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Volume 217 - November 2020

Contents

Page 1 of 7

Highlights of this issue

  • Highlights of this issue
  • Rahul (Tony) Rao
  • Published online by Cambridge University Press: 28 August 2020, p. A35
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  • Highlights from this issue
  • Derek K. Tracy
  • Published online by Cambridge University Press: 27 July 2020, p. A31
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  • Highlights of this issue
  • Rahul (Tony) Rao
  • Published online by Cambridge University Press: 26 October 2020, p. A43
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  • Highlights of this issue
  • Derek K. Tracy
  • Published online by Cambridge University Press: 28 September 2020, p. A39
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  • Highlights of this issue
  • Rahul (Tony) Rao
  • Published online by Cambridge University Press: 29 June 2020, p. A27
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  • Highlights of this issue
  • Derek K. Tracy
  • Published online by Cambridge University Press: 30 November 2020, p. A47
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Editorial

  • Mental health and COVID-19: is the virus racist?
  • Anuj Kapilashrami, Kamaldeep Bhui
  • Published online by Cambridge University Press: 05 May 2020, pp. 405-407
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    COVID-19 has changed our lives and it appears to be especially harmful for some groups more than others. Black and Asian ethnic minorities are at particular risk and have reported greater mortality and intensive care needs. Mental illnesses are more common among Black and ethnic minorities, as are crisis care pathways including compulsory admission. This editorial sets out what might underlie these two phenomena, explaining how societal structures and disadvantage generate and can escalate inequalities in crises.

  • What kind of in-patient psychiatry for Africa? Report from Zimbabwe
  • Derek Summerfield
  • Published online by Cambridge University Press: 06 January 2020, pp. 467-468
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    The expanding global mental health field has paid little attention to evaluating the culture of psychiatry prevailing in in-patient settings across Africa. For example, in Zimbabwe in-patient psychiatry has been heavily pathologising, with over-reliance on the diagnosis of schizophrenia and on antipsychotic polypharmacy. It is not helpful that the next generation of African doctors are learning unmediated Western psychiatry, with little credence given to background cultural factors and mentalities shaping presentations. Some of the psychiatric and social consequences of this for patients in Zimbabwe are discussed.

  • Proposed directions for suicide research: incorporating successful approaches from other disciplines
  • David Mou, Evan M. Kleiman, Matthew K. Nock
  • Published online by Cambridge University Press: 31 March 2020, pp. 659-660
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    Despite decades of suicide research, our ability to predict suicide has not changed. Why is this the case? We outline the unique challenges facing suicide research. Borrowing successful strategies from other medical fields, we propose specific research directions that aim to translate scientific findings into meaningful clinical impact.

  • Treatment concerns for psychiatric symptoms in patients with COVID-19 with or without psychiatric disorders
  • Kai Zhang, Xiaoqin Zhou, Huanzhong Liu, Kenji Hashimoto
  • Published online by Cambridge University Press: 09 April 2020, p. 351
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    Many psychiatric patients have been infected with COVID-19, and patients with COVID-19 may develop psychiatric symptoms after treatment with antiviral drugs. Given the tolerability and minimal P450 interactions, antidepressants (i.e., citalopram, escitalopram etc.), antipsychotics (i.e., olanzapine) and valproate can be considered to be safe in combination with antiviral drugs.

  • Challenges to welcoming people with mental illnesses into faith communities
  • Patrick W. Corrigan
  • Published online by Cambridge University Press: 30 April 2020, pp. 595-596
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    Faith communities are important to the psychiatric care of people with mental illness. I distinguish the effects of two principles of becoming welcoming communities: compassion, in which the community accommodates members with mental illnesses so they are fully included, and dignity, which rests on the essential worth of everyone.

  • What should be done to support the mental health of healthcare staff treating COVID-19 patients?
  • Derek K. Tracy, Mark Tarn, Rod Eldridge, Joanne Cooke, James D.F. Calder, Neil Greenberg
  • Published online by Cambridge University Press: 19 May 2020, pp. 537-539
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    There is an urgent need to provide evidence-based well-being and mental health support for front-line clinical staff managing the COVID-19 pandemic who are at risk of moral injury and mental illness. We describe the evidence base for a tiered model of care, and practical steps on its implementation.

  • Questioning the status of aberrant speech patterns as psychiatric symptoms
  • Eric J. Tan, Susan L. Rossell
  • Published online by Cambridge University Press: 26 March 2020, pp. 469-470
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    Speech disturbances manifest in various psychiatric conditions and demonstrate temporal variability in relation to acute and stable symptom periods. They can be externally assessed, which facilitates their potential use as an objective marker of illness stage. Continued research will have positive implications for diagnostics and long-term management in clinical settings.

