RCPsych Article of the Month

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From a small seed to a giant Iroko tree: A postgraduate training programme in Child and Adolescent Mental Health in Africa

Sub-Saharan Africa (SSA) has the youngest population of any region in the world with 70% under the age of 30 years. This youthful demographic profile can be both a blessing and a challenge. While the youth have the potential to drive economic development, meeting their educational, social, and health needs can over-stretch already limited human and material resources.

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Uniting in Resilience: How Collective Belief Heals War’s Hidden Wounds

War doesn't merely result in physical devastation. The mental and emotional aftermath, particularly from modern warfare that targets civilians, is profound. Civilians suffer alongside combatants, facing deaths, injuries, chronic disability, multiple displacements with uprooting of whole communities, loss of homes, destruction of essential services, infrastructure and environment. These traumatic experiences lead to a wide range of mental health issues, from depression, anxiety, PTSD, and substance abuse to family and collective trauma impeding personal and community recovery.

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Computational neuroscience and clinical perspective: Approaching negative symptomatology

We are honoured that our paper “Longitudinal trajectories in negative symptoms and changes in brain cortical thickness: 10-year follow-up” has been chosen as RCPsych Article of the Month. During recent years, our team has been part of the “Programa de Atención a Fases Iniciales de Psicosis (PAFIP)”. PAFIP is a three-year early intervention initiative designed for individuals who have experienced their first episode of psychosis (FEP). Those who willingly joined this program received comprehensive care from a team of professionals, including psychiatric nursing, psychology, psychiatry, and social work. A decade after the onset of psychotic disorders, the PAFIP team reconnected with the participants for a follow-up evaluation.

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Wairua and Psychiatry: healing partners  

From my Māori world view, wairua or spirituality is our essence. Everything else flows out from there. If we don’t get spiritual wellbeing right, other approaches will have only limited benefit. It seems to me that psychiatry offers treatments that are focused on the brain, addressing physical and psychological wellbeing. I notice that western talking therapies often don’t address spiritual values that are of critical importance to Māori and other Indigenous peoples.

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Higher rates of involuntary psychiatric hospital admission among minoritised ethnic groups are not explained by lack of access to care

The RCPsych Article of the Month for January is ‘Ethnic inequalities in involuntary admission under the Mental Health Act: an exploration of mediation effects of clinical care prior to the first admission’ and the blog is written by authors Daniela Fonseca Freitas, Susan Walker, Patrick Nyikavaranda, Johnny Downs, Rashmi Patel, Mizanur Khondoker, Kamaldeep Bhui and Richard D. Hayes. The article is published in The British Journal of Psychiatry.

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What is the reluctance! (“It couldn’t possibly be ADHD”) (Is it ADHD?)

We know that the prevalence rates of physical and mental disorders are higher in people with intellectual disabilities than in the general population. ADHD is one of those neurodevelopmental disorders where clinicians appear reluctant to make the diagnosis in people with ID. Of course, diagnosing ADHD-ID can be difficult for many reasons such as other diagnoses overshadowing the core signs of ADHD. Despite clearly observing and documenting symptoms of ADHD (without calling it ADHD), we are slow to consider the diagnosis. We always wonder why health professionals are very reluctant to consider the diagnosis of ADHD in people with ID that has led us to write the article.

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Is the female autism brain different?

Our 5-year-old-daughter has been evaluated by multiple clinical psychologists for autism spectrum disorder with all of them saying she doesn't meet the criteria for ASD, even though we strongly believe that she has the disorder’, a case and a conundrum I first heard from a mother in 2011 and from countless other parents since then.

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Magical Thinking and Moral Injury: Exclusion Culture in Psychiatry

This article arose out of mounting frustration at the modern mental health system. It is a distillation of many conversations, rants, angry emails and personal ruminations. It is a psychiatrist’s scream into the abyss. However, from the abyss, many screamed back. The reaction to this article since its publication online has been surprising and heartening. A number of clinicians and patients have emailed from all over the UK (and beyond) to express their agreement and relief at a psychiatrist having ‘said it’. Patients have spoken of how much the article reflects their own experience. iBut this raises a further troubling question: if the content resonates with so many, why are services still getting it wrong? What will it take to bring about genuine culture change? One thing is clear: this requires group action and not lone voices.

