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The relationship between normative beliefs towards suicide and support for suicide prevention in Taiwan: addressing suicide as human rights, individual choice, or irrationality Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-03-18 Nina Ming-Hsin Hsu, Ying-Yeh Chen, Shu-Sen Chang, Ying-Chen Chi, Kevin Chien-Chang Wu
East Asian countries are known to take a more permissive attitude towards suicide. However, the nuanced beliefs fostering these attitudes remain unexplored. This study aimed to examine socio-demogr...
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Comparing forensic and non-forensic women with schizophrenia spectrum disorders: a European study Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-03-15 Laura Iozzino, Rebecca Noventa, Manuel Zamparini, Alessia Cicolini, Simone Giacco, Janusz Heitzman, Matthew Large, Marco Picchioni, Johannes Wancata, Marlene Koch, Giovanni de Girolamo
Studies about violence by women with severe mental disorders are rare. The aim of this paper is to analyse the sample of women diagnosed with Schizophrenia Spectrum Disorders (SSD) from the EU-VIOR...
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Suicide among migrants: a comprehensive narrative review of literature Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-03-12 Gaspare Spataro, Antonio Ventriglio, Maria Salvina Signorelli, Giovanna Marrazzo
Suicidality among migrants represents a multifaceted and complex issue with significant implications and challenges for public mental health and policies. This narrative review aims to explore the ...
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Suicidal ideation amongst medical students in Shiraz, South of Iran: a cross-sectional study Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-03-04 Ali Ghorbanpour, Alireza Salehi, Marziyeh Doostfatemeh, Arash Mowla
Suicide is a preventable act, but irreversible once committed; Hundreds of thousands of people commit suicide annually around the globe. One of the groups at high risk of suicide is medical student...
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Defeat, entrapment and suicidal ideation in a Turkish community sample of young adults: an examination of the Integrated Motivational-Volitional (IMV) model of suicidal behaviour Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-02-27 Nuri Türk, Meryem Betül Yasdiman, Alican Kaya
The present study examines the relationships between defeat, entrapment, suicidal ideation, thwarted belongingness, and perceived burdensomeness through the Integrated Motivational-Volitional (IMV)...
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Personal and work-related burnout is associated with increased episodes of suicidal ideation or behavior among working adults in Chile Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-02-26 Alexa Cumming, Yinxian Chen, Diana Juvinao-Quintero, Juan Carlos Velez, Jessica Castillo, Alejandro Mardones, Bizu Gelaye
Burnout has been previously associated with suicidal risk factors and suicide itself, but these associations have only focused on work-related burnout among high-demand occupations. We aimed at exa...
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The arts and humanities are fundamental to health professions education Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-02-26 Margaret S. Chisolm, Dinesh Bhugra
Published in International Review of Psychiatry (Vol. 35, No. 7-8, 2023)
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Perceived helpfulness of medication and psychotherapy among adults with suicidal ideation Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-02-21 Mathilde M. Husky, Christophe Léon, Enguerrand du Roscoät, Helen-Maria Vasiliadis
The objective of the study is to examine perceived helpfulness of medication and psychotherapy among adults with suicidal ideation. Data were drawn from the 2017 Health Barometer, a nationally repr...
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Homicide-suicide cases during the COVID-19 lockdown in Pakistan: content analysis of newspaper reports Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-02-21 Rameez Ali Mahesar, Muhammad Ashfaq, Amna Fazail, Huma Tahir, Ghazala Shoukat, Sheikh Shoaib, Antonio Ventriglio
Homicide-suicide is a tragic event characterized by multiple fatalities within the intimate relationships, familial bonds, and community networks. Our aim was to explore the extent of coverage of h...
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The experience of self-harming behaviours that inflict external injuries to the body in UK-based Bangladeshi, Indian and Pakistani women: a literature review Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-02-13 Sharmin Aktar, Rachel Tribe
Studies carried out on self-harm in the UK have consistently reported a higher level of self-harm among women with South Asian heritage resident in the UK when age-compared with other British women...
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The relationship between spirituality and suicide in young adults: the mediating role of early maladaptive schemas in Turkey Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-02-12 Metin Erdem
Suicide rates among young adults are high. There are many reasons for this. In this study, the effect of early maladaptive schemas on the relationship between spirituality and suicide among young a...
