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Ametaj AA, Denckla CA, Stevenson A, Stroud RE, Hall J, Ongeri L, Milkias B, Hoffman J, Naisanga M, Akena D, Kyebuzibwa J, Kwobah EK, Atwoli L, Gichuru S, Teferra S, Alemayehu M, Zingela Z, Stein DJ, Pretorius A, Newton CR, Mwema RM, Kariuki SM, Koenen KC, Gelaye B. Cross-cultural equivalence of the Kessler Psychological Distress Scale (K10) across four African countries in a multi-national study of adults. SSM - MENTAL HEALTH 2024; 5:100300. [PMID: 38706931 PMCID: PMC11064105 DOI: 10.1016/j.ssmmh.2024.100300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
The Kessler Psychological Distress Scale (K10) has been widely used to screen psychological distress across many countries. However, its performance has not been extensively studied in Africa. The present study sought to evaluate and compare measurement properties of the K10 across four African countries: Ethiopia, Kenya, Uganda, and South Africa. Our hypothesis is that the measure will show equivalence across all. Data are drawn from a neuropsychiatric genetic study among adult participants (N = 9179) from general medical settings in Ethiopia (n = 1928), Kenya (n = 2556), Uganda (n = 2104), and South Africa (n = 2591). A unidimensional model with correlated errors was tested for equivalence across study countries using confirmatory factor analyses and the alignment optimization method. Results displayed 30 % noninvariance (i.e., variation) for both intercepts and factor loadings across all countries. Monte Carlo simulations showed a correlation of 0.998, a good replication of population values, indicating minimal noninvariance, or variation. Items "so nervous," "lack of energy/effortful tasks," and "tired" were consistently equivalent for intercepts and factor loadings, respectively. However, items "depressed" and "so depressed" consistently differed across study countries (R2 = 0) for intercepts and factor loadings for both items. The K10 scale likely functions equivalently across the four countries for most items, except "depressed" and "so depressed." Differences in K10 items were more common in Kenya and Ethiopia, suggesting cultural context may influence the interpretation of some items and the potential need for cultural adaptations in these countries.
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Affiliation(s)
- Amantia A. Ametaj
- Institute of Health Equity and Social Justice, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T. H Chan School of Public Health, Boston, MA, 02115, USA
| | - Christy A. Denckla
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Anne Stevenson
- Department of Epidemiology, Harvard T. H Chan School of Public Health, Boston, MA, 02115, USA
- Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rocky E. Stroud
- Department of Epidemiology, Harvard T. H Chan School of Public Health, Boston, MA, 02115, USA
- Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Jasmine Hall
- Department of Epidemiology, Harvard T. H Chan School of Public Health, Boston, MA, 02115, USA
| | - Linnet Ongeri
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Barkot Milkias
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jacob Hoffman
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Unit on Risk and Resilience in Mental Disorders, South African Medical Research Council (SAMRC), Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Molly Naisanga
- Department of Psychiatry, Makerere University, Kampala, Uganda
| | - Dickens Akena
- Department of Psychiatry, Makerere University, Kampala, Uganda
| | | | - Edith K. Kwobah
- Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Lukoye Atwoli
- Department of Mental Health, Moi University School of Medicine, Eldoret, Kenya
- Department of Internal Medicine, Medical College East Africa, Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - Stella Gichuru
- Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret, Kenya
- Department of Internal Medicine, Medical College East Africa, Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - Solomon Teferra
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Melkam Alemayehu
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zukiswa Zingela
- Executive Dean’s Office, Faculty of Health Sciences, Nelson Mandela University, Gqeberha, South Africa
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Unit on Risk and Resilience in Mental Disorders, South African Medical Research Council (SAMRC), Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Adele Pretorius
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Charles R.J.C. Newton
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Unit, Kenya Medical Research Institute - Wellcome Trust Research Program, Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Rehema M. Mwema
- Neuroscience Unit, Kenya Medical Research Institute - Wellcome Trust Research Program, Kilifi, Kenya
| | - Symon M. Kariuki
- Neuroscience Unit, Kenya Medical Research Institute - Wellcome Trust Research Program, Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T. H Chan School of Public Health, Boston, MA, 02115, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Bizu Gelaye
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T. H Chan School of Public Health, Boston, MA, 02115, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Albuquerque Perrelli JG, García-Cerde R, Medeiros PFPD, Sanchez ZM. Profiles of mental illness in college students and associated factors: A latent class analysis. J Psychiatr Res 2024; 175:9-19. [PMID: 38701610 DOI: 10.1016/j.jpsychires.2024.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 03/26/2024] [Accepted: 04/22/2024] [Indexed: 05/05/2024]
Abstract
Mental illness among university students poses a pressing challenge for educational institutions, urging the need for strategies that foster health and mitigate mental distress, with an emphasis on preventing suicide. Our study sought to discern the profiles of mental illness among college students and explore the factors associated with them. We examined data from 918 students at a Brazilian Federal Institute, utilizing Latent Class Analysis and multinomial regression for our analyses. We identified three distinct mental illness profiles: Anxiety with Low Suicide Risk; Mental Illness with Moderate Suicide Risk; and Mental Illness with High Suicide Risk. We observed a reduced association of these profiles with religious beliefs. Conversely, there was a heightened association with cisgender women, individuals identifying as LGBTQI+, those with learning disabilities, and victims of sexual violence. Our findings underscore the importance of tailored prevention and health promotion programs to enhance student well-being. There's a compelling need to devise mental health strategies tailored to the specific needs of the identified groups, particularly students from the LGBTQI + community, survivors of sexual abuse, and those grappling with learning disabilities.
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Affiliation(s)
- Jaqueline Galdino Albuquerque Perrelli
- Department of Preventive Medicine, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Department of Nursing, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
| | - Rodrigo García-Cerde
- Department of Preventive Medicine, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Zila M Sanchez
- Department of Preventive Medicine, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
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Kambulandu M, Ogundipe RM, Bryden M, Sao L, Thompson DM, McGuire CM, Jack BW. Psychological distress and PTSD among clinicians in Roma, Lesotho during the COVID-19 pandemic. S Afr Fam Pract (2004) 2024; 66:e1-e7. [PMID: 38572883 PMCID: PMC10913056 DOI: 10.4102/safp.v66i1.5785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Since 2020, the world has been battling the coronavirus disease 2019 (COVID-19) pandemic. The mortality and morbidity at the height of the pandemic sparked generalised fear and uncertainty about the future. Concerns were raised about the psychological impact of the pandemic on workers in healthcare systems globally. This study was conducted to establish the degree of psychological impact of the pandemic on frontline health workers in Lesotho. METHODS The study used a quantitative cross-sectional survey design. The Kessler psychological distress screening tool (K-10) and the post-traumatic stress disorder (PTSD) checklist for civilians (PCL-C) were administered to screen for psychological distress among clinical staff at St. Joseph's Hospital in Roma and its four Health Centres. Additional open- and closed-ended questions were added for context. Data were analysed using Fisher's exact tests, Pearson chi-square tests and correlation studies. RESULTS Of the 101 participants, 42 (41.6%) scored ≥ 24 on the K-10 scale (95% CI: 32.0% - 51.2%) indicating moderate to severe psychological distress and 32 (31.7%) scored ≥ 50 on the PCL-C checklist suggesting severe PTSD (95% CI: 24.5% - 42.9%). High scores on the K-10 were found more among men than women (17 [37.8%] vs. 4 [7.1%]; p ≤ 0.001). Post-traumatic stress disorder was more in the younger age group (p ≤ 0.03), in those reporting anxiety (p = 0.005) and those with more co-morbidities (p ≤ 0.001). CONCLUSION This study revealed the grave psychological impact of the COVID-19 pandemic on frontline clinical health workers in Lesotho.Contribution: These data will assist health leaders and policymakers to implement mental health support interventions for health workers in future.
