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Journal ArticleDOI

The WPA-Lancet Psychiatry Commission on the Future of Psychiatry

01 Oct 2017-The Lancet Psychiatry (Elsevier)-Vol. 4, Iss: 10, pp 775-818
TL;DR: The therapeutic relationship remains paramount, and psychiatrists will need to acquire the necessary communication skills and cultural awareness to work optimally as patient demographics change, and psychiatry faces major challenges.
About: This article is published in The Lancet Psychiatry.The article was published on 2017-10-01 and is currently open access. It has received 268 citations till now. The article focuses on the topics: Mental health law & Military psychiatry.
Citations
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Journal ArticleDOI
TL;DR: How Internet research could be integrated into broader research settings to study how this unprecedented new facet of society can affect the authors' cognition and the brain across the life course is proposed.

210 citations

Journal ArticleDOI
05 Apr 2019
TL;DR: Health care professionals prescribing apps should not rely on disclosures about data sharing in health app privacy policies but should reasonably assume that data will be shared with commercial entities whose own privacy practices have been questioned and, if possible, should consider only apps with data transmission behaviors that have been subject to direct scrutiny.
Abstract: Importance Inadequate privacy disclosures have repeatedly been identified by cross-sectional surveys of health applications (apps), including apps for mental health and behavior change. However, few studies have assessed directly the correspondence between privacy disclosures and how apps handle personal data. Understanding the scope of this discrepancy is particularly important in mental health, given enhanced privacy concerns relating to stigma and negative impacts of inadvertent disclosure. Because most health apps fall outside government regulation, up-to-date technical scrutiny is essential for informed decision making by consumers and health care professionals wishing to prescribe health apps. Objective To provide a contemporary assessment of the privacy practices of popular apps for depression and smoking cessation by critically evaluating privacy policy content and, specifically, comparing disclosures regarding third-party data transmission to actual behavior. Design and Setting Cross-sectional assessment of 36 top-ranked (by app store search result ordering in January 2018) apps for depression and smoking cessation for Android and iOS in the United States and Australia. Privacy policy content was evaluated with prespecified criteria. Technical assessment of encrypted and unencrypted data transmission was performed. Analysis took place between April and June 2018. Main Outcomes and Measures Correspondence between policies and transmission behavior observed by intercepting sent data. Results Twenty-five of 36 apps (69%) incorporated a privacy policy. Twenty-two of 25 apps with a policy (88%) provided information about primary uses of collected data, while only 16 (64%) described secondary uses. While 23 of 25 apps with a privacy policy (92%) stated in a policy that data would be transmitted to a third party, transmission was detected in 33 of all 36 apps (92%). Twenty-nine of 36 apps (81%) transmitted data for advertising and marketing purposes or analytics to just 2 commercial entities, Google and Facebook, but only 12 of 28 (43%) transmitting data to Google and 6 of 12 (50%) transmitting data to Facebook disclosed this. Conclusions and Relevance Data sharing with third parties that includes linkable identifiers is prevalent and focused on services provided by Google and Facebook. Despite this, most apps offer users no way to anticipate that data will be shared in this way. As a result, users are denied an informed choice about whether such sharing is acceptable to them. Privacy assessments that rely solely on disclosures made in policies, or are not regularly updated, are unlikely to uncover these evolving issues. This may limit their ability to offer effective guidance to consumers and health care professionals.

171 citations


Cites background or methods from "The WPA-Lancet Psychiatry Commissio..."

  • ...31 The destination and content of each transmission were tagged automatically to identify (1) the owner of the destination, whether developer or third party and (2) instances of personal and other usergenerated data contained within each message....

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  • ...We adopted a permissive stance that reviewed all policy material, whether (1) presented within, or linked from, the app user interface; (2) hyperlinked from the app marketplace entry; or (3) presented on the developer’s website....

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Journal ArticleDOI
TL;DR: It is shown that short-term exposure to more extreme weather, multiyear warming, and tropical cyclone exposure each associate with worsened mental health, providing added quantitative support for the conclusion that environmental stressors produced by climate change pose threats to human mental health.
Abstract: Sound mental health—a critical facet of human wellbeing—has the potential to be undermined by climate change. Few large-scale studies have empirically examined this hypothesis. Here, we show that short-term exposure to more extreme weather, multiyear warming, and tropical cyclone exposure each associate with worsened mental health. To do so, we couple meteorological and climatic data with reported mental health difficulties drawn from nearly 2 million randomly sampled US residents between 2002 and 2012. We find that shifting from monthly temperatures between 25 °C and 30 °C to >30 °C increases the probability of mental health difficulties by 0.5% points, that 1°C of 5-year warming associates with a 2% point increase in the prevalence of mental health issues, and that exposure to Hurricane Katrina associates with a 4% point increase in this metric. Our analyses provide added quantitative support for the conclusion that environmental stressors produced by climate change pose threats to human mental health.

