To Di World: Jamaican soccer, poiesis and post-colonial transformation.

This article presents a case study of an innovative culturally based therapeutic approach using collective poiesis to improve the functioning of a youth sports team in Jamaica. In recent decades, Jamaica has endured high levels of violence and corruption, and has been ranked among the top four countries in the world in terms of murder rate per capita. We conjecture that a high prevalence of personality disorder linked to the legacy of slavery and colonialism often impedes Jamaicans from achieving success in diverse fields, including sports. Psychological interventions in the preparation of football teams are a novelty, and have been used mainly to enhance global team performance or individual player skill. The use of psychological interventions to address personality disorder psychopathology on the soccer pitch has not been reported. Psychohistoriographic cultural therapy (PCT) integrates psychological perspectives with a dialectic method of historical analysis and uses collective poiesis as a vehicle to translate insights through an embodied cognitive restructuring process. Two workshops were carried out with a high school football team using PCT techniques. The process of dialectic reasoning engaged their collective ideas and insights to establish a psychic centrality that was expressed in poetic form to illustrate the pathologies of the group in an emotionally safe and psychologically acceptable narrative. This poetic narrative of the group's psychic centrality counters the personality disorder psychopathology caused by the lingering intergenerational wounds of slavery, colonial oppression and collective trauma.

Psychedelic Assisted Psychotherapy preparing your target using psychohistoriography: a Jamaican perspective.

The efficacy of psilocybin and other psychedelics as modes of treatment have been demonstrated through clinical trials and other studies in the management of a number of mental illnesses, including some treatment resistant cases. In Psychedelic Assisted Psychotherapy (PAP), psychedelics catalyze or enhance the experience fostered by psychotherapeutic methods. Psychohistoriographic Brief Psychotherapy, conceptualized by the late Professor Frederick Hickling in the 1970's in Kingston, Jamaica, offers a pathway for exploration in the Jamaican context. Applied to individuals, Psychohistoriographic Brief Therapy (PBT) has already shown success in patients with personality disorders in Jamaica through a process which includes documenting life experiences in a psychohistoriogram. In the De La Haye psilocybin Treatment Protocol (DPTP), micro-doses of crushed, dried psilocybin mushrooms are taken throughout an 8-week outpatient process of documenting the components of the psychohistoriogram, making use of the increased openness and empathy associated with the use of psychedelic agents. These sessions are followed by supervised in-office therapeutic/mystical doses of crushed, dried psilocybin mushrooms in the 9th week. Given the legal status and availability of psilocybin containing products in a few countries like Jamaica, there is a potential role for a regulated psychedelic industry contributing to the body of useful and rigorous clinical research which is needed in this area. Clients could benefit as we venture into this new frontier in psychiatry.

Prevalence and sociodemographic factors associated with polysubstance use: analysis of a population-based survey in Jamaica.

BACKGROUND: In Latin America and the Caribbean, there is a dearth of research exploring polysubstance use. This study aims to determine the prevalence, varying combinations and associated sociodemographic characteristics of polysubstance use in Jamaica. METHODS: This study involved a secondary data analysis of the Jamaica National Drug Prevalence Survey 2016 dataset where 4,623 participants between the age of 12 and 65 years from each household were randomly selected as respondents. Statistical analysis was performed to determine the prevalence and the sociodemographic correlates of polysubstance use among Jamaicans. RESULTS: 19.6% of respondents used two or more drugs in their lifetime. Of this amount 68.7% reported past year use and 61.9% reported past month use. Bivariate analyses reported polysubstance use was statistically significantly higher amongst males (U = 54,579, p = 0.000), those living in rural areas (U = 91,892, p = 0.003), non-Christian (U = 89,514, p = 0.014), and married persons (U = 74,672, p = 0.000). Past month polysubstance use was statistically significantly higher among employed persons than unemployed persons were (U = 81,342, p = 0.001). Surprisingly, there was a lack of significant differences between education level, household income and past month concurrent polysubstance use (p = 0.609; p = 0.115 respectively). Logistic regression model indicated males were 3.076 times more likely than females to report past month polysubstance use than females. Also, when compared to those 55-65 years old, participants 35-54 years were 2.922 times more likely and those 18-34 years were 4.914 times more likely to report past month polysubstance use. Additionally, those living in rural areas were 1.508 times more likely than participants living in urban areas to report past month polysubstance use. As it relates to occupational status, when compared to armed forces, skilled workers were 4.328 times more likely and unskilled workers were 7.146 times more likely to report past month polysubstance use. CONCLUSIONS: One in five Jamaicans identified as polysubstance users, predominated by marijuana as the most common factor amongst the polysubstance combinations examined, signalling the need for early marijuana interventions.

Prevalence, perceived risk and associated factors of tobacco use amongst young, middle-aged and older adults: analysis of a national survey in Jamaica.

