About Journal

Global Psychiatry Archives aims to advance global mental health by making relevant scientific knowledge accessible to all. We help authors from across the world publish their research, especially on neglected areas of mental health. We help them with careful and supportive reviews of their submitted papers. We particularly want to enable new and young researchers and authors from developing economies, from communities that don't have robust state-funded or private healthcare systems or where medical funding for research is unavailable. Global Psychiatry Archives is an open-access journal...
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Journal Information

Publisher: Global Psychiatric Association

Email:  globalpsychiatry@gmx.com

Editor-in-chief: Professor Christopher Paul Szabo

Online ISSN: 2754-9380

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 ARCHIVES, 2022, Volume 5, Issue 1, Pages 1-9
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.

Epidemiology of suicides in Brazil: a systematic review

Leonardo Baldaçara; Alexandrina Meleiro; João Quevedo; Homero Vallada; Antônio Geraldo da Silva

GLOBAL PSYCHIATRY ARCHIVES, 2022, Volume 5, Issue 1, Pages 10-25
DOI: 10.52095/gp.2022.4377.1035

Aim: Find and review data about suicide prevalence and incidence in Brazil.
Methods: This is a Systematic Review that used PRISMA protocol and has PROSPERO registration at the number CRD42021288299. Using the PubMed, Scielo databases, Brazilian Ministry of Health, and WHO documents; 203 papers (metanalysis, systematic reviews, cohorts, cross-sectional, and government documents) published from 2010 to 2021 were initially selected, of which forty-three remained in the review. This is a Systematic Review that used PRISMA protocol and has PROSPERO registration at the number CRD42021288299. Risk of bias was assessed by Cochrane Bias Risk Assessment tool.
Results: The data showed that suicide rates in Brazil range between 4.6 and 6.6 per 100,000 inhabitants. From 2000 to 2020 and showed an increased risk of death from suicide in all regions of Brazil, highlighting the South and Midwest regions. Overall, suicide in Brazil is more prevalent in older, among those aged 15 to 45 years (besides there is an increase in adolescent mortality rates), unmarried, males, and those who present mental disorders, and is associated with unemployment and economic deprivation. Indigenous people have elevated levels of suicide compared to non-indigenous. Hanging and poisoning were the most common methods used and the suicide most happen at home.
Limitations: Only English and Portuguese publications were included in the present work. All studies published in the different periods were included. Some biases were observed: some studies had restricted eligibility criteria, different measures, other fail to adequately control confound variables. We protect the quality of article excluding studies were bias could compromise interpretation.
Conclusions: The consolidated information from this present systematic review about suicidal behaviour in Brazil may contribute to the assessment of the current situation and future planning of public health interventions, especially better prevention efforts.

The study of mental illness in Iraq and its common trends: A systematic review

Darya Rostam Ahmed

GLOBAL PSYCHIATRY ARCHIVES, 2022, Volume 5, Issue 1, Pages 26-35
DOI: 10.52095/gp.2022.3774.1026

Background and Objectives: Most of the population worldwide is suffering from mental illness due to one reason, or other but very limited data is available specifically in Iraq. Iraq has had a long history of wars and terrorist activities during the last four decades. Limited research is carried out that focus specifically on mental health and its related subheadings to understand the trends of research in this field. Therefore, this systematic review aims to understand the connection between the studies in a special period on mental health and the areas that these papers cover in this field.
Methods: by using the protocol of PRISMA, 33 full-length English language articles were searched in the major databases, (PubMed, EMBASE and MEDLINE). With the help of specific keywords like "mental health in Iraq," "anxiety," "depression," "Iraq survey," "Psychosis," "postpartum," "prevalence of mental illness in Iraq," "Prevalence of Mental disorders in Iraq." 14 articles were finally selected for further data extraction.
Result: findings revealed a wide coverage of different factors like violence, war, individuals with diabetes, stressful environment, infertile women, parents of children with cancer, and old aged are responsible for mental health problems. Topics such as child and adolescent mental health include hospital-based studies on psychiatric problems of children, community-based investigation on the mental health of a different group of minorities, the prevalence rate among different age groups child and adolescent population, and studies on prevention and intervention strategies for boosting mental health care in the area should be considered for further detail investigation.
Conclusion: This systematic review indicated that research in the mental health field needs to be reconsidered regarding the priorities and focuses according to the need of country. Though major factors have been identified but there is an uneven distribution of the present mental health situation and published studies.

