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Introduction: In Azerbaijan the same as in the other countries of Central and Eastern Europe mental health services remain to be resource-directed rather than need-directed. Therefore multitude of unmet needs in people with serious mental illness (SMI) is unarticulated and under-recognized by healthcare providers. At the same time mental health reform focusing on the transition from institutional towards community-based services requires better understanding of psychiatric, physical and psychosocial needs of mental health service users. Objectives: The aimof this study was to assess met and unmet needs in patients with SMI and their family members, as well as their contribution to the burden of illness and satisfaction with services. Methods: The study involved 50 patients with SMI and 50 family memberswho were applying for outpatient treatment to theNational Mental Health Centre in Baku. CamberwellAssessment of Need Scale (CANSAS) and Verona Services Satisfaction Scale(VSSS-EU) were administered to both patients and family members, while Involvement Evaluation Questionnaire was used in family members only. Results: Patients and their family members reported very similar need profiles irrespective of age, gender, educational and marital status. A significant burden in families caring for people with SMI was associated with support provided by mental health services. Despite the moderate level of satisfaction with care in patients and relatives, many services were unavailable or unaffordable for them. Conclusions: The implication of the study results may be used for the future planning and development of mental health service in Azerbaijan to achieve better outcomes in terms of addressing patients and their families' most prominent needs. [ABSTRACT FROM AUTHOR]

Introduction: Despite ongoingmental health reform taking place in Azerbaijan, the services for people suffering from Severe Mental Illness (SMI) are still underdeveloped. Available services are limited with traditional psychiatric interventions while psychological counseling and psychotherapy are not accessible for peoplewith SMI. Objectives: The study aimed to measure patient's satisfaction with mental health services and their families as well as to find possible relations between satisfaction, sociodemografic and clinical variables. Methods: Sociodemographic questionnaire, BPRS and Verona Service Satisfaction Scale-EU was completed by 50 patients and 50 family members. Results: The overall satisfaction with services scores among patients and their family members was relatively high (M=3.9; 95% CI=3.65-4.15) and (M=4.02; 95% CI=3.83-4.21), and did not differ significantly (Wilcoxon Z= -0.738; p=0.460). Age of onset, duration of illness, number of hospitalizations and BPRS scores did not associated with overall satisfaction with services, but there was a correlation between overall satisfaction scores estimated by patients and number of episodes (rs=-0.301; p<0.05). The more episodes a patient had, the less satisfaction with services he/she reported. Moreover, the majority of patients and their families are not informed about various services other than drug treatment. Conclusions: The services related to finding employment and sheltered work are wished the most of all by the patients and their relatives. However these services are not provided yet. Likewise, desirable services include practical help at home, leisure activities and group sessions. As these services are not familiar to mental health care providers in our country, it will be beneficial to obtain international experience on establishing them. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has brought significant mental health challenges, particularly for vulnerable populations, including non-binary gender individuals. The COMET international study aimed to investigate specific risk factors for clinical depression or distress during the pandemic, also in these special populations., Methods: Chi-square tests were used for initial screening to select only those variables which would show an initial significance. Risk Ratios (RR) were calculated, and a Multiple Backward Stepwise Linear Regression Analysis (MBSLRA) was followed with those variables given significant results at screening and with the presence of distress or depression or the lack of both of them., Results: The most important risk factors for depression were female (RR = 1.59-5.49) and non-binary gender (RR = 1.56-7.41), unemployment (RR = 1.41-6.57), not working during lockdowns (RR = 1.43-5.79), bad general health (RR = 2.74-9.98), chronic somatic disorder (RR = 1.22-5.57), history of mental disorders (depression RR = 2.31-9.47; suicide attempt RR = 2.33-9.75; psychosis RR = 2.14-10.08; Bipolar disorder RR = 2.75-12.86), smoking status (RR = 1.15-5.31) and substance use (RR = 1.77-8.01). The risk factors for distress or depression that survived MBSLRA were younger age, being widowed, living alone, bad general health, being a carer, chronic somatic disorder, not working during lockdowns, being single, self-reported history of depression, bipolar disorder, self-harm, suicide attempts and of other mental disorders, smoking, alcohol, and substance use., Conclusions: Targeted preventive interventions are crucial to safeguard the mental health of vulnerable groups, emphasizing the importance of diverse samples in future research., Limitations: Online data collection may have resulted in the underrepresentation of certain population groups., Competing Interests: Declaration of competing interest None pertaining to the current paper., (Copyright © 2024. Published by Elsevier B.V.)

Background: The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders., Methods: The sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions., Results: About 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15-20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome., Conclusions: The finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.

