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Gender differences in mental illness in Hong Kong

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ADMINISTRATION AND POLICY IN MENTAL HEALTH 2003年第4期30卷 361-368页

作者： Yip, KS Hong Kong Polytech Univ Dept Appl Social Studies Kowloon Hong Kong Peoples R China

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Ethnic differences in admissions to secure forensic psychiatry services

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BRITISH JOURNAL OF PSYCHIATRY 2000年第3期177卷 241-247页

作者： Coid, J Kahtan, N Gault, S Jarman, B St Bartholomews & Royal London Sch Med & Dent Sect Forens Psychiat London England Univ London Imperial Coll Sci Technol & Med Sch Med Dept Primary Hlth Care & Gen Practice London England

Background Persons of African-Caribbean origin are more frequently imprisoned, and increasing evidence suggests they are detained more frequently in psychiatric hospitals, following offending behaviour. Aims To estimate population-based prevalence rates of treated mental disorder in different ethnic groups compulsorily admitted to secure forensic psychiatry services. Method A survey was recorded of 3155 first admissions, from 1988 to 1994, from half of England and Wales, with 1991 census data as the denominator adjusted for under-enumeration. Results Compulsory admissions for Black males were 5.6 (Cl 5.1-6.3) times as high as, and for Asian males were half, those for White males;for Black females, 2.9 (Cl 2.4-4.6) times as high and for Asian females one-third of those for White females. Admissions of non-Whites rose over the study period. Patterns of offending and diagnoses differed between ethnic groups. Conclusions Variations in compulsory hospitalisation cannot be entirely attributed to racial bias. Community-based services may be less effective in preventing escalating criminal and dangerous behaviour associated with mental illness in African-Caribbeans. Declaration of interest None. Funding was provided by the Department of Health.

关键词：精神病人强制住院/统计学和数值数据英格兰/流行病学人种群/统计学和数值数据司法精神病学/组织和管理医院精神病/利用精神障碍/人种学精神障碍/预防和控制危险因素社会控制正式社会正义社会经济因素威尔士/流行病学西印度群岛/人种学青少年成年人女(雌)性人类男(雄)性

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The need for treatment evidence for common mental disorders in developing countries

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PSYCHOLOGICAL MEDICINE 2000年第4期30卷 743-746页

作者： Patel, V The Sangath Centre Goa 403521 841/1 Alto Porvorim India

There is now a considerable body of epidemiological evidence from developing countries and multilateral agencies that so called common mental disorders are common and disabling (e.g. Murray & Lopez, 1996; Patel et al. 1998). The logical next step is to identify efficacious and cost-effective health services interventions that can tackle the all-important ‘so-what’ question that is posed by doctors and policy makers in developing countries when confronted with startling prevalence statistics. The rise of evidence-based medicine has highlighted the need for quality trials that can inform and guide clinical practice. This editorial poses the question of whether we need treatment evidence from developing countries. The key issue is whether we can assume that psychiatric treatment evidence can be applied from one culture, or region, to another. If, for example, this was possible, then clinical practice in developing countries could be fairly well informed by trials conducted in the West. However, there are several factors that limit the cross-cultural applicability of treatment research in psychiatry.

关键词：大陆人口群文化发展中国家药物评价/经济学药物评价/心理学药物评价/标准循证医学精神障碍/药物疗法精神障碍/人种学公共卫生/经济学公共卫生/标准人类

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Criminal behavior and emotional disorder: Comparing youth served by the mental health and juvenile justice systems

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JOURNAL OF BEHAVIORAL HEALTH SERVICES & RESEARCH 2000年第2期27卷 227-237页

作者： Rosenblatt, JA Rosenblatt, A Biggs, EE Univ Calif San Francisco Child Serv Res Grp San Francisco CA 94104 USA

This study explored whether youth involved in joint service systems differed from single-agency users in terms of types of crimes committed and clinical functioning. Data from 4, 924 youth involved in one county's public mental health and juvenile justice service systems were examined. Twenty percent of those youth receiving mental health services had recent arrest records, and 30% of youth arrested received mental health services. Of all youth arrested in the county, mental health service users had more arrests than non-mental health service users. A subsample of 94 mental health service users with arrests was matched on demographics with 94 mental health service users without arrests. Youth with arrests had a higher frequency of conduct disorder higher Child Behavior Checklist Externalizing and Total Problem Scale scores, and more functional impairment on the Child and Adolescent Functional Assessment Scale as compared to youth without arrests. Implications for behavioral health service delivery were discussed.

