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Consortium Psychiatricum

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«Consortium Psychiatricum» is a scientific peer-reviewed medical journal, founded in 2020 by the Russian Society of Psychiatrists (RSP) and Russian Association for the Advancement of Science (RAAS).

Mission: to create an open international platform for publishing cutting-edge scientific papers on mental health

Topics: clinical psychiatry, biological and social psychiatry, psychology, psychotherapy, public mental health, epidemiology of mental disorders, neuroscience and fundamental research, interdisciplinary research

Publication formats: reviews, research articles, commentaries, clinical cases, special views and discussions

Periodical: 4 issues a year

Language: English

Peer-review: double blind

Subscription: open access to the journal is available on the web-site, paper version is distributed by the individual mailing list

Editor-in-Chief: professor George P. Kostyukdirector of Mental-health clinic No.1 named after N.A. Alexeev, chief expert in psychiatry of Moscow Healthcare Department

DEAR COLLEAGUES,

I am delighted to welcome you to the first issue of the Consortium Psychiatricum journal.

As you know, the word “consortium” means joining groups of people for a shared purpose. This paradigm is the cornerstone of modern science and it will serve as the basis of our editorial policy. “Another journal?” you may ask. “What can separate this journal from thousands of others?”

An acknowledged and respected trend in 21st century science (apart from joining interdisciplinary, international, intercultural collaborations) is to provide free access to knowledge. One special feature of our journal is that it provides open access to the content with no charge to the authors.

Another unique feature about Consortium Psychiatricum comes from the history of Russia and the history of science in Russia. For decades, Russian science in the field of psychiatry was, for various reasons, closed off from the rest of the world. However, in recent years Russian psychiatrists have become increasingly involved in professional collaborations all over the globe. My personal reason for starting this journal was understanding the need to make Russian psychiatry more visible on the global scientific scene. This process makes sense when it is mutual, i.e., Russian psychiatrists should also be more aware of global trends.

Consortium Psychiatricum aims to cover a wide range of mental health issues. Its mission is to provide a platform for sharing opinions on different aspects of mental health as well as to provide scope for cutting-edge research in the field.

For the first issue, we collected articles that we believe reflect current reality and contemporary concerns. We could not ignore the global challenge of the COVID-19 pandemic, and we give a general overview of the situation in the editorial article and present the results of a study performed in Russia. Modern approaches to known techniques are reflected in the systematic review on the use of virtual reality in cognitive behaviour therapy. Another “hot” topic is the development of available and non-restrictive mental help in the community. We start by publishing a series of articles about the organization of community-based psychiatry in countries allover the world. In the special cultural mental health issue, we reflect on the paradox of Islamophobia in our tolerant world. Additionally, the influence of infection on mental health is presented in the research article on toxoplasmosis and schizophrenia.

I want to thank all the authors, editors and reviewers who contributed to making the journal happen. While preparing this issue, shocking news came in from Lebanon regarding the explosion in Beirut. I want to express my sincere condolences to our colleagues from Lebanon and we appreciate their input to the journal despite the tragic disaster in their city.

I do hope that you will enjoy reading this journal. You are welcome to send us your papers and join our team of reviewers.

George P. Kostyuk,
Editor-in-Chief

Current issue

Vol 1, No 2 (2020)
View or download the full issue PDF

EDITORIAL

3-6 18
Abstract
The syndemic framework goes beyond the concept of comorbidity and considers how diseases interact within their wider environmental context, along with social and political factors, to mutually exacerbate negative outcomes. The syndemic approach enhances the way mental disorders are understood in terms of their aetiology, treatment and prognosis and therefore influences the direction of clinical practice, policy development and research priorities in the field of psychiatry. Using a syndemic framework to develop mental health policy globally can help address the mental health “treatment gap” in countries where resources are limited. In Russia, identified syndemics have been of particular relevance to mental disorders and further research using a syndemic framework will continue to build upon the strong background of integrated mental healthcare currently provided.

SPECIAL ARTICLE

7-13 16
Abstract

Similar to trends in Europe, approaches to mental illness in colonial America and recorded in early United States history were commonly characterized by incarceration and the removal of individuals from communities. In the mid-20th century, a major shift began in which treatment was offered in the community with the aim of encouraging individuals to rejoin their communities. In this paper, we will provide a brief history of community mental health services in the United States, and the forces which have influenced its development. We will explore the early antecedents of community-based approaches to care, and then detail certain factors that led to legislative, peer and clinical efforts to create ‘Community Mental Health Centers.’ We will then provide an overview of current community mental health practices and evolving challenges through to the present day, including the development of services which remain focused on recovery as the ultimate goal.