Background: Stigma related to mental illness (and its treatment) is prevalent worldwide. This stigma could be at the structural or organizational level, societal level (interpersonal stigma), and the individual level (internalized stigma). Vulnerable populations, for example, gender minorities, children, adolescents, and geriatric populations, are more prone to stigma. The magnitude of stigma and its negative influence is determined by socio-cultural factors and macro (mental health policies, programs) or micro-level factors (societal views, health sectors, or individuals' attitudes towards mentally ill persons). Mental health stigma is associated with more serious psychological problems among the victims, reduced access to mental health care, poor adherence to treatment, and unfavorable outcomes. Although various nationwide and well-established anti-stigma interventions/campaigns exist in high-income countries (HICs) with favorable outcomes, a comprehensive synthesis of literature from the Low- and Middle-Income Countries (LMICs), more so from the Asian continent is lacking. The lack of such literature impedes growth in stigma-related research, including developing anti-stigma interventions., Aim: To synthesize the available mental health stigma literature from Asia and LMICs and compare them on the mental health stigma, anti-stigma interventions, and the effectiveness of such interventions from HICs., Materials and Methods: PubMed and Google Scholar databases were screened using the following search terms: stigma, prejudice, discrimination, stereotype, perceived stigma, associate stigma (for Stigma), mental health, mental illness, mental disorder psychiatric* (for mental health), and low-and-middle-income countries, LMICs, High-income countries, and Asia, South Asian Association for Regional Cooperation/SAARC (for countries of interest). Bibliographic and grey literature were also performed to obtain the relevant records., Results: The anti-stigma interventions in Asia nations and LMICs are generalized (vs. disorder specific), population-based (vs. specific groups, such as patients, caregivers, and health professionals), mostly educative (vs. contact-based or attitude and behavioral-based programs), and lacking in long-term effectiveness data. Government, international/national bodies, professional organizations, and mental health professionals can play a crucial in addressing mental health stigma., Conclusion: There is a need for a multi-modal intervention and multi-sectoral coordination to mitigate the mental health stigma. Greater research (nationwide surveys, cultural determinants of stigma, culture-specific anti-stigma interventions) in this area is required., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Psychiatry.)

Introduction: The current study aimed to investigate the rates of anxiety, clinical depression, and suicidality and their changes in health professionals during the COVID-19 outbreak., Materials and Methods: The data came from the larger COMET-G study. The study sample includes 12,792 health professionals from 40 countries (62.40% women aged 39.76 ± 11.70; 36.81% men aged 35.91 ± 11.00 and 0.78% non-binary gender aged 35.15 ± 13.03). Distress and clinical depression were identified with the use of a previously developed cut-off and algorithm, respectively., Statistical Analysis: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses, and Factorial Analysis of Variance (ANOVA) tested relations among variables., Results: Clinical depression was detected in 13.16% with male doctors and 'non-binary genders' having the lowest rates (7.89 and 5.88% respectively) and 'non-binary gender' nurses and administrative staff had the highest (37.50%); distress was present in 15.19%. A significant percentage reported a deterioration in mental state, family dynamics, and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (24.64% vs. 9.62%; p < 0.0001). Suicidal tendencies were at least doubled in terms of RASS scores. Approximately one-third of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop clinical depression was associated with a history of Bipolar disorder (RR = 4.23)., Conclusions: The current study reported findings in health care professionals similar in magnitude and quality to those reported earlier in the general population although rates of clinical depression, suicidal tendencies, and adherence to conspiracy theories were much lower. However, the general model of factors interplay seems to be the same and this could be of practical utility since many of these factors are modifiable., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Introduction: During the COVID-19 pandemic various degrees of lockdown were applied by countries around the world. It is considered that such measures have an adverse effect on mental health but the relationship of measure intensity with the mental health effect has not been thoroughly studied. Here we report data from the larger COMET-G study pertaining to this question., Material and Methods: During the COVID-19 pandemic, data were gathered with an online questionnaire from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Anxiety was measured with the STAI, depression with the CES-D and suicidality with the RASS. Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively., Statistical Analysis: It included the calculation of Relative Risk (RR), Factorial ANOVA and Multiple backwards stepwise linear regression analysis RESULTS: Approximately two-thirds were currently living under significant restrictions due to lockdown. For both males and females the risk to develop clinical depression correlated significantly with each and every level of increasing lockdown degree (RR 1.72 and 1.90 respectively). The combined lockdown and psychiatric history increased RR to 6.88 The overall relationship of lockdown with severity of depression, though significant was small., Conclusions: The current study is the first which reports an almost linear relationship between lockdown degree and effect in mental health. Our findings, support previous suggestions concerning the need for a proactive targeted intervention to protect mental health more specifically in vulnerable groups., (Copyright © 2022. Published by Elsevier B.V.)

Introduction: There are few published empirical data on the effects of COVID-19 on mental health, and until now, there is no large international study., Material and Methods: During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively., Statistical Analysis: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables., Results: Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed., Conclusions: The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them., Competing Interests: Conflict of Interest None pertaining to the current paper., (Copyright © 2021 Elsevier B.V. and ECNP. All rights reserved.)

The European Psychiatric Association (EPA), the main association in the field of mental health in Europe, has long been supporting the development of early career psychiatrists. The EPA Early Career Psychiatrists Committee (ECPC) and its core task forces promote research activities among young psychiatrists, contribute to their professional development through organising courses and other educational events, prepare online educational materials and publications, and actively collaborate with other organisations. The EPA ECPC is always open to fostering cooperation on new professional, educational or research initiatives with early career psychiatrists from different countries., Competing Interests: T.M.G. received personal fees from VP Valeant Polska, Lundbeck Poland, Janssen-Cilag Polska, Apotex Poland (currently Aurovitas Pharma Polska), EGIS Polska, and GL Pharma outside the submitted work., (© The Authors 2020.)

Persons with serious mental illness and their families in low- and middle-income households continue to face important challenges and barriers to care. In Azerbaijan, the needs of individuals with serious mental illness have been studied to gain insight for improvement of mental health policy and research. This column describes needs assessment work by the National Mental Health Center, located in Baku, as well as lessons learned and further recommendations regarding better targeted, culturally informed, and person-centered care. In particular, the authors emphasize the importance of gender and socioeconomic disparities in care provision, disparities that have a significant parallel in other post-Soviet Eastern European and Central Asian countries.