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Affiliation(s)
- Muila Kambulandu
- Department of Family Medicine, Faculty of Family Medicine, Lesotho Boston Health Alliance, Leribe.
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Ramlagan S, Sewpaul R, Shean Y, Schmidt T, North A, Reddy SP. Psychological distress among South African healthcare workers during the COVID-19 pandemic. Curationis 2024; 47:e1-e12. [PMID: 38426792 PMCID: PMC10912894 DOI: 10.4102/curationis.v47i1.2477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 11/23/2023] [Accepted: 12/07/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has placed immense pressure on healthcare workers (HCWs). OBJECTIVES This study sought to find the prevalence and factors associated with psychological distress among HCWs in South Africa during the beginning phases of COVID-19 and make relevant recommendations. METHOD The survey was administered online through a data-free platform. Data were benchmarked to the national population of over 500 000 healthcare professionals in South Africa. Multiple logistic regressions were used to determine association between psychological distress and potential explanatory variables. RESULTS A total of 7607 healthcare professionals participated in the study (1760 nurses, 2843 medical practitioners and 3004 other healthcare professionals). Half of the nurses, 41% of medical practitioners and 47% of other healthcare professionals were classified as psychologically distressed. Those who were of older age, provided with well-being support services and having a positive outlook on the healthcare system were significantly less likely to be distressed. Being female medical practitioners and female other healthcare professions, requesting routine counselling, being concerned about not having enough leave and that their life insurance policy did not cover COVID-19 were more likely to be distressed. CONCLUSION Psychological well-being of HCWs in South Africa is at risk. We recommend that psychological distress of HCWs be routinely assessed and that routine counselling, well-being support services, appropriate hazardous leave and insurance be provided to all HCWs.Contribution: This study adds to the literature on the psychological distress faced by HCWs in South Africa during COVID-19.
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Affiliation(s)
- Shandir Ramlagan
- Department of Human and Social Capabilities, Human Sciences Research Council, Pretoria.
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Culbreth RE, Nielsen KE, Mobley K, Palmier J, Bukuluki P, Swahn MH. Life Satisfaction Factors, Stress, and Depressive Symptoms among Young Women Living in Urban Kampala: Findings from the TOPOWA Project Pilot Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:184. [PMID: 38397675 PMCID: PMC10887819 DOI: 10.3390/ijerph21020184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/19/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024]
Abstract
Young women living in Kampala, Uganda, often face adversities related to Social Determinants of Mental Health (SDoMH) including poverty, food scarcity, environmental stressors such as high levels of community violence, and lack of adequate healthcare access. Two consecutive pilot studies were conducted to assess the feasibility and acceptability of survey questions, wearable fitness trackers, and daily diaries before launching a larger prospective cohort study. Preliminary associations between SDoMH factors with depressive symptoms, stress levels, and life satisfaction were examined among the total sample of 60 women across two pilot studies. A total of 32.2% of respondents (out of n = 59) reported being depressed most or all of the time in the past 30 days. Frequent depressive symptoms correlated with food insecurity (χ2 = 5.38, df = 1, p = 0.02). Higher stress levels were significantly associated with lower overall life satisfaction scores (t = 2.74, df = 6.20, p = 0.03). Additionally, frequent depressive symptoms were associated with lower satisfaction scores in the living conditions and lifestyle domain (t = 2.22, df = 36.18, p = 0.03). However, overall life satisfaction scores and other domains (social relationships and personal independence) were not statistically associated with frequent depressive symptoms. Identifying the most impactful SDoMH factors among young women in Kampala can inform targeted approaches to improve mental health outcomes.
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Affiliation(s)
- Rachel E. Culbreth
- American College of Medical Toxicology, 10645 N. Tatum Blvd, Phoenix, AZ 85028, USA;
| | - Karen E. Nielsen
- School of Public Health, Georgia State University, 140 Decatur Street, Atlanta, GA 30303, USA;
| | - Kate Mobley
- School of Data Science and Analytics, College of Computing and Software Engineering, Kennesaw State University, Kennesaw, GA 30144, USA;
| | - Jane Palmier
- Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA 30144, USA;
| | - Paul Bukuluki
- School of Social Sciences, Makerere University, Kampala P.O. Box 7062, Uganda;
| | - Monica H. Swahn
- Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA 30144, USA;
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Talebi M, Taghipour A, Raouf-Rahmati A, Farokhani EM, Ghaffariyan-Jam S, Samarghandi A, Nemati M, Nemati A. Prevalence of mental disorders among middle-aged population of primary healthcare centers in Northeastern Iran. BMC Public Health 2024; 24:80. [PMID: 38172756 PMCID: PMC10763134 DOI: 10.1186/s12889-023-17598-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/27/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Primary healthcare centers (PHCs) serve as the cornerstone of accessible medical services in society, playing a crucial role in screening, detecting, and treating various health issues. This study aimed to investigate the prevalence of psychiatric disorders in middle-aged individuals who refer to PHCs and the potential of PHCs in diagnosing mental disorders. METHODS This cross-sectional study was implemented at PHCs under the supervision of Mashhad University of Medical Sciences (MUMS) in northeast Iran in 2018. The enrolled subjects were middle-aged adults who had electronic medical records in SINA, an integrated health management system, and the electronic medical records of MUMS. The prevalence of psychiatric disorders by type and their relationship with demographic information was evaluated by a Chi-square test using SPSS 22. RESULTS This study involved 218,341 middle-aged participants. Prevalence of psychiatric disorders was 8.59%, and depression (53.72%) and anxiety (42.02%) were the most common psychiatric disorders in both males and females. The prevalence of mental disorders was significantly higher in females than in males (88.18% vs. 18.81%; P < 0.0001). Indeed, a significant higher prevalence of depression, anxiety, somatoform, childhood psychiatric disorder, and bipolar disorders was observed in females compared to males (P < 0.05). In addition, individuals between the age of 45-60 years, and those from rural areas showed more prevalence of mental disorders than others, but these differences were not significant. CONCLUSIONS Considering the previous studies in Iran, the prevalence of mental disorders among patients presenting to PHCs was noticeably lower than expected rates. It seems probable that this huge difference is due to poor screening and detection of mental illness in PHCs of MUMS. It is recommended that health policymakers pursue specific measures to make PHCs more helpful for people with mental health problems in the community.
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Affiliation(s)
- Mehdi Talebi
- Department of Community and Family Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Taghipour
- Health Sciences Research Center, Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amene Raouf-Rahmati
- Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | | | - Azadeh Samarghandi
- Department of Psychology, Faculty of Education Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Maryam Nemati
- Internal Medicine, Endocrinology and Diabetes Optum, Laguna Niguel, Ca, USA
| | - Ahmad Nemati
- Mashhad University of Medical Sciences, Mashhad, Iran.
