The MSc Psychiatry at Cardiff University: introduction of new modules further supporting continuing professional development in psychiatry

The MSc Psychiatry at Cardiff University is an established postgraduate programme offering students a sound theoretical basis in psychiatry as a medical science and specialty. The programme currently offers six taught modules (focusing on mood and anxiety disorders, psychosis, old age psychiatry, forensic psychiatry, substance misuse, and child and adolescent psychiatry), as well as a dissertation module that students complete towards the end of the programme. In catering for the professional needs of clinical students and students pursuing careers in academia, two additional taught modules have been proposed exploring Leadership and Management in Psychiatry and Advances in Psychiatric Research. Feedback on the proposed introduction of the new modules was collated from the current full-time and part-time student cohorts

The efficacy and therapeutic alliance of augmented reality exposure therapy in treating adults with phobic disorders: systematic review

Background: Phobic disorders are characterized by excessive fear of a stimulus that can affect the quality of a patient’s life. The lifetime prevalence in adults is 7.7% to 12.5%. The current literature provides evidence-based inferences about the effectiveness of in-vivo exposure therapy (IVET) in treating phobia. However, this method can put the therapist and the client in danger, with high drop out and refusal rates. A newer approach for exposure therapy using augmented reality technology is under assessment. Objective: This systematic review investigated the novel technology’s efficacy, cost-efficacy, and therapeutic alliance in treating adults with phobia. Methods: An extensive search was conducted using 4 major databases (MEDLINE, PsycINFO, Embase, and Scopus) using a comprehensive list of synonyms for augmented reality exposure therapy (ARET) and phobic disorders. The search targeted any randomized control trial testing ARET in adults with phobic disorders up to August 8, 2022. Results: A total of 6 studies were included, with 208 participants providing results. Studies investigating the efficacy of ARET compared to no intervention showed significant results (P.05) in the effectiveness and therapeutic alliance between both therapies. Further, the results demonstrated that the ARET group had a better long-term effect than IVET, with the ability to put the patients in more situations to face the feared object. Conclusions: The current data suggest clinically significant efficacy and a promising therapeutic alliance of ARET. However, no data are available investigating the cost-effectiveness of ARET. Further research is warranted to ascertain ARET’s cost-effectiveness and examine its efficacy in other populations and anxiety conditions

The effectiveness of mindfulness-based interventions for anxiety disorders in adults: a systematic narrative review

In recent years there has been accelerated clinical interest in Mindfulness based interventions (MBI's) leading to an upswell in research due the impact of its wide clinical application. Mindfulness Based Cognitive Therapy (MBCT) and Acceptance and Commitment Therapy (ACT) have recently been investigated for the beneficial treatment of anxiety-based disorders in adults. The aim of the current review was to appraise and synthesise findings of studies published within the last decade, in determining the efficacy of MBCT and ACT in treating anxiety disorders in adults, given gaps identified in the existing literature

Stigma, Secrecy and Masculine Norms: A Systematic Review of How Perinatal Mental Illness in Men and Their Partners Is Experienced by Males

