The epidemiology of schizophrenia among Caribbean-born and first- and second-generation migrants in Britain

The study of migrants in their new environments is often a useful means of investigating environmental influences on health. Migrants have been found to develop higher rates of mental illness compared to their counterparts who remain at home. These deleterious effects of migration have been attributed to selection factors and stressful life experiences. Migration from an agricultural and traditional society to an urban industrial society where value systems can be demanding, often leads to role strain and role conflict. These kinds of incongruities are the beginning of a series of stressful experiences that contribute to poor health/mental health status. The extent to which one experiences stress is dependent on a number of factors. First, it depends on the perceived difference between home and the new environment. Second, it depends on the cultural homogeneity of the new environment, that is, the extent to which the migrant is readily assimilated into the new culture or is able to maintain a traditional lifestyle by living in an ethnic enclave, and the psychological resources available to successfully access services in the new environment. This paper examines the rates, incidence, and prevalence of schizophrenia found in Caribbean-born immigrants to Britain, and first- and second-generation people of Caribbean background born in Britain. It is argued that Afro-Caribbean people in England are overrepresented in the diagnosis of schizophrenia. Factors that may contribute to this finding range from unemployment, social disadvantage status, social adversity, racism in the health and criminal justice systems, and misdiagnosis.This paper was completed when the author served as Distinguished Visiting Professor-William Patterson College, Wayne, New Jersey.     

Trauma and health risk behaviors in people with severe mental illness

The current study tests the association between a composite measure of unsafe sex and sharing syringes for drug use with six of the more common lifetime traumatic/stressful events in 421 community mental health clients with severe mental illness (SMI) while controlling for psychiatric symptoms and related problems. A small but significant proportion of respondents said they had injected drugs with a shared needle in their lifetime (30, 7.2%), and a much larger proportion of respondents had engaged in unprotected sex (165, 39.2%). Unprotected sex and needle sharing were significantly correlated (Spearman’s rho = .20, p < .01). Frequency of lifetime traumatic events that occurred at least once was reported by one third to three quarters of clients depending on type of trauma. Regression analysis revealed that substance abuse and lifetime homelessness were significantly correlated with health risk behaviors. Practitioners need to be continuously vigilant to comorbid substance use and the housing needs of people with SMI. Limitations of the study include its cross-sectional design.     

精神分裂分析：解析资本主义的新视角——读《反俄狄浦斯：资本主义与精神分裂症》

在《反俄狄浦斯：资本主义与精神分裂症》中，法国当代哲学家吉莱斯·德勒兹与利克斯·瓜塔里认为，弗洛伊德的俄狄浦斯情结是人们心中的欲望源泉，又是资本主义统治的基础。因此，为了使人们能够挣脱资本主义，欲望本能需转向为欲望机器。通过精神分裂分析，他们提出了精神分裂症患者才是“去俄狄浦斯化”的革命代理人，这与马克思分析资本主义造就自己掘墓人的思想如出一辙。     

Evidence-Based Social Work Practice with Mentally Ill Persons who Abuse Alcohol and Other Drugs

Abstract

The current article outlines a comprehensive approach to evidence-based social work practice, and applies it to persons with severe and persistent mental illness who also abuse alcohol and other drugs. Representative empirical literature is summarized within a framework that delineates the three major functions of evidence-based social work practice: assessment, intervention and evaluation. Assessment protocol, which incorporates the use of valid scales to complement the qualitative interview, is based on domain-specific research that outlines relevant psychosocial risk factors, and highlights those that are amenable to change. Intervention strategies are derived from the growing body of controlled research findings, but flexibility in implementation is recommended to accommodate clients' individual needs and the vagaries of daily practice. Naturalistic evaluation methods are used to capitalize on the use of brief, valid process and outcome measures to augment individual qualitative evaluation and to aggregate data for program evaluation. The implications of this integrated evidence-based strategy for social work practice are discussed.     

Cultural influences upon psychopathology: Clinical and practical implications

Information on the role of cultural factors in abnormal behavior and experience is selectively reviewed, and several conclusions are drawn about the nature, extent, and impact of such influence. Although a number of demonstrated universals exist in the manifestations of schizophrenia and depression, the scope of cultural variation in all aspects of psychopathology is vast. Both universalist and relativist positions in their pure or exclusive form are rejected and the view is espoused that psychological manifestations are the joint result of panhuman and culture-specific factors. Several conclusions concerning the operation and the results of such influences are presented and the issues that are as yet unresolved are identified. The self is introduced as the key concept in explaining both the constancy and the variation of experience across cultures and four dimensions derived from Hofstede's worldwide multicultural research are described. Their potential relevance is spelled out for systematically investigating the culturally preferred and/or characteristic modalities of psychotherapy.     

Is it schizophrenia or spirit possession?

This paper addresses the question of whether spirit possession, a concept with a religious/spiritual base, is, in fact, more accurately defined as a major symptom of a mental disorder, such as schizophrenia, and according to the Eurocentric tradition, should be treated with psychotropic medication and psychotherapy. On the other hand, should this culturally determined phenomenon and such alternative curative interventions as spiritual healing be more seriously examined as viable ways of defining and treating mental illness? The way in which the self is defined and understood, within different cultural contexts, is employed to explore the differing ways in which psychotic symptoms are understood and ultimately treated.     

新型注射用利培酮微球的药效学研究

制备了新型注射用利培酮微球(NRMI),采用5-HTP诱导大鼠甩头和APO诱导大鼠过度活动模型,与商品注射用利培酮微球(恒德)进行对比,评价了NRMI的药效优势.结果显示,NRMI和恒德对大鼠甩头和过度活动均有抑制作用,NRMI给药后立即起效,维持约3～4周,而恒德给药3周后起效,维持约2周.表明NR-MI起效时间早于恒德,且维持时间长于恒德,如用于临床治疗依从性可能优于恒德.     

Speech Timing of Mood Disorders

Summary

Computerized evaluation of pauses between spoken words can be conducted in the medical office or over the telephone. Frequency and duration of long speech hesitation pauses (LP = > 1 sec.) can be correlated with coronary-risk and mood. Pauses of 100 + msec are sorted into many fluency levels. Peak fluency of LP irrespective of pause-time, and at maximal pause-time, are behavioral correlates of mood. At intermediate fluency they are explained by left-hemisphere, right-hemisphere and interhemispheric transit, respectively. Short pauses (SP = < 1 sec.) sorted at these fluency nodes monitor competence of asymmetric and interhemispheric brain functions. Diurnal mood variation is monitored by comparing the morning and evening frequency and duration of the patient's pauses. The frequency of pauses within < 1.16 second may diagnose manic mood modulated by the basal region of the right temporal lobe. LP and SP may monitor interrelationships among mood and thought disorders subserved by the left dorsal prefrontal cortex.     

The Jam Session

This experiment describes a spontaneous jazz performance and shows that the jam session can be a useful tool for studying small groups. To determine why and how it works, the author brought together five jazz musicians and gave them three musical tasks. They also participated in a post-performance discussion and filled out a questionnaire to elicit their feelings about the workings of a jam session. The jam session may be a unique group because of the speed with which it coalesces and its use of nonverbal communication, but it also exhibits classic characteristics of small group sociology by conforming to several basic small-group models and principles.