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What differentiates suicidal ideation from depressive symptoms amongst Korean young adults aged 20–39 years? Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-02-08 Jiwon Kang, Soog-nang Jang, Hyun-soo Kim
This study aimed to examine and compare factors influencing depressive symptoms from those influencing suicidal ideation in Korean adults aged 20–39 years. Data were collected from September 15 to ...
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Risky business: an examination of drinking games in college settings and their impact: a systematic review Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-02-01 Guilherme Farias de Santana, Luiza Larrubia Alvares Florence, Kae Leopoldo, João Mauricio Castaldelli-Maia
This systematic review explores the prevalence and impact of Drinking Games (DG) among college students. DGs involve social drinking with the goal of heavy alcohol consumption and are associated wi...
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Addiction Medicine or Addiction Psychiatry? Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-02-01 João Mauricio Castaldelli-Maia
Published in International Review of Psychiatry (Vol. 35, No. 5-6, 2023)
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Addiction psychiatry and psychiatry trainees: a still complicated relationship Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-02-01 Julio Torales, Marcelo O’Higgins, Iván Barrios
Published in International Review of Psychiatry (Vol. 35, No. 5-6, 2023)
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Comparing the Addiction Severity Index (ASI) and Measurements in the Addictions for Triage and Evaluation (MATE) Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-02-01 Anderson Sousa Martins-da-Silva, Wélissa da Silva Moura, Ciro Marco, Lucas Galvão, Eric Balliari, Isabela Cavallo, Ruth Becker, Lucina Silva, Eclesiaster Oliveira, Felipe Gil, Nathalie Moschetta Monteiro-Gil, Marcela Waisman Campos, Julio Torales, Antonio Ventriglio, Cintia de Azevedo-Marques Périco, João Mauricio Castaldelli-Maia
Substance use disorder (SUD) assessment and measurement in Brazil, as well as in many other countries, face significant shortcomings. The Measurement in the Addictions for Triage and Evaluation (MA...
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Suicide Prevention in Southeast Asia Region: A Review of National Suicide Prevention Strategies Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-01-25 Gayatri Bhatia, Avni Karamta, Manish Roshan Thakur, Rahul Mathur
Suicide is a major public health concern, impacting societies worldwide. This study was an analysis of national suicide prevention strategies of various SEAR countries. To date, only five out of el...
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Victim involvement in forensic psychiatric treatment: opportunities and challenges from a restorative justice perspective Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-01-13 Lydia Dalhuisen, Mieke Knoppers, Rianka Rijnhout, Gerben Meynen
Victims have a right to participate in restorative justice practices, also if offenders are detained within forensic mental healthcare. However, the deployment of restorative justice interventions ...
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Capacity to consent to treatment in severe eating disorders Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-01-12 Giovanna Parmigiani, Lorenzo Tarsitani, Fabiano Grassi, Gabriele Mandarelli, Stefano Ferracuti
Eating disorders represent a disabling, deadly and costly condition, whose principal treatment is constituted by weigh restoration and psychotherapy. Partial or total refuse of treatment is very co...
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The sociocultural lens in psychobiography Int. Rev. Psychiatry (IF 3.287) Pub Date : 2024-01-02 Claude-Hélène Mayer, Roelf van Niekerk
Published in International Review of Psychiatry (Ahead of Print, 2024)
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Muslim experiences and Islamic perspectives on suicide: a qualitative analysis of fatwa inquiries Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-12-18 Khalid Elzamzamy, Rumia B. Owaisi, Hussein Elayan, Tariq Elsaid
Suicide is a rising global public health challenge. Yet, the determinants and magnitude of the problem are understudied in both Muslim-majority countries and Muslim diaspora communities. The overal...
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Functional disability and suicidal ideation in Korean older adults: the moderating role of socioeconomic status Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-12-13 Ji-Young Choi
Although the relationship between functional disability and suicidal ideation among older adults has been well documented, limited research exists regarding how socioeconomic status might moderate ...
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Age and sex differences in the annual and seasonal variation of Australia’s suicide rate, 2000–2020 Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-12-11 Richard Andrew Burns, Kerry Sargent, Peter Butterworth, Dimity Ann Crisp
Suicide is a major public health concern both globally and in Australia. But in Australia the extent of substantive annual and seasonality trends since 2000 through the first two decades of the 21s...
