 1, Pages 4-19
DOI: 10.52095/gp.2021.8114

In March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic. The Section on Suicidology and Suicide Prevention of the European Psychiatric Association (EPA) wants to raise awareness about the potential increase in mental health disorders and suicides as a result of the socio-economic impact of the COVID-19 pandemic, and of the necessary restrictive measures adopted worldwide to contain its spread. Even if fear, worries and symptoms of anxiety, depression and stress can be considered a natural response to this global crisis, some individuals are overexposed to its potential negative effects, such as healthcare workers, COVID-19 and psychiatric patients, prisoners, members of the LGBTQ+ community, migrants (including migrant workers), ethnic minorities and asylum seekers and internally displaced populations. Nevertheless, social support, resilience, a supportive work environment and other protective factors may buffer the impact of this crisis on mental health. These unprecedented times are calling for unprecedented efforts. Evidence-based and coordinated actions to prevent the risk of increased mental health disorders and suicide are needed. However, most of the data about COVID-19 impact on mental health comes from online surveys using non-probability and convenience sample in which females are often over-represented. For this reason the quality of future research should be also improved.

Perceptions of Pakistani community towards their mental health problems: a systematic review

GLOBAL PSYCHIATRY, 2020, Volume 3, Issue 1, Pages 28-50
DOI: https://doi.org/10.2478/gp-2020-0001

Objectives
The objective of this research is to explore how Pakistani community perceive their mental health problems by systematically reviewing the scientific literature published on major databases. The findings expectedly will be useful for general public, for clinicians and for the researchers.


Methods
The methodology of this systematic literature search involved identifying and critically appraising studies that attempted to explore how Pakistani community perceives and understands its mental health problems. We carried out literature search on some major databases including PubMed, Cochrane database of systematic reviews and Google Scholar. We followed selection criteria where researchers aimed to find perceptions and understandings of Pakistani participants regarding their mental health by adopting scientific methodologies. The extraction of data was carried out after reading the selected papers and organising the findings under specific categories, in the form of a table. Data analysis was based on the information gathered from these studies.


Results
The results suggest that Pakistani community exhibits negligible to little understanding regarding their psychological experiences and emotional processes as separate identifiable entities. Nonetheless, multiple parallel sociocultural concepts such as religion or faith driven practices and mythical or supernatural understandings are highlighted by this research. These are accepted and practiced in order to address mental health problems.


Conclusion
It appears that Pakistani community has limited understanding and scarce vocabulary to describe their inner psychological and emotional experiences. However, in order to address the mental health issues, the community exhibits a variety of responses and reactions that are driven from several unique social, cultural and religious factors. Whether these are general perceptions or causations or protective factors towards illness or possible treatment options, they all are approached and addressed with some unique understandings and perceptions that are specific to this community.

Depression and associated factors among international students in a private University of Bangladesh

Adamu Jamilah; Md Imdadul Haque; Russell Kabir

GLOBAL PSYCHIATRY, 2021, Volume 4, Issue 1, Pages 55-61
DOI: 10.52095/gp.2020.1406

Background: Depression is the second major cause of disability and is a principal source of disease burden worldwide which is quite common among international students.
Aim: This study explored the depression and its associated factors among international students of a private university in Bangladesh.
Methods: This cross-sectional study was conducted among 149 international students at a private university in Dhaka, Bangladesh using the Center for Epidemiologic Studies Depression (CES-D 10) Scale.
Results: The prevalence of depressive symptoms among international students was 47.7%. Students’ age, marital status, satisfaction with living conditions and problems concerning studies, food, homesickness, finances, accommodation, and health were significantly associated with depression.
Conclusion: This study concluded that there is an unmet need for psychological support for international students studying in Bangladesh. Appropriate support services should be directed to them to help and to overcome the challenges they face.

Media portrayal of panic buying: A content analysis of online news portals

S.M. Yasir Arafat; Sujita Kumar Kar; Vikas Menon; Marthoenis Marthoenis; Pawan Sharma; Angi Alradie-Mohamed; Srijeeta Mukherjee; Charanya Kaliamoorthy; Russell Kabir

GLOBAL PSYCHIATRY, 2020, Volume 3, Issue 2, Pages 249-254
DOI: 10.2478/gp-2020-0022

Objectives: Media reporting has an influential role in panic buying (PB). We aimed to evaluate the media portrayal of PB during this COVID-19 pandemic.
Methods: We searched, collected, and analysed the news reports from the English media discussing the PB events. The search was done between 23 and 30 May 2020.
Results: A total of 525 news reports were analysed. Approximately half (49.3%) discussed the government action to handle the situation, 36.4% discussed the expert opinion regarding PB, 20.6% discussed the psychology of PB, 21.5% discussed the rumours, and 18.5% suggested remedial measures. Concerning the negative aspects, 96.6% of the titles mentioned panic buying, 75.4% mentioned the cause, and 62.3% mentioned the photos of empty shelves. The media in low–middle-income countries are 1.5 times more likely to include expert opinion (p = 0.03), 2.1 times more likely to discuss rumours regarding PB (p = 0.001), almost thrice more likely to report the cause of PB (p = 0.001), and thrice more likely to mention its impact (p = 0.001).
Conclusion: Media has been portraying more negative aspects of PB. Further, there are variations in reporting patterns between highincome and low–middle-income countries.

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APC WAIVED FOR THE NEXT PAPERS TO BE SUBMITTED
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Feedback from author, reviewer and now editor Yasir Arafat
Dear Reiner,I must appreciate your efforts to improve the submitted manuscript inGlobal Psychiatry. As an author, I got extensive, rigorous, andconstructive reviews from the editors as well as the reviewers. ...

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Publications by Reiner Heun
If you want to check out the publication by R Heun please use the following link. Many papers are open access. If you need a PDF please email globalpsychiatry@gmx.com   https://pubmed.ncbi.nlm.nih.gov/?term=heun-r    

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New cartoon
New cartoon from Jimmy reminds us about important papers on mental health during Covid-19 published ib Global Psychiatry

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Cartoon from Jimmy reminds us that we should publish on gambling addiction.
We received the offer by Jimmy Whittaker a young and talented trainee psychiatrist and cartoonist to publish his cartoons on our website. We are very grateful for this offer and will initially put these ...

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