A bibliometric analysis of Koro syndrome

Sujita Kumar Kar; S.M. Yasir Arafat; Vikas Menon; Pawan Sharma; Anamika Das; Sayuri Perera; Akanksha Shankar

GLOBAL PSYCHIATRY ARCHIVES, 2022, Volume 5, Issue 1, Pages 36-41
DOI: 10.52095/gp.2022.4460.1039

Objective:
Koro is a culture-bound syndrome that primarily affects males of China, South Asia, and Africa. Our objective was to perform a bibliometric analysis of available published literature on Koro, till date
Methods:
The SCOPUS database was searched, from inception, for publications on Koro using a combination of terms "Koro Syndrome" OR "Genital Retraction”. Available articles were screened to identify the relevant articles.
Results:
A total of 62 relevant articles were found in the SCOPUS database and included in the study. Majority (n=46;74.2%) of these were original articles. Medicine (n=61;98%) followed by Psychology (n=8; 12.9%) were the common originating specialties for research on Koro. The oldest publication was in 1973; maximum publications were in 1990 (9.68 %, n=6) followed by in the year 2005 (8.06%, n=5). The British Journal of Psychiatry published maximum articles on Koro (n=6). Culture Medicine and Psychiatry, Journal of Urology and Medicine Clinica had 3(4.8%) publications each. One hundred and thirty-one authors from 67 institutes and twenty-four countries contributed to research output on Koro; of them, most publications were from the United States of America (n=10).
Conclusion:
Although "Koro" is a well-known entity, the number of publications on Koro is scarce, sporadic, and not globally representative.

Women with schizophrenia have worse clinical presentation compared to their men counterpart in Kosovo: a cross-sectional study

Manuela Russo; Nikolina Jovanovic; Fitim Uka; Jon Konjufca; Dashamir Berxulli; Aliriza Arenliu

GLOBAL PSYCHIATRY ARCHIVES, 2022, Volume 5, Issue 1, Pages 42-50
DOI: 10.52095/gp.2022.4548.1043

Objectives: Gender differences have been reported in schizophrenia and suggested that later onset, predominant affective symptoms and better functioning are reported in women, while higher prevalence with more severe negative symptoms, and higher comorbidity for substance abuse in men. However, since the majority of data come from high-income countries, it is almost unknown whether gender differences exist in people with schizophrenia from socially and economically diverse contexts. The objective of this study is to explore gender differences in socio-demographic and clinical characteristics in a sample of people with schizophrenia in Kosovo, a low- and middle-income country (LMIC).
Methods: The study included 101 patients with schizophrenia recruited from community services. Data on demographics, socio-economic characteristics, use of psychological therapy, and medication was collected through direct interviews. Clinical symptoms were assessed by using a combination of self-rated and researcher-rated measures. Gender differences were examined using χ2, independent sample t- tests, and univariate analysis of variance.
Results: The sample was composed of 31.7% (n=32) women. Most demographic characteristics did not differ by gender, apart from marital status (higher proportion of women were separated; p=0.010). Women presented with more depressive (p=0.010) and paranoid symptoms (p=0.011), and attended psychological therapy less frequently (50% women vs 80% men; p=0.014). For both genders, attending psychological therapy was associated with lower negative symptoms (p=0.002).
Conclusions: Women with schizophrenia had worse clinical presentation compared with men, and reported lower psychological therapy attendance. More research is needed to better describe schizophrenia in LMICs, and to understand whether access to mental health services, particularly psychological therapy, is attributable to clinical or contextual factors. Offering psychological therapy to people with schizophrenia of either gender included here could alleviate the burden of negative symptoms.