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Mental health of transgender people in prison: a systematic review and meta-analysis Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-12-08 Mattia Marchi, Ilaria Corbellini, Emma Vaccari, Luca Pingani, Silvia Ferrari, Francesco Amaddeo, Manlio Converti, Andrea Fiorillo, Massimo Mirandola, Federica Pinna, Antonio Ventriglio, Gian M. Galeazzi
This systematic review aims to explore the condition of Transgender Inmates (TGI) in correctional facilities (CF), focusing on their mental health, their access to Gender-affirming Treatments (GAT)...
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What’s art got to do with it?—Transfer of learning in museum-based health professions education Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-12-05 Elizabeth Gaufberg, Brooke DiGiovanni Evans, Pooja Rutberg, Margaret S. Chisolm
Museum-based education for health professionals is a rich and expanding field in which educators engage health professions learners in arts-based activities intentionally designed to support transf...
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A chronicle of the liberation struggle: the career development of Ahmed Kathrada Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-12-01 Roelf van Niekerk, Vikki Botes
Ahmed Kathrada (1929–2017), an anti-apartheid activist, political prisoner, and parliamentary politician had been at the centre of South Africa’s liberation struggle for six decades and is remember...
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Adherence to the WHO guidelines of newspaper-reporting on suicides in Pakistan: a content analysis Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-11-29 Rameez Ali Mahesar, Ahmed Ali Memon, Sana Shahid, Sara Fatima, Sheeraz Ali Gorar, Antonio Ventriglio
There is a lack of evidence regarding the rate of adherence to the World Health Organization (WHO) media guidelines of vernacular newspapers reporting on suicides in Pakistan. Also, the relevance o...
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The Harvard Macy Institute Art Museum-based Health Professions Education Fellowship: Transformational faculty development through the arts Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-11-29 Elizabeth Gaufberg, Corinne Zimmermann, Lisa M. Wong, Ray Williams, Brandy King, Kristin King, Ranjani Paradise
Museum-based education for health professionals can lead to a variety of important learning outcomes within the domain of skills development, personal insight, perspective-taking and social advocac...
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Personality disorders and schizophrenia spectrum disorders in the Italian forensic psychiatric population: clinical features, pattern of violence and treatment Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-11-28 Anna Margari, Roberto Catanesi, Felice Francesco Carabellese, Luigi Buongiorno, Francesco Maria Piarulli, Gabriele Mandarelli
Starting in 2015, the Residencies for Execution of Security Measures (REMS) became the place of treatment and care for dangerous offenders who were acquitted due to a mental disorder in Italy. Schi...
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Suicidal hanging in Pakistan: an exploratory two-year content analysis study Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-11-23 Rameez Ali Mahesar, Ahmed Raza ul Mustafa, Muhammad Latif, Nusrat Azeema, Mahnoor Aslam Rao, Antonio Ventriglio
Suicidal hanging is common in Pakistan and is considered a serious challenge globally. We conducted a content analysis of reports about suicidal hangings published in six English-language newspaper...
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Understanding food addiction in Post-Bariatric patients Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-11-23 Ligia Florio, Cintia de Azevedo-Marques Périco, João Mauricio Castaldelli-Maia
This study delves into the construct validity of Food Addiction (FA) as evaluated by the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) within the context of post-bariatric surgery patients in ...
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Visual thinking Strategies and the peril of ‘see one, do one, teach one’ Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-11-15 Heather J. Kagan, Philip Yenawine, Linda Duke, Mark B. Stephens, Margaret S. Chisolm
Visual Thinking Strategies is an arts and humanities pedagogical intervention increasingly incorporated into medical education. As a straightforward method that appears easy to use, its nuances are...
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Evaluating an intergenerational art and storytelling program with older adults and medical students Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-11-10 Sujal Manohar, Oluwapelumi Oloyede, Mary E. Kollmer Horton
Older adults in residential communities face loneliness and isolation, challenges exacerbated by COVID-19, leading to adverse physical and mental health outcomes. Intergenerational arts and humanit...
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A systematic review of the arts and humanities in psychiatry education Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-11-08 Mary E. Yaden, Rayah T. Sawaya, Jessica Reddy, Katherine A. Jong, Jacob White, Tracy Moniz, Margaret S. Chisolm
This systematic review characterizes the published literature on arts and humanities curricula for psychiatry learners that include any form of program evaluation. Authors searched three databases ...