关键词：加利福尼亚/流行病学病例对照研究社区精神卫生服务/组织和管理社区精神卫生服务/统计学和数值数据罪行/人种学罪行/心理学罪行/统计学和数值数据体内外控制青少年犯罪/人种学青少年犯罪/心理学青少年犯罪/统计学和数值数据精神障碍/并发症精神障碍/流行病学精神障碍/人种学精神障碍/心理学患病率精神病状态评定量表青少年儿童女(雌)性人类男(雄)性中年人

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Biracial youth and families in therapy: Issues and interventions

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JOURNAL OF MARITAL AND FAMILY THERAPY 2000年第3期26卷 305-315页

作者： Milan, S Keiley, MK Vanderbilt Univ George Peabody Coll Teachers Nashville TN 37203 USA Purdue Univ Marriage & Family Therapy Program Dept Child Dev & Family Studies W Lafayette IN 47907 USA

Empirical research and clinical resources focusing specifically on minority youth and families have increased tremendously in the last 2 decades. Despite this trend, certain groups continue to be relatively neglected. In particular very few resources exist for understanding the unique challenges that often face biracial youth and their families. In this article, we use a nationally representative database to compare functioning in biracial youth to white adolescents and other minority adolescents. Results suggest that biracial/biethnic youth are a particularly vulnerable group in terms of self-reported delinquency, school problems, internalizing symptoms, and self-regard. As a group, they are also more likely to receive some form of psychological intervention. Given these findings and the shortcoming of clinical resources for work with this population, we provide an in-depth discussion of why biracial youth may be particularly vulnerable from a social constructionist framework and offer several strategies based on narrative family therapy for working with biracial youngsters and their families.

关键词：文化多样性家庭心理疗法精神障碍/人种学精神障碍/预防和控制精神障碍/心理学少数民族/心理学人格发展危险因素自我概念青少年女(雌)性人类男(雄)性

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Promoting the mental health of elderly African Americans: A case illustration

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ARCHIVES OF PSYCHIATRIC NURSING 2000年第4期14卷 191-198页

作者： Thornton, KA Tuck, I Virginia Commonwealth Univ Sch Nursing Richmond VA 23298 USA Florida Atlantic Univ Coll Nursing Boca Raton FL 33431 USA

Promoting mental health in an illness-oriented health care delivery system is challenging. Health promotion from a holistic perspective requires that mental health be viewed as important as physical health. The mental health needs of the elderly are numerous and often not addressed during routine visits for primary health care. Research consistently reports that elderly African Americans are not equal participants in the formal health care system. Consequently, promoting mental health in the African American elderly is a challenge made even more complicated because of this group's limited access to and use of mental health care services. Promoting the health of African Americans confronts many traditional values and practices of health care institutions and mental health practice. Therefore, health care providers must be innovative and creative to facilitate mental health promotion in this population of clients. The authors suggest that the Revised Health Promotion Model can serve as a framework for guiding the mental health care of elderly African Americans, Aspects of the model are particularly relevant for this population. The case of an elderly Black woman is presented as an illustration of ways in which the model may be applied with many cultural nuances, Copyright (C) 2000 by W.B. Saunders Company.

关键词：非洲裔美国人/心理学老年人/心理学健康态度/人种学健康知识态度实践健康促进/方法精神障碍/人种学精神障碍/护理精神卫生模型护理学病人医疗护理计划精神病护理学/方法生活质量跨文化护理/方法美国/流行病学老年人 80以上女(雌)性人类

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Immigration and mental health: Mexican Americans in the United States

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HARVARD REVIEW OF PSYCHIATRY 2000年第2期8卷 64-72页

作者： Escobar, JI Nervi, CH Gara, MA Univ Med & Dent New Jersey Robert Wood Johnson Med Sch Dept Psychiat Piscataway NJ 08854 USA

The Hispanic population in the United States continues to expand rapidly due primarily to a large flow of immigrants from Mexico. Historical observations of disadvantage in the immigrant population, when compared to the native population, had helped to shape prevailing theories on immigration and mental health. However, data emerging from new research on Mexican Americans have come to challenge the old idea that immigrants are necessarily disadvantaged. The goal of this article is to review these new studies critically, to draw conclusions concerning the relationship between immigration and psychopathology, and to offer potential explanations for the major findings. We review five recent large-scale studies that examined the prevalence of mental disorders among Mexican-born immigrants and U.S.-born Mexican Americans in the United States. Results of these studies are inconsistent with traditional tenets on the relationship among immigration, acculturation, and psychopathology. They show that Mexico-born immigrants, despite significant socioeconomic disadvantages, have better mental health profiles than do U.S.-born Mexican Americans. Possible explanations for the better mental health profile of Mexican immigrants include research artifacts such as selection bias, a protective effect of traditional family networks, and a lower set of expectations about what constitutes "success" in America. The elevated rates of psychopathology in U.S.-born Mexican Americans may be related to easier access to abused substances and an elevated frequency of substance abuse among the U.S.-born.

