Psychiatry and psychotherapy: the science of sitting with uncertainty.

Objective: This perspective piece aims to delve into the challenges and possibilities arising from uncertainty in psychiatry and psychotherapy.

Method: This is a perspective piece.

Results: Historical considerations, polarised conceptual frameworks, interacting systems, limited randomised controlled research, and varying practice approaches, coalesce to form an exoskeleton of ambiguity and uncertainty in psychiatry and psychotherapy that seems almost impenetrable.

Why do people use drugs? A neglected question.

The aim of this article is to revisit the multivariate causes of drug use. From the initial drive to experiment, to a progression towards dependence, this review endeavours to extrapolate the aetiology of causation. In doing so, prevalence of, and attitudes towards drug use are firstly examined.

The Goldwater Rule: a bastion of a bygone era?

In tandem with the changing political landscape in recent years, interest in the Goldwater Rule has re-emerged within psychiatric discourse. Initiated in 1973, the Goldwater Rule is an ethical code specific to psychiatry created by the American Psychiatric Association in response to events surrounding the USA presidential election of 1964, in which the integrity of the psychiatric profession was challenged. Current detractors view the rule as an antiquated entity which obfuscates psychiatric pragmatism and progression.

Minding metabolism: targeted interventions to improve cardio-metabolic monitoring across early and chronic psychosis.

Background: Antipsychotics (APs) increase weight, metabolic syndrome, diabetes and cardiovascular disease. Guidelines recommend cardio-metabolic monitoring at initial assessment, at 3 months and then annually in people prescribed APs.

Aim: To determine the rates of cardio-metabolic monitoring in AP treated early and chronic psychosis and to assess the impact of targeted improvement strategies.

The suburban-city divide: an evaluation of emergency department mental health presentations across two centres.

Objective: To evaluate the characteristics of mental health presentations to the emergency department in two different hospital settings.

Methods: This was a retrospective cross-sectional study examining ED referrals to psychiatry in an inner-city and suburban centre. The authors collected data on gender, age, employment, housing, clinical presentation, time of assessment and admissions, over a 1-month period.

Mood matters: a national survey on attitudes to depression.

Background: Depression is the leading contributor to the burden of disease worldwide. Stigma and negative attitudes to depression can act as barriers to treatment and to social inclusion. Understanding attitudes to depression and treatment has implications for individual outcomes and societal mental health.

Stress, coping, and psychological resilience among physicians.

Background: Recent research has demonstrated that burnout is widespread among physicians, and impacts their wellbeing, and that of patients. Such data have prompted efforts to teach resilience among physicians, but efforts are hampered by a lack of understanding of how physicians experience resilience and stress. This study aimed to contribute to knowledge regarding how physicians define resilience, the challenges posed by workplace stressors, and strategies which enable physicians to cope with these stressors.