Global Experts Meeting on
Psychiatry and Mental Health

Sharon Gil is a clinical social worker, psychotherapist, and clinical supervisor; senior lecturer at the School of Social Work, University of Haifa; head of the clinical social work specialization in the MA program. My research projects have consistently derived from my clinical work. While working at the psychiatric clinic in Rambam Medical Center, I treated trauma patients. Accordingly, my doctoral research and the publications focused on the relationship between dissociative amnesia, caused by traumatic head injury, and the development of PTSD. Later, I have expanded my research to include various personality features as risk factors for subsequent PTSD. In recent years, both my clinical work and my research efforts focus on adults' survivors of childhood sexual abuse.

Modern technology has made possible unprecedented opportunities for second-hand exposure to disasters and violence. Exposure to traumatic video footage of terror attacks as distributed over social networks can cause significant emotional distress. Dealing with such stress requires attention to significant personal resources. This study examined the relationship between tendency to forgive and mastery with PTSD symptoms and stress among 249 participants (N = 249). The study questionnaires were filled out at two points in time. At Time 1, tendency-to-forgive, mastery, and general PTSD symptoms, and stress were completed. At Time 2 after watching a 3-minute video clip of a series of terror attacks that were distributed over social networks the participants filled out PTSD-symptom and perceived-stress questionnaires once again. The study results demonstrated that tendency to forgive the self was negatively associated with stress levels at T1, whereas tendency to forgive the situation was negatively associated with both PTSD symptoms at T1 and stress levels at T1. Mastery was positively associated with both PTSD symptoms at T1 and stress levels at T1. In addition, PTSD symptoms at T1 were positively associated with both PTSD symptoms at T2 and stress at T2. However, stress at T1 was only positively associated with stress atT2. The study findings make an important contribution to our understanding of tendency to forgive, mastery, PTSD symptoms, and stress among those exposed to traumatic social-media content. Theoretical and clinical implications are discussed.

Objective: To investigate the effects of Polygala Tenuifolia - Acori Graminei Rhizoma on behavior including spontaneous activity, impulsivity, learning-memorial ability of spontaneously hypertensive rats (SHR) as a model of attention-deficit/hyperactivity disorder (ADHD), and explore its possible mechanism. Methods: 4-week-old SHR rats were randomly divided into the model group, methylphenidate (MPH) group, Polygala Tenuifolia - Acori Graminei Rhizoma group, the same age WKY young rats were selected as the normal control group, 10 rats in each group. Rats were gavage for 4 weeks in the dark-phase. Open field test (OFT) were conducted to evaluate the spontaneous activity of rats before the gavage, at the end of 4-week treatment, two weeks after the medicine withdrawal; elevated plus maze (EPM), novel object recognition test (NORT)were conducted to evaluate the impulsivity and learning-memorial ability individually at the end of treatment. Prefrontal cortex(PFC) were seperated two weeks after the medicine withdrawal, and contents of dopamine(DA) and dopamine transportor (DAT) in PFC were detected by ELISA. Results: Compared with the control group, Polygala Tenuifolia - Acori Graminei Rhizoma group had shorter movement distance and less rearing activities in the OFT, reduced percentage of the times entering the open arms and staying duration in the total period in the EPM, and the elevated preference index in the NORT after receiving four weeks treatment(P<0.05). The Polygala Tenuifolia - Acori Graminei Rhizoma group still had shorter movement distance and less rearing activities than model group two weeks after the medicine withdrawal(P<0.05), and the contents of DA in PFC of the Polygala Tenuifolia - Acori Graminei Rhizoma-treated rats were higher than that of control group(P<0.05), but there was no significant difference in DAT levels between the two groups(P>0.05). Conclusion: Polygala Tenuifolia - Acori Graminei Rhizoma could relieve the spontaneous activity and impulsivity, improve learning-memorial ability of ADHD model rats, and still exert the therapeutic effects after the withdrawal, which may be related to elevated dopamine levels in the PFC.