In recent years, fathers have become increasingly involved in pregnancy and childcare and the concept of paternal perinatal mental illness (PMI) has gained research interest. There has been increased recognition of the impact of parenthood on the mental health of males, particularly in first time fathers where feelings of helplessness and marginalisation are common. Prevalence of paternal PMI is thought to be 10–16%, with higher risk demonstrated when their partner too experiences PMI. The importance of this topic was highlighted in the NHS long term plan, which recognised the disparity in service provision between males and females and the need to address this. Aim: To conduct a systematic review to establish the knowledge, beliefs, and experiences of males with PMI and whose partners had PMI, and to understand the barriers associated with help-seeking for paternal PMI. Five databases including EMBASE, Web of Science, Ovid MEDLINE, Scopus and PsycINFO were searched for qualitative studies investigating the experiences of males affected by PMI personally or through their partner's illness. The research question and inclusion criteria were determined using the PICOSS (population, intervention, comparison, outcome, setting, study design) method. 11 studies met criteria for inclusion and were appraised for quality using the Critical Appraisal Skills Programme and Joanna Briggs Institute Qualitative checklists. Evidence was synthesised using thematic analysis and study quality and risk of bias were assessed using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) checklist and Risk of Bias in Systematic Reviews (ROBIS) too. 5 main themes and 17 sub-themes were identified, and demonstrated lack of knowledge and preparation for fatherhood, and distress and isolation experienced by males with PMI. Males were reluctant to seek help, and factors including stigma and lack of awareness regarding PMI and available support services were identified as barriers. The option to remain anonymous, flexibility of appointments and an emphasis on peer support were considered facilitators to engagement. Unhelpful and potentially damaging stereotypes regarding masculinity and PMI still exist, prohibit help-seeking for PMI and promote the marginalisation of males in perinatal settings. Support for males with PMI is warranted but lacking, and effective communication and education regarding paternal PMI for both professionals and the public is needed to allow successful expansion of services to include males

An investigation into the impact of dementia knowledge and attitudes on individuals’ confidence in practice: a survey of non-healthcare staff inside the prison estate in England and Wales

Whilst the majority of age groups are seeing a decline in numbers in prison custody, the older male population continues to rise year on year. This unexpected trend has led researchers to investigate the needs of this particular cohort in more detail and start to question if the prison estate is able to care for the specific needs of the ageing population. This primary research specifically, looks to investigate what relationship, if any knowledge and attitudes to dementia have on how the confidence in practice levels of non-healthcare prison staff

The Effects of Trait Extraversion on University Student Mental Health and Well-being During Lockdown: A Systematic Review

Personality traits such as extraversion and neuroticism are associated with mental health and well-being with trait extraversion positively associated with resilience, and negatively associated with a plethora of mental disorders including depression. Resilience was likely a useful trait during the COVID-19 pandemic which studies have shown negatively impacted the mental health of several different population groups, particularly university students. Mental health may also have been impacted differentially based on trait extraversion, with some evidence finding the mental health of extraverts was negatively impacted by lockdown. This review aimed to investigate whether trait extraversion was protective to university student mental health and well-being, operationalised by different symptom domains including stress and anxiety, during lockdown. We hypothesised that due to an extravert's proclivity to seek out and enjoy social interaction and the restriction of these very activities during lockdown, trait extraversion would no longer have a protective effect on mental health and well-being. Methods Six databases (EMBASE, MEDLINE, PSYCHINFO, SCOPUS, Web of Science and Cardiff University Full Text Journals) were consulted, and forty-five studies identified. Briefly, the eligibility criteria were studies of university students that had trait extraversion measured using either the Big Five or Eysenck's Personality Questionnaire in addition to a measure of mental health or well-being. Furthermore, at least 50% of the study must have been conducted under lockdown conditions with cross-sectional and longitudinal studies eligible for inclusion. After data screening, three longitudinal and seven cross-sectional studies were identified as eligible for inclusion. Following data extraction, a qualitative narrative synthesis was applied to the extracted data. Results Significant results were found for positive affect, negative affect, life satisfaction, quality of life enjoyment and satisfaction, anxiety and depression which suggested extraversion was protective. Non-significant results were also found for anxiety, depression, mental health, global quality of life, perceived stress, COVID-19 student stress and coronavirus anxiety. Conclusion The hypothesis that extraversion would be protective for mental health and well-being was accepted unanimously for life satisfaction and tentatively for anxiety. Furthermore, the hypothesis was rejected for depression and stress whose relationship with trait extraversion differed from pre-pandemic findings. The review recommended that extraverted university students should be mindful of the increased risk of depression and stress during lockdown. Additionally, further research should be carried out on extraversion's relationship with stress, an important factor in mental health, and also look at interactions of trait extraversion with other personality traits such as neuroticism

The impact of the COVID-19 pandemic on symptom subtypes of obsessive-compulsive disorder: a cross-sectional study