Monitoring the Adverse Effects of Psychotropic drugs – Need for An Evidence-Based Approach

Sumeet Gupta; Udayan Khastgir; Ogba Onwuchekwa; Ioana Varvari

GLOBAL PSYCHIATRY ARCHIVES, 2022, Volume 5, Issue 1, Pages 51-63
DOI: 10.52095/gpa.2022.4362.1034

Psychotropic drugs are associated with adverse effects. Mostly adverse effects are reported by patients or elicited by clinicians. For many other adverse effects, it is necessary to do baseline blood tests to avoid giving a medication to patients who are at a high risk of a particular adverse effects and to monitor blood tests to either avoid or to manage specific adverse effects. Most treatment guidelines recommend blood tests to monitor adverse effects of psychotropic drugs. However, mostly these recommendations are based on low levels of scientific evidence and expert opinions. Hence, it is not uncommon to see significant variations amongst different guidelines. Ideally, the monitoring recommendations should take in to account clinical significance and pathophysiology of the adverse effects. Moreover, before proposing any form of monitoring, we must be reasonably sure that such monitoring will be beneficial for patients and lastly monitoring should be cost effective as well. In the field of medicine, monitoring recommendations are increasingly subjected to scientific rigour. In this review, we have compared blood tests monitoring recommendations, by various national and international treatment guidelines, of commonly used psychotropic drugs such as antipsychotic drugs, lithium, and valproate. This is a narrative review, in which we have critically appraised the recommendations and highlighted the need for evidence-based monitoring of adverse effects of psychotropic drugs.

Observation of Rare Psychosocial and Mental Health Symptoms in ISIS Psychiatric Patients: A Pilot Study Among ISIS Affiliates

Darya Rostam Ahmed

GLOBAL PSYCHIATRY ARCHIVES, 2022, Volume 5, Issue 1, Pages 64-69
DOI: 10.52095/gpa.2022.4505.1042

Objectives: The invasion of Iraq and Syria by the so-called "Islamic State of Iraq and Syria" (ISIS) began in 2014. Most of the people were displaced or forced to migrate in great numbers, and as a result, they suffered from mental and emotional disorders. The purpose of this pilot study is to assess ISIS psychiatric patients and report on possible unusual psychosocial symptoms that may occur among them.
Methods: The prospective multicenter study, which included 18 patients from a community mental health facility within the IDP camp in Ninewa, included nine former ISIS members and nine general controls both groups suffering MDD and PTSD. The purpose of this study was to screen for unusual signs and symptoms using a semi-structured interview and a mental health assessment.
Results: There were a total of nine patients from ISIS affiliates, with an average age of 29 years. The ISIS patients met DSM-V diagnostic criteria for MDD, PTSD, and unusual psychosocial symptoms, but the control group only met DSM-V diagnostic criteria for general mental illnesses, not unusual psychosocial symptoms. This is the first time that uncommon psychosocial symptoms including low self-esteem, dread, suicidal thoughts, aggressive behavior, self-blaming, isolation, and disguising identity have been identified among ISIS psychiatric patients.
Conclusion: Extremist groups, particularly ISIS affiliates, are thought to have a considerable prevalence rate of uncommon symptoms, which are thought to be unique to them. Future studies should be encouraged in order to understand more about these unique and unusual characteristics in order to find a more effective therapy and it may be recognized as a novel syndrome.

Quality of Online Media Reporting of Suicidal Behavior in Iran during COVID-19 pandemic in Reference to the World Health Organization Guidelines

S.M. Yasir Arafat; Araz Ahmad; Ayoob Kareem Saeed; Omar Feizi; Fahimeh Saeed; Vikas Menon; Sujita Kumar Kar; Sheikh Shoib

GLOBAL PSYCHIATRY ARCHIVES, 2022, Volume 5, Issue 1, Pages 70-76
DOI: 10.52095/gpa.2022.4883.1047

Background: Mass media has a diverse effect on suicidal behavior and has a significant impact on framing prevention strategies for the general population. However, the quality of news reporting of suicide has not been assessed in Iran adequately specially during the COVID-19 pandemic.
Aim: The study aimed to evaluate the quality of online news reporting of suicidal behavior in Iran against the World Health Organization (WHO) suicide reporting guidelines during the COVID-19 pandemic.
Methods: We analyzed the news reports to recognize the reporting characteristics and compared them with the WHO guidelines. A search was carried out in March and April 2021 on Google using the term "suicide news in Iran," and online news stories published in the Farsi language from January to December 2020, were extracted.
Results: A total of 125 news reports was retrieved from thirteen newspapers where all the reports were published in Farsi. Among the reports, 50 (40%) mentioned the name, and 62 (49.6%) mentioned the occupation of the deceased. The name of the method was mentioned in 111 (88.9%) reports, mono causality was reported in 49 (39.2%) reports, the word "suicide" was mentioned in the headline in 117 (93.6%) reports, a method was reported in the headline in 34 (27.2%) reports, and 32 (25.6%) reports published the photo of the deceased. Only four (3.2%) reports mentioned psychiatric disorders, 13 (10.4%) disseminated expert opinion, and none of the reports cited prevention program, helpful contact identity, or education material.
Conclusion: The study showed Farsi news reports were not firmly compliant with WHO guidelines for reporting suicide during the COVID-19 pandemic. Further studies are warranted considering these findings to change into accountable media reporting and to shape the prevention strategies.

