How to adopt the biopsychosocial model

2020 ◽  
pp. 363-380
Author(s):  
Rebecca Roache
Keyword(s):  
Mental Illness ◽  
Biopsychosocial Model ◽  
A Priori ◽  
Mental Illnesses ◽  
The Other ◽  
Social Aspects ◽  
Social Approach ◽  
Biopsychosocial Approach ◽  
Social Explanations ◽  
Social Causes

This chapter focuses on how the biopsychosocial psychiatrist can most appropriately take account of the fact that mental illness has biological, psychological, and social aspects. Commitment to the biopsychosocial model should not involve an a priori acceptance of the view that mental illness always has biological, psychological, and social causes. Adopting the biopsychosocial model should involve recognizing that the understanding of any given mental illness may best be advanced by considering explanations at each of the biological, psychological, and social levels. Often, explanation at one of these levels may be more elucidating than explanations at the other levels, but considering all of them combined is likely to maximize one's understanding. Psychological and social explanations are not eliminable in favour of biological ones, largely because of the way that mental illnesses are conceived and diagnosed. Moreover, commitment to a biopsychosocial approach should not involve commitment to the view that treatment of mental illness should always involve interventions at every level. Which treatment is most effective in any given case—that is, whether a biological, a psychological, or a social approach—can best be decided empirically.

The biopsychosocial model in psychiatry: Engel and beyond

2020 ◽  
pp. 6-22
Author(s):  
Rebecca Roache
Keyword(s):  
Mental Illness ◽  
Mental Disorder ◽  
Effective Treatment ◽  
Empirical Evidence ◽  
Biopsychosocial Model ◽  
Biopsychosocial Approach ◽  
The Social ◽  
The Way

This chapter examines the biopsychosocial model in psychiatry. The term ‘biopsychosocial’ is most strongly associated with George L. Engel, whose most famous article on the biopsychosocial model was published in 1977. In advancing the model, Engel aimed to make explicit how the biological, the psychological, and the social all had a place in conceptualizing mental disorder, and to systematize and enshrine this recognition in the way in which psychiatry is practised. In making decisions about how to treat mental illness, or a given patient, adopting a biopsychosocial approach should involve keeping in mind that the most effective treatment may involve a solely biological intervention, a solely psychological one, a solely social one, or a combination of these. Indeed, a useful and effective biopsychosocial approach reminds one to consider all of these possibilities, and select the most promising one, based on the available empirical evidence.

scholarly journals How Do We Understand Children’s Restlessness? A Critique of the Biopsychosocial Model and ADHD as the Dominating Perspective in Current Understanding and Treatment

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Anna Helle-Valle
Keyword(s):  
Biopsychosocial Model ◽  
Active Role ◽  
The Other ◽  
Current Understanding ◽  
Levels Of Analysis ◽  
Historical Ontology ◽  
Biopsychosocial Approach ◽  
Different Levels ◽  
Better Than

How is children’s restlessness understood and handled by surrounding adults? Two approaches are outlined in this article: one is the biomedical and later the biopsychosocial model, the other is a tradition that can be traced back to Foucault’s concept of historical ontology. The biopsychosocial model and ADHD is currently the dominating perspective when it comes to describing, understanding and treating restlessness in children. In this tradition, a focus on pathology and biology places the root of the problem within the child and positions the surrounding adults as neutral observers and helpers. By contrast, historical ontology opens up to questions about the neutrality and validity of a biopsychosocial approach by pointing to our active role as subjects in creating ideas of truth about children, in judging their behaviour and in “helping” them. Rather than claiming that one approach is better than the other, it can be useful to regard the two traditions as providing different levels of analysis and be aware of the possibilities and limitations pertaining to these.

scholarly journals Improved attitudes of interns versus undergraduate medical students towards patients with mental illness in Saudi Arabia

2021 ◽  
Vol 27 (4) ◽  
pp. 361-372
Author(s):  
Abdulrahman A. Al-Atram
Keyword(s):  
Mental Illness ◽  
Saudi Arabia ◽  
Medical Students ◽  
Mental Illnesses ◽  
The Other ◽  
Psychiatric Training ◽  
Undergraduate Medical Students ◽  
Cross Sectional ◽  
Significant Difference ◽  
Beliefs And Attitudes

