Abstract
Healthcare professionals are increasingly recognizing how mental and social factors influence not only psychological well-being and quality of life, but also physical health and medical outcomes. The bio-psycho-social-spiritual model of healthcare is now considered the standard of holistic person-centered healthcare. The goal of the International Journal of Psychiatry in Medicine (IJPM) is to become a world-leading journal that brings clinical, epidemiological, and basic biological research using this model into the hands of our readers. However, we are totally dependent on thoughtful authors and researchers submitting articles to the Journal in order to make this happen. Please join with us in this effort.
The May issue of IJPM includes numerous articles relevant to current and future primary care physicians and the training of such physicians, as well as articles on other timely topics, many from an international perspective. The articles include a description of collaborative psychiatric care in a family medicine clinic in Colorado; preparation of residents to practice integrated behavioral health care; examination of medical students’ attitudes toward mental illness in Saudi Arabia; a description of Tele-Balint groups for mental health clinicians during COVID-19; a Balint group intervention for urban public school teachers; burnout among university students during COVID-19 in the country of Jordan; and the epidemiology of somatic symptom disorder among patients attending primary care clinics in the country of Oman.
The first article in this issue is on the implementation of collaborative psychiatric care in a family medicine clinic. In the model presented in this paper, patients with a psychiatric diagnosis meet with a team composed of a primary care provider, behavioral health provider, and psychiatric consultants. Researchers found evidence that this model of care delivery may help to reduce depressive and anxiety symptoms in patients with mental health problems. The second article examines a competency-based, multi-module curriculum for preparing residents to practice integrated behavioral health (IBH) in a primary care setting. Qualitative interviews were conducted with program instructors, while residents completed a survey assessing their IBH skills and knowledge before and after the training. Instructors emphasized the importance of flexibility and adjusting faculty development based on levels of experience, whereas residents reported an increase in competency following the training.
The third article in this issue examines medical student attitudes toward mental illness in Saudi Arabia by identifying characteristics of medical students who hold mind-brain dualism (MBD) beliefs and then determining whether such beliefs impact their perceptions of patients with mental illness. Fictitious vignettes describing patients with schizophrenia, antisocial personality disorder (APD), and depression were presented to students. Attitudes were particularly negative towards patients with APD. MBD beliefs of students were associated with greater perceptions of patient self-infliction, preventability, controllability, and blameworthiness.
The fourth and fifth articles examine the benefits of Balint group involvement, first among mental health clinicians and then among urban public school teachers. Balint groups provide a safe place for professionals to discuss difficult cases (or students), with the purpose of providing space for self-introspection and personal development. The first of these articles examines tele-Balint groups for mental health professionals during the COVID-19 pandemic by employing qualitative interviews with these clinicians. A total of five major themes were uncovered with results emphasizing the importance of professional and personal growth: the necessity of clinicians providing emotional support to each other, the wide range of experiences that led to burnout, the importance of psychological safety, the extent to which these groups met clinicians’ needs, and the need to adapt these groups during the COVID-19 pandemic. In the second article, which examined a Balint group intervention in urban public school teachers, researchers examined whether a 6-month intervention of this type influenced teachers self-efficacy, experiences of burnout, and intention to continue to teach in the classroom. A mixed methods approach was used that included semi-structured focus group interviews, field notes from the group cofacilitator and Balint group leader, semi-structured debriefs with group leaders, and open-ended questions about their experience. Quantitative data were collected prior to and after the intervention. Researchers concluded that Balint groups provide an opportunity to address the social and emotional needs of teachers (just as they do for healthcare providers).
The sixth article in this issue examines burnout among university students during the COVID-19 pandemic at the University of Jordan. A modified version of the Maslach Burnout Inventory was administered to over 500 students, revealing that 6.6% of students were experiencing significant levels of burnout. Having a hobby, level of satisfaction with distance-learning, and thoughts about quitting were strongly correlated with burnout symptoms. Researchers concluded that while the prevalence of burnout among these students was low, identifying factors associated with high levels of burnout may help to develop strategies to prevent and treat student burnout.
Finally, the last article examines the epidemiology of somatic symptom disorder (SSD) among 2000 adult patients in Oman attending primary care clinics. Based on the Arabic version of the Somatic Symptom Scale-8, 18% of these patients (nearly 1 out of every 5) met criteria for SSD. The presence of SSD was associated with gender, education, and chronic comorbidities. Researchers concluded that there was an urgent need to identify and treat SSD at the primary care level in Gulf region countries, with the goal of reducing healthcare costs and increasing patient satisfaction.
Call for papers
Several special theme-based issues of IJPM are planned for the future. Readers are encouraged to submit original research or state-of-the-art systematic or meta-analytic reviews focused on psychological, social, and behavioral issues in medical settings. The first of these special issues is on Depression in the Medically Ill, a topic that primary care physicians and consultation-liaison psychiatrists often confront, one that affects both compliance with treatment and medical outcomes.
The second of these special issues is on the topic of Moral Injury. Moral injury results when individuals transgress moral/ethical values during high stress situations or after experiencing severe trauma. This syndrome, which can affect the perpetrator, the victim, or the observer, was first observed among active-duty military and war veterans suffering from PTSD, but has also been increasingly recognized among first responders (police, emergency medical technicians, firemen) and, in particular, among healthcare professionals during COVID-19 (and since the pandemic as well). Because moral injury affects the quality of care that physicians, nurses, and allied health professionals provide and may increase the risk of medical errors, this topic is highly relevant to IJPM readers.
The third special issue will focus on chronic pain, its prevalence, predictors, and treatment. Recent limitations on the use of opioids for treating chronic pain have left medical practitioners with few options. In response, novel treatments and alternative therapies, including various kinds of psychosocial and behavioral treatments, are now being developed to help relieve chronic pain. Please consider submitting a paper to IJPM that involves original research, systematic reviews, or meta-analyses on one or more of these topics, which will be prioritized in terms of review.