关键词：文化适应移民(移出和移入) 精神障碍/流行病学精神障碍/人种学精神障碍/心理学精神卫生墨西哥裔美国人/心理学物质相关性障碍/流行病学物质相关性障碍/心理学美国/流行病学人类

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The long-term factors associated with removal from parents amongst Indigenous prisoners in NSW

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AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 2000年第4期24卷 454-455页

作者： Egger, SJ Butler, T Univ New S Wales Sch Law Sydney NSW 2052 Australia

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Patients' desire to participate in decision-making in psychiatry: A questionnaire survey in Japan

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PSYCHOLOGICAL REPORTS 2000年第2期86卷 389-399页

作者： Hasui, C Hayashi, M Tomoda, A Kohro, M Tanaka, K Dekio, F Kitamura, T NIMH Dept Sociocultural & Environm Res NCNP Chiba 2720827 Japan Japan Soc Promot Sci Tokyo Japan Keio Univ Tokyo 108 Japan

Japanese national sentiment has been described as paternalistic, which has potentially wide-ranging implications for the manner in which psychiatric patients should participate in medical decision-making. To examine the extent and possible determinants of the desire to participate in medical decision-making among Japanese people, we distributed a packet of questionnaires to 747 (nonmedical) university students and 114 of their parents. The questionnaires included an imaginary case vignette of psychotic depression. The participants sere asked whether they would want Various types of medical information, i.e., diagnosis, aetiology, treatment, outcomes, medical charts, etc., disclosed to them were they in such a psychiatric condition. Also included was the 1995 Scale for Independent and Interdependent Construal of the Self by Kiuchi. More than hall of the participants wanted all the types of medical information disclosed to them. Those participants who wanted to have all types of information disclosed to them (n=413) as compared to those who did not want to know at least one type of information (n=445), tended to be male and to have an educational background in psychiatry (9.7% vs 5.4%) as well as an assertive attitude as indicated by a higher score on independence on the Scale for Independence and Interdependent Construal of the Self. These results suggest that the Japanese in this sample are more likely to want to make an autonomous contribution to the psychiatric decision-making process and that less desire for information can be predicted by some demographic and personality factors.

关键词：文化交叉比较抑郁症/人种学抑郁症/心理学人种群/心理学知情同意日本精神障碍/人种学精神障碍/心理学病人参与/心理学精神病/人种学精神病/心理学真相揭露青少年成年人老年人女(雌)性人类男(雄)性中年人

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Cost-effectiveness of assertive community treatment for homeless persons with severe mental illness

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BRITISH JOURNAL OF PSYCHIATRY 1999年第4期174卷 346-352页

作者： Lehman, AF Dixon, L Hoch, JS Deforge, B Kernan, E Frank, R Univ Maryland Dept Psychiat Ctr Mental Hlth Serv Res Baltimore MD 21201 USA Univ Maryland Dept Family Med Baltimore MD 21201 USA Harvard Univ Dept Hlth Care Policy Cambridge MA 02138 USA

Background Homelessness is a major public health problem among persons with severe mental illness (SMI). Cost effective program mes that address this problem are needed. Aims To evaluate the cost-effectiveness of an assertive community treatment (ACT) programme for these persons in Baltimore, Maryland. Methods A total of 152 homeless persons with SMI were randomly allocated to either ACTor usual services. Direct treatment costs and effectiveness, represented by days of stable housing, were assessed. Results Compared with usual care, ACT costs were significantly lower for mental health in-patient days and mental health emergency room care, and significantly higher for mental health outpatient visits and treatment for substance misuse. ACT patients spent 31% more days in stable housing than those receiving usual care. ACTand usual services incurred $242 and $415 respectively in direct treatment costs per day of stable housing, an efficiency ratio of 0.58 in favour of ACT. Patterns of care and costs varied according to race. Conclusion ACT provides a cost-effective approach to reducing homelessness among persons with severe and persistent mental illnesses. Declaration of interest This work was supported by a grant from the Center for Mental Health Services, Rockville, Maryland.

关键词：巴尔的摩预算社区精神卫生服务/经济学直接服务费用无家可归者精神障碍/经济学精神障碍/人种学精神障碍/治疗回顾性研究成年人女(雌)性人类男(雄)性

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