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Socratic questioning put into clinical practice | Socratic dialogue in CBT

Socratic questioning is a core communication skill in the process and delivery of cognitive-behavioural therapy (CBT). The mastery of this clinical skill requires enduring training, practice and supervision, which are intrinsically linked to therapists’ competence development and personal growth. Surprisingly, there are few practical and theoretical resources to assist clinicians’ and psychotherapy trainees’ learning, and little research has been conducted on the process and mechanisms of change underlying the use of Socratic questioning in CBT.

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To Zoom or not to Zoom?

One thing is certain. Life will never be the same again after this devastating pandemic caused by Covid19. But in this new norm, not all is bad. Certainly, clinical psychiatry and the interaction of psychiatrists with patients and with colleagues has become significantly better despite the challenges of digital exclusion and digital poverty. For once there is real choice, for patients as well as for psychiatrists. A parallel pandemic of digital psychiatry has imploded across the globe, and so virtual consultations have become a reality

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Nature and Human Health

The RCPsych Article of the Month for August is ‘The need for biodiversity champions in psychiatry: the entwined crises of climate change and ecological collapse‘ and the blog is written by author Dr Jacob Krzanowski published in BJPsych Bulletin Scientists have shown that through the cumulative effects of habitat loss, climate change, and pollution, life on Earth is crossing into the sixth mass extinction event.…

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Mental Health and Children with Intellectual Disability: A Quadruple Inequality

Fortunately, we have moved on from a time when individuals with intellectual disability may have been considered incapable of experiencing mental health problems. However, in the context of current talk about mental health crises, the mental health of children and young people with intellectual disability is perhaps the biggest crisis of them all. Children with intellectual disability face a quadruple inequality in relation to their mental health.

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Insights from Hikikomori (prolonged social withdrawal) for global psychiatry

Hikikomori is a Japanese term that refers to extreme social isolation. First introduced to the medical community by psychiatrist Tamaki Saito in a bestselling book in 1998, the condition has since seen much interest. In Japan, prevalence studies estimating it to occur in 1.2% of 20-49yr olds seemed to confirm anecdotal concerns from many parents worried about whether their children might suffer from the condition and attracted government attention.

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Looking at Pictures

The RCPsych Article of the Month for February is: ‘Mad agency’, reflections on Goya’s ‘The Madhouse’ by Jennifer Radden published in BJPsych Bulletin.

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Doctors in Parliament

The RCPsych Article of the Month for June is from BJPsych Bulletin and is entitled ‘The Parliamentary Scholar Scheme: a way to engage doctors in healthcare policy and politics’ by Jen Perry, Paul Lomax, Fiona Taylor, Susan Howson and Kathleen McCurdy.

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Shame and the medical identity

The RCPsych Article of the Month for February is from BJPsych Bulletin and is entitled ‘Addressing shame: what role does shame play in the formation of a modern medical professional identity?’ by Sandy Miles. 

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Strategies for RelaTives (START) – family carers of people with dementia mood is improved by START but does it continue to make a difference years later?

The RCPsych Article of the Month for January is from The British Journal of Psychiatry (BJPsych) and is entitled ‘Clinical effectiveness of the START (STrAtegies for RelaTives) psychological intervention for family carers and the effects on the cost of care for people with dementia: 6-year follow-up of a randomised controlled trial’

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A mental health crisis in Lesbos

The RCPsych Article of the Month for December is from BJPsych International and is entitled ‘Headaches in Moria: a reflection on mental healthcare in the refugee camp population of Lesbos' by Tom Nutting.

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Patients in Crisis

The RCPsych Article of the Month for June is from BJPsych Bulletin and is entitled ‘Do patients get better? A review of outcomes from a crisis house and home treatment team partnership’ by Authors Mohsin Faysal Butt, David Walls, Rahul Bhattacharya.

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What makes a decision ‘shared’?

RCPsych Article of the Month for April is from The British Journal of Psychiatry (BJPsych) and is entitled ‘Involving patients with dementia in decisions to initiate treatment: effect on patient acceptance, satisfaction and medication prescription’ by Authors Jemima Dooley, Nick Bass, Gill Livingston and Rose McCabe.

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Discrediting Experiences

The RCPsych Article of the Month for March is from BJPsych Open and is entitled ‘Discrediting experiences: outcomes of eligibility assessments for claimants with psychiatric compared with non-psychiatric conditions transferring to personal independence payments in England'

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