An overview of the peer review process in biomedical sciences.

OBJECTIVE: This paper aims to provide an introductory resource for beginner peer reviewers in psychiatry and the broader biomedical science field. It will provide a concise overview of the peer review process, alongside some reviewing tips and tricks. CONCLUSION: The peer review process is a fundamental aspect of biomedical science publishing. The model of peer review offered varies between journals and usually relies on a pool of volunteers with differing levels of expertise and scope. The aim of peer review is to collaboratively leverage reviewers' collective knowledge with the objective of increasing the quality and merit of published works. The limitations, methodology and need for transparency in the peer review process are often poorly understood. Although imperfect, the peer review process provides some degree of scientific rigour by emphasising the need for an ethical, comprehensive and systematic approach to reviewing articles. Contributions from junior reviewers can add significant value to manuscripts.

Meta-analysis of clinical risk factors for suicide among people presenting to emergency departments and general hospitals with suicidal thoughts and behaviours.

BACKGROUND: Suicidal thoughts and behaviours (STB) are a common reason for presentation to emergency departments and general hospitals. A meta-analysis of the strength of clinical risk factors for subsequent suicide might aid understanding of suicidal behaviour and help suicide prevention. METHODS: We conducted a meta-analysis of cohort and controlled studies on clinical risk factors and later suicide among people presenting to emergency departments and general hospitals with STB. Data were extracted from papers meeting inclusion criteria, published in Medline, PsycINFO, and Embase between 1 January 1960 and 10 October 2022 using papers located with the search terms ((suicide*).m_titl AND (emergency* OR accident and emergency OR casualty OR general hospital OR toxicology service).mp) or were indexed in PubMed and had titles located with the search terms (suicide* OR self-harm OR self-harm OR self-injury OR self-injury OR self-poisoning OR self-poisoning OR overdose OR para-suicide OR parasuicide [title/abstract]) AND (Emergency department OR emergency room OR Casualty OR general hospital OR toxicology OR accident and emergency [all fields]). Data about the association between clinical risk factors and suicide extracted from three or more studies were included in a random-effects meta-analysis of the odds of later death by suicide. The study was registered in PROSPERO and conducted according to MOOSE and PRISMA guidelines. RESULTS: Seventy-five studies reported on 741,624 people, of which 19,649 died by suicide (2.65%). Male sex (odds ratio (OR) = 1.99) and age (OR = 2.01) were the most consistently reported risk factors. The strongest associations with subsequent death by suicide related to violent self-harm methods at the hospital presentation, including: unspecified violent method (OR = 4.97), any violent method (OR = 4.57) and the specific violent methods of drowning (OR = 4.32), hanging (OR = 4.26), and use of firearms (OR = 10.08). Patients categorised as higher risk using suicide prediction scales or any other method that combined risk factors had moderately increased odds of suicide (OR = 2.58). Younger age, Black and Hispanic ethnicity, overdose, a diagnosis of adjustment disorder, and the absence of any psychiatric diagnosis were protective against suicide. CONCLUSIONS: Most risk factors for suicide among people who have presented with STB are not strongly associated with later suicide. The strongest risk factors relate to self-harm methods. In the absence of clear indicators of future suicide, all people presenting with suicidality warrant a thorough assessment of their needs, and further research is needed before we can meaningfully categorise people with STB according to suicide risk.

The importance of appraising articles and conducting psychiatric journal clubs.

OBJECTIVE: To describe the importance of scientifically rigorous journal clubs in psychiatric education, and to provide a framework to effectively run journal clubs and appraise articles in a journal club format. This paper explores the concept of journal clubs and describes issues with the current state of academic science. It then lists factors associated with effectiveness of journal clubs and outlines a structure for appraising articles relevant to psychiatric practice in a journal club format. CONCLUSIONS: Current models of academic research and publishing, which can reward practices vulnerable to multiple forms of bias, make the consistent and valued use of journal clubs in psychiatric education and continuing professional development more important than ever. The literature shows that journal clubs can provide a valuable forum for mental health clinicians to update themselves on recent medical and scientific knowledge, while practicing and teaching skills in critical appraisal of research, statistics, clinical decision-making and epidemiology.

Issues for eHealth in Psychiatry: Results of an Expert Survey.

BACKGROUND: Technology has changed the landscape in which psychiatry operates. Effective, evidence-based treatments for mental health care are now available at the fingertips of anyone with Internet access. However, technological solutions for mental health are not necessarily sought by consumers nor recommended by clinicians. OBJECTIVE: The objectives of this study are to identify and discuss the barriers to introducing eHealth technology-supported interventions within mental health. METHODS: An interactive polling tool was used to ask "In this brave new world, what are the key issues that need to be addressed to improve mental health (using technology)?" Respondents were the multidisciplinary attendees of the "Humans and Machines: A Quest for Better Mental Health" conference, held in Sydney, Australia, in 2016. Responses were categorized into 10 key issues using team-based qualitative analysis. RESULTS: A total of 155 responses to the question were received from 66 audience members. Responses were categorized into 10 issues and ordered by importance: access to care, integration and collaboration, education and awareness, mental health stigma, data privacy, trust, understanding and assessment of mental health, government and policy, optimal design, and engagement. In this paper, each of the 10 issues are outlined, and potential solutions are discussed. Many of the issues were interrelated, having implications for other key areas identified. CONCLUSIONS: As many of the issues identified directly related to barriers to care, priority should be given to addressing these issues that are common across mental health delivery. Despite new challenges raised by technology, technology-supported mental health interventions represent a tremendous opportunity to address in a timely way these major concerns and improve the receipt of effective, evidence-based therapy by those in need.

Characteristics of recently arrived Asian men who have sex with men diagnosed with HIV through sexual health services in Melbourne and Sydney.

OBJECTIVES: Asian men who have sex with men (MSM) who have recently arrived in Australia are an emergent risk group for HIV; however, little is known about how they compare to Australian MSM diagnosed with HIV. This study compared the characteristics of these two groups. METHODS: A retrospective, cross-sectional study of MSM diagnosed with HIV between January 2014 and October 2017 in Melbourne and Sydney public sexual health clinics. Asian MSM were those who had arrived in Australia within 4 years of diagnosis. RESULTS: Among 111 Asian men, 75% spoke a language other than English, 88% did not have Medicare and 61% were international students. Compared with Australian men (n=209), Asian men reported fewer male sexual partners within 12 months (median 4 versus 10, p<0.001), were less likely to have tested for HIV previously (71% versus 89%, p<0.001) and had a lower median CD4 count (326 versus 520, p<0.001). Among Asian men, HIV subtype CRF01-AE was more common (55% versus 16%, p<0.001) and subtype B less common (29% versus 73%, p<0.001). CONCLUSIONS: Asian MSM diagnosed with HIV reported lower risk and had more advanced HIV. Implications for public health: HIV testing and preventative interventions supporting international students are required.