Background: The attitudes of medical students towards mental illness are important since these students will be providing care to this group in the future. Aims: To assess the beliefs and attitudes of undergraduate medical students regarding mental illness and to compare students at different levels. Methods: This descriptive, cross-sectional study was conducted among undergraduate medical students in the College of Medicine, Majmaah University, Saudi Arabia, during the 2018–2019 academic years. Male students were included from Years 3–5 (25 from each year) and 25 male interns using the proportionate stratified random sampling method. The participants responded to the Beliefs about Mental Illness (BMI) Scale and the Attitudes towards Mental Illness Questionnaire (AMIQ) Results: Bonferroni post hoc tests were used to conduct between-group comparisons of the year 3 group, who were at the beginning of their psychiatric training, with the other groups with more training. This revealed significant differences in scores for 11 of 21 items on the BMI Scale (P < 0.05). All questions regarding the 4 vignettes of the AMIQ (substance abuse, depression, psychosis, and obsessive compulsive disorders) showed a significant difference between students in year 3 and those in the other groups who had more psychiatric training (P < 0.05). Conclusions: The current medical psychiatric training positively improved the beliefs and attitudes of medical students towards patients with mental illnesses.

scholarly journals What neuroscience has already done for us

2020 ◽  
Vol 44 (3) ◽  
pp. 110-112
Author(s):  
Lindsey Isla Sinclair
Keyword(s):  
Mental Illness ◽  
Life Events ◽  
Biopsychosocial Model ◽  
Mental Illnesses ◽  
Genetic Abnormalities

SummaryEach of the components of the biopsychosocial model of mental illness is important for understanding mental illness. Biological and genetic abnormalities have been demonstrated in major mental illnesses. These are leading to changes in our understanding of these conditions, as well as our understanding of the link between life events and mental illness.

scholarly journals A case for psychosocial interventions to prevent mental illness

2019 ◽  
Vol 25 (05) ◽  
pp. 333-334
Author(s):  
Tom K. J. Craig
Keyword(s):  
Risk Factors ◽  
Mental Illness ◽  
Psychosocial Interventions ◽  
Well Being ◽  
Early Years ◽  
Mental Illnesses ◽  
The Other ◽  
Targeted Intervention ◽  
Psychosocial Conditions ◽  
The Many

SUMMARYThe development of effective preventions for psychosis is hindered by conceptual challenges underlying diagnosis and the fact that few of the many biological risk factors identified to date are sufficiently well understood to form the basis of a targeted intervention. On the other hand, a great deal is known of the psychosocial conditions that increase the lifetime risk of most mental illnesses: surely enough to justify better resourcing of interventions focused on antenatal care and the emotional well-being of children from the early years through adolescence, where as much as a half of all mental ill health has its roots.DECLARATION OF INTERESTNone.

scholarly journals Two aspects of art: Suicide mental illness and therapy

2017 ◽  
Vol 6 (3) ◽  
pp. 77-82
Author(s):  
Hakkı Engin Giderer
Keyword(s):  
Mental Illness ◽  
Art Therapy ◽  
Life Stories ◽  
Mental Illnesses ◽  
The Other ◽  
Other Hand ◽  
Commit Suicide

Examining the life stories of some productive artists; it is seen that they struggle with mental illnesses, intensely deal with the thought of death and they even commit suicide. On the other hand, we believe that art has a curative power. Art therapy is known by physicians, therapists and trainers. Art is also used in various ways for treatment. If the process of creation pulls an artist into a mental illness and thoughts about death, then how does it possibly cure? This text tries to explain the dilemma in question.   Keywords: art, mental illness, therapy, suicide, madness.  

scholarly journals Meaning and Matter in Psychiatry: A Historical View and New Approach

2020 ◽  
Vol 8 (3) ◽  
pp. 376
Author(s):  
Ketil Slagstad
Keyword(s):  
Mental Illness ◽  
Network Model ◽  
Biopsychosocial Model ◽  
Cultural Factors ◽  
Mental Illnesses ◽  
Social Psychological ◽  
New Approach ◽  
Historical View ◽  
Medical Network ◽  
Person Centered Approach

