Epidemiology of Untreated Psychoses in 3 Diverse Settings in the Global South: The International Research Program on Psychotic Disorders in Diverse Settings (INTREPID II)

IMPORTANCE: Less than 10% of research on psychotic disorders has been conducted in settings in the Global South, which refers broadly to the regions of Latin America, Asia, Africa, and Oceania. There is a lack of basic epidemiological data on the distribution of and risks for psychoses that can inform the development of services in many parts of the world. OBJECTIVE: To compare demographic and clinical profiles of cohorts of cases and rates of untreated psychoses (proxy for incidence) across and within 3 economically and socially diverse settings in the Global South. Two hypotheses were tested: (1) demographic and clinical profiles of cases with an untreated psychotic disorder vary across setting and (2) rates of untreated psychotic disorders vary across and within setting by clinical and demographic group. DESIGN, SETTING, AND PARTICIPANTS: The International Research Program on Psychotic Disorders in Diverse Settings (INTREPID II) comprises incidence, case-control, and cohort studies of untreated psychoses in catchment areas in 3 countries in the Global South: Kancheepuram District, India; Ibadan, Nigeria; and northern Trinidad. Participants were individuals with an untreated psychotic disorder. This incidence study was conducted from May 1, 2018, to July 31, 2020. In each setting, comprehensive systems were implemented to identify and assess all individuals with an untreated psychosis during a 2-year period. Data were analyzed from January 1 to May 1, 2022. MAIN OUTCOMES AND MEASURES: The presence of an untreated psychotic disorder, assessed using the Schedules for Clinical Assessment in Neuropsychiatry, which incorporate the Present State Examination. RESULTS: Identified were a total of 1038 cases, including 64 through leakage studies (Kancheepuram: 268; median [IQR] age, 42 [33-50] years; 154 women [57.5%]; 114 men [42.5%]; Ibadan: 196; median [IQR] age, 34 [26-41] years; 93 women [47.4%]; 103 men [52.6%]; Trinidad: 574; median [IQR] age, 30 [23-40] years; 235 women [40.9%]; 339 men [59.1%]). Marked variations were found across and within settings in the sex, age, and clinical profiles of cases (eg, lower percentage of men, older age at onset, longer duration of psychosis, and lower percentage of affective psychosis in Kancheepuram compared with Ibadan and Trinidad) and in rates of untreated psychosis. Age- and sex-standardized rates of untreated psychoses were approximately 3 times higher in Trinidad (59.1/100 000 person-years; 95% CI, 54.2-64.0) compared with Kancheepuram (20.7/100 000 person-years; 95% CI, 18.2-23.2) and Ibadan (14.4/100 000 person-years; 95% CI, 12.3-16.5). In Trinidad, rates were approximately 2 times higher in the African Trinidadian population (85.4/100 000 person-years; 95% CI, 76.0-94.9) compared with the Indian Trinidadian (43.9/100 000 person-years; 95% CI, 35.7-52.2) and mixed populations (50.7/100 000 person-years; 95% CI, 42.0-59.5). CONCLUSIONS AND RELEVANCE: This analysis adds to research that suggests that core aspects of psychosis vary by historic, economic, and social context, with far-reaching implications for understanding and treatment of psychoses globally

Viewing the ganglion impar in vivo utilizing ultrasound: A feasibility study and literature review

“Ganglion impar” is the final unpaired ganglion demarcating the caudal convergence of the sympathetic chain ganglia in the pelvic region of the human body. The general position of the ganglion impar is anterior to the coccyx, but both researchers and practitioners note significant variability in its location, size and shape. Direct visualization of the ganglion by ultrasound has not been carried out to date. Cadaveric studies have been informative, but limited in their ability to sufficiently assist physicians in non-invasively locating and targeting the surprisingly inconsistent ganglion impar for clinical procedures in patients. RESOURCES. Literature on the ganglion impar is scarce. Cadaveric studies focusing on ganglion impar anatomy describe variations in the ganglion's size and location. Clinical studies show that ganglion impar nerve block, with varying degrees of success, can result in significant pain relief in patients with coccydynia and other forms of pelvic pain. A recently published case report involved an innovative ultrasound guided approach was attempted in this study. DESCRIPTION. This study utilized ultrasound to investigate the ganglion impar in one subject in both prone and transverse positions to assess its sonographic visibility and anatomical morphology. However, by the use of this technique the ganglion structure was not visualized. SIGNIFICANCE. Failure to view the ganglion in both positions suggests that the ganglion impar cannot be visualized using ultrasound in this case study. Previous studies used ultrasound to monitor needle insertion targeting ganglion impar, but not specifically to visualize the ganglion itself. This may help explain the variations seen in therapeutic outcomes and pain relief after administration of nerve blocks. The use of other landmarks, such as the coccyx and sacro-coccygeal junction, might be more useful in locating the ganglion impar

Psi Chi в глобальном мире: взгляд 9 международных отделений

Since 2009, when Psi Chi became the International Honor Society in Psychology, outstanding faculty and students across many nations have stepped forward to join the Psi Chi family of 750000 life members in 1130 schools on six continents. How is the Psi Chi experience changing lives around the world, as it has been doing since 1929 in the USA? Here, for the first time, Psi Chi “pioneers” in 9 international Chapters share in their own words and images their Psi Chi experiences.С тех пор как в 2009 году Psi Chi стало Международным психологическим обществом почета, выдающиеся преподаватели и студенты из многих стран вступили в семью Psi Chi, которая в настоящее время насчитывает более 750 000 человек, работающих и обучающихся в 1130 учебных заведениях на шести континентах. Меняет ли принадлежность к Psi Chi жизнь людей в глобальном мире, как это происходит в США, начиная с 1929 года? Впервые в этой статье пионеры Psi Chi из девяти международных отделений рассказывают о собственном опыте работы в организации