The consumption of psychoactive substances (PAS) is increasingly high in patients with psychological disorders. The aim of our cross-sectional descriptive study carried out from November 2016 to April 2017 is to assess the prevalence of PAS consumption in hospitalized patients at the psychiatric department of CHU Tlemcen, Algeira. Methods: Our study included 165 male and female patients aged> 15 years old with psychiatric disorders (schizophrenic, bipolar and depression). Data were collected by a questionnaire and completed by information from doctors and toxicological results in blood and urine. Drugs (opiods, cocain, cannabis, benzodiazepines, barbiturates and tricyclic antidepressant) where identified and quantified by EMIT technic. Khi 2 test was used for statisical analysis. Results: Among 165 patients, (55.8%) were schizophrenic, (39.4%) with bipolar disorder and (4.8%) depressed. There were (55%) PAS consumers. The sex ratio=17.2 and age average of 36.38+/-8.9 years. Schizophrenics are dominant users (62%) associating tobacco and cannabis (60%). Psychological disorders appeared after chronic use in (60%) of cases. Toxicological analysis in blood and urine gave positive results in (20%) confessing the use and (11%) denying it. The main factors seen in consumers are education, jobs and familial instability and family history of substance abuse. Conclusion: It is important to improve the management of patients with comorbidity of addiction and psychic disorder by psycho toxicological cooperation.

Objective To study the effects of baicalein on spontaneous activity, impulsivity, learning-memorial ability, and the adenylate cyclase (AC)-cyclic adenosine monophosphate (cAMP)-protein kinase A (PKA) signaling pathway in prefrontal cortex (PFC) of rats with attention deficit hyperactivity disorder (ADHD). Methods Fifty 4-week-old SHR rats aged 4 were randomly divided into the model group, methylphenidate (MPH) group(2 mg/kg), and low-dose, mid-dose and high-dose group(100, 200, 400 mg/kg) baicalein groups. and WKY rats of the same age were selected as the normal control group (n=10 in each group). Rats were orally gavaged for 4 weeks in the dark-phase. Open field test (OFT), elevated plus maze (EPM) and novel object recognition test (NORT)were conducted to evaluate the spontaneous activity, impulsivity and learning-memorial ability of rats individually at the end of treatment.. AC, cAMP and PKA quantity were determinated with enzyme-linked immunosorbent(ELISA)method. Results Movement distance in OFT was shortened in high-dose baicalein group and mid-dose baicalein group (P<0.05) afterwards, Vertical movements also decreased in all baicalein groups. Percentage of the times entering the open arms in the EPM was significantly reduced in the mid-dose baicalein group (P<0.05); staying duration in the total period in the EPM was also reduced in all baicalein groups(P<0.05). The preference index in the testing phase of NORT increased in the mid-dose baicalein group (P<0.05). Levels of AC and cAMP in the prefrontal cortex increased in all baicalein groups(P<0.05), while PKA increased in high-dose and mid-dose baicalein group (P<0.05). Conclusion Baicalein could increase the levels of AC, cAMP and PKA in prefrontal cortex of ADHD rats, which may shed some light to the mechanism how baicalein could relieve the spontaneous activity and impulsivity, improve learning-memorial ability of ADHD rats.

Hongye Luo, lecturer of Guanxi Medical University. Now study Epidemiology and Biostatistics In Prince of Songkla University as a Ph.D. candidate. Her works in mental health service and policy area for many years and conducted several projects related to mental health.