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Bulterys MA, Njuguna I, King'e M, Chebet D, Moraa H, Gomez L, Onyango A, Malavi K, Nzia G, Chege M, Neary J, Wagner AD, Lawley KA, Wamalwa D, Benki-Nugent S, John-Stewart G. Neurodevelopment of children who are HIV-exposed and uninfected in Kenya. J Int AIDS Soc 2023; 26 Suppl 4:e26149. [PMID: 37909174 PMCID: PMC10618871 DOI: 10.1002/jia2.26149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 08/14/2023] [Indexed: 11/02/2023] Open
Abstract
INTRODUCTION Predictors of neurodevelopment among children who are HIV-exposed uninfected (CHEU) are poorly understood. METHODS Mothers with and without HIV and their children were enrolled during 6-week postnatal care visits across seven sites in Kenya between March 2021 and June 2022. Infant neurodevelopment was assessed using the Malawi Developmental Assessment Tool, including social, language, fine motor and gross motor domains. We used multivariate linear mixed effects models to identify associations between 1-year neurodevelopment scores, HIV and antiretroviral therapy (ART) exposures, and household factors, adjusted for potential confounders and clustered by the site. RESULTS At 1-year evaluation, CHEU (n = 709) and children who are HIV-unexposed uninfected (CHUU) (n = 715) had comparable median age (52 weeks) and sex distribution (49% vs. 52% female). Mothers living with HIV were older (31 vs. 27 years), had lower education (50% vs. 26% primary) and were more likely to be report moderate-to-severe food insecurity (26% vs. 9%) (p < 0.01 for all). Compared to CHUU, CHEU had higher language scores (adjusted coeff: 0.23, 95% CI: 0.06, 0.39) and comparable social, fine and gross motor scores. Among all children, preterm birth was associated with lower gross motor scores (adjusted coeff: -1.38, 95% CI: -2.05, -0.71), food insecurity was associated with lower social scores (adjusted coeff: -0.37, 95% CI: -0.73, -0.01) and maternal report of intimate partner violence (IPV) was associated with lower fine motor (adjusted coeff: -0.76, 95% CI: -1.40, -0.13) and gross motor scores (adjusted coeff: -1.07, 95% CI: -1.81, -0.33). Among CHEU, in utero efavirenz (EFV) exposure during pregnancy was associated with lower gross motor scores compared to dolutegravir (DTG) exposure (adjusted coeff: -0.51, 95% CI: -1.01, -0.03). Lower fine and gross motor scores were also associated with having a single or widowed mother (adjusted coeff: -0.45, 95% CI: -0.87, -0.03) or a deceased or absent father (adjusted coeff: -0.81, 95% CI: -1.58, -0.05), respectively. CONCLUSIONS Biologic and social factors were associated with child neurodevelopment. Despite socio-demographic differences between CHEU and CHUU, 1-year neurodevelopment was similar. Addressing IPV and food insecurity may provide benefits regardless of maternal HIV status. DTG use was associated with higher neurodevelopmental scores in CHEU, compared to EFV regimens, potentially contributing to a lack of neurodevelopmental difference between CHEU and CHUU.
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Affiliation(s)
- Michelle A Bulterys
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Irene Njuguna
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Kenyatta National Hospital, Nairobi, Kenya
| | - Maureen King'e
- Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Daisy Chebet
- Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | | | - Laurén Gomez
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | | | | | | | | | - Jillian Neary
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Anjuli D Wagner
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Kendall A Lawley
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Dalton Wamalwa
- Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Sarah Benki-Nugent
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Grace John-Stewart
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Departments of Pediatrics, Medicine, University of Washington, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
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Lee BEC, Ling M, Boyd L, Olsson CA, Sheen J. Key predictors of psychological distress and wellbeing in Australian frontline healthcare workers during COVID-19 (Omicron wave). Front Psychol 2023; 14:1200839. [PMID: 37484084 PMCID: PMC10361570 DOI: 10.3389/fpsyg.2023.1200839] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/12/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction The COVID-19 pandemic has led to significant challenges for frontline healthcare workers' (FHW), raising many mental health and wellbeing concerns for this cohort. To facilitate identification of risk and protective factors to inform treatment and interventions, this study investigated key predictors of psychological distress and subjective wellbeing in FHWs. Methods During the Omicron wave of the COVID-19 pandemic (January 2022), Victorian (Australia) doctors, nurses, allied health and non-medical staff from Emergency Departments, Intensive Care units, Aged Care, Hospital In The Home, and COVID Wards completed a cross-sectional survey consisting of the Kessler 6 item (Psychological Distress), Personal Wellbeing Index (Subjective Wellbeing), Coronavirus Health Impact Survey tool (COVID-19 related factors) and occupational factors. Multivariable linear regressions were used to evaluate unadjusted and adjusted associations. Relative weight analysis was used to compare and identify key predictors. Results Out of 167 participants, 18.1% screened positive for a probable mental illness and a further 15.3% screened positive for low wellbeing. Key risk factors for greater psychological distress included COVID infection worries, relationship stress and younger age. For both psychological distress and lower wellbeing, health status and supervisor support were key protective factors, while infection risks were key risk factors. Only positive changes in relationship quality was protective of lower wellbeing. Conclusion This study highlights the significance of social determinants and individual level factors alongside work related factors, in influencing FHWs' mental health and wellbeing during public health crises, such as the COVID-19 pandemic. Findings suggest that future interventions and supports should take a more holistic approach that considers work, social and individual level factors when supporting FHWs' mental health and wellbeing.
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Affiliation(s)
- Brian En Chyi Lee
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Mathew Ling
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Neami National, Preston, VIC, Australia
| | | | - Craig A. Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Parkville, VIC, Australia
| | - Jade Sheen
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia
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Burger JW, Bantjes J, Derman W, Whitesman S, Gomez-Ezeiza J. Associations between psychological distress and facets of mindfulness: Implications for campus-based university wellness services. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1074-1083. [PMID: 34242527 DOI: 10.1080/07448481.2021.1920601] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 03/18/2021] [Accepted: 04/18/2021] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To investigate associations between components of psychological distress and five facets of mindfulness (i.e. observing; describing; acting with awareness; non-reactivity; non-judging). PARTICIPANTS Students from a university in South Africa (n = 174). METHODS This cross-sectional study assessed psychological distress and mindfulness using the K10 and Five Facet Mindfulness Questionnaire. Multivariate regression analysis identified associations between psychological distress and facets of mindfulness, controlling for demographics. RESULTS Prevalence of psychological distress was 56.9% (95% CI 49.2%-64.4%). Acting with awareness, non-reactivity, and non-judging predicted significantly lower psychological distress, whereas observing and describing did not. Acting with awareness was the only facet of mindfulness that consistently predicted lower levels of negative affect, fatigue, nervousness, and agitation. CONCLUSIONS Acting with awareness appears to be a key component of psychological wellbeing. To advance theory and practice, future research should consider why and how various facets of mindfulness predict lower psychological distress and its components among university students.