In this article, I argue that a person-centered approach in psychiatry needs to pay attention to how mental illnesses are historically constituted and products of biological, social, psychological and cultural factors. Even if the ambition of the biopsychosocial model and the medical network model was to break with reductionist understandings of (mental) illness, I argue that these models risk stabilising, rather than deconstructing dichotomies between nature versus culture, brain versus mind, somatic versus mental or hard facts versus soft sciences. I rather propose to re-orient psychiatry as a form of “relational medicine” in which causes and reasons are treated as inseparable and where matter and meaning are entangled. A person-centered approach in psychiatry must start with the person including the embodied production of meaning in Society.

Prescriptive Power: Biologism, Biopsychiatry and Drug-centred Psychopharmacology

Somatechnics ◽  
2019 ◽  
Vol 9 (2-3) ◽  
pp. 291-309
Author(s):  
Francis Russell
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Social Justice ◽  
Cultural Theory ◽  
Human Experience ◽  
Mental Illnesses ◽  
False Consciousness ◽  
The Subject ◽  
Biological Ontology ◽  
Health Discourse

This paper looks to make a contribution to the critical project of psychiatrist Joanna Moncrieff, by elucidating her account of ‘drug-centred’ psychiatry, and its relation to critical and cultural theory. Moncrieff's ‘drug-centred’ approach to psychiatry challenges the dominant view of mental illness, and psychopharmacology, as necessitating a strictly biological ontology. Against the mainstream view that mental illnesses have biological causes, and that medications like ‘anti-depressants’ target specific biological abnormalities, Moncrieff looks to connect pharmacotherapy for mental illness to human experience, and to issues of social justice and emancipation. However, Moncrieff's project is complicated by her framing of psychopharmacological politics in classical Marxist notions of ideology and false consciousness. Accordingly, she articulates a political project that would open up psychiatry to the subjugated knowledge of mental health sufferers, whilst also characterising those sufferers as beholden to ideology, and as being effectively without knowledge. Accordingly, in order to contribute to Moncrieff's project, and to help introduce her work to a broader humanities readership, this paper elucidates her account of ‘drug-centred psychiatry’, whilst also connecting her critique of biopsychiatry to notions of biologism, biopolitics, and bio-citizenship. This is done in order to re-describe the subject of mental health discourse, so as to better reveal their capacities and agency. As a result, this paper contends that, once reframed, Moncrieff's work helps us to see value in attending to human experience when considering pharmacotherapy for mental illness.

Effective e-health design for those with, and without, mental health disorders: shallow navigation, concentrated contents, modest number of links, one screen area for links. (Preprint)

2018 ◽  
Author(s):  
Armando Rotondi ◽  
Jonathan Grady ◽  
Barbara H. Hanusa ◽  
Michael R. Spring ◽  
Kaleab Z. Abebe ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Success Rate ◽  
Fractional Factorial ◽  
Mental Illnesses ◽  
Schizophrenia Spectrum Disorders ◽  
Design Elements ◽  
Website Usability ◽  
Schizophrenia Spectrum ◽  
Health Applications

BACKGROUND E-health applications are an avenue to improve service responsiveness, convenience, and appeal, and tailor treatments to improve relevance, engagement, and use. It is critical to user engagement that the designs of e-health applications are intuitive to navigate. Limited research exists on designs that work for those with a severe mental illness, many of whom infrequently seek treatment, and tend to discontinuation medications and psychosocial treatments. OBJECTIVE The purpose of this study was to evaluate the influence of 12 design elements (e.g., website depth, reading level, use of navigational lists) on the usability of e-health application websites for those with, and without, mental health disorders (including severe mental illness). METHODS A 212-4 fractional factorial experimental design was used to specify the designs of 256 e-health websites, which systematically varied the 12 design elements. The final destination contents of all websites were identical, only the navigational pages varied. Three subgroups of participants comprising 226 individuals, were used to test these websites (those with schizophrenia-spectrum disorders, other mental illnesses, and no mental illness). Unique to this study was that the 12 design elements were manipulated systematically to allow assessment of combinations of design elements rather than only one element at a time. RESULTS The best and worst designs were identified for each of the three subgroups, and the sample overall. The depth of a website’s navigation, that is, the number of screens/pages users needed to navigate to find desired content, had the strongest influence on usability (ability to find information). The worst performing design for those with schizophrenia-spectrum disorders had an 8.6% success rate (ability to find information), the best had a 53.2% success rate. The navigational design made a 45% difference in usability. For the subgroup with other mental illnesses the design made a 52% difference, and for those with no mental illness a 50% difference in success rate. The websites with the highest usability all had several key similarities, as did the websites with the poorest usability. A unique finding is that the influences on usability of some design elements are variable. For these design elements, whether they had a positive or negative effect, and the size of its effect, could be influenced by the rest of the design environment, that is, the other elements in the design. This was not the case for navigational depth, a shallower hierarchy is better than a deeper hierarchy. CONCLUSIONS It is possible to identify evidence-based strategies for designing e-health applications that result in a high level of usability. Even for those with schizophrenia, or other severe mental illnesses, there are designs that are highly effective. The best designs have key similarities, but can also vary in some respects. Key words: schizophrenia, severe mental illness, e-health, design, website, usability, website design, website usability, fractional factorial design.