Since the COVID-19 outbreak was declared a global pandemic, public health messages have emphasised the importance of frequent handwashing in limiting the transmission of the virus. Whilst crucial in controlling transmission, such messaging may have an adverse effect on individuals with OCD. The primary aim of this study was to investigate any significant changes to handwashing behaviour, as well as other related hygiene behaviours, across all symptom dimensions of OCD. The frequency of engaging with pandemic-related media coverage was also considered across all symptom subtypes. A cross-sectional study was conducted, with a total of 332 participants recruited. Participants who scored above the optimal cut-off score on the Obsessive-Compulsive Inventory Revised edition (OCI-R) were included in the analysis (n = 254). Scores on the six subscales of the OCI-R were correlated with responses to a COVID-19 Impact measure. Factor analysis of the COVID-19 Impact measure revealed that items loaded on two components of the measure (handwashing and distress-avoidance). A significant correlation was revealed between the handwashing component and the OCI-R washing subscale (rs = 0.523, p = 0.0001), as well as between distress-avoidance and the OCI-R washing and ordering subscales (s = −0.227, p = 0.0001; rs = −0.159, p = 0.006). Content analysis revealed disruption to treatment delivery and worsening symptom severity in participants with contamination-related OCD. The pandemic has had a significant impact on individuals with contamination-related OCD symptoms, in relation to symptom severity and treatment disruption. Consideration should be given to targeted support tailored to patients with this subtype of OCD

Reuse and enrichment for building an ontology for Obsessive-Compulsive Disorder

Building ontologies for mental diseases and disorders facilitates effective communication and knowledge sharing between healthcare providers, researchers, and patients. General medical and specialized ontolo- gies, such as the Mental Disease Ontology, are large repositories of concepts that require much effort to create and maintain. This paper proposes ontology reuse and automatic enrichment as means for design- ing and building an Obsessive-Compulsive Disorder (OCD) ontology. The methods are demonstrated by designing and building an ontology for the OCD. Ontology reuse is proposed through ontology alignment design patterns to allow for full, partial or nominal reuse. Enrichment is proposed through deep learning with a language representation model pre-trained on large-scale corpora of clinical notes and discharge summaries, as well as a text corpus from an OCD discussion forum. An ontology design pattern is proposed to encode the discovered related terms and their degree of similarity to the ontological concepts. The proposed approach allows for the seamless extension of the ontology by linking to other ontological resources or other learned vocabularies in the future. The OCD ontology is available online on Bioportal

Investigating the association between obsessive-compulsive disorder symptom subtypes and health anxiety as impacted by the COVID-19 pandemic: a cross-sectional study

Background Since the COVID-19 outbreak was declared a global pandemic, public health messages have emphasised the importance of frequent handwashing in limiting the transmission of the virus. Whilst crucial in controlling transmission, such messaging may have an adverse effect on individuals with OCD. Methods A cross-sectional study was conducted, with a total of 332 participants recruited. Participants who scored above the optimal cut-off score on the Obsessive-Compulsive Inventory Revised edition (OCI-R) were included in the analysis (n = 254). Scores on the six subscales of the OCI-R were correlated with responses to a COVID-19 Impact measure. Results Factor analysis of the COVID-19 Impact measure revealed that items loaded on two components of the measure (handwashing and distress-avoidance). Canonical correlation analyses revealed significant associations between the OCI-R subscales and COVID-19 Impact measure, F (12, 490) = 8.14, p = 0.001, and the SHAI subscales with the COVID-19 Impact Measure, F (4, 498) = 8.18, p = 0.001). Specifically, washing and checking OCI-R subscales correlated with both components of the COVID-19 Impact measure, as did the health anxiety and beliefs SHAI subscales. Content analysis revealed disruption to treatment delivery and worsening symptom severity in participants with contamination-related OCD. Discussion Contamination and checking OCD subtypes have been associated with increased hand-washing behaviour and avoidance of distress-inducing cues. Consideration should be given to targeted support tailored to patients with these subtypes of OCD