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Affiliation(s)
- James W Burger
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Institute of Sport and Exercise Medicine, Division of Orthopedic Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Wayne Derman
- Institute of Sport and Exercise Medicine, Division of Orthopedic Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- IOC Research Center, Cape Town, South Africa
| | - Simon Whitesman
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- Institute for Mindfulness South Africa, Cape Town, South Africa
| | - Josu Gomez-Ezeiza
- Institute of Sport and Exercise Medicine, Division of Orthopedic Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- IOC Research Center, Cape Town, South Africa
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Anyanwu MU, Demetrovics Z, Griffiths MD, Horváth Z, Czakó A, Bajunirwe F, Tamwesigire I. Problem Gambling Among Adolescents in Uganda: A Cross-sectional Survey Study. J Gambl Stud 2023; 39:971-985. [PMID: 37029857 PMCID: PMC10175322 DOI: 10.1007/s10899-023-10205-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2023] [Indexed: 04/09/2023]
Abstract
In recent years, gambling has evolved and grown substantially with new gambling activities and facilities being introduced, making gambling products and opportunities more available than ever before in Uganda. While the growth of gambling industry is considered to have a beneficial impact on the economy, it is increasingly becoming a social and public health issue especially among a minority of young people who experience problem gambling, which can damage personal, family, vocational, and academic pursuits. The present study estimated the prevalence of problem gambling and identified the socio-demographic, school, environmental and health risks of problem gambling among secondary school students in Mbarara Municipality, Uganda. A cross-sectional study was conducted among secondary school students in Mbarara Municipality. A total of 921 students from 12 schools were recruited using cluster sampling. An ordinal logistic regression model was used to explore the relationship between problem gambling and the socio-demographic, academic, environmental and health variables. Of 905 participants, 362 reported having ever gambled (40%), and 160 were classified as problem gamblers (17.7%; 44.2% among those who had ever gambled). Problem gambling was significantly associated with being male, being non-religious, other religion (African traditional religion), having employment (outside of school), distance to nearest gambling venue, parental gambling, peer gambling, substance use, risky sexual behavior, and psychological distress. The present study found a very high prevalence of problem gambling among Ugandan secondary school students. Therefore, there is need to institute public health measures towards raising awareness, prevention and treatment of problem gambling among Ugandan adolescents.
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Affiliation(s)
- Michael U Anyanwu
- Department of Community Health, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda
| | - Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Mark D Griffiths
- International Gaming Research Unit Psychology Department, Nottingham Trent University, Nottingham, UK.
| | - Zsolt Horváth
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Andrea Czakó
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Francis Bajunirwe
- Department of Community Health, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda
| | - Imelda Tamwesigire
- Department of Community Health, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda
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Impact of Sertraline, Fluoxetine, and Escitalopram on Psychological Distress among United States Adult Outpatients with a Major Depressive Disorder. Healthcare (Basel) 2023; 11:healthcare11050740. [PMID: 36900745 PMCID: PMC10001334 DOI: 10.3390/healthcare11050740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/25/2023] [Accepted: 03/02/2023] [Indexed: 03/06/2023] Open
Abstract
How impactful is the use of Sertraline, Fluoxetine, and Escitalopram monotherapy on psychological distress among adults with depression in the real world? Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants. Medical Expenditure Panel Survey (MEPS) longitudinal data files from 1 January 2012 to 31 December 2019 (panel 17-23) were used to assess the effects of Sertraline, Fluoxetine and Escitalopram on psychological distress among adult outpatients diagnosed with a major depressive disorder. Participants aged 20-80 years without comorbidities, who initiated antidepressants only at rounds 2 and 3 of each panel, were included. The impact of the medicines on psychological distress was assessed using changes in Kessler Index (K6) scores, which were measured only in rounds 2 and 4 of each panel. Multinomial logistic regression was conducted using the changes in the K6 scores as a dependent variable. A total of 589 participants were included in the study. Overall, 90.79% of the study participants on monotherapy antidepressants reported improved levels of psychological distress. Fluoxetine had the highest improvement rate of 91.87%, followed by Escitalopram (90.38%) and Sertraline (90.27%). The findings on the comparative effectiveness of the three medications were statistically insignificant. Sertraline, Fluoxetine, and Escitalopram were shown to be effective among adult patients suffering from major depressive disorders without comorbid conditions.
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12
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Measuring distress in older population: Rasch analysis of the Kessler Psychological Distress Scale. J Affect Disord 2023; 330:117-124. [PMID: 36863471 DOI: 10.1016/j.jad.2023.02.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 02/11/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVES The 10-item Kessler Psychological Distress Scale (K-10) is a widely applied distress measure; however, its psychometric properties were not established with older populations using advanced methodology. The aim of this study was to examine psychometric properties of the K-10 through application of Rasch methodology and if possible, develop an ordinal-to-interval conversion to improve its reliability in older populations. METHOD The Partial Credit Rasch Model was applied to analyse K-10 scores of the sample including 490 participants (56.3 % females) aged 70 to 90 years and without dementia from the Sydney Memory and Ageing Study (MAS). RESULTS The initial analysis of the K-10 showed poor reliability and significant deviation from the expectations of the Rasch model. The best model fit was evident after correcting disordered thresholds and creating two testlet models to address local dependency between items (χ2(35) = 29.87, p = 0.71). The modified K-10 demonstrated strict unidimensionality, enhanced reliability and scale invariance across personal factors, such as sex, age, and education and permitted development of ordinal-to-interval transformation algorithms. LIMITATIONS Ordinal-to-interval conversion can only be applied for older adults with complete data. CONCLUSIONS The K-10 satisfied principles of fundamental measurement defined by Rasch model after minor modifications. Clinicians and researchers can transform K-10 raw scores into interval-level data using converging algorithms published here without altering the original scale response format, which increases reliability of the K-10.
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13
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Gibson M, Moreau N, Balzamo E, Crompton D. Peer Intervention following Suicide-Related Emergency Department Presentation: Evaluation of the PAUSE Pilot Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3763. [PMID: 36834458 PMCID: PMC9960257 DOI: 10.3390/ijerph20043763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/12/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
The risk for future suicidal behaviours is elevated following suicide attempts, particularly for those with complex needs or those who are disconnected from healthcare systems. The PAUSE program was designed to address this gap using peer workers to provide continuity and coordination of care following suicide-related emergency presentations. This study aimed to evaluate the pilot program's effect on suicidal ideation and hope, and to explore the acceptability and participants' experiences. A mixed-methods design was employed with pre- and post-evaluation questionnaires, including the GHQ-28-SS (general health questionnaire suicide scale), AHS (adult hope scale), and K10 (Kessler psychological distress scale). Participant engagement rates and semi-structured interviews were used to explore program acceptability. In total, 142 people were engaged with the PAUSE pilot between 24 August 2017 and 11 January 2020. There were no significant gender differences in engagement. The suicidal ideation scores decreased, and the hope scores increased after participation in PAUSE. A thematic analysis revealed that participants identified that the key program mechanisms were holistic and responsive support, ongoing social connectedness, and having peer workers who understood their experiences and treated them like people rather than clients. The small number of participants and lack of a control group limited the result generalizability. The findings suggest that PAUSE was an effective and acceptable model for supporting people following suicide-related hospitalisations in this pilot sample.