Assessing and Responding to Suicide Risk in Health Research in Low-Resource Settings: Implementation of a Suicide Response Protocol in Ghana

Emma Lawrence; Hannah Lawrence; Adu Appiah-Kubi; Ruth Owusu-Antwi; Tom Konney

GLOBAL PSYCHIATRY ARCHIVES, 2022, Volume 5, Issue 1, Pages 77-82
DOI: 10.52095/gpa.2022.4897.1048

Introduction: Risk for suicide is high in low and middle-income countries (LMICs) where over 75% of deaths by suicide occur. Thus, assessing for suicidal ideation and behavior and intervening appropriately when conducting research in LMICs is a critical step toward lowering risk for suicide among at-risk research participants. This is important even when conducting non-psychiatric research, especially when evaluating high-risk populations such as those experiencing bereavement. In this paper, we address questions that commonly arise as researchers in LMICs consider assessing for suicide risk.

Key considerations: Using expert opinion and review of the literature, we discuss factors to consider when establishing an interdisciplinary research team and effectively assessing for and responding to suicide risk. We pose key questions and responses, using examples from a case study in which our team implemented a suicide assessment and response protocol as part of a research study on maternal mortality in Ghana, a LMIC. Through discussion of this case study, we demonstrate the feasibility and importance of (1) an interdisciplinary research team involving providers from the local community, (2) a practical framework for assessing suicide risk among study participants, and (3) a protocol to respond when risk is indicated. Assessing for suicidal ideation and behavior and intervening appropriately when conducting research in LMICs is a critical step toward lowering risk for suicide among at-risk research participants.

Conclusions: By assessing for risk, appropriate care and follow-up can be provided with the goal of ultimately reducing the likelihood of suicide. To optimize impact, suicide risk protocols should be individualized to the specific setting, language, and available resources.

Similar Attitudes Toward Death among Muslims and Christians in Iraq

Darya Rostam Ahmed

GLOBAL PSYCHIATRY ARCHIVES, 2022, Volume 5, Issue 1, Pages 83-89
DOI: 10.52095/gpa.2022.4504.1041

Objectives: Knowing people’s attitudes towards death is useful in examining people’s level of flexibility, problem management, and self-care. The religious and related cultural background of an individual may affect an individual's attitude towards death. Hence, the current study evaluated Christian and Muslim respondents' attitudes towards death in Iraqi society.
Methods: In a cross-sectional study, 100 individuals from the two main religious groups (Muslim and Christian) were group-matched for gender, age, marital status, and personal monthly income. The attitude towards death was measured through a death attitude profile-revised questionnaire, and findings were analyzed via SPSS version 20 by applying Pearson correlation and central tendencies.
Results: Findings revealed that both religions' followers have no fear of death (No death anxiety) and, at the same time, approach acceptance towards death. Although overall, religion had no significant effect on participant attitudes towards death, which means both religion’s followers share the same approaches and attitudes towards death.
Conclusion: From the current research work, it can be concluded that there is no impact of religion on individual attitudes towards death and both religious followers have no death anxiety, meanwhile, both Muslims and Christians have positive attitudes through five-dimensional attitudes toward death. Future studies should focus on a larger population with different cultures and religious backgrounds to generalize these findings to other populations and cultural backgrounds.