Introduction: tobacco smoking remains a significant threat to public health. This paper sought to examine the prevalence, perceived risk and the associated factors of current tobacco use amongst Jamaican adults. Methods: this study is a secondary data analysis of the Jamaican National Household Survey 2016. The data for this study was extracted from a pre-coded questionnaire using a standardized extraction sheet. Adults were categorized into young adults (18-35), Middle-aged adults (36-55) and Older adults (56 and older) groups. Statistical analysis was performed to determine the prevalence, perceived risk and associated factors of tobacco use among Jamaican adults. Results: young adults had the lowest lifetime prevalence of tobacco smoking at 23% yet the highest percentage of current users at 48.3% (p=0.000), with gender being the only significant associated factor. Males were 2.565 times more likely to be current tobacco users than females (p < 0.01). In middle-aged adults, and older adults the highest predictive factor was risk perception. Current tobacco use was 3.375 times higher in middle-aged adults (p=0.044) and 2.815 times higher in older adults with low risk perception (p=0.025). Conclusion: four out of 10 Jamaican adult tobacco users are current users. Young adults had significantly fewer mitigating factors to tobacco usage despite being the most prevalent group for current use. Significantly, perception of risk impacted current usage in middle-aged and older adults but not in younger adults. Innovative and targeted approaches are needed in young adults such as incorporating the health and wellness promotion model with tobacco emphasis.

Community Engagement Mental Health Model for Home Treatment of Psychosis in Jamaica.

Economic constraints in low- and middle-income countries like Jamaica challenge health care services to identify efficient methods of mental health care. This column describes the community engagement mental health (CEMH) model in Kingston, Jamaica, for patients with mental disorders, including psychosis. The CEMH uses a task sharing methodology to deliver acute psychiatric treatment within a community setting. Preliminary results suggest high service user and provider satisfaction and good clinical outcomes. The authors discuss challenges and benefits of the CEMH in terms of its potential as a cost-effective service innovation.

Benzodiazepines for catatonia in people with schizophrenia or other serious mental illnesses.

BACKGROUND: Catatonia is a debilitating disorder of movement and volition associated with schizophrenia and some other mental illnesses. People with catatonia are more likely to require hospitalisation and highly supervised care than those without the disorder. They also have an increased risk of secondary complications such as pneumonia, malnutrition and dehydration. The mainstay of treatment has been drug therapies and electroconvulsive therapy. OBJECTIVES: To compare the effects of benzodiazepines with other drugs, placebo or electroconvulsive therapy for catatonia in people with schizophrenia or other similar serious mental illnesses (SMIs). SEARCH METHODS: We updated our previous search (28 February 2007) by searching the Cochrane Schizophrenia Group's Study-Based Register of Trials (9 November 2016; 6 February 2019). This register is compiled by systematic searches of major resources (including CENTRAL, MEDLINE, Embase, AMED, BIOSIS, CINAHL, PsycINFO, PubMed, and registries of clinical trials) and their monthly updates, handsearches, grey literature, and conference proceedings, with no language, date, document type, or publication status limitations for inclusion of records into the register. We also manually searched reference lists from studies selected by the search. SELECTION CRITERIA: All controlled clinical trials that randomised people who have schizophrenia or other similar SMI and experiencing catatonia to receive benzodiazepines or another relevant treatment. We included studies that met our inclusion criteria and reported usable data. We excluded those not meeting our inclusion criteria or those not reporting usable data. We contacted authors when we required further information; and if we received no response, we put those studies aside as 'awaiting assessment'. DATA COLLECTION AND ANALYSIS: Review authors extracted data independently. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis using a fixed-effect model. We completed a 'Risk of bias' assessment for the included study and generated a 'Summary of findings' table using GRADE. MAIN RESULTS: The searches found 130 citations, from which we could identify 22 possibly relevant studies. From these, we could only include one study. This study had a relatively small sample size of 17 participants who received lorazepam or oxazepam and were drug free for one week before the trial started. The only usable data reported by this study were clinically important change in symptoms of catatonia measured as 50% improvement on the Visual Analogue Scale (VAS). There was no difference in the numbers of participants showing a clinically important change in their catatonic symptoms (RR 0.95, 95% CI 0.42 to 2.16; participants = 17; studies = 1; very low quality evidence).No data were reported for other important outcomes of hospital stay, clinically important change in satisfaction with care, global state, adverse effects or general functioningWe did find a few studies meeting our inclusion criteria but they reported no usable data. We had to exclude these. Although poorly reported, these studies do illustrate that relevant studies have been undertaken - they are not impossible to design and conduct. AUTHORS' CONCLUSIONS: Analysis of the results from this review, which was a head-to-head comparison of two benzodiazepine monotherapies, does not show a clear difference in effect. No data were available for benzodiazepines compared to placebo or standard care. The lack of usable data and very low quality of data available makes it impossible to draw firm conclusions and further studies with a high-quality methodology and reporting are required in order to determine more definitively the outcomes associated with benzodiazepine use in the clinical management of catatonia in persons with schizophrenia and other SMI.