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Affiliation(s)
- Mandy Gibson
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD 4122, Australia
| | - Nick Moreau
- Brook Red Mental Health Charity Ltd., Brisbane, QLD 4122, Australia
| | | | - David Crompton
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD 4122, Australia
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14
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Carter SR, Collins JC, Hu J, O’Reilly CL, Wheeler AJ, McMillan SS, El-Den S. Confirmatory Factor Analysis of the Kessler-6 Psychological Distress (K6) Scale in a Community Sample of People Living with Severe and Persistent Mental Illness: a Bifactor Model. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00981-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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15
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Zhang L, Li Z. Factor structure and longitudinal measurement invariance of the K6 among a national representative elder sample of China. BMC Public Health 2022; 22:1789. [PMID: 36131316 PMCID: PMC9491003 DOI: 10.1186/s12889-022-14193-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/15/2022] [Indexed: 11/30/2022] Open
Abstract
Background As the number of older people is rapidly growing, prevention, screening, and treatment of mental health problems (including anxiety and depression) in this population increasingly become a heavy burden to individuals, families, and even the whole society. The Kessler-6 screening measure (K6) is an efficient and effective instrument for general mental health problems. However, few studies have examined its measurement invariance across time, which is particularly important in longitudinal studies, such as exploring developmental trajectories of non-specific psychological distress and evaluating the effects of certain interventions. Methods The current study investigated the factor structure and the longitudinal measurement invariance of the K6 among a national representative elder sample of China. Longitudinal data in two survey waves (the year 2010, and the year 2014) from the China Family Panel Studies were drawn for secondary data analysis. A total of 3845 participants aged 60 years old and above (52.2% male, mean age = 66.99 years, SD = 5.93 years) responded to both waves of the survey. Results A comparison of four existing models with confirmatory factor analysis supported a two-factor solution of the K6. A series of multi-group confirmatory factor analyses further indicated that the K6 held strict longitudinal measurement invariance across time. Additionally, the internal consistency indices across time and the stability coefficients over time were acceptable. Conclusions The findings further confirmed the psychometric defensibility of the K6 when used in the old Chinese population. The longitudinal measurement invariance justified comparisons of psychological distress scores among different measurement time points.
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Affiliation(s)
- Lisong Zhang
- School of Sociology and Population, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Zhongquan Li
- School of Social and Behavioral Sciences, Nanjing University, 163 Xianlin Avenue, Qixia District, Nanjing, 210023, Jiangsu, China.
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16
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Sharp G, Fernando AN, Oates J, McEvoy P. Men's Experiences and Psychological Outcomes of Nonsurgical Medical Penile Girth Augmentation: A Preliminary Prospective Study. Aesthet Surg J 2022; 43:181-191. [PMID: 36039668 PMCID: PMC9896141 DOI: 10.1093/asj/sjac243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The popularity of penile augmentation procedures is increasing, but investigation into men's experiences with these procedures and their impact on psychological well-being is lacking. OBJECTIVES The aim of this study was to investigate men's experiences with nonsurgical medical penile girth augmentation and assess, based on valid psychological measures, the impacts these procedures have on psychological well-being. METHODS Men seeking to undergo a girth augmentation (n = 19) completed an online questionnaire prior to their procedure and 6 months later that contained standardized measures assessing impacts of the procedure, penile size self-discrepancy, body dysmorphic disorder, psychological distress, self-esteem, and body image-related quality of life. Girth size was also measured preprocedure and 6 months postprocedure for a subsample of men. RESULTS Almost half of the men reported positive impacts of "increased self-confidence" and "increased sexual pleasure" after their procedure. Despite an average girth increase of 3.29 cm, the men still perceived that their penile girth and length was less than what they should be or less than the ideal size after their augmentation procedure. However, this perceived discrepancy was significantly smaller than before their procedures. Prior to the procedure, the men who met diagnostic criteria for body dysmorphic disorder according to self-reported questionnaire (11%, n = 2/19) and clinical interview (7%, n = 1/15) lost this diagnosis at 6 months. There were no changes in psychological distress, self-esteem, or body image-related quality of life from pre- to postprocedure. CONCLUSIONS Men report positive impacts on their lives after penile girth augmentation, but impacts on broader psychological well-being are mixed. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Gemma Sharp
- Corresponding Author: Dr Gemma Sharp, Monash Alfred Psychiatry Research Centre, Monash University, 4/607 St Kilda Road, Melbourne, Victoria 3004, Australia. E-mail: ; Twitter: @gemmasharp11
| | - Anne Nileshni Fernando
- Ms Fernando is a research assistant, Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Jayson Oates
- Dr Oates is a facial plastic and cosmetic surgeon in private practice in Subiaco, Western Australia, Australia
| | - Peter McEvoy
- Dr McEvoy is a professor of psychology and clinical psychologist, School of Population Health and enAble Institute at Curtin University, Bentley, Western Australia, Australia
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Prevalence of mental distress and associated factors among medical students of University of Gondar, Northwest Ethiopia: a cross-sectional study. BMC Psychiatry 2022; 22:523. [PMID: 35918673 PMCID: PMC9345005 DOI: 10.1186/s12888-022-04174-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental distress is the most common problem among medical students. This is associated with severe consequences of lack of empathy for their patients, committing medical errors, and suicidal ideations and attempts. However, there is limited data on this aspect where the study was conducted especially in this segment of the population. Considering its seriousness, this study will have pivotal input information to plan possible interventions for the future. So, this study is aimed at assessing the prevalence of mental distress and its associated factors among medical students of the University of Gondar, Northwest Ethiopia, 2021. METHODS An institutional-based cross-sectional study was conducted using a stratified random sampling technique to get a total of 438 study subjects from April 15-30/2021. Mental distress data were collected using a self-administrated questionnaire of the 10-item Kessler Psychological Distress Scale. Data was entered to Epi-data version 4.6.02 and cleaned, coded, and analyzed using STATA version 14. RESULTS The prevalence of mental distress among medical students was 193(45.95%) with 95% CI (41.2, 50.7). In multi-variable logistic regression being female sex (AOR = 4.5, 95% CI = 2.66, 8.12), lack of interest towards field of study (AOR = 4.4, 95%, CI = (2.18, 8.78), current alcohol use (AOR = 5.8, 95% CI = 3.03, 11.15), monthly pocket money < 735 Ethiopian birr (AOR = 3.1, 95% CI = 1.53, 6.04), extremely high test anxiety (AOR = 3.9, 95% CI = 1.27, 11.88), family history mental illness (AOR = 2.5 95% CI = 1.12, 5.53) and poor social support (AOR = 4.2, 95% CI = (1.94, 9.16) were significantly associated with mental distress. CONCLUSION AND RECOMMENDATION Prevalence of mental distress among medical students of University of Gondar was found to be higher when compared to previous studies among this population in Ethiopia. It is recommended that the school of medicine should give undue attention to address those identified factors by establishing counseling centers to minimize mental distress.
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18
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Hoffman J, Cossie Q, Ametaj AA, Kim HH, James R, Stroud RE, Stevenson A, Zingela Z, Stein DJ, Gelaye B. Construct validity and factor structure of the Kessler-10 in South Africa. BMC Psychol 2022; 10:177. [PMID: 35851071 PMCID: PMC9290237 DOI: 10.1186/s40359-022-00883-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 06/29/2022] [Indexed: 11/21/2022] Open
Abstract
Background The Kessler Psychological Distress Scale (K-10) is a short screening tool developed to identify, with good sensitivity, non-specific psychological distress in the general population. Sensitivity and specificity of the K-10 have been examined in various clinical populations in South Africa; however, other psychometric properties, such as construct validity and factor structure, have not been evaluated. We present evidence of the prevalence and severity of psychological distress in an outpatient setting in South Africa and evaluate the internal reliability, construct validity, and factor structure of the K-10 in this population. Methods We explored prevalence estimates of psychological distress using previously established cutoffs and assessed the reliability (consistency) of the K-10 by calculating Cronbach’s alpha, item-total correlations and omega total and hierarchical coefficients. Construct validity and factor structure of the K-10 were examined through split-sample exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA), comparing several theoretical models and the EFA. Results Overall, there was low prevalence of psychological distress in our sample of 2591 adults, the majority of whom were between the ages of 18–44 (77.7%). The K-10 showed good construct validity and reliability, with a Cronbach’s alpha of 0.84 and omega total of 0.88. EFA yielded a four-factor solution with likely measurement artifacts. CFA showed that the four-factor model from EFA displayed the best comparative fit indices, but was likely overfitted. The unidimensional model with correlated errors was deemed the best fitting model based on fit indices, prior theory, and previous studies. Conclusion The K-10 displays adequate psychometric properties, good internal reliability, and good fit with a unidimensional-factor structure with correlated errors. Further work is required to determine appropriate cutoff values in different populations and clinical subgroups within South Africa to aid in determining the K-10’s clinical utility.
