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  1. Tay AK, Miah MAA, Khan S, Badrudduza M, Morgan K, Balasundaram S, et al.
    Epidemiol Psychiatr Sci, 2019 Aug 23;29:e47.
    PMID: 31441397 DOI: 10.1017/S2045796019000416
    AIMS: Refugees are confronted with the task of adapting to the long-term erosion of psychosocial systems and institutions that in stable societies support psychological well-being and mental health. We provide an overview of the theoretical principles and practical steps taken to develop a novel psychotherapeutic approach, Integrative Adapt Therapy (IAT), which aims to assist refugees to adapt to these changes. This paper offers the background informing ongoing trials of IAT amongst refugees from Myanmar.

    METHODS: A systematic process was followed in formulating the therapy and devising a treatment manual consistent with the principles of the Adaptation and Development After Persecution and Trauma (ADAPT) model. The process of development and refinement was based on qualitative research amongst 70 refugees (ten from West Papua and 60 Rohingya from Myanmar). The therapeutic process was then piloted by trained interventionists amongst a purposively selected sample of 20 Rohingya refugees in Malaysia.

    RESULTS: The final formulation of IAT represented an integration of the principles of the ADAPT model and evidence-based techniques of modern therapies in the field, including a transdiagnostic approach and the selective use of cognitive behavioural treatment elements such as problem-solving and emotional regulation techniques. The steps outlined in refining the manual are outlined in relation to work amongst West Papuan refugees, and the process of cultural and contextual modifications described during early piloting with Rohingya refugees in Malaysia.

    CONCLUSIONS: IAT integrates universal principles of the ADAPT model with the particularities of the culture, history of conflict and living context of each refugee community; this synthesis of knowledge forms the basis for participants gaining insights into their personal patterns of psychosocial adaptation to the refugee experience. Participants then apply evidence-based techniques to improve their capacity to adapt to the serial psychosocial changes they have encountered in their lives as refugees. The overarching goal of IAT is to provide refugees with a coherent framework that assists in making sense of their experiences and their emotional and interpersonal reactions to the challenges they confront within the family and community context. As such, the principles of a general model (ADAPT) are used as a springboard for making concrete, manageable and meaningful life changes at the individual level, a potentially novel approach for psychosocial interventions in the field.

  2. Heim E, Henderson C, Kohrt BA, Koschorke M, Milenova M, Thornicroft G
    Epidemiol Psychiatr Sci, 2019 Apr 01;29:e28.
    PMID: 30929650 DOI: 10.1017/S2045796019000167
    AIMS: This systematic review compiled evidence on interventions to reduce mental health-related stigma among medical and nursing students in low- and middle-income countries (LMICs). Primary outcomes were stigmatising attitudes and discriminatory behaviours.

    METHODS: Data collection included two strategies. First, previous systematic reviews were searched for studies that met the inclusion criteria of the current review. Second, a new search was done, covering the time since the previous reviews, i.e. January 2013 to May 2017. Five search concepts were combined in order to capture relevant literature: stigma, mental health, intervention, professional students in medicine and nursing, and LMICs. A qualitative analysis of all included full texts was done with the software MAXQDA. Full texts were analysed with regard to the content of interventions, didactic methods, mental disorders, cultural adaptation, type of outcome measure and primary outcomes. Furthermore, a methodological quality assessment was undertaken.

    RESULTS: A total of nine studies from six countries (Brazil, China, Malaysia, Nigeria, Somaliland and Turkey) were included. All studies reported significant results in at least one outcome measure. However, from the available literature, it is difficult to draw conclusions on the most effective interventions. No meta-analysis could be calculated due to the large heterogeneity of intervention content, evaluation design and outcome measures. Studies with contact interventions (either face-to-face or video) demonstrated attitudinal change. There was a clear lack of studies focusing on discriminatory behaviours. Accordingly, training of specific communication and clinical skills was lacking in most studies, with the exception of one study that showed a positive effect of training interview skills on attitudes. Methods for cultural adaptation of interventions were rarely documented. The methodological quality of most studies was relatively low, with the exception of two studies.

    CONCLUSIONS: There is an increase in studies on anti-stigma interventions among professional students in LMICs. Some of these studies used contact interventions and showed positive effects. A stronger focus on clinical and communication skills and behaviour-related outcomes is needed in future studies.

  3. Maruta T, Matsumoto C
    Epidemiol Psychiatr Sci, 2019 Jun;28(3):262-264.
    PMID: 30370893 DOI: 10.1017/S2045796018000598
    The movement towards renaming of schizophrenia in Japan started in 1993 upon receipt of a letter by The National Federation of Families with Mentally Ill in Japan addressed to the board of Japanese Society of Psychiatry of Neurology (JSPN), requesting to rename schizophrenia as the then-official term for the condition, Seishin-Bunretsu-Byo, or 'mind-splitting disease', was humiliating. A committee was established within JSPN to address the issue, public comments were collected, a new name 'Togo-Shitcho-Sho' ('disintegration disorder') was approved in 2002, and in 2005, the new name was adopted in the Revised Mental Health and Welfare Act. This paper describes the process of renaming, and also the current situation in Korea, Taiwan, China, Hong Kong and Malaysia, where Chinese characters are used. Also, it presents alternative names for schizophrenia that have been suggested in the process of two research projects conducted by the authors and also additional candidates suggested by others.
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