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Promoting psychobiography: models and perspectives from multiple countries Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-11-06 Abigail Jareño, Claude-Hélène Mayer, Zoltán Kőváry, Joseph G. Ponterotto, James William Anderson
This article promotes and advocates for the integration of psychobiography into academic training in psychology. While psychobiography has been foundational to the discipline of psychology since Fr...
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A psychobiographical analysis of Empress Dowager Cixi: exploring the femininity castrated complex Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-11-01 Zeyu Wang, Claude-Hélène Mayer, Jiaming Li
In Chinese culture, there is a widely circulated phrase, ‘A hen crows in the morning’. This phrase is used to humiliate women who steal power and engage in the political field. It demonstrates the ...
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Assessment and Management of Suicide Risk: What Psychiatrists Should Know Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-11-02 Maurizio Pompili
Suicide is a major public health issue worldwide, and scholars now recognise the multifactorial perspective of this phenomenon. However, psychiatric disorders are often considered the main determin...
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How to design and implement a Group Poem activity Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-10-22 Diane Jung, Natasha Chugh, Mark Stephens, Mary Blazek, Michael P. Flanagan, Margaret S. Chisolm
Museum-based learning activities provide interactive and innovative ways to integrate the arts and humanities into medical education. Like other museum-based activities, the Group Poem supports the...
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Dowager queens and Dewey decimals: psychiatry and the theatre of the absurd Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-10-20 Matthew Kelly
Published in International Review of Psychiatry (Vol. 35, No. 7-8, 2023)
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Experiential learning spaces and student wellbeing: a mixed-methods study of students at three research intensive UK universities Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-10-20 Esme Elsden, Thomas Kador, Hannah Sercombe, Kim Piper, Melissa Barkan, Emma Webster, Flora Smyth Zahra
There is clear evidence that university students are experiencing significant mental health difficulties, further exacerbated by the temporary closure of university campuses during the height of th...
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Status foe: a psychobiographical investigation of Ida B. Wells Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-10-20 Benjamin R. Wegner
Ida B. Wells (1862-1931) led an extraordinary life as a journalist, educator, and activist while navigating the intersecting social realities of race, gender, and class. She embodied courage, advoc...
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Writing to Heal: The Arts as a Learning Methodology in Psychiatry Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-10-18 Meher Kalkat
This piece explores how poetry and prose can be used as an adjunct to medical education and patient care, especially in the field of psychiatry. It details the author’s personal experience with spo...
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Exploring the intersection of psychiatry, art, and medical education through photographic portraits Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-10-16 Eloise Ballou, Elizabeth Gaufberg
This paper describes a technique using photographic portraits in medical education to encourage close observation, cultivate empathic curiosity, explore learners’ values and beliefs, and to reveal ...
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Character and virtue development in medical learners: another role for the arts? Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-10-12 Margot Kelly-Hedrick, Sarah R. Louis, Margaret S. Chisolm
Medical education serves to teach students how to think and act as future physicians. Doing so successfully requires supporting learners’ acquisition of clinical skills and knowledge, but also atte...
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The role of the photographic arts in psychiatry Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-10-08 Carlyle H Chan, David Mintz, Mara Pheister
Photography is a medium that has historical roots in psychiatry. It is an art form that shares some concepts with psychodynamic psychotherapy and can also provide psychotherapeutic value. In additi...
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Performance measures for alcohol and other drugs services: a commentary Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-10-02 Ricardo Abrantes do Amaral
Alcohol and other drugs treatment includes a wide range of service and personal characteristics, along with expected and unexpected barriers to treatment. To capture the benefits and the gaps of a ...
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Art in medicine: in the classroom, exam room, and Reading room Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-09-28 Todd Guth, Molly Medakovich, Sarah S. Milla
In this article, the authors discuss the development and current curriculum of the Art in Medicine course at the University of Colorado School of Medicine (CUSOM), developed in collaboration with t...
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The ‘Clinical Humanities & Wellbeing programme’- sustainable healthcare education for an era of uncertainty Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-09-28 Flora Smyth Zahra, Jayne Pearson, Kim Piper
This article presents a case study where integration of arts and humanities into a clinical programme is being implemented at scale, as core mandatory learning for all students within a UK dental, ...
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Evaluation of arts and humanities programs in surgery education: a systematic review Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-09-26 Diane Jung, Margot Kelly-Hedrick, Erin Brush, Jacob White, Tracy Moniz, Margaret S. Chisolm
This systematic review seeks to understand what outcomes have been reported for arts and humanities programs in surgery education.Authors searched Medline ALL (Ovid), Embase.com, Web of Science, an...
