Matthias C. Angermeyer

The aim of this study was to compare users’ and mental health workers’ (MHW) perception of respect of human rights and job/care satisfaction in mental health services in Italy during the COVID-19 pandemic. A sample of users and MHW of Sardinia, Italy, fulfilled the “Well-Being at work and respect for human rights questionnaire” (WWRR). The study included 240 MHW and 200 users. Users showed a higher level of satisfaction of care than MHW of work, and a higher perception of the satisfaction of users and human rights respected for health workers. Both user and MHW responses were about 85% of the maximum score, except for satisfaction with resources. Responses were higher for users, but users and MHW both showed high levels of satisfaction. In previous surveys, MHW of Sardinia showed higher scores in all items of WWRR, except for satisfaction with resources, compared with workers from other health sectors of the same region, and with MHW from other countries. The low score for satisfaction with resources (in users and staff) is consistent with a progressive impoverishment of resources for mental health care in Italy. The study, although confirming the validity of the Italian model, fully oriented towards community, sets off an alarm bell on the risks resulting from the decrease in resources.

This study aimed to examine the association of alcohol and tobacco use with severity of depression in older age. Analyses were performed on a pooled data set (n = 3724) from two German old-age cohort studies (LEILA 75+, 6 follow-ups and AgeCoDe/AgeQualiDe, 9 follow-ups). Depressive symptoms were assessed via two screening scales for depression (CES-D and GDS-15) which were harmonized for pooled analysis. A mixed-effects linear regression model for the total sample and additional stratified models for men and women were used. Smoking at baseline was significantly associated with a higher level of depression severity (β = 0.142, 95% CI: 0.051–0.233, p = 0.002), whereas drinking was significantly associated with a decreased level of depression (β = −0.069, 95% CI: −0.119–−0.021, p = 0.005). Concurrent substance use at baseline increased longitudinal depression severity (β = 0.193, 95% CI: 0.011–0.375, p = 0.037). Analyses stratified by gender showed a significant inverse association between drinking and depressive symptoms in men (β = −0.138, 95% CI: −0.231–−0.045, p = 0.004), but not in women (β = −0.060, 95% CI: −0.120–0.001, p = 0.052). Given the burden of major depression, it is important that health care providers, especially primary care physicians, assess and monitor lifestyle factors, even at older ages.

The purpose is to verify trends of scientific production from 2010 to 2020, considering the best universities of the United States, China, the European Union (EU), and private companies. The top 30 universities in 2020 in China, the EU, and the US and private companies were selected from the SCImago institutions ranking (SIR). The positions in 2020, 2015, and 2010 in SIR and three sub-indicators were analyzed by means of non-parametric statistics, taking into consideration the effect of time and group on rankings. American and European Union universities have lost positions to Chinese universities and even more to private companies, which have improved. In 2020, private companies have surpassed all other groups considering Innovation as a sub-indicator. The loss of leadership of European and partly American universities mainly concerns research linked to the production of patents. This can lead to future risks of monopoly that may elude public control and cause a possible loss of importance of research not linked to innovation.

Background: In recent years there is a growing interest in public beliefs about mental disorders. Numerous representative population-based studies have been conducted around the globe, also in European countries bordering on the Mediterranean Sea. However, relatively little is known about public beliefs in countries in Northern Africa. Objective: To fill this gap by comparing public beliefs about mental disorders in Tunisia and Germany, focusing on causal beliefs, help-seeking recommendations and treatment preferences. Methods: Representative national population-based surveys have been conducted in Tunisia in 2012 (N = 811) and in Germany in 2011 (N = 1852), using the same interview mode and the same fully structured interview starting with a vignette depicting a person suffering from either schizophrenia or depression. Results: In Tunisia, the public was more likely to adopt psychosocial and to reject biogenetic explanations than in Germany. Correspondingly, psychological treatments were more frequently recommended and biological ones more frequently advised against. There was also a strong inclination to share religious beliefs and to recommend seeking religious advice. Tunisians tended much more than Germans to hold moralistic views and to blame the afflicted person for his or her illness. In Tunisia, the public tended less to differentiate between schizophrenia and depression than in Germany. Conclusion: Marked differences between Tunisia and Germany exist in public beliefs about the causes of mental disorders and their treatment, which correspond to differences in cultural orientations prevailing in these countries. Mental health professionals need to be sensitive to the particular cultural context in which they operate, in order to be able to reach those they intend to care for.

