Arabic version of the Global Mental Health Assessment Tool-Primary Care version [GMHAT/PC]: a validity and feasibility study

Mental health services are far from satisfactory in the Eastern Mediterranean Region. The Global Mental Health Assessment Tool-Primary Care version [GMHAT/PC] is a semi-structured, computerized clinical assessment tool that was developed to assist health workers in making quick, convenient and comprehensive standardized mental health assessments. A study was carried out in the United Arab Emirates to evaluate the validity and feasibility of the Arabic version of the GMHAT/PC. Mental health nurses administered the GMHAT/PC Arabic version to 50 patients in mental health and rehabilitation settings and their GMHAT/PC diagnosis was compared with the psychiatrist's independent ICD-10 based clinical diagnosis on the same patients. The nurses found GMHAT/PC easy to administer in an average of 16 minutes. The GMHAT/PC-based diagnosis had a good agreement with the psychiatrist's diagnosis [kappa = 0.91] and a high sensitivity [97%] and specificity [94%]

Conducting randomized controlled trials of psychological interventions in the field of drug addiction-trials and tribulations

We have completed a randomized controlled trial [RCT] of the effectiveness of enhanced prevention counseling [EPC] in the primary prevention of Hepatitis C viral [HCV] infection in injecting drug users [IDU]. In the conduct of the trial we faced many challenges, which have not enabled us to recruit the required number of participants. Hence, we were not able to demonstrate the effectiveness of EPC in decreasing the incidence of HCV in IDUs. To describe the challenges encountered in carrying out the RCT and critically discuss their implications for conducting RCTs of psychological interventions in the field of drug addiction. The challenges faced were organized into 3 main themes: issues relating to the type of the client group, behavior and health; issues relating to the service environment from which participants were recruited; and issues relating to the trial design. The main challenges encountered were related to the chaotic behavior and motivation of drug users, to the high disengagement rates with the treatment; to issues relating to the service environment such as the definition of IDU, HCV methods of testing and to the variation in service set-up; to issues relating to research design including compensation for participation and the use of trained regular staff rather than dedicated research workers as therapists. The main lessons learnt were that piloting of a new intervention is a crucial first step before conducting pragmatic RCTs of psychological interventions in the field of addiction; that an infrastructure and culture for psychosocial interventions is needed to enable applied research in the service environment, and research funding is needed for enabling the recruitment of dedicated trained therapists for the delivery of these interventions

contribution of psychiatry to the undergraduate medical curriculum: the Liverpool experience

This article deals with the teaching experiences that had been delivered to undergraduate medical students. They included behavioral sciences, psychiatry, clinical interview and medical ethics. In addition, psychotherapy psychogeriatrics, learning disability forensic, child psychiatry and drug abuse it also deals with evaluation of students and future developments

Laboratory diagnosis in psychiatry

The value of utilising laboratory techniques in the diagnosis of psychiatric disorders has been discussed. Since the causation of psychiatric disorders is still unknown; exploration into biochemistry is being saught. Neuroendocrine tests as laboratory diagnostic tools provide usefull depression paradigms for the study of the pathophysiology of psychiatric disorders. The Dexamethasone suppression test may aid diagnosis and prognosis of biological

Vitamin deficiency and mental health

The evidence for an association between nutritional deficiency and psychiatric disorder is abundant. Subclinical deficiency in members of vitamin B group and vitamin C are common occurrences in a variety of psychiatric disorders. Folate deficiency in particular has been implicated in psychiatric disorders associated with epilepsy, in dementia, and depression. In the latter condition, folate deficiency has been proposed as an aetiological factor, and associated with severe illness and resistance to treatment. Similar conclusions were reached in connection with alchoholism. Folic acid therapy has been linked to improvements in psychiatric disturbances during anticonvulsant therapy, depressive symptoms, neurasthenic symptoms, and in overall improvement in schizophrenia, endogenous depression and organic psychoses. The mechanisms mediating the association between folate deficiency and depression are not settled. Methylation and hydroxylation of amino acids implicated in depression are influenced by folic acid. Still folate deficiency may be secondary to depression rather than the cause of it. A nutritional deficiency model for the psychoses is proposed. Neurotransmitter changes may result from or drain vitamin resources which are needed as cofactors in their synthesis. In turn these changes may aggravate nutritional deficiency and a vicious circle sets in. There are several reasons why geriatric patients are linkely to suffer from nutritional deficiencies. These possibilities should not be neglected in the aetiology of psychogeriatric disorders and their management

long-term management of unipolar depression: grounds for optimism

The author discusses the literature on the outcome of unipolar depression, exploring the role of Imipramine and types of psychotherapy, he is suggesting further studies to assess the efficacy of new antidepressants in the long term management of this condition

management of patient at risk for suicide

The paper reviews the literature in the field of managing patients at risk of suicide, exploring the complex relationship with affective disorders, emphasis on the assessment and management through, history of previous attempts, family history of suicidal behaviour, personality, medical diseases, and abuse of Alcohol and drugs. The biological risk factors and the acute and long term treatment are discussed