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Polemicists, politicians, and tyrants have long understood that language does not just express ideas; it also shapes ideas and influences the way people think. Nowhere is the manipulation of language and perception more evident than in the contemporary debate about immigration policy. As Jake Scobey-Thal (Anthropology of an Idea: Illegal Alien, September/October 2014) illustrates, the battle over terminology pertaining to immigration can be as heated as the policy debate itself. Adapted from the source document.

The global burden of disorders has shifted from infectious disease to non-communicable diseases, including neuropsychiatric disorders. Whereas infectious disease can sometimes be combated by targeting single causal mechanisms, such as prevention of contact-spread illness by handwashing, in the case of mental disorders multiple causal mechanisms are typically relevant. The emergent field of global mental health has emphasized the magnitude of the treatment gap, particularly in the low- and middle-income world and has paid particular attention to upstream causal factors, for example, poverty, inequality, and gender discrimination in the pathogenesis of mental disorders. However, this field has also been criticized for relying erroneously on Western paradigms of mental illness, which may not be relevant or appropriate to the low- and middle-income context. Here, it is important to steer a path between scientism and skepticism. Scientism regards mental disorders as essential categories, and takes a covering law approach to causality; skepticism regards mental disorders as merely social constructions and emphasizes the role of political power in causal relations. We propose an integrative model that emphasizes the contribution of a broad range of causal mechanisms operating at biological and societal levels to mental disorders and the consequent importance of broad spectrum and multipronged approaches to intervention.

The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) provides a useful opportunity to revisit debates about the nature of psychiatric classification. An important debate concerns the involvement of mental health consumers in revisions of the classification. One perspective argues that psychiatric classification is a scientific process undertaken by scientific experts and that including consumers in the revision process is merely pandering to political correctness. A contrasting perspective is that psychiatric classification is a process driven by a range of different values and that the involvement of patients and patient advocates would enhance this process. Here we draw on our experiences with input from the public during the deliberations of the Obsessive Compulsive-Spectrum Disorders subworkgroup of DSM-5, to help make the argument that psychiatric classification does require reasoned debate on a range of different facts and values, and that it is appropriate for scientist experts to review their nosological recommendations in the light of rigorous consideration of patient experience and feedback.

The facts seem to indicate that South Africa is one of the more violent places on earth. We have been, and continue to be, a country with significant levels of political violence, criminal violence and domestic violence. And now, we are witnessing violence against fellow Africans. While many have termed this 'xenophobia', a more accurate term may well be 'Afrophobia'. For clinician-scientists, many questions arise. In this editorial, we briefly consider a few of the most pertinent.

IntroductionPain is one of the most commonly reported symptoms in people living with HIV/AIDS (PLWHA). However, wide ranges of pain prevalence have been reported, making it difficult to determine the relative impact of pain in PLWHA. A systematic review of the literature was conducted to establish the prevalence and characteristics of pain and to explore pain management in PLWHA.MethodsStudies that included cross‐sectional data were included in the search, which was conducted in April 2012. Databases searched using a time limit of March 1982 to March 2012 included PubMed, Scopus, Africa‐wide: NIPAD, CINAHL, PsychARTICLES, PSYCINFO, PSYCHIATRYONLINE, ScienceDirect and Web of Science. Search terms selected were "pain" and "HIV" or "acquired immune deficiency syndrome." Two reviewers independently screened all citation abstracts for inclusion. Methodological quality was evaluated using a standardized 11‐item critical appraisal tool.ResultsAfter full text review, 61 studies fulfilled the inclusion criteria. Prevalence of pain ranged from a point prevalence of 54% (95%CI 51.14–56.09) to 83% (95%CI 76–88) using a three‐month recall period. The reported pain was of moderate‐to‐severe intensity, and pain was reported in one to two and a half different anatomical sites. Moderate levels of pain interference with function were reported. All nine studies reporting on the adequacy of pain management recorded marked under‐treatment of pain.DiscussionThe studies reviewed reported that pain commonly presents at multiple pain sites with a range of severity suggesting that there are several differing pathological processes contributing to pain at one time. The interplay of variables associated with pain suggests that the biopsychosocial model of pain is an appropriate paradigm from which to view pain in PLWHA and from which to approach the problem, explore causes and establish effective treatment.ConclusionsThe results highlight that pain is common in PLWHA at all stages of the disease. The prevalence rates for pain in PLWHA do not appear to have diminished over the 30 years spanning the studies reviewed. The body of work available in the literature thus far, while emphasizing the problem of pain, has not had an impact on its management.

Drawing on data collected from 3 focus groups with 24 traditional healers, the aim of this qualitative study was to use the constructs of the Theory of Planned Behaviour (TPB) to gain an understanding of traditional healer referral practices of their patients with a mental illness. Results indicated that traditional healers possess a concept of mental illness, mainly referring to a patient behaving abnormally. They often report regularly treating patients with these behaviours. Traditional healer referral to Western care is considered a temporary measure or a last resort. A majority of healers feel that allopathic physicians do not treat them with the respect that they feel their contribution to the health of the community warrants. Recommendations include the need for traditional healers to be trained to identify potential cases of mental illness in their communities and for dialogue between traditional and allopathic physicians in regard to mental health care.