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Affiliation(s)
- Jacob Hoffman
- Unit on Risk and Resilience in Mental Disorders, South African Medical Research Council (SAMRC), Cape Town, South Africa. .,Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. .,Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
| | - Qhama Cossie
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.,Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Amantia A Ametaj
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Hannah H Kim
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Roxanne James
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.,Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Rocky E Stroud
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Anne Stevenson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Zukiswa Zingela
- Psychology Department, Faculty of Health Sciences, Nelson Mandela University, Gqeberha, South Africa
| | - Dan J Stein
- Unit on Risk and Resilience in Mental Disorders, South African Medical Research Council (SAMRC), Cape Town, South Africa.,Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.,Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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19
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Sharp G, Fernando AN, Kyron M, Oates J, McEvoy P. Motivations and Psychological Characteristics of Men Seeking Penile Girth Augmentation. Aesthet Surg J 2022; 42:1305-1315. [PMID: 35511228 PMCID: PMC9558456 DOI: 10.1093/asj/sjac112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The popularity of penile augmentation procedures is increasing, but little is known about the motivations and psychological characteristics of men who seek these procedures. OBJECTIVES Employing valid psychological measures, the authors sought to investigate the motivations and psychological characteristics of men seeking penile girth augmentation. METHODS Men seeking to undergo a penile girth augmentation (n = 37) completed an online questionnaire containing standardized measures assessing their motivations to undergo augmentation, penile size self-discrepancy, psychological distress, self-esteem, body image-related quality of life, body dysmorphic disorder (BDD), and cosmetic procedure screening scale-penile focused dysmorphic disorder. RESULTS Men's motivations for seeking penile girth augmentation were characterized as "improve self-confidence," "change penile size/appearance," "sexual function/pleasure," "feelings of insecurity," and "medical issues," with self-confidence being the most commonly reported motivation. The men perceived their actual penis size (girth, flaccid length, erect length) as significantly smaller than ideal size, the size they believed their penis should be, and their expected size postaugmentation. Compared with non-clinical norms, the men seeking penile augmentation had higher penile dysmorphic disorder symptoms, lower self-esteem and lower body image-related quality of life, but comparable psychological distress. In addition, 4 of the men met diagnostic criteria for BDD according to self-reported questionnaire (11%, n = 4/37) and clinical interview (14%, n = 4/29). CONCLUSIONS Men seek penile girth augmentation for a variety of reasons and perceive all their penile dimensions to be smaller than ideal sizes. They differ from non-clinical samples in some psychological characteristics, and a small but sizeable portion experience BDD.
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Affiliation(s)
- Gemma Sharp
- Corresponding Author: Dr Gemma Sharp, Monash Alfred Psychiatry Research Centre, Monash University, 4/607 St Kilda Road, Melbourne, Victoria 3004, Australia. E-mail: ; Twitter: @gemmasharp11
| | - Anne Nileshni Fernando
- Monash Alfred Psychiatry Research Centre at Monash University, Melbourne, Victoria, Australia
| | - Michael Kyron
- School of Population Health and enAble Institute at Curtin University, Bentley, Western Australia, Australia
| | | | - Peter McEvoy
- School of Population Health and enAble Institute at Curtin University, Bentley, Western Australia, Australia
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20
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Andersen AG, Kotsadam A, Somville V. Material resources and well-being - Evidence from an Ethiopian housing lottery. JOURNAL OF HEALTH ECONOMICS 2022; 83:102619. [PMID: 35436664 DOI: 10.1016/j.jhealeco.2022.102619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 04/03/2022] [Accepted: 04/03/2022] [Indexed: 06/14/2023]
Abstract
Do better material conditions improve well-being and mental health? Or does any positive relationship merely reflect that well-being promotes economic success? We compare winners and losers from a large Ethiopian housing lottery in a preregistered analysis. Winners gain access to better housing, experience a substantial increase in wealth, and report higher levels of overall life satisfaction and lower levels of financial distress. However, we find no average effects of winning on psychological distress. Our results suggest that not all aspects of well-being and mental health are equally sensitive to economic conditions.
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Affiliation(s)
| | - Andreas Kotsadam
- Ragnar Frisch Centre for Economic Research, Norway; PROMENTA Research Center Department of Psychology, University of Oslo, Norway
| | - Vincent Somville
- NHH Norwegian School of Economics, Norway; Chr. Michelsen Institute, Norway.
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21
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Psychometric properties and factor structure of the Kessler-10 among Ethiopian adults. J Affect Disord 2022; 303:180-186. [PMID: 35151678 PMCID: PMC8948279 DOI: 10.1016/j.jad.2022.02.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 01/08/2022] [Accepted: 02/09/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Many common mental disorders are underdiagnosed and undertreated in low-resource countries. The ten-item Kessler Psychological Distress Scale (K10) is a brief screening tool widely used to assess psychological distress. We evaluated the K10's performance in an Ethiopian population by assessing internal consistency and construct validity through factor structure. METHODS K10 survey responses and sociodemographic data were collected from 1928 adults, including patients and caregivers from a general medical setting, who served as controls of a large epidemiological study. RESULTS The K10 had good internal consistency, with a Cronbach's alpha of 0.83. Results from exploratory factor analyses showed that the K10 had a two-factor solution that accounted for approximately 66% of the variance. Confirmatory factor analyses demonstrated that a unidimensional model with correlated errors, informed by a theoretical model, was the best fitting model for the setting (comparative fit index of 0.90 and root mean square error of approximation of 0.10). LIMITATIONS We did not assess the K10's test-retest reliability or its criterion validity (i.e., agreement with a reference measure). CONCLUSIONS Based on internal consistency and construct validity, the K10 can effectively assess psychological distress among Ethiopian adults for population-based research and potentially clinical screening, consistent with previous findings in this setting. Further studies are needed to test its criterion validity against a reference measure of psychological distress.