  • Emotional abuse and neglect: time to focus on prevention and mental health consequences
  • Veena Kumari
  • Published online by Cambridge University Press: 07 September 2020, pp. 597-599
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    Emotional abuse and emotional neglect are among the most prevalent of childhood maltreatment types and associated with a range of poor mental health outcomes. We need to move beyond correlational research and shift our focus to sophisticated multimodal studies to fully understand the psychobiological mechanisms underlying these associations and to intervention studies.

  • Coronavirus disease 2019: achieving good mental health during social isolation
  • Rowan Diamond, John Willan
  • Published online by Cambridge University Press: 04 May 2020, pp. 408-409
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    The coronavirus disease 2019 pandemic has led to unprecedented disruption to the normal way of life for people around the globe. Social distancing, self-isolation or shielding have been strongly advised or mandated in most countries. We suggest evidence-based ways that people can maintain or even strengthen their mental health during this crisis.

  • General hospital services in the UK for adults presenting after self-harm: little evidence of progress in the past 25 years
  • Allan House, David Owens
  • Published online by Cambridge University Press: 05 May 2020, pp. 661-662
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    Self-harm remains a serious public health concern, not least because of its strong link with suicide. Twenty-five years ago we lamented the deficits in UK services, research and policy. Since then, there has not been nearly enough effective action in any of these three domains. It is time for action.

  • Coronavirus disease: challenges for psychiatry
  • Brendan D. Kelly
  • Published online by Cambridge University Press: 15 April 2020, pp. 352-353
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    Coronavirus disease (COVID-19) presents two urgent health problems: the illness caused by the virus itself and the anxiety, panic and psychological problems associated with the pandemic. Both problems present substantial challenges for our patients, their families, our multidisciplinary teams and our psychiatrist colleagues. We need good psychiatry, now more than ever.

  • Safe and informed prescribing of psychotropic medication during the COVID-19 pandemic
  • Jurjen J. Luykx, Sisco M. P. van Veen, Arne Risselada, Paul Naarding, Joeri K. Tijdink, Christiaan H. Vinkers
  • Published online by Cambridge University Press: 04 May 2020, pp. 471-474
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    Treatment with psychotropic medication may sometimes be jeopardised because of the COVID-19 pandemic. One underlying reason is the lack of COVID-19-specific psychopharmacology guidelines. Here, we discuss five considerations arising from our clinical experience and pharmacological background knowledge to enable safe and well-informed psychopharmacotherapy during the COVID-19 pandemic.

Review article

  • Effects of parental mental illness on children's physical health: systematic review and meta-analysis
  • Matthias Pierce, Holly F. Hope, Adekeye Kolade, Judith Gellatly, Cemre Su Osam, Reena Perchard, Kyriaki Kosidou, Christina Dalman, Vera Morgan, Patricia Di Prinzio, Kathryn M. Abel
  • Published online by Cambridge University Press: 15 October 2019, pp. 354-363
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    Background

    Children of parents with mental disorder face multiple challenges.

    Aims

    To summarise evidence about parental mental disorder and child physical health.

    Method

    We searched seven databases for cohort or case–control studies quantifying associations between parental mental disorders (substance use, psychotic, mood, anxiety, obsessive–compulsive, post-traumatic stress and eating) and offspring physical health. Studies were excluded if: they reported perinatal outcomes only (<28 days) or outcomes after age 18; they measured outcome prior to exposure; or the sample was drawn from diseased children. A meta-analysis was conducted. The protocol was registered on the PROSPERO database (CRD42017072620).

    Results

    Searches revealed 15 945 non-duplicated studies. Forty-one studies met our inclusion criteria: ten investigated accidents/injuries; eight asthma; three other atopic diseases; ten overweight/obesity; ten studied other illnesses (eight from low-and middle-income countries (LMICs)). Half of the studies investigated maternal perinatal mental health, 17% investigated paternal mental disorder and 87% examined maternal depression. Meta-analysis revealed significantly higher rates of injuries (OR = 1.15, 95% CI 1.04–1.26), asthma (OR = 1.26, 95% CI 1.12–1.41) and outcomes recorded in LMICs (malnutrition: OR = 2.55, 95% CI 1.74–3.73; diarrhoea: OR = 2.16, 95% CI 1.65–2.84). Evidence was inconclusive for obesity and other atopic disorders.

    Conclusions

    Children of parents with mental disorder have health disadvantages; however, the evidence base is limited to risks for offspring following postnatal depression in mothers and there is little focus on fathers in the literature. Understanding the physical health risks of these vulnerable children is vital to improving lives. Future work should focus on discovering mechanisms linking physical and mental health across generations.

    Declaration of interest

    None.

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