Integrating neuroscience in psychiatry: a cultural-ecosocial systemic approach.

Psychiatry has increasingly adopted explanations for psychopathology that are based on neurobiological reductionism. With the recognition of health disparities and the realisation that someone's postcode can be a better predictor of health outcomes than their genetic code, there are increasing efforts to ensure cultural and social-structural competence in psychiatric practice. Although neuroscientific and social-cultural approaches in psychiatry remain largely separate, they can be brought together in a multilevel explanatory framework to advance psychiatric theory, research, and practice.

The shared genetic architecture of modifiable risk for Alzheimer's disease: a genomic structural equation modelling study.

Targeting modifiable risk factors may help to prevent Alzheimer's disease (AD), but the pathways by which these risk factors influence AD risk remain incompletely understood. We identified genome-wide association studies for AD and its major modifiable risk factors. We calculated the genetic correlation among these traits and modelled this using genomic structural equation modelling.

The feasibility of using life skills training in primary schools to improve mental health and academic performance: a pilot study in Kenya.

Background: There is no Kenyan evidence on the relationship between mental illness and academic performance. We aimed to determine the effect of life skills training on mental health and academic performance.

Methods: We administered to 1848 primary school children a researcher designed socio-demographic questionnaire, and the Youth Self Report (YSR) and Child Behavior Checklist (CBCL) to their parents, followed by eight sessions of life skills training.

A global needs assessment in times of a global crisis: world psychiatry response to the COVID-19 pandemic.

The COVID-19 pandemic has stunned the global community with marked social and psychological ramifications. There are key challenges for psychiatry that require urgent attention to ensure mental health well-being for all - COVID-19-positive patients, healthcare professionals, first responders, people with psychiatric disorders and the general population. This editorial outlines some of these challenges and research questions, and serves as a preliminary framework of what needs to be addressed.

Cultural Consultation in Context: A Comparison of the Framing of Identity During Intake at Services in Montreal, London, and Paris.

Cultural diversity poses a challenge to mental Health care systems in many settings. Specialized cultural consultation services have been developed in a number of countries as a way to supplement existing services. The objective of this paper is to compare and contrast cultural consultation services in Montreal, London, and Paris to determine how culture and society have shaped the evolution of these services to meet local sensitivities and imperatives.

When a corrigendum is not sufficient.

We present the reasoning behind a retraction noting that even small, honest errors can result in significant changes in findings.

Where next for understanding race/ethnic inequalities in severe mental illness? Structural, interpersonal and institutional racism.

In this article we use the example of race/ethnic inequalities in severe mental illness to demonstrate the utility of a novel integrative approach to theorising the role of racism in generating inequality. Ethnic minority people in the UK are at much greater risk than White British people of being diagnosed with a severe - psychosis related - mental illness, and this is particularly the case for those with Black Caribbean or Black African origins. There is entrenched dispute about how we might understand the drivers of this inequality.

Addiction care in crisis: evidence should drive progressive policy and practice.

Addictions are challenging health and social problems that need to be addressed to preserve and promote good mental health and ensure that individuals within society lead healthy and productive lives. Tackling addictions is complex and requires communities, public health, specialist services, and local and national government to act in unison and implement evidence-based interventions. This editorial raises systemic issues that need attention and proposes a range of systemic options.

Ensuring research integrity: setting standards for robust and ethical conduct and reporting of research.

We present an account of why we decided to retract a paper. We discovered a lack of adherence to conventional trials registration, execution, interpretation and reporting, and consequently, with the authors, needed to correct the scientific record. We set out our responses in general to strengthen research integrity.

From Allostatic Load to Allostatic State-An Endogenous Sympathetic Strategy to Deal With Chronic Anxiety and Stress?

The concepts of allostatic load and overload, i. e., a dramatic increase in the allostatic load that predisposes to disease, have been extensively described in the literature.

Pursuing parity: genetic tests for psychiatric conditions in the UK National Health Service.

Schizophrenia and anorexia nervosa were recently added to the list of conditions for which whole genome sequencing might be indicated as part of the 100 000 Genomes Project, reflecting the remarkable recent progress in findings emerging from psychiatric genetics research. Genetic testing methods may offer increased opportunities for diagnosis and estimation of familial risk and could have implications for management and treatment options. They also present ethical and philosophical questions about the role of testing and storage of genetic information.