Global Mental Health and Psychotherapy: Adapting Psychotherapy for Middle- and Low-Income Countries takes a detailed look at how psychotherapies can be adapted and implemented in low- and middle-income countries, while also illuminating the challenges and how to overcome them. The book addresses the conceptual framework underlying global mental health and psychotherapy, focusing on the importance of task-shifting, a common-elements approach, rigorous supervision, and the scaling up of psychotherapies. Specific psychotherapies, such as cognitive-behavioral therapy, interpersonal therapy and collaborative care are given in-depth coverage, as is working with special populations, such as children and adolescents, pregnant women, refugees, and the elderly. In addition, treatment strategies for common disorders, such as depression, anxiety and stress, and substance abuse are covered, as are strategies for more severe mental disorders, such as schizophrenia

Posttraumatic Stress Disorder (PTSD) is a chronic, under-detected and under-treated psychiatric consequence of trauma that is often linked to new-onset medical and psychological conditions, impaired quality of life and long-term disability across the globe. This book is the first systematic analysis of the rates, risk factors, consequences and global burden of trauma and PTSD across a variety of wealthy and underdeveloped settings. An analysis of a global survey conducted by the World Health Organization and featuring findings from over 70,000 participants around the world, this text demonstrates a unique perspective on the prevalence of exposure to trauma and PTSD and the impact it has on population health. The findings inside this text underscore the urgent need for policymakers and healthcare providers to prioritize interventions aimed at reducing the burden of trauma, PTSD and its consequences

Background: Although there is a growing literature on internalized stigma from the developed world, very little research has been conducted in developing countries such as South Africa. Therefore, the purpose of this study was to describe the internalized stigma experienced by members of a mental health advocacy group in South Africa and relationships between self-stigma and other constructs, namely, empowerment, perceived devaluation and discrimination. Methods: Self-administered questionnaires measuring respondents reported levels of internalized stigma, empowerment and perceived devaluation and discrimination were distributed to all the members of the South African Depression & Anxiety Group (SADAG) by post and via email. Of the 850 members invited to participate, 142 members of SADAG completed the questionnaire. Pearson correlations were computed and multiple regression analyses were carried out to analyse the data. Results: The highest reports of stigma were for stigma resistance (mean = 2.9), alienation (mean = 2.47) and perceived discrimination (mean = 2.24). Low levels of stereotype endorsement (mean = 1.77) and social withdrawal (mean = 1.22) were reported. Although respondents often felt that the public held negative attitudes towards individuals suffering with a mental illness (perceived devaluation and discrimination scale (PDD), mean = 2.95), a majority of respondents reported high levels of empowerment (mean = 3.0) and self-efficacy (mean = 2.47). After controlling for socio-demographic factors, higher scores on the PDD were associated with social withdrawal and having experienced discrimination. Conclusion: Internalization of stigma, disempowerment and loss of self-esteem are not inevitable consequences for all individuals with a mental illness. Nevertheless, perceived stigma is significantly associated with social withdrawal and experienced discrimination.

The South African population is exposed to multiple forms of violence. Using nationally representative data from 4,351 South African adults, this study examined the relative risk for posttraumatic stress disorder (PTSD) associated with political, domestic, criminal, sexual and other (miscellaneous) forms of assault in the South African population. Violence exposure was assessed using the 'worst event' list from the WHO's Composite International Diagnostic Interview (CIDI) and a separate questionnaire assessing experiences of human rights abuses, and lifetime PTSD was assessed according to the APA's Diagnostic and Statistical Manual of Mental Disorders criteria using the CIDI. Findings indicated that over a third of the South African population has been exposed to some form of violence. The most common forms of violence experienced by men were criminal and miscellaneous assaults, while physical abuse by an intimate partner, childhood physical abuse and criminal assaults were most common for women. Among men, political detention and torture were the forms of violence most strongly associated with a lifetime diagnosis of PTSD, while rape had the strongest association with PTSD among women. At a population level, criminal assault and childhood abuse were associated with the greatest number of PTSD cases among men, while intimate partner violence was associated with the greatest number of PTSD cases among women. Recommendations for mental health service provision in South Africa and for future research on the relative risk for PTSD are offered.

"PTSD is a chronic, under-detected and under-treated psychiatric consequence of trauma that is often linked to new-onset medical and psychological conditions, impaired quality of life and long-term disability across the globe. This book is the first systematic analysis of the rates, risk factors, consequences and global burden of trauma and PTSD across a variety of wealthy and underdeveloped settings. An analysis of a global survey conducted by the World Health Organisation and featuring findings from over 70,000 participants around the world, this text demonstrates a unique perspective on the prevalence of exposure to trauma and PTSD and the impact it has on population health. The findings inside this text underscore the urgent need for policymakers and healthcare providers to prioritize interventions aimed at reducing the burden of trauma, PTSD and its consequences"--Provided by publisher

This unique book presents original research from the largest cross-national survey of the epidemiology of mental disorders ever conducted. It provides the latest findings from the WHO World Mental Health Surveys based on interviews of nearly 150,000 individuals in twenty-six countries on six continents. The book is ordered by specific disorder, with individual chapters dedicated to presenting detailed findings on the prevalence, onset timing, sociodemographic profile, comorbidity, associated impairment and treatment for eighteen mental disorders. There is also discussion of important cross-national consistencies in the epidemiology of mental disorders and highlighting of intriguing patterns of cross-national variation. This is one of the most comprehensive summaries of the epidemiology of mental disorders ever published, making this an invaluable resource for researchers, clinicians, students and policy-makers in the fields of mental and public health