14-20 16
Abstract

Community mental health care in the UK was established by two influential mental health acts (MHAs). The 1930 MHA legislated for voluntary admissions and outpatient clinics. The 1959 MHA required hospitals to provide local follow- up after discharge, required them to work closely with local social services and obliged social services to help with accommodation and support. An effect of this was to establish highly sectorized services for populations of about 50,000. These were served by multidisciplinary teams (generic CMHTs), which accepted all local referrals from family doctors. Sector CMHTs evolved a pragmatic approach with an emphasis on skill-sharing and outreach, depending heavily on community psychiatric nurses. The NHS is funded by central taxation, with no distortion of clinical practice by per-item service fees. It is highly centrally regulated, with a strong emphasis on evidence-based treatments.

Since 2000, generic sector teams have gradually been replaced or enhanced by Crisis Resolution Home Treatment teams, Assertive Outreach Teams and Early Intervention Teams. Assertive Outreach Teams were resorbed into CMHTs, based on outcome evidence. The last decade has seen a major expansion in outpatient psychotherapy (Improving Access to Psychological Treatments (IAPT) services) and in specialist teams for personality disorders and perinatal psychiatry. The traditional continuity of care across the inpatient-outpatient divide has recently been broken. During the last decade of austerity, day care services have been decimated, and (along with the reduction in availability of beds) compulsory admission rates have risen sharply. Mental health care is still disadvantaged, receiving 11% of the NHS spend while accounting for 23% of the burden of disease.

21-27 10
Abstract

Community-based mental health services are important for the treatment and recovery of patients with mental health disorders. The Chinese government has made the establishment of a highly efficient community-based health service an enduring priority. Since the 1960s, community-based mental health services have been developed in many Chinese cities and provinces. National policies, including mental health regulations and five-year national mental health working plans, have been issued to support the development of quality of mental health services. The accessibility and efficiency of community-based mental health services are now highly promoted to community residents.

According to the National Standards for Primary Public Health Services, community-based mental health services are one of the most important components of primary public health services. They are mainly provided via Community Health Service Centres (CHCs), by a combination of general practitioners, public health physicians, nurses and social workers. Patients receive individualized and continuous health services according to their rehabilitation status. These services include regular physical examination, health education, rehabilitation guidance, social function rehabilitation training, vocational training and referral services; family members also receive care and psychological support. Future work will focus on expanding mental health service coverage and usage, increasing awareness of mental health and decreasing stigma, and strengthening service capability to establish an integrated model to enhance the overall efficiency of mental health services.

REVIEW

43-51 19
Abstract

Background. Cariprazine is a new piperazine derivative atypical antipsychotic, like aripiprazole and brexpiprazole. It has been approved for treating schizophrenia in many countries and has recently been included on the List of Essential Medicines in Russia. Unlike most other atypical antipsychotics, it shows high in vivo occupancy of dopamine D2 and D3 receptors at clinically relevant doses. In animal models, cariprazine has demonstrated dopamine D3 receptor- dependent pro-cognitive and anti-anhedonic effects, suggesting its potential for treating negative symptoms. This review summarizes the efficacy of cariprazine in the treatment of negative symptoms of schizophrenia.

Methods. A literature search of databases covering international and Russian journals, for articles published between 1st January 2010 and 1st June 2020.

Results. Cariprazine demonstrated at least comparable efficacy in the treatment of schizophrenia symptoms to active comparators including risperidone, olanzapine or aripiprazole. The drug has a good safety profile. It appeared to be associated with a lower risk of metabolic syndromes and most extrapyramidal symptoms. The positive effect of cariprazine on the negative symptoms of schizophrenia may be associated with the elimination of secondary negative symptoms. However, of all the atypical antipsychotics to date, only cariprazine has a convincingly, methodologically robust proven advantage over risperidone in eliminating the predominant negative symptoms of schizophrenia. Yet only four studies have investigated the effect of cariprazine on the negative symptoms of schizophrenia. There is a lack of research into its direct impact on emotional-volitional disorders, anhedonia, cognitive symptoms and personality changes. However, there is evidence to suggest cariprazine is effective in treatment-resistant cases, but this requires further confirmation.

Conclusion. Cariprazine is an effective and well-tolerated agent for the treatment of schizophrenia and may be effective in cases where other antipsychotics have failed. Cariprazine has been shown to have a positive effect on negative symptoms. Further studies are needed to collect more data on long-term treatment of schizophrenia and especially negative symptoms.