Objectives: To identify the rate and predictors of utilization of rehabilitation services among people with psychotic disorders in rural communities of Guangxi. Study design: A cross-sectional survey was conducted among individuals with schizophrenia or other psychoses (severe mental disorder, ICD10: F20-F29), aged over 15 years, and their care-givers in Guangxi, China. Trained village doctors located individuals known to them and suspected as having schizophrenia or other psychoses within the target area and recruited them into the study. Data on demographic characteristics, clinical symptoms and functions, treatment history, and reasons, if any, for non-utilization of mental health service were collected. Logistic regression was used to determine associated factors for utilization of mental health services. Results: A total of 424 individuals experiencing psychosis (mean age: 41.4±13.0 years, 60.6% male) and 319 caregivers (mean age: 55.3±14.2 years) were interviewed. The median duration of disease was 13.4 years. 83.0% of patients had never used rehabilitation services. Greater use of rehabilitation was associated with having a non-organic disorder (OR=11.6, 95% CI=1.6-86.0) and living with a caregivers (OR=3.2, 95% CI=1.2-8.3). The top three reasons for not using rehabilitation services were lack of awareness (57.1%), lack of money (14.2%) and lack of belief in the service (12.8%). Conclusions: These findings indicate a high unmet need for psychiatric rehabilitation services among people with psychotic disorders in rural areas of Guangxi. Strategies such as outreach programme and collaborative and partnership network with the local community are needed to encourage people with psychotic disorders in rural communities to increase their utilization of rehabilitation services.

There has been limited research focusing on the association of early childhood bully victimizations and levels of depression in adulthood. The present study investigates this relationship while controlling for prior levels of mental health as well as a variety of stressful events that occur in the participants’ lives. Using data from the National Longitudinal Survey of Youth 1997 (NLSY97), a population-based longitudinal study of individuals who were between the ages of 12 and 16 as of December 31, 1996, repeat bully victimizations were assessed before the age of 12. These measures were associated with measures of depression beginning in late adolescence and into adulthood. Subgroup analyses were then conducted to explore the potential differences across categories of sex and race. Data indicate that repeat bully victimizations experienced before the age of 12 were associated with higher levels of depression in late adolescence and adulthood. Gender subgroup analyses revealed that these relationships were specific to females only; levels of depression for male respondents were not related to repeat bully victimizations. Race subgroup analyses revealed that whites were primarily affected in late adolescence while non-whites were impacted in adulthood. Being the victim of a bully during childhood serves as a marker for subsequent mental health problems in late adolescence and adulthood. Prevention and intervention programs aimed at reducing mental health problems would benefit by targeting bully victimization occurring early in the life course.

Gyungjoo Lee has her expertise in teaching, research, and counselling for improving the mental health of clients and their families. She is a passionate professor who teachesnursing students about psychiatric mental health nursing atthe Catholic University of Korea. She is also interested in the development of a training program for enhancing the quality of Psychiatric-Mental Health Nurse professionals in South Korea. Her research field is family counselling for improving children’s mental health. She has been contributing to the community as an educator, researcher, and child and family counselor.

Advanced nurse practitioners play an important role in the improvement of mental health of the global population. Therefore, it is important to train quality mental health professionals and to improve their clinical competency through effective training programs.This study aimed to identify the role of supervision and professional efficacy in enhancing the professional competency of Psychiatric and Mental Health Nurse Practitioners(PMHNP) in South Korea. Itused a cross-sectional exploratory survey to establish a structural equation model of the role of quality supervision and professional efficacy in the relationship between quality of training institutions, the learned knowledge and skills, and professional competency. Study participants were 297 PMHNP working in hospitals and community mental health centers nationwide. They were conveniently recruited from 17 regions covering all of South Korea. They received a one-year training program and national license as mental health professionals based on mental health acts in South Korea. Participants were administered questionnaires that measuredthe quality of training, the quality of supervision, satisfaction with the overall training course, knowledge and skills learned in the training, professional efficacy, and professional competency. All measures were reliable with Cronbach’s alphas between .91 and .97. A structural equation model was conducted using AMOS 23.0. Overall model fits were good, with chi-square=133.53(p<.001), NFI=.91, TLI=.88, CFI=.92, and RMSEA=.12. The quality of supervision significantly improved the acquisition of knowledge and skills among PMHNP. Professional efficacy significantly mediated the relationship between knowledge and skills and professional competency. In order to train well-qualified mental health professionals with high competency, specific strategies to enhance the quality of supervision are needed. Effective educational contents and methods for improving not only professional knowledge and skills but also professional efficacy of mental health professionals should also be developed.