In Vietnam, the mental health care infrastructure is on the verge of transformation with an increase in the demand for access to adequate and effective mental health care services. Public attitudes towards mental illness, as well as corresponding treatment options influence help-seeking behaviors of patients and caregivers, affecting the course of their treatment. This study assesses attitudes towards treatment options for depression and schizophrenia, as the two most common psychiatric disorders in Vietnam, accounting for at least 75% of all psychiatric inpatients. A general population-based survey was conducted in Hanoi, Vietnam between April and August 2013. Participants received a description of a person with symptoms of either depression (n = 326) or schizophrenia (n = 403) and were asked to give recommendations for adequate sources of mental health support and treatment options. Multiple analyses on a single item level compared the likelihood of recommendation between schizophrenia and depression. Overall, respondents recommended health care services, ranging from seeking mental health care professionals, psychotherapists, and psychiatrists for both disorders. Psychotherapy was the most favored treatment method, whereas further treatment options, such as concentration and relaxation exercises, meditation or yoga and psychotropic medication were also endorsed as helpful. For the schizophrenia vignette condition, psychotherapy, visiting a psychiatrist or psychotherapist received stronger endorsement rates as compared to the depression vignette. Furthermore, ECT, Feng Shui-based practices, praying and visiting natural healers were recommended less by respondents for the depression vignette in comparison with the schizophrenia vignette. The Vietnamese public endorsed evidence-based treatment recommendations from a variety of treatments options. Differences in the treatment recommendations between depression and schizophrenia reflected the perceived severity of each disorder. Further developments of the Vietnamese mental health care system concerning mental health care providers, as well as the legal regulations surrounding the provision of psychotherapy are needed.

Zusammenfassung: Ziel Analyse der Entwicklung der psychiatrischen Einstellungsforschung in Deutschland. Methode Historischer Überblick auf der Basis systematischer Reviews. Ergebnisse Die Einstellung der Bevölkerung zu psychisch Kranken und zur Psychiatrie wurde ursprünglich aus soziologischer Perspektive untersucht, später dominierte die sozialpsychologische bzw. individualpsychologische Perspektive. Schlussfolgerung Auch wenn dieser Ansatz wichtige Einblicke in die dem Stigma zugrunde liegenden Prozesse erlaubte, erscheint es an der Zeit die individuelle Perspektive durch eine gesellschaftliche zu ergänzen.

Introduction: In Vietnam, as well as in other low and middle-income countries, stigmatization and discrimination of mentally ill patients is highly prevalent.Objectives: It is important to identify determinants of stigmatization in a socio-cultural context as they may reveal anchor points for anti-stigma efforts.Aims: This population based study conducted in urban and rural Hanoi aims to explore whether public perception of prognosis and course of illness concerning people with symptoms indicating schizophrenia have an impact on the desire for social distance, an important factor of stigmatization.Methods: Based on a population survey using unlabelled vignettes for schizophrenia carried out in the greater Hanoi area in 2013, a sum score of the Social Distance Scale was calculated. A regression analysis was carried out to examine the impact perception of prognostic factors on the desire for social distance. The stratification of the sample (n = 455) was representative in terms of gender, age, urbanity and household size to the Hanoi population according to the 2013 census.Results: Factor analysis revealed three independent factors of prognosis perception:– 1. lifelong dependency on others;– 2. loss of social integration and functioning;– 3. positive expectations towards treatment outcome.Both negative prognostic ideas (1,2) were significantly correlated with more desire for social distance in schizophrenia.Conclusion: Stronger desire for social distance was observed among people with negative expectations about the prognosis of persons suffering from psychotic symptoms. Thus, our study indicates a link between social acceptance and ability to maintain a social role in the Vietnamese society.Disclosure of interest: The authors have not supplied their declaration of competing interest.

Subjective cognitive decline (SCD), i.e., the self-perceived feeling of worsening cognitive function, may be the first notable syndrome of preclinical Alzheimer’s disease and other dementias. However, not all individuals with SCD progress. Stability of SCD, i.e., repeated reports of SCD, could contribute to identify individuals at risk, as stable SCD may more likely reflect the continuous neurodegenerative process of Alzheimer’s and other dementias. Cox regression analyses were used to assess the association between stability of SCD and progression to MCI and dementia in data derived from the population-based Leipzig Longitudinal Study of the Aged (LEILA75+). Of 453 cognitively unimpaired individuals with a mean age of 80.5 years (SD = 4.2), 139 (30.7 %) reported SCD at baseline. Over the study period (M = 4.8 years, SD = 2.2), 84 (18.5 %) individuals had stable SCD, 195 (43.1 %) unstable SCD and 174 (38.4 %) never reported SCD. Stable SCD was associated with increased risk of progression to MCI and dementia (unadjusted HR = 1.8, 95 % CI = 1.2–2.6; p < .01), whereas unstable SCD yielded a decreased progression risk (unadjusted HR = 0.5, 95 % CI = 0.4–0.7; p < .001) compared to no SCD. When adjusted for baseline cognitive functioning, progression risk in individuals with stable SCD was significantly increased in comparison to individuals with unstable SCD, but not compared to individuals without SCD. Our results, though preliminary, suggest that stable SCD, i.e., repeated reports of SCD, may yield an increased risk of progression to MCI and dementia compared to unstable SCD. Baseline cognitive scores, though within a normal range, seem to be a driver of progression in stable SCD. Future research is warranted to investigate whether stability could hold as a SCD research feature.