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22
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Hoter-Ishay G, Mashiach-Eizenberg M, Roe D. Young help-seeker profiles in Israel: The case of the first Israeli headspace centre. Early Interv Psychiatry 2022; 16:302-310. [PMID: 34342140 DOI: 10.1111/eip.13195] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 04/08/2021] [Accepted: 07/04/2021] [Indexed: 11/30/2022]
Abstract
AIM To describe clinical and demographic characteristics of youths who seek help at the first Headspace centre in Israel and their families. METHODS A sample of 291 (65%) of the youths (12- to 25-year-olds) who applied to Headspace between March 2016 and June 2018 completed an assessment, including reasons for referral and clinical status; the Kessler Psychological Distress Scale, evaluating psychological distress; and the Strengths and Difficulties Questionnaire, measuring emotional and behavioural difficulties. Their families reported burden of care via the Burden Assessment Scale. RESULTS Of the sample, 75% were between the ages of 12 and 17 years (equal gender distribution); for 45%, Headspace was their first encounter with mental health services. Participants' most-reported referral source was school counsellors (27%), and presenting concern (51%) was emotional problems, mainly depression (18%) and anxiety (16%). Female and older participants had more emotional difficulties than did males and younger participants, respectively. Overall, most help-seekers expressed high distress levels upon entry, and their family's burden was associated with those levels. CONCLUSIONS This first study of the first Headspace centre in Israel sheds light on and broadens knowledge about young help-seekers of Headspace outside of Australia. It emphasizes the trend across all ages of help-seeking youths with high psychological-distress levels and the role of family and school staff in the help-seeking process. Establishing youth services that improve access and deliver early intervention to a widely underserved population at times of high distress can be a global trajectory.
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Affiliation(s)
- Gili Hoter-Ishay
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Michal Mashiach-Eizenberg
- Department of Health Systems Management, The Max Stern Yezreel Valley College, Jezreel Valley, Israel
| | - David Roe
- Department of Community Mental Health, University of Haifa, Haifa, Israel
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Measuring psychological distress using the K10 in Kenya. J Affect Disord 2022; 303:155-160. [PMID: 35151672 PMCID: PMC7612413 DOI: 10.1016/j.jad.2022.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/30/2021] [Accepted: 02/09/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND The Kessler psychological distress scale (K10) is a brief screening tool that assesses psychological distress in both clinical and epidemiological settings. Despite wide applicability of the K10 globally, there are no data on psychometric properties of the K10 in Kenya. This study investigated the reliability, factor structure, and construct validity of the K10 as a measure of psychological distress among adults in Kenya. METHODS A total of 2556 adults attending 11 outpatient clinics in the western and coastal regions of Kenya without a history or clinical diagnosis of psychotic disorders were included. Data were collected on demographic characteristics of the participants and the K10. Internal consistency was evaluated using Cronbach's alpha. Construct validity and factor structures of the K10 were evaluated using both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) approaches. RESULTS The mean K10 score was 3.4 and Cronbach's alpha was 0.85, indicating good internal consistency (reliability). EFA resulted in a two-factor solution that accounted for 67.6% of variance. CFA results indicated that a unidimensional model with correlated errors best fit the data. LIMITATIONS The K10 was only administered to a control group of our study population, which had low levels of psychological distress. CONCLUSION The K10 has good construct validity and reliability for use as a broad measure of psychological distress in Kenyan adults and may be useful in general medical setting to assess anxiety and depressive disorders.
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Mahmud S, Mohsin M, Dewan MN, Muyeed A. The Global Prevalence of Depression, Anxiety, Stress, and Insomnia Among General Population During COVID-19 Pandemic: A Systematic Review and Meta-analysis. TRENDS IN PSYCHOLOGY 2022. [PMCID: PMC8726528 DOI: 10.1007/s43076-021-00116-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This study aimed to examine research findings related to depression, anxiety, stress, and insomnia during the COVID-19 pandemic. This study also explored periodic changes in the prevalence of depression, anxiety, stress, and insomnia among the general people during this pandemic. We performed a meta-analysis by searching articles from several sources (PubMed, MEDLINE, and Google Scholar). We used the random-effects models, subgroup analysis, and heterogeneity test approaches. Results show that the prevalence of depression, stress, and insomnia increased during March to April 2020 (30.51%, 29.4%, and 25%, respectively) compared to the study period before February 2020 (25.25%, 16.27%, and 22.63%, respectively) and followed in May to June 2020 (16.47%, 5.1%, and 19.86, respectively). The prevalence of depression and anxiety from k = 30 studies was 28.18% (95% CI: 23.81–32.54) and 29.57% (95% CI: 24.67–34.47), respectively. And the prevalence of stress (k = 13) was 25.18% (95% CI: 14.82–35.54), and the prevalence of insomnia (k = 12) was 23.50% (95% CI: 16.44–30.57). These prevalence estimates during the pandemic are very high compared to normal times. Hence, the governments and policymakers should apply proven strategies and interventions to avoid psychological adversity and improve overall mental health during the COVID-19 pandemic.
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Affiliation(s)
- Sultan Mahmud
- Department of Applied Statistics, Institute of Statistical Research and Training, University of Dhaka, Dhaka, 1000 Bangladesh
| | - Md Mohsin
- Department of Applied Statistics, Institute of Statistical Research and Training, University of Dhaka, Dhaka, 1000 Bangladesh
| | - Md. Nayem Dewan
- Department of Applied Statistics, Institute of Statistical Research and Training, University of Dhaka, Dhaka, 1000 Bangladesh
| | - Abdul Muyeed
- Department of Statistics, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh 2224 Bangladesh
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Kirabira J, Ben Forry J, Ssebuufu R, Akimana B, Nakawuki M, Anyayo L, Mpamizo E, Chan Onen B, Ingabire J, Gumisiriza N, Waiswa A, Mawanda A, Ashaba S, Kyamanywa P. Psychological distress and associated factors among hospital workers in Uganda during the COVID-19 lockdown - A multicentre study. Heliyon 2022; 8:e08807. [PMID: 35075435 PMCID: PMC8769903 DOI: 10.1016/j.heliyon.2022.e08807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/28/2021] [Accepted: 01/13/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To assess the prevalence of psychological distress (PD), and its associated demographic, psychosocial, hospital and health-related factors among hospital workers in Uganda during the COVID-19 related lockdown. METHODS An online cross-sectional study was conducted among three hundred ninety six participants recruited from eight hospitals and PD was assessed using the Kessler 6 distress scale from May to June 2020. RESULTS PD was present in 92.7% of the participants with majority (78.3%) having mild to moderate PD whereas 14.4% had severe PD. Severe PD had statistically significant association with having financial liabilities (O.R = 3.69 (1.55-8.77), p = 0.003). However, ability to maintain contact with family members and friends (O.R = 0.43 (0.22-0.84), p value = 0.013), and having enough personal protective equipment and safety tools at work place (O.R = 0.44 (0.23-0.84), p value = 0.012) were protective against severe PD. having excessive worry about getting infected with COVID-19, conflicts within a home, segregation by friends or community, longer working hours or involvement in management of suspected or confirmed case were not associated with severe PD. CONCLUSION The findings indicate the need to take into consideration the mental wellbeing of health workers during this COVID-19 outbreak. Whereas hospital workers continue to provide their services during the COVID-19 pandemic and related lockdown, it is important that they maintain contact with social support networks and be provided with counselling and mental health and psychosocial services in order to optimise their mental health during this pandemic.