164 citations


Cites background from "The WPA-Lancet Psychiatry Commissio..."

  • ...Regions with less-temperate climates, insufficient resources (51), and greater reliance on ecological systems may see more severe effects of climate change on mental health (28)....

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Journal ArticleDOI
TL;DR: It is argued that, as developments in digital technology are outpacing the evaluation of rigorous digital health interventions, more advanced methodologies are needed to keep up with the pace of digital technology development.
Abstract: The digital revolution is evolving at an unstoppable pace. Alongside the unprecedented explosion of digital technology facilities and systems, mental health care is under greater pressure than ever before. With its emphasis on big data, computing power, mobile technology, and network information, digital technology is set to transform health care delivery. This article reviews the field of digital health technology assessment and intervention primarily in secondary service mental health care, including the barriers and facilitators to adopting and implementing digitally mediated interventions in service delivery. We consider the impact of digitally mediated communication on human interaction and its potential impact on various mental states such as those linked to mood, anxiety but also well-being. These developments point to a need for both theory- and data-driven approaches to digital health care. We argue that, as developments in digital technology are outpacing the evaluation of rigorous digital health interventions, more advanced methodologies are needed to keep up with the pace of digital technology development. The need for co-production of digital tools with and for people with chronic and mental health difficulties, and implications of digital technology for psychotherapy practice, will be central to this development. PRACTITIONER POINTS: Mental health problems are one of the main causes of global and societal burden and are a growing public health. People with mental health problems around the world have limited, if any, chance of accessing psychological help at all. Technological innovations and solutions are being considered in an attempt to address the size and scale of the mental health crisis worldwide. Digital platforms allow people to self-monitor and self-manage in a way that face-to-face/paper-based methods of assessment have up until now not allowed. We provide examples of digital tools that are being developed and used in the secondary setting and identify a number of challenges in the digital health field that require careful consideration.

157 citations


Cites background from "The WPA-Lancet Psychiatry Commissio..."

  • ...Facilitators / Barriers to digital platforms in mental healthcare Digital innovation is central to mental health service reform worldwide (Bhugra et al., 2017; NHS, 2014)....

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References
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Book
01 Jan 1962
TL;DR: The Structure of Scientific Revolutions as discussed by the authors is a seminal work in the history of science and philosophy of science, and it has been widely cited as a major source of inspiration for the present generation of scientists.
Abstract: A good book may have the power to change the way we see the world, but a great book actually becomes part of our daily consciousness, pervading our thinking to the point that we take it for granted, and we forget how provocative and challenging its ideas once were-and still are. "The Structure of Scientific Revolutions" is that kind of book. When it was first published in 1962, it was a landmark event in the history and philosophy of science. And fifty years later, it still has many lessons to teach. With "The Structure of Scientific Revolutions", Kuhn challenged long-standing linear notions of scientific progress, arguing that transformative ideas don't arise from the day-to-day, gradual process of experimentation and data accumulation, but that revolutions in science, those breakthrough moments that disrupt accepted thinking and offer unanticipated ideas, occur outside of "normal science," as he called it. Though Kuhn was writing when physics ruled the sciences, his ideas on how scientific revolutions bring order to the anomalies that amass over time in research experiments are still instructive in our biotech age. This new edition of Kuhn's essential work in the history of science includes an insightful introductory essay by Ian Hacking that clarifies terms popularized by Kuhn, including paradigm and incommensurability, and applies Kuhn's ideas to the science of today. Usefully keyed to the separate sections of the book, Hacking's essay provides important background information as well as a contemporary context. Newly designed, with an expanded index, this edition will be eagerly welcomed by the next generation of readers seeking to understand the history of our perspectives on science.

36,808 citations

Journal ArticleDOI
TL;DR: In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity, which makes it a useful clinical and research tool.
Abstract: OBJECTIVE: While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity.