Age, memory loss and perceptions of dementia in South Asian ethnic minorities.

Background: South Asian older adults are represented less frequently in mainstream mental health services or those for people with dementia. This study aimed to explore in detail the perceptions of dementia (symptoms, causes, consequences, treatments) held by South Asians and to discern how these understandings vary by age and by the self-recognition of memory problems, as these influence help-seeking behaviour.

Methods: Participants were allocated to three groups: younger adults; older adults; and older adults with subjective memory problems.

Changes in health in England, with analysis by English regions and areas of deprivation, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Background: In the Global Burden of Disease Study 2013 (GBD 2013), knowledge about health and its determinants has been integrated into a comparable framework to inform health policy. Outputs of this analysis are relevant to current policy questions in England and elsewhere, particularly on health inequalities. We use GBD 2013 data on mortality and causes of death, and disease and injury incidence and prevalence to analyse the burden of disease and injury in England as a whole, in English regions, and within each English region by deprivation quintile.

Interventions to improve therapeutic communications between Black and minority ethnic patients and professionals in psychiatric services: systematic review.

Background: Communication may be an influential determinant of inequality of access to, engagement with and benefit from psychiatric services.

Aims: To review the evidence on interventions designed to improve therapeutic communications between Black and minority ethnic patients and clinicians who provide care in psychiatric services.

Method: Systematic review and evidence synthesis (PROSPERO registration: CRD42011001661).

Perceptions of self-defined memory problems vary in south Asian minority older people who consult a GP and those who do not: a mixed-method pilot study.

Objective: South Asian older adults access services for mental health problems and dementia less than other older people in the UK, unlike for physical health problems. This pilot study investigated how South Asians with self-defined memory problems, with and without GP consultation, construe the symptoms, causes, consequences and treatment of the condition.

Methods: Participants were recruited through community centres, their networks and memory clinics in Greater Manchester.

Illness perceptions and explanatory models of viral hepatitis B & C among immigrants and refugees: a narrative systematic review.

Background: Hepatitis B and C (HBV, HCV) infections are associated with high morbidity and mortality. Many countries with traditionally low prevalence (such as UK) are now planning interventions (screening, vaccination, and treatment) of high-risk immigrants from countries with high prevalence. This review aimed to synthesise the evidence on immigrants' knowledge of HBV and HCV that might influence the uptake of clinical interventions.

Adaptation of the Barts Explanatory Model Inventory to dementia understanding in South Asian ethnic minorities.

Objective: Studies indicate a limited understanding of dementia and its associated symptoms, causes and consequences among South Asian older adults. As a consequence, fewer people from this ethnic group receive a diagnosis of dementia. The aim of this study was to adapt the previously designed Barts Explanatory Model Inventory Checklist (BEMI-C), a tool designed to elicit perceptions of mental illness from people with different cultural backgrounds, for use with people with dementia in the South Asian population.

Explanations of illness experiences among community mental health patients: an argument for the use of an ethnographic interview method in routine clinical care.

Cultural variations in perceptions of mental distress are important issues for healthcare. They can affect communication between patients and professionals and may be a root cause for misdiagnosis, patient disengagement, and disparities in access, outcomes and overall experiences of treatment by patients. Taking into account patients' explanatory models (EMs) of mental distress is fundamental to patient-centred care, and improved outcomes.

A cultural consultation service in East London: experiences and outcomes from implementation of an innovative service.

This paper reports on a feasibility study and evaluation of a new type of cultural consultation service (CCS). This multi-component and systemic complex intervention was offered over 18 months to specialist mental health providers in one of the poorest regions of the UK. The service received 900 clinically related contacts and 99 in-depth consultations.

South Asian older adults with memory impairment: improving assessment and access to dementia care.

Objective: With increasing international migration, mental health care of migrants and ethnic minorities is a public health priority. South Asian older adults experience difficulties in accessing services for memory impairment, dementia and mental illness. This review examines barriers and facilitators in the pathway to culturally appropriate mental health care.