29-42 13
Abstract

Depression is the third most common illness among patients with schizophrenia which negatively affects the course of the disease and significantly contributes to the mortality rate, due to increased suicide. Depression, along with negative symptoms and cognitive deficits, is one of the main factors that significantly decreases the quality of life and the disease prognosis in patients with schizophrenia. In addition, depression increases the frequency of exacerbations and readmissions, decreases the quality and duration of remissions and is associated with more frequent substance abuse and an increased economic burden. Data on the prevalence of depression among patients with schizophrenia are contradictory and are associated with a low detection rate of depression in such patients, a lack of clear diagnostic criteria and difficulties in differentiation between extrapyramidal and negative symptoms. The average prevalence of depression that meets the diagnostic criteria of major depressive episodes in patients with schizophrenia is 25% at a specific point, and 60% over the course of a lifetime; the frequency of subsyndromal depression is much higher. It is essential to distinguish between primary (axial syndrome) and secondary depressive symptoms (extrapyramidal symptoms, psychogenic or nosogenic reactions, social factors, etc.) to determine treatment strategies.

The published data relating to randomized clinical trials for the development of evidence-based guidelines are limited. Current recommendations are based mainly on the results of small-scale trials and reviews. Certain atypical antipsychotics (quetiapine, lurasidone, amisulpride, aripiprazole, olanzapine, clozapine) are superior to typical antipsychotics in the reduction of depressive symptoms. Clozapine is effective in the management of patients at risk from suicide. The additional prescription of antidepressants, transcranial magnetic stimulation and electroconvulsive therapy are not always effective and are only possible following the management of acute psychosis in cases when antipsychotic monotherapy proved to be ineffective.

CASE REPORT

53-62 12
Abstract

This article discusses case reports of treatment with paliperidone palmitate in comparison with data from recent publications. Second-generation long-acting injectable antipsychotics have been shown to provide better control of psychiatric manifestations, reduce the severity of negative symptoms, improve social functioning and quality of life of patients and relatives, and reduce the burden of disease for both the healthcare system and the caregivers. The case reports presented in this article demonstrate better quality of remission in schizophrenia patients treated with one- monthly and three-monthly paliperidone palmitate formulations, due to higher effi  in preventing relapses, better safety and good tolerability regardless of patient age.

COMMENTARY

64-71 13
Abstract

Commentary on the COVID-19 pandemic must necessarily consider the medical issues in social and political context. This paper discusses one important dimension of the context, the long-term history of human activity as intrinsically technological in its nature. The pandemic has accelerated the use of technology to mediate relations between people “at a distance”. This involves not only a change in the skills people have (though acquiring these skills has become the central project of work for many people), but changes the sort of person they are. Our notions of “closeness” and “distance”, or of “touching” and “being touched”, and so on, refer simultaneously to states that are spatial and emotional, factual and evaluative. Inquiry into the differences in human relations where there is physical presence and where there is not raises very significant questions. What are the differences and why are they thought, and felt, to matter? What are the differences when the relationship is supposed to be a therapeutic one? What are the financial and political interests at work in enforcing relations at a distance by new media, i.e., “mediated” relations? How is a person’s agency affected by a lack of freedom to move or a lack of face-to-face contact? What happens to all those human relations for which physical presence was previously the norm, relations such as those performed in the rituals of birth, marriage and death, or in activities like sport and the arts? Can it be said that new technologies involve a “loss of soul”? The present paper seeks to provide a reflective and open-ended framework for asking such questions.

INFORMATION

72-76 32
Abstract

Mental health and psychological education activities are being carried out in Moscow (the Russian Federation), along with measures aimed at prevention of social stigma in mental health care. The medical, social and educational project To Say or Not to Say has been developed by a group of experts from the Mental-health clinic No. 1 named after N.A. Alexeev, for Moscow residents. The title chosen for the project urges participants to make a choice: continue living with their problems or take a step towards solving them. A new educational activity format has been created and tested in the course of the project, and this format provides an opportunity to largely overcome the stigmatizing barriers that prevent people from seeking psychological and psychiatric help in Moscow. Sixteen events involving over 7,000 citizens have been held, and the psychiatrists engaged in the project have spent 2,280 man-hours in this volunteering activity. We believe that this educational activity could help to overcome social stigma in psychiatry, further research is needed to measure the effect of our educational project on social stigma associated with mental health.



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