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West Indian Medical Journal

versión impresa ISSN 0043-3144

West Indian med. j. vol.61 no.5 Mona ago. 2012




Mental health



EN Barton

Editor-in-Chief, West Indian Medical Journal and Department of Medicine, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica




In this issue of the Journal, there is a compilation of papers on mental health. Over the last fifty years, there has been a movement away from involuntary certification and custodialization of psychiatric patients to one of family therapy and community engagement (1). Although research has revealed longstanding psychopathological effects of slavery and colonialism on the Caribbean population, Robertson-Hickling and Hickling have argued that the mechanism of resilience and formation of social capital have ensured the well-being of Caribbean people through dire circumstances (2, 3).

Abel et al commends the progress in integration of mental health policy and practice in the English-speaking Caribbean. He argues that much effort is still needed to reform mental health legislation and incorporate mental health practice in primary care (4).

Depression is a major cause of morbidity worldwide and can lead to fatality. Campbell et al report on a head-on comparison between the Zung Self-rating Depression Scale and the Beck Depression Inventory-II (BDI-II) in university students. They found that the BDI-II demonstrated superior psychometric properties (5). Ignjatovic-Ristić et al, also in a university sample, showed no significant difference in depression with respect to year of testing, age, economic status and educational profile but there were differences between genders using the Beck Depression Inventory (6). Abel et al researched depressive symptoms in adolescents in primary and secondary schools in Jamaica and reported a frequency of 4.5% with depressive symptoms (7). Physicians are alerted to look for depression in chronic disease patients such as patients with cardiovascular diseases assessed by Martin et al (8).

Abdirahman et al surveyed adolescents in the Cayman Islands, St Lucia, St Vincent and the Grenadines, and Trinidad and Tobago and found a strong association between bullying and poor mental health (9). This bulling could be a cause of depression and suicide.

Suicide is a major public health issue in Japan and Inoue et al in two letters to the editor emphasized the importance of suicide prevention measures in bipolar disorders and in the elderly (10, 11). Abel et al reported that suicide rates in Jamaica between 2002 and 2010 were stable with a mean overall incidence of 2.1 per 100 000 population (12). However, according to Holder-Nevins et al, in adolescents in Jamaica, the suicide rate was 1.1 per 100 000 for 2007 to 2010 (13). Abel et al noted that the prevalence of suicide ideation among Jamaican youth was 9.7% (14) and Williams-Johnson et al reported that in the Emergency Room at the University Hospital of the West Indies, attempted suicide by self-poisoning was seen more in females and the age group 16–30 years represented the largest number of cases (15). Inoue et al investigated the relationship between suicide and some climatic conditions and reported that annual age-adjusted suicide rates were significantly correlated with annual mean relative humidity (16).

Belli and Ural reported from a literature search on the association between schizophrenia and violent or homicidal behaviour. They outlined some factors which might increase the potential for violent episodes in schizophrenic patients (17).

Sertbas et al found that for all psychiatric symptoms and diseases, co-morbidities were higher in patients with irritable bowel syndrome than the population without it (18).

Al-Mobeeriek assessed psychiatric patients' oral health and found that oral health among psychiatric patients was worse than in normal controls (19).

Mental health must be considered pertinent to the management of the whole patient and mental health practices must be integrated into primary care.



1. Hickling FW, Gibson RC. Decolonization of psychiatric public policy in Jamaica. West Indian Med J 2012; 61: 437–41.

2. Hickling FW, Hutchinson G. Caribbean contributions to contemporary psychiatric psychopathology. West Indian Med J 2012; 61: 442–6.

3. Robertson-Hickling H, Hickling FW. Risk and resilience in African Caribbean migration to the United Kingdom. In: Thomas Hope E, ed. Freedom and constraint in Caribbean migration and diapora. Kingston, Jamaica: Ian Randle Publishers; 2008.

4. Abel WD, Kestel D, Eldemire-Shearer D, Sewell C, Whitehorne-Smith P. Mental health policy and service system development in the English-speaking Caribbean. West Indian Med J 2012; 61: 475–82.

5. Campbell MH, Maynard D, Roberti JW, Emmanuel MK. A comparison of the psychometric strengths of the public-domain Zung Self-rating Depression Scale with the proprietary Beck Depression Inventory-II in Barbados. West Indian Med J 2012; 61: 483–8.

6. Ignjatovic-Ristić D, Hinić D, Jović J. Evaluation of the Beck Depression Inventory in a nonclinical student sample. West Indian Med J 2012; 61: 489–93.

7. Abel WD, Bailey-Davidson Y, Gibson RC, Martin JS, Sewell CA, James S et al. Depressive symptoms in adolescents in Jamaica. West Indian Med J 2012; 61: 494–8.

8. Martin JS, Neita SM, Gibson RC. Depression among cardiovascular disease patients on a consultation-liaison service at a general hospital in Jamaica. West Indian Med J 2012; 61: 499–503.

9. Abdirahman HA, Bah TT, Shrestha HL, Jacobsen KH. Bullying, mental health and parental involvement among adolescents in the Caribbean. West Indian Med J 2012; 61: 504–8.

10. Inoue K, Okazaki Y, Kaiya H, Fujita Y. An issue to keep in mind regarding specific suicide prevention measures: focussing on bipolar disorders. West Indian Med J 2012; 61: 555.

11. Inoue K, Fukunaga T, Fujita Y, Okazaki Y. The continued importance of suicide prevention among the elderly in Japan. West Indian Med J 2012; 61: 555.

12. Abel W, James K, Bridgelal-Nagassar R, Holder-Nevins D, Eldemire H, Thompson E et al. The epidemiology of suicide in Jamaica 2002–2010: rates and patterns. West Indian Med J 2012; 61: 509–15.

13. Holder-Nevins D, James K, Bridgelal-Nagassar R, Bailey A, Thompson E, Eldemire H et al. Suicide among adolescents in Jamaica: what do we know. West Indian Med J 2012; 61: 516–20.

14. Abel WD, Sewell C, Martin JS, Bailey-Davidson Y, Fox K. Suicide ideation in Jamaican youth: sociodemographic prevalence, protective and risk factors. West Indian Med J 2012; 61: 521–5.

15. Williams-Johnson J, Williams E, Gossell-Williams M, Sewell CA, Abel WD, Whitehorne-Smith PA. Suicide attempt by self-poisoning: characteristics of suicide attempters seen at the emergency room at the University Hospital of the West Indies. West Indian Med J 2012; 61: 526–31.

16. Inoue K, Nishimura Y, Fujita Y, Ono Y, Fukunaga T. The relationship between suicide and five climate issues in a large-scale and long term study in Japan. West Indian Med J 2012; 61: 532–7.

17. Belli H, Ural C. The association between schizophrenia and violent or homicidal behaviour: the prevention and treatment of violent behaviour in these patients. West Indian Med J 2012; 61: 538–43.

18. Sertbas Y, Belli H, Piskinpasa N, Ural C, Akbudak M, Sertbas M et al. Assessment of psychiatric symptoms and co-morbidities in patients with irritable bowel syndrome. West Indian Med J 2012; 61: 544–8.

19. Al-Mobeeriek A. Oral health status among psychiatric patients in Riyadh, Saudi Arabia. West Indian Med J 2012; 61: 549–54.



Professor EN Barton
Department of Medicine, Faculty of Medical Sciences, The University of the West Indies
Kingston 7, Jamaica