Current concerns about mental health in Bangladesh

This month's issue of BJPsych International focuses on Bangladesh, one of the most densely populated countries in the world and geographically vulnerable to a wide range of natural disasters. Mental health has been deteriorating since the COVID-19 crisis, but few psychiatrists and clinical psychologists are available to manage the consequences

Minority status, stigma, prejudice and bullying: Growing up in jeopardy

Stigma and alienation are suffered by many individuals with mental health disorders, in societies around the world. Rejection is all the more common among those who have intellectual disabilities or who are from ethnic minorities. In this issue, three papers consider the suffering experienced by patients with vulnerabilities that militate against their being in receipt of the psychiatric care they assuredly deserve

BJPsych International: Its aims and its future

Our mission on BJPsych International is simple. First, to promote best practice in the care and treatment of people with mental health problems worldwide. Second, to educate psychiatrists and other mental health professionals about international developments in policy and the delivery of mental health services. We aim to provide a publication platform for authors globally, with a focus on those from low- and middle-income countries who have a message to send about innovations in their country's mental health services that would be of interest to our readership. Our recent success in obtaining a listing on PubMed makes all our articles accessible to a much wider audience and will enhance interest in the journal's unique content. Importantly, the journal, which has a distribution of over 20 000 copies, is entirely open access

Gambling and governmental responsibilities

Human beings seem to be genetically predisposed to take risks in the hope of reward, but in gambling the risks often significantly outweigh the rewards. Should societies and governments attempt to regulate gambling, and how? Two papers in this month's issue of BJPsych International discuss problem gambling in Nigeria and in Malaysia, and how government and society address it

Conflict and community: Mental health in the Arab world

This month's issue of BJPsych International focuses on the Middle East, with papers on psychiatric care in conflict zones, the persistence of institutionalisation in Arab countries, service delivery in Iraq, improved media attitudes towards mental illness in Qatar and integration of mental health services into primary care in that country

Meanings in motion and faces: Developmental associations between the processing of intention from geometrical animations and gaze detection accuracy

Aspects of face processing, on the one hand, and theory of mind (ToM) tasks, on the other hand, show specific impairment in autism. We aimed to discover whether a correlation between tasks tapping these abilities was evident in typically developing children at two developmental stages. One hundred fifty-four normal children (6-8 years and 16-18 years) and 13 high-IQ autistic children (11-17 years) were tested on a range of face-processing and IQ tasks, and a ToM test based oil the attribution of intentional movement to abstract shapes in a cartoon. By midchildhood, the ability accurately and spontaneously to infer the locus of attention of a face with direct or averted gaze was specifically associated with the ability to describe geometrical animations using mental state terms. Other face-processing and animation descriptions failed to show the association. Autistic adolescents were impaired at both gaze processing and ToM descriptions. using these tests. Mentalizing and gaze perception accuracy are associated in typically developing children and adolescents. The findings are congruent with the possibility that common neural Circuitry underlies, at least in part, processing implicated in these tasks. They are also congruent with the possibility that autism may lie at one end of a developmental continuum with respect to these skills, and to the factor(s) underpinning them

Validating the Developmental and Well-Being Assessment (DAWBA) in a clinical population with high-functioning autism [version 1; peer review: awaiting peer review]

Background: With increasing numbers of referrals to health services for assessment of Autism Spectrum Disorder (ASD), the Developmental and Well-Being Assessment (DAWBA) has been suggested as a useful screening instrument to assist in prioritising patients for review. It is an online interview for parents that has been previously validated for ASD in a non-clinical community sample of twins. Our study aimed to evaluate its predictive validity in a complex clinically-referred sample of children with suspected high-functioning autism. / Methods: The sample comprised 136 children (females = 53; males = 83) who were referred for ASD assessment at the Social Communication Disorder Clinic (SCDC) at Great Ormond Street Hospital. Parents completed the DAWBA online prior to undergoing a multi-disciplinary team (MDT) assessment. This included completing the Developmental, Dimensional and Diagnostic Interview (3di) and the Autism Diagnostic Observation Schedule (ADOS). Two clinicians independently rated the DAWBA using DSM-5 diagnostic criteria and compared results to the MDT outcome, which was considered gold standard. / Results: Compared with an MDT assessment, the DAWBA interview demonstrated good sensitivity (0.91) but poor specificity (0.12). Overall, 64% of cases were accurately assigned as case/non-case. Estimates of positive (0.66) and negative (0.43) predictive validity were influenced by the relatively high prevalence of ASD in the study sample (65%). / Conclusion: The DAWBA online interview has excellent sensitivity in a clinical population of complex neurodevelopmental disorders, containing a high prevalence of ASD, but specificity was poor. As the SCDC offers tertiary opinions on disputed cases of suspected ASD, the population cohort limits the generalisability of these results. Further evaluation is required in community child mental health or paediatric services