Title: Significant co-dependency, anxiety, depression and family burden among the caregivers of patients with opioid dependence syndrome: an observational study

Sudha Mishra; Sanju Pant; Sujita Kumar Kar

GLOBAL PSYCHIATRY ARCHIVES, In Press
DOI: 10.52095/gpa.2022.4425.1038

Abstract
Background: The opioid dependence syndrome impacts patients and affects their caregivers. In India, the caregivers tie a strong bond with patients and play a significant role in their treatment. However, the caregivers suffer adverse effects like violence, anxiety, depression symptoms, and other psychological stress due to the opioid use of those they care for. Especially, spouses of opioid users experience a greater rate of co-dependency (excessive emotional or psychological dependency on their partner) and family burden.
Aim: This study measured the co-dependency, depression, anxiety, and family burden and their association among caregivers of patients with opioid dependence syndrome.
Method: A cross-sectional study was conducted among 132 caregivers of patients with opioid dependence syndrome at a tertiary care unit of Lucknow, Uttar Pradesh using the MINI 6.0 for co-morbidities, Span Fischer co-dependency scale for co-dependency, Patient Health Questionnaire-9 for depression, Generalized Anxiety Disorder-7 for anxiety, and Family Burden Interview Schedule for family burden tools. The data were collected and analyzed using SPSS version 16.
Result: The study demonstrated that caregivers of opioid dependence syndrome patients reported severe co-dependency (50%), severe anxiety (75.6%), and moderately severe depression (54.5%). All participants reported a high burden (100%). A positive correlation was found between variables like- co-dependency and anxiety, co-dependency and depression, co-dependency and family burden, anxiety and depression, anxiety and family burden, and depression and family burden. A significant association was found among variables like co-dependency and anxiety, depression, and family burden which is the following hypothesis.
Conclusion: The present study illustrated that all the caregivers experienced anxiety, depression, co-dependency, and family burden. Preventive measures need to address these issues of caregivers during the treatment of patients with opioid use disorder.
Keywords: Caregivers; Opioid Dependence Syndrome; Co-Dependency; Anxiety; Depression; Family Burden

Increased risk for mental disorders and suicide during the COVID-19 pandemic: the 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 Barrigón; Silvia Bartollino; Julian Beezhold; Julio Bobes; Raffaella Calati; Narcís Cardoner; Erminia Colucci; Philippe Courtet; Lavinia Duica; Christine Dunkley; Laura Dunkley; Ricardo Gusmão; 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; José Carlos Santos; Alexandra Tubiana Potiez; Christina Van Der Feltz-Cornelis; Tereza Vitcheva; Petr Winkler; Patrizia Zeppegno

GLOBAL PSYCHIATRY ARCHIVES, 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 ARCHIVES, 2020, Volume 3, Issue 2, Pages 201-210
DOI: 10.52095/gpa.2020.1377

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 ARCHIVES, 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.

The effects of Rhodiola Rosea supplementation on depression, anxiety and mood – A Systematic Review

Fanaras Konstantinos; Reinhard Heun

GLOBAL PSYCHIATRY ARCHIVES, 2020, Volume 3, Issue 1, Pages 72-82
DOI: https://doi.org/10.2478/gp-2019-0022

Objectives
Rhodiola rosea is an adaptogen herb from the Crassulaceae family, which has been vastly used in the Russian and Chinese medicine. The herb is used against depression, anxiety, mental and physical fatigue and to promote overall health. In this systematic review, we examined the effects of R. rosea on depression, anxiety and mood, as these are the most relevant to mental health.


Methods
Literature searches were made in PubMed using the term ‘Rhodiola rosea’. Inclusion criteria were: Randomized controlled trials using interventions of R. rosea on any type of participants, while focusing on the effects of the intervention on depression, anxiety or mood. Mixed interventions of R. rosea with other herbs were excluded. Studies not published in English or Greek were excluded.


Results
A total of 39 randomized controlled trials were identified and their abstract was screened. After screening, a total of 17 papers were excluded because they were focusing on irrelevant outcomes. The full text of the remaining 22 papers was read and an additional 17 papers were excluded. These papers were excluded because they were eventually not focusing on our main outcome or they were using R. rosea interventions with other herbs. In the end, a total of 5 papers (n = 327 participants) were found eligible for our systematic review. In these studies, R. rosea seems to improve the symptoms of mild to moderate depression, symptoms of mild anxiety and to enhance mood. The last date of our search was October 13, 2019.


Conclusion
Rhodiola rosea supplementation may alleviate symptoms of mild to moderate depression and mild anxiety, while it may also enhance mood. The findings of our review are not definite due to the lack of available experimental data. Randomized controlled trials with a low risk of bias are needed to further study the herb.