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Art and activism in medical education: a modern necessity Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-09-25 Anson J. Koshy
Artivism is the use of visual art to promote activism and foster meaningful action and change. This commentary argues that artivism should be embraced and utilised more consistently in medical educ...
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Managing drug-induced psychosis Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-09-24 Leonardo Baldaçara, Artur Ramos, João Maurício Castaldelli-Maia
Substance-induced psychosis is a secondary psychotic disorder resulting from drug abuse, characterized by one or more psychotic episodes. Drug-induced psychosis is expected to resolve after a 30-da...
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The transformative palette: the use of art and Visual Thinking Strategies in nursing Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-09-24 Margaret Moorman PhD RN ANEF CNE
Visual Thinking Strategies is a teaching technique initially studied in primary education but recently has been used to teach nursing students and other healthcare professionals. VTS has been found...
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Desire for a sense of power and religious suicide in psychobiographical research: combining personality and sociocultural theories Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-09-22 Amadeusz Citlak
The article presents two theoretical perspectives that provide a helpful framework in psychobiographical research, especially when psychobiographies concern religious suicide. The first is typical ...
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Impact of intergenerational conflict on young people and interventions to mitigate its effects: a scoping review Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-09-21 Vaishnavi K. Madhavan, A. Akshaya, N. P. Haritha, Karthikeyan Pandiyambakkam Rajendran, Aditi Anand, Sujatha Kesh, Harihara Murthy Subramanian, Sujit John, Vijaya Raghavan, M. Suresh Kumar, R. Padmavati, Lakshmi Vijayakumar
Intergenerational conflicts with parents or grandparents have been shown to have adverse effects on young people. Inevitably these conflicts influence the mental health and well-being of young peop...
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The art of resilience: a psychobiography of Frida Kahlo Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-09-16 Brittney Romagna
This psychobiography of Frida Kahlo explores the psychology of the famous Mexican artist. Drawing upon Kahlo’s paintings and diary entries, a rich psychological analysis of the feminist icon is jux...
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Drawing on medical school experiences Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-09-15 Oscar Li
As a medical student, engagement with the medical humanities allowed me to express myself, reflect on experiences, and share my inner thoughts and feelings. Drawing has played a critical role in my...
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Breaking barriers: a psychobiography of Siya Kolisi from a sociocultural perspective Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-09-14 Tinashe Harry
Abstract Siyamthanda (Siya) Kolisi OIG (1992-) is the first black captain of the South African rugby team (Springboks) in its 128 years of existence. The Springboks have long been associated with Afrikaner people and a history of racism. Siya had to navigate a tumultuous upbringing in an environment characterised by various issues such as socioeconomic inequalities, high unemployment among Black people
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Forensic psychiatry in Turkiye Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-09-12 Yasin Hasan Balcioglu, Fatih Oncu, Harry G. Kennedy
Abstract Turkiye, with its origins in an enduring civilisation rooted in preceding Turkish states from ancient and medieval eras, possesses its own firmly established legal traditions. Legislation concerning to the mentally ill was introduced post the French Revolution in the Ottoman Empire and underwent reforms with the advent of Turkiye’s modern Republic in 1923, led by Mustafa Kemal Atatürk. This
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Cross-cultural experiences and self-development: a psychobiographical study of Bruce Lee Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-09-13 Xia Xie, Chao Pan, Min Xu, Ao He, Yueyu Shu
Abstract A common challenge people face in today’s cross-cultural world is how to solve a series of adaptation problems caused by cultural conflict. Exploring Bruce Lee’s successful cross-cultural experiences through psychobiography offers some inspiration and thoughts. How did Bruce Lee successfully integrate martial arts, symbolising the Eastern culture, with films representing the Western culture
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Facilitating difficult conversations through art: creating an anti-racism digital image library for health professions education Int. Rev. Psychiatry (IF 3.287) Pub Date : 2023-09-11 Kamna S. Balhara Philip, Philip Yenawine, Nathan Irvin, Lauren Eller, Leila Habib, Claire Tatham, Margaret Chisolm
Racism has been recognised as a threat to patient outcomes, public health, and the healthcare workforce, and health professions (HP) educators and learners alike are seeking effective ways to teach...