Psychosis and the diagnostic context of schizophrenia spectrum disorders describe clinically significant positive symptoms (delusions, hallucinations), negative symptoms (social withdrawal, flat affect) and neurocognitive impairment that often present during adolescence and early adulthood. Early identification of the prodrome, the time when attenuated psychotic symptoms emerge, predicts a high-risk phase for psychotic disorder development and is critical for long-term recovery and maintaining a high quality of life. The peak incidence of the prodromal period leading up to first-episode psychosis (FEP) occurs in the late teens and early 20s, coinciding with the typical age of college enrollment. Delayed recognition of FEP due to the insidious pattern of behavioral and perceptual disturbances impacts academic performance, work activities and interpersonal relations (Kane et al., 2016). Given the chronic and costly state of psychotic illness, early detection and intervention to treat or prevent the onset of psychosis in the college setting offers significant potential for improved outcomes.

INTRODUCTION: Methamphetamine associated psychosis (MAP) represents a mental disorder induced by chronic methamphetamine use in a subset of users. The prevalence of the disorder has increased in several countries in Europe and Asia where methamphetamine use has increased. MAP remains difficult to distinguish from primary psychiatric disorders, especially schizophrenia, creating complications in prescribing treatment plans to patients. DESIGN: This narrative review sought to summarize difficulties related to MAP diagnosis and highlight the need for a better treatment model. Current best practices are described and potential novel therapies and future research suggested. RESULTS: Results suggest that clear biological and clinical differences appear between patients presenting with MAP and schizophrenia and that there may exist distinct subgroups within MAP itself. MAP-specific treatment studies have been few and have focused on the use of antipsychotic medication. Antipsychotic treatment has been shown to alleviate the psychotic symptoms of MAP but produce debilitating adverse effects and fail to adequately address methamphetamine use in patients. CONCLUSIONS: Continued identification of subgroups within the heterogenous MAP population may lead to better diagnosis, treatment, and outcomes for patients. Psychosocial therapies should be explored in addressing the cooccurring substance use and psychosis in the treatment of MAP.

Creative art therapy (CAT) for severe mental illness (SMI) represents an extremely heterogenous body of literature that encompasses the use of a large variety of creative mediums (i.e. visual art, music, dance, drama, writing) in the treatment of mental disorders. The present review provides a narrative summary of the findings on the use of CAT for the selected SMI, being: schizophrenia, trauma-related disorders, major depression, and bipolar disorder. A database search of PubMed and the Cochrane Library was conducted related to the use of CAT in the treatment of mental disorders published between January 2008 and March 2019. A total of 9697 citations were identified to match the search criteria and 86 full-texts were reviewed. Although literature suggests CAT to be a potentially low-risk and high benefit intervention to minimize symptoms and maximize functioning in individuals living with SMI, the lack of methodological rigor, and inconsistency in study methods and outcome measures have prevented the advancement of CAT for use in SMI. Although creation of a single CAT regimen for all psychiatric disorders stands neither practical nor advisable, greater standardization of methods would improve evaluation of CAT interventions. Future research should elucidate biological mechanisms underlying CAT methods.

Dear Editor, Individuals diagnosed with a severe mental illness (SMI) hold a significantly increased risk of obesity, diabetes, and cardiovascular disease (Teasdale et al., 2017; Gurusamy et al., 2018). Elevated cardiovascular risk for individuals diagnosed with SMI may be attributable to numerous factors, prominently including a cluster of clinical features that define the metabolic syndrome (MetS): abdominal adiposity, atherogenic dyslipidemia, hypertension, and impaired fasting glucose/ diabetes (Kucerova et al., 2015). The incidence rate of MetS and obesity among patients diagnosed with schizophrenia has been estimated to be as high as 54% and 40–50% respectively, twice that observed in the general population (Gurusamy et al., 2018;Fan et al., 2010).

PURPOSE: The present study sought to examine the diagnosis and treatment of mental disorders comparing Asian American (AA) and non-Hispanic Whites (WNH) drawn from a population accessing a large general hospital for any reason. Socio-demographic predictors of diagnosis and treatment were also explored. METHODS: Data were obtained from de-identified medical records in the Partner Health Care System's Research Patient Data Registry. RESULTS: The final sample included 345,070 self-identified WNH and 16,418 self-identified AA's between January 1, 2009 and December 31, 2009. WNH patients were more likely than AA patients to carry a diagnosis of a mental disorder (18.1% vs. 8.6%, p < 0.0001) and were more likely to receive psychotropic medication treatment (15.0% vs 8.5%, p < 0.0001). Logistic regression analyses of the AA cohort identified several risk factors (i.e. language, religion, gender, age) predicting the diagnosis of a mental disorder or use of psychotropic medication. CONCLUSIONS: Our findings on the racial disparity in mental disorder diagnosis and treatment between AA and WNH patients suggest that mental disorders are under-recognized and mental health services are under-utilized in the AA community. There remains a need for health care providers to improve screening services and to gain a better understanding of the cultural barriers that hinder mental health care among AA patients.