 

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 ARCHIVES, 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.

A systematic review on the effect of Ramadan on mental health: minor effects and no harm in general, but increased risk of relapse in schizophrenia and bipolar disorder

Reinhard Heun

GLOBAL PSYCHIATRY ARCHIVES, 2018, Volume 1, Issue 1, Pages 7-16
DOI: 10.52095/gpa.2018.1323

Objectives
Globally, Moslems are the second largest religious group. During the month of Ramadan from dawn to sundown, healthy Moslems are required to refrain from eating, drinking, smoking, sexual activity and harmful behaviour towards others and themselves. Thus Ramadan may change individual physical states and social interactions. Both might affect mental health within society. Consequently, this systematic review looks at the various effects of Ramadan on mental health.


Methods
A literature search on Ramadan and mental health initially identified 294 papers. We finally selected all 22 relevant papers covering Ramadan and mental health from which study data were extracted.


Results
Relevant papers focussed on the general population and healthy volunteers, on subjects practising sports, on subjects with severe physical disorders, on subjects at risk of eating disorders and on subjects with mental health disorders. The effects of Ramadan on mental well-being were mixed. Positive and negative effects were usually minor, except in subjects with schizophrenia and metabolic syndrome, and in subjects with bipolar disorder who suffered a substantial increase of relapses.


Conclusion
Ramadan fasting is safe in most conditions and disorders, but caution is required in subjects with schizophrenia and bipolar disorder. The research on mental health and Ramadan would profit from larger studies with more representative samples to help understand the intra-individual and social factors that affect the mental health and well-being in patients and in society. The scientific potential of such studies may have been overlooked in the psychiatric community.

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 ARCHIVES, 2020, Volume 3, Issue 2, Pages 201-210
DOI: 10.52095/gpa.2020.1377

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.

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

Adamu Jamilah; Md Imdadul Haque; Russell Kabir

GLOBAL PSYCHIATRY ARCHIVES, 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.

The effects of Rhodiola Rosea supplementation on depression, anxiety and mood – A Systematic Review

Fanaras Konstantinos; Reinhard Heun

GLOBAL PSYCHIATRY ARCHIVES, 2020, Volume 3, Issue 1, Pages 72-82
DOI: https://doi.org/10.2478/gp-2019-0022

Objectives
Rhodiola rosea is an adaptogen herb from the Crassulaceae family, which has been vastly used in the Russian and Chinese medicine. The herb is used against depression, anxiety, mental and physical fatigue and to promote overall health. In this systematic review, we examined the effects of R. rosea on depression, anxiety and mood, as these are the most relevant to mental health.


Methods
Literature searches were made in PubMed using the term ‘Rhodiola rosea’. Inclusion criteria were: Randomized controlled trials using interventions of R. rosea on any type of participants, while focusing on the effects of the intervention on depression, anxiety or mood. Mixed interventions of R. rosea with other herbs were excluded. Studies not published in English or Greek were excluded.


Results
A total of 39 randomized controlled trials were identified and their abstract was screened. After screening, a total of 17 papers were excluded because they were focusing on irrelevant outcomes. The full text of the remaining 22 papers was read and an additional 17 papers were excluded. These papers were excluded because they were eventually not focusing on our main outcome or they were using R. rosea interventions with other herbs. In the end, a total of 5 papers (n = 327 participants) were found eligible for our systematic review. In these studies, R. rosea seems to improve the symptoms of mild to moderate depression, symptoms of mild anxiety and to enhance mood. The last date of our search was October 13, 2019.


Conclusion
Rhodiola rosea supplementation may alleviate symptoms of mild to moderate depression and mild anxiety, while it may also enhance mood. The findings of our review are not definite due to the lack of available experimental data. Randomized controlled trials with a low risk of bias are needed to further study the herb.










 

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

Anton Minty; Gavin Minty

GLOBAL PSYCHIATRY ARCHIVES, 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.

NEW NAME: GLOBAL PSYCHIATRY ARCHIVES
Dear readers and authors  from the next issue Global Psychiatry will be renamed Global Psychiatry Archives. This will help us with pubmed and scopus indexation. The scientific content has been positively ...

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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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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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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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