scholarly journals Use of a Consultation Service Following Pharmacogenomic Testing in Psychiatry

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 179-180
Author(s):  
Daniel Dowd ◽  
David S. Krause
Keyword(s):  
Mental Illness ◽  
Drug Interactions ◽  
Metabolic Pathways ◽  
Patient Characteristics ◽  
Healthcare Resource Utilization ◽  
Machine Learning Algorithms ◽  
Mental Illnesses ◽  
Variable Response ◽  
Drug Induced ◽  
Commercial Laboratory

AbstractBackgroundThere is a plethora of drugs available to psychiatrists for treatment of mental illness, which can vary in efficacy, tolerability, metabolic pathways and drug-drug interactions. Psychotropics are the second most commonly listed therapeutic class mentioned in the FDA’s Table of Pharmacogenomic Biomarkers in Drug Labeling. Pharmacogenomic (PGx) assays are increasingly used in psychiatry to help select safe and appropriate medication for a variety of mental illnesses. Our commercial laboratory offers PGx expert consultations by PharmDs and PhDs to clinician-users. Our database contains valuable information regarding the treatment of a diverse and challenging population.MethodsGenomind offers a PGx assay currently measuring variants of 24 genes relevant for selection of drugs with a mental illness indication. Since 2012 we have analyzed > 250,000 DNA samples. Between 10/18 - 8/20 6,401 reports received a consult. The data contained herein are derived from those consults. Consultants record information on prior meds, reason for failure or intolerability, potential risk-associated or useful drugs based on the genetic variants. Consultants only recommend specific drugs and doses consistent with a published PGx guideline.ResultsThe 5 most commonly discussed genes were SLC6A4, MTHFR, CACNA1C, COMT and BDNF. The 3 most commonly discussed drugs were fluoxetine, lithium and duloxetine. The most common reasons for drug failure were inefficacy and drug induced “agitation, irritability and/or anxiety”. SSRIs were the most common class of discontinued drug; sertraline, escitalopram and fluoxetine were the three most commonly reported discontinuations and were also the 3 most likely to be associated with “no improvement”. Aripiprazole was the most commonly reported discontinued atypical antipsychotic. The providers rated 94% of consultations as extremely or very helpful at the time of consult. An independent validation survey of 128 providers confirmed these ratings, with 96% reporting a rating of “very helpful” or “extremely helpful”. In addition, 94% reported that these consults were superior to PGx consults provided through other laboratories. Patient characteristics captured during consults via a Clinical Global Impressions-Severity (CGI-S) scale revealed that the majority of patients were moderately (54%) or markedly ill (23%). The most frequent symptoms reported were depression, anxiety, insomnia and inattentiveness.DiscussionThe large variety of psychotropic drugs available to providers, and their highly variable response rates, tolerability, capacity for drug-drug interactions and metabolic pathways present a challenge for even expert psychopharmacologists. Consultation with experts in PGx provides additional useful information that may improve outcomes and decrease healthcare resource utilization. This database may provide future opportunities for machine learning algorithms to further inform implications of included gene variants.FundingGenomind, Inc.

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