Dear colleagues,
Welcome to the first issue of the International Journal of Psychiatry in Clinical Practice for 2011.
The review of Sharpley and Bitsika addressed the question of which criteria can be used for deciding when to use antidepressants or psychotherapy for unipolar depression. It emerged that the presence of personality disorder comorbidity might have some value and, based on the findings of the authors, a genetic predisposition provides the strongest evidence supporting it as a criterion for treatment decision making.
Colleagues Nasser and Salamoun communicated a seldomly addressed issue about the treatment of mental disorder and pathways to care in Arab countries. There were only a total of 23 articles included in this review, which revealed that there is a paucity of treatment of mental disorders, and when present, individuals were more likely to receive it from the general medical than from the mental health sector. They concluded that there is a need for national studies on mental disorders in this part of the world and a need for improvement of public awareness in this field.
The series of original investigations begins with an article by Gbiri et al. on socio-economic correlates of relapsed patients admitted in a Nigerian mental health institution. Based on a cross-sectional survey of all relapsed patients admitted to the Neuro-Psychiatric Hospital in Lagos, Nigeria, it emerged that relapse and readmission of psychiatric patients have a negative impact on the socio-economic well-being of the patients, their families and society. Furthermore, it was apparent that mentally ill individuals suffer stigmatization and social isolation in Nigeria. The prevalence and predictors of poor medication adherence among outpatients at a psychiatric hospital in Benin City, Nigeria, were analyzed by colleagues James and Omoaregba. It was evident that the prevalence of poor medication adherence in Nigeria is higher than from that known in Western Cultures. The factors determining poor adherence can form a template for intervention studies and programs to improve compliance.
Colleagues Linden and Westram investigated in Germany what psychiatrists talk about with their depressed patients parallel to prescribing antidepressants. They found that the average encounter lasts for about 18 minutes and the primary contents of their conversation are case-management, supportive reassurance and alliance building. Specific psychotherapeutic interventions are the exception. Therefore it is evident that “psychiatry counseling and psychotherapy” in routine care is more frequently performed than “specific psychotherapy”. However, in the general public “specific psychotherapy” is usually valued higher than the necessary and evident psychotherapy done in everyday clinical practice.
Hardt and colleagues introduced a new symptom checklist for screening mental health problems. They concluded that the checklist is suitable for international comparison comparing Germany and Poland. A Japanese scale to assess the severity of depression, the so-called Himorogi Self-Rating Depression Scale, was been published by Mimura et al. It is of importance since there is no depression scale designed for the Japanese culture that has been shown to be valid. Data were collected on 204 outpatients by using this new scale as well as the Hamilton Depression Scale. It revealed that this new scale could be a source of important information in the assessment of depression severity in addition to clinical rating scales. Konstantidinis et al. have studied the Major Depression Inventory (MDI) as well as the Beck Depression Inventory (BDI) in 51 severely depressed patients. The psychometric analysis of both inventories showed a good coefficiency score and it was revealed that the MDI could be a useful tool in diagnosing and monitoring depressed patients.
Stefanopoulou et al addressed the topic of global assessment of psychosocial functioning and predictors of outcome in schizophrenia. It was apparent that the numbers of previous psychotic episodes as well the duration of untreated illness were the strongest predictors of patients’ levels of functioning amongst all main outcome measures. Furthermore, older age at illness onset also predicted poorer functioning.
Sansone et al. investigated various facets of sexual behavior in female patients with borderline personality disorder (BPD). It emerged that in psychiatric patients with BPD compared to patients without this characteristic a higher number of sexual partners, a greater likelihood of being raped by a stranger and/or a greater frequency of being coerced into having sex were apparent.
The interesting question of which antidepressant psychiatrists and nurses from developing countries would choose for themselves was studied by Chaudhry et al. In Pakistan it emerged that SSRIs are the preferred medication of Pakistani psychiatrists and nurses for their patients as well as for themselves. Both efficacy and safety are likely to play a greater role in drug choice than the costs of the drug.