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Affiliation(s)
- Joseph Kirabira
- Department of Psychiatry and Mental Health, Kampala International University, Western Campus, Ishaka, Bushenyi, Uganda
- Department of Psychiatry, Busitema University, P.O. Box 236, Tororo, Uganda
| | - Jimmy Ben Forry
- Department of Psychiatry and Mental Health, Kampala International University, Western Campus, Ishaka, Bushenyi, Uganda
- Department of Psychiatry, Mubende Regional Referral Hospital, P.O. Box 4, Mubende, Uganda
| | - Robinson Ssebuufu
- Department of Surgery, Kampala International University, Western Campus, P.O Box 71, Ishaka, Bushenyi, Uganda
| | - Benedict Akimana
- Department of Psychiatry and Mental Health, Kampala International University, Western Campus, Ishaka, Bushenyi, Uganda
| | - Madrine Nakawuki
- Department of Psychiatry and Mental Health, Kampala International University, Western Campus, Ishaka, Bushenyi, Uganda
| | - Lucas Anyayo
- Department of Psychiatry, Lira University, P.O. Box 1035, Lira, Uganda
| | - Emmanuel Mpamizo
- Department of Psychiatry, Gulu University, P.O. Box 166, Gulu, Uganda
| | - Bruno Chan Onen
- Department of Surgery, Makerere College of Health Science, P.O. Box 7072, Kampala, Uganda
| | - Jane Ingabire
- Department of Obstetrics and Gynaecology, Jinja Regional Referral Hospital, P.O. Box 43, Jinja, Uganda
| | - Nolbert Gumisiriza
- Department of Psychiatry and Mental Health, Kampala International University, Western Campus, Ishaka, Bushenyi, Uganda
| | - Ali Waiswa
- Department of Pathology, Makerere College of Health Science, P.O. Box 7072, Kampala, Uganda
| | - Anatoli Mawanda
- Department of Pathology, Makerere College of Health Science, P.O. Box 7072, Kampala, Uganda
| | - Scholastic Ashaba
- Department of Psychiatry and Mental Health, Kampala International University, Western Campus, Ishaka, Bushenyi, Uganda
- Department of Psychiatry, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Patrick Kyamanywa
- Department of Surgery, Kampala International University, Western Campus, P.O Box 71, Ishaka, Bushenyi, Uganda
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Racial disparities in psychological distress in post-apartheid South Africa: results from the SANHANES-1 survey. Soc Psychiatry Psychiatr Epidemiol 2022; 57:843-857. [PMID: 34617128 PMCID: PMC8494453 DOI: 10.1007/s00127-021-02175-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/30/2021] [Indexed: 11/05/2022]
Abstract
PURPOSE South Africa has long endured a high prevalence of mental disorders at the national level, and its unique social and historical context could be a contributor to an increased risk of mental health problems. Our current understanding is limited regarding the relative importance of various social determinants to mental health challenges in South Africa, and how existing racial inequities may be explained by these determinants. METHODS This study attempted to elucidate potential social determinants of mental health in South Africa using data from the nationally representative South African National Health and Nutrition Examination Survey (SANHANES-1). The main outcome of interest was psychological distress, measured with the Kessler-10 scale. Hierarchical linear regression models included covariates for demographic and socioeconomic factors, count of traumatic events, and a series of stress-related constructs. Analyses were conducted on two populations: the entire sample (n = 15,981), and the African subpopulation (n = 10,723). RESULTS Regression models on the entire sample indicated racial disparities in psychological distress, with Africans experiencing higher distress than White and Coloured individuals. Results within the African sub-population indicated geo-spatial disparities, with Africans in formal urban settings experiencing higher psychological distress than those living in formal and informal rural locales. Across both samples, results indicated a cumulative association between count of stressors and traumatic events and distress. CONCLUSION We found racial disparities across several mental health-related domains. Africans had greater exposure to traumatic events, social stressors, and psychological distress. This research is a necessary foundation for public health interventions and policy change to effectively reduce inequities in psychological distress.
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Reddy SP, Mbewu AD, Williams DR, Harriman NW, Sewpaul R, Morgan JW, Sifunda S, Manyaapelo T, Mabaso M. Race, geographical location and other risk factors for hypertension: South African National Health and Nutrition Examination Survey 2011/12. SSM Popul Health 2021; 16:100986. [PMID: 34950763 PMCID: PMC8671114 DOI: 10.1016/j.ssmph.2021.100986] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Hypertension is the leading cardiovascular disease in Africa. It is increasing in prevalence due partly to the epidemiological transition that African countries, including South Africa, are undergoing. This epidemiological transition is characterised by a nutrition transition andurbanisation; resulting in behavioural, environmental and stress changes that are subject to racial and geographic divides. The South African National Health and Nutrition Examination Survey (SANHANES) examined the association of traditional risk factors; and less traditional risk factors such as race, geographical location, social stressors and psychological distress with hypertension in a national population-based sample of South Africans. METHODS Data were analysed on individuals ≥15 years who underwent a physical examination in the SANHANES (n = 7443). Hypertension was defined by blood pressure ≥140/90 mmHg or self-reported hypertension medication usage. Stepwise regression examined the association of demographic, socioeconomic, life stressors, and health risk factors with systolic blood pressure, diastolic blood pressure, and hypertension. Secondly, the risk factor associations and geographical location effects were investigated separately for the African race group. RESULTS Increasing age (AOR = 1.069, p < 0.001); male gender (AOR = 1.413, p = 0.037); diabetes (AOR = 1.66, p = 0.002); family history of high blood pressure (AOR = 1.721, p < 0.001); and normal weight, overweight and obesity (relative to underweight: AOR = 1.782, p = 0.008; AOR = 2.232, p < 0.001; AOR = 3.874, p < 0.001 respectively) were associated with hypertension. Amongst African participants (n = 5315) age (AOR = 1.068, p < 0.001); male gender (AOR = 1.556, p = 0.001); diabetes (AOR = 1.717, p = 0.002); normal weight, overweight and obesity (relative to underweight: AOR = 1.958, p = 0.006; AOR = 2.118, p = 0.002; AOR = 3.931, p < 0.001); family history of high blood pressure (AOR = 1.485, p = 0.005); and household crowding (AOR = 0.745, p = 0.037) were associated with hypertension. There was a significantly lower prevalence of hypertension in rural informal compared to urban formal settings amongst African participants (AOR = 0.611, p = 0.005). Other social stressors and psychological distress were not significantly associated with hypertension. CONCLUSION There was no significant association between social stressors or psychological distress and hypertension. However, the study provides evidence of high-risk groups for whom hypertension screening and management should be prioritised, including older ages, males, people with diabetes or with family history of hypertension, and Africans who live in urban formal localities.
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Affiliation(s)
- Sasiragha Priscilla Reddy
- Health & Wellbeing, Human & Social Capabilities (HSC), Human Sciences Research Council (HSRC), Private Bag X9182, Cape Town, 8000, South Africa
- Faculty of Health Sciences, Nelson Mandela University, PO Box 77000, Port Elizabeth, 6031, South Africa
| | - Anthony David Mbewu
- School of Medicine, Sefako Makgatho Health Sciences University, Molotlegi Street, Ga-Rankuwa, Pretoria, South Africa
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA, 02115, USA
| | - Nigel Walsh Harriman
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA, 02115, USA
| | - Ronel Sewpaul
- Health & Wellbeing, Human & Social Capabilities (HSC), Human Sciences Research Council (HSRC), Private Bag X9182, Cape Town, 8000, South Africa
| | - Justin Winston Morgan
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA, 02115, USA
| | - Sibusiso Sifunda
- Health & Wellbeing, Human & Social Capabilities (HSC), Human Sciences Research Council (HSRC), Private Bag X9182, Cape Town, 8000, South Africa
| | - Thabang Manyaapelo
- Health & Wellbeing, Human & Social Capabilities (HSC), Human Sciences Research Council (HSRC), Private Bag X9182, Cape Town, 8000, South Africa
| | - Musawenkosi Mabaso
- Health & Wellbeing, Human & Social Capabilities (HSC), Human Sciences Research Council (HSRC), Private Bag X9