26,004 citations

Journal Article
TL;DR: Diagnostic and statistical manual of mental disorders (DSM-5) was translated by psychiatrists and psychologists, mainly from the University psychiatric hospital Vrapce and published by the Naklada Slap publisher.
Abstract: Title: Diagnostic and statistical manual of mental disorders (DSM-5) Author: American Psychiatric Association Editors of Croatian Edition: Vlado Jukic, Goran Arbanas ISBN: 978-953-191-787-2 Publisher: Naklada Slap, Jastrebarsko, Croatia Number of pages: 936Diagnostic and statistical manual of mental disorders is a national classification, but since its third edition it became a worldwide used manual. [1] It has been published by the American Psychiatric Association and two years ago the fifth edition was released. [2] Croatian was among the first languages this book was translated to. [3] DSM-5 was translated by psychiatrists and psychologists, mainly from the University psychiatric hospital Vrapce and published by the Naklada Slap publisher.DSM has always been more publicly debated than the other main classification - the International Classification of Diseases (ICD). [4] The same happened with this fifth edition. Even before it was released, numerous individuals, organizations, groups and associations were publicly speaking about the classification, new diagnostic entities and changing criteria. [5]Although there is a tendency of authors of both DSM and ICD to synchronize these two classifications and to make them more harmonized with each new edition, there are several differences among them. While ICD covers all the diseases, disorders and reasons for making a contact with the health system, DSM covers "only" mental disorders. Other disorders (medical conditions, as they are named in DSM-5) are not included, except in situations when they lead to a development of a mental disorder. The other main difference is that DSM is more operational zed, and gives criteria for each of the disorders, listing how many criteria have to be met to make a diagnosis of a particular disorder, and what excluding criteria are.Due to the fact that it is used all around the globe and since it has become the most used psychiatric manual, it is sometimes said that DSM is a "psychiatric Bible". [6]Some critics of DSM say that it stigmatizes people and that in each edition it includes more diagnostic entities. It is true that in each edition of DSM there are more disorders listed, but this is due to the fact that medicine is a developing area and new insights are made every year, so some disorders are separated into different subtypes or subgroups and different new diagnoses, giving the impression more behaviour are being pathologized. The intention of the authors was to make more homogenous groups. But, the truth is that, compared with ICD, it is more difficult to get a diagnosis in DSM, than in ICD, with the same clinical presentation. [7] DSM requires functional impairment or distress to pathologize behaviour, while in ICD this criterion is not present in every case.During the process of developing DSM-5 there was an open public discussion. [2] For over a year any person was able to participate in the discussion about future criteria, inclusion or exclusion of diagnostic entities from DSM. More than 21000 letters was sent to the authors. This was the unprecedented way of developing a classification that ICD now tries to follow in preparation of its 11th edition.As a direct consequence of such an open and wide discussion, some new disorders were included (e.g. hoarding disorder), some were excluded even though they were included during the proposal period (e.g. hypersexual disorders), some were heavily debated (e.g. narcissistic personality disorder). [8-10]As previously mentioned, DSM and ICD systems try to harmonize more. There were more non-American authors included in DSM-5 than ever before and some of the experts in the field were in the task force of DSM-5 and ICD-11. [2, 11]What is new in DSM-5, compared to DSM-IV. The organization of the chapters has been changed, so now the flow of the disorders follow life cycle. The book starts with neurodevelopmental disorders, followed by schizophrenia, bipolar and depressive disorders, and closing with neurocognitive disorders. …

15,478 citations

Related Papers (5)
Frequently Asked Questions (2)
Q1. What have the authors contributed in "The wpa-lancet psychiatry commission on the future of psychiatry" ?

The future of the psychiatric patient in the health care system will be influenced by many factors, several of which will be discussed in other sections of this report this paper. 

Psychiatry should embrace the possibilities offered by digital technology, and take an active role in ensuring research and care delivery in this area is ethically sound and evidence based. And how will psychiatrists of the future be trained ? To answer these questions, the World Psychiatric Association and The Lancet Psychiatry have commissioned a team of mental health professionals, researchers, and service users to write and review this new Commission on the future of psychiatry. The individual would be part of this discussion, with reasonable adjustments made to increase the possibility of them being fully involved in the process. 

Trending Questions (1)
How long should mental health records be kept?

Mental health law should be reformed on the basis of evidence and the rights of the individual.