25 research outputs found
WPA guidance on mental health and mental health care in migrants
The WPA is committed to promote equity in the access
to mental health services for persons of different age, gender,
race/ethnicity, religion and socioeconomic status. As
part of this commitment, the Association decided to devote
one of the guidances to be developed within its Action
Plan 2008-2011 (1,2) to mental health and mental
health care in migrants. A Task Force was appointed for
this purpose, which produced the present document.
Mental health practitioners work in an increasingly
multicultural world, shaped by the migrations of people of
many different cultural, racial and ethnic backgrounds.
People migrate for many reasons: political, socioeconomic
and educational. The diversity of cultures, ethnicity, races
and reasons for migration can make understanding experiences
of illness challenging in migrants whose background
differs significantly from the clinician.
Culture has an important role in the presentation of
distress and illness, and cultural differences impact upon
the diagnosis and treatment of migrant populations in
part due to linguistic, religious and social variation from
the clinician providing care. Additionally, it appears that
the incidence and prevalence of mental disorders varies
among people of different cultural backgrounds, due to an
interplay of biological, psychological and social factors.
The provision of health care is necessarily influenced by
the demands of people of many different cultures, and it
is important that cultural differences be appreciated and
understood to arrive at a correct diagnostic impression
and treatment plan
Psychological characteristics of religious delusions
Purpose
Religious delusions are common and are considered to be particularly difficult to treat. In this study we investigated what psychological processes may underlie the reported treatment resistance. In particular, we focused on the perceptual, cognitive, affective and behavioural mechanisms held to maintain delusions in cognitive models of psychosis, as these form the key treatment targets in cognitive behavioural therapy. We compared religious delusions to delusions with other content.
Methods
Comprehensive measures of symptoms and psychological processes were completed by 383 adult participants with delusions and a schizophrenia spectrum diagnosis, drawn from two large studies of cognitive behavioural therapy for psychosis.
Results
Binary logistic regression showed that religious delusions were associated with higher levels of grandiosity (OR 7.5; 95 % CI 3.9–14.1), passivity experiences, having internal evidence for their delusion (anomalous experiences or mood states), and being willing to consider alternatives to their delusion (95 % CI for ORs 1.1–8.6). Levels of negative symptoms were lower. No differences were found in delusional conviction, insight or attitudes towards treatment.
Conclusions
Levels of positive symptoms, particularly anomalous experiences and grandiosity, were high, and may contribute to symptom persistence. However, contrary to previous reports, we found no evidence that people with religious delusions would be less likely to engage in any form of help. Higher levels of flexibility may make them particularly amenable to cognitive behavioural approaches, but particular care should be taken to preserve self-esteem and valued aspects of beliefs and experiences
The catatonic dilemma expanded
Catatonia is a common syndrome that was first described in the literature by Karl Kahlbaum in 1874. The literature is still developing and remains unclear on many issues, especially classification, diagnosis, and pathophysiology. Clinicians caring for psychiatric patients with catatonic syndromes continue to face many dilemmas in diagnosis and treatment. We discuss many of the common problems encountered in the care of a catatonic patient, and discuss each problem with a review of the literature. Focus is on practical aspects of classification, epidemiology, differential diagnosis, treatment, medical comorbidity, cognition, emotion, prognosis, and areas for future research in catatonic syndromes