RESUMEN
Background Prejudice, stigma and discrimination against people with mental health problems are largely responsible for their limited social participation. Joining the globalised wokeness movement could reduce the tendency of social injustice. Aim To explore the reasons why people with mental health problems experience difficulties to integrate into the wokeness debate and to suggest possible solutions. Results Intersectionality, persons with mental health problems often being part of different vulnerable minority groups, stress and public stigma, are the main reasons of the limited level of advocacy for this target group. Conclusion The struggle against social injustice that mental vulnerable persons are victims of, remains unequal even in times of wokeness. A strategic, non-patronising cooperation between psychiatrists, patients, family members and interest groups in the media and in the public and political forum, could make it possible to join the international wokeness movement.
Asunto(s)
Trastornos Mentales , Familia/psicología , Humanos , Trastornos Mentales/psicología , Estigma SocialRESUMEN
BACKGROUND: Although the efficacy of antidepressants has been clearly established, 30-60% of patients with major depressive disorder (MDD) appear to have a poor response. However, many patients labeled with treatment-resistant depression actually have pseudo-resistance due to suboptimal approach. AIM: To provide an overview of the causes of pseudo-resistance, as well as the interventions to counteract it in patients with MDD. METHOD: A literature search was conducted using the PubMed, Embase, and Web of Science databases. RESULTS: The causes of pseudo-resistance can be multiple and can be attributed to both the clinician (inappropriate prescribing behavior, misdiagnosis or incomplete diagnosis) and the patient (ultra-fast metabolism, poor medication adherence, comorbidity). Advice and interventions to prevent pseudo-resistance must therefore be targeted to the clinician (knowledge of clinical guidelines, simplified dosage schedules, correct diagnosis, interventions to improve poor medication adherence), as well as the patient (personalized psychoeducation, social support, care management). CONCLUSION: Pseudo-resistance is a multifactorial phenomenon that requires complex intervention strategies. In addition to adequate treatment provided by the clinician, personalized psychoeducation, good patient support and intensive follow-up of, as well as open communication with the patient are also required.
Asunto(s)
Antidepresivos/uso terapéutico , Trastorno Depresivo Mayor/tratamiento farmacológico , Prescripción Inadecuada , Cumplimiento de la Medicación , Conducta , Comorbilidad , Trastorno Depresivo Mayor/psicología , Errores Diagnósticos , HumanosRESUMEN
BACKGROUND: Stigma is one of the greatest challenges facing people with severe mental illness (smi) and can have profound psychological, social and professional consequences.
AIM: To systematically review the evidence of effectiveness of anti-stigma interventions (anti-stigma campaigns and specific interventions to reduce public stigma and self-stigma) for people with smi and to make recommendations for clinical practice.
METHOD: A systematic literature search for individual studies and reviews concerning the efficacy of interventions that reduce stigma for people with smi.
RESULTS: Anti-stigma interventions have small-to-medium effects. Although head-to-head comparisons do not show a clear advantage for educational or contact interventions, results suggest that the elements of contact, recovery and continuity (for public stigma) and psycho-education (for self-stigma) may yield the greatest effects. Due to the short follow-up period of most studies, there is limited evidence on the long-term effectiveness of these interventions. More specifically, it remains unknown whether these interventions lead to changes in actual behavior.
CONCLUSION: Anti-stigma interventions have limited effects on knowledge, attitudes and behavior. Several methodological shortcomings, as well as short follow-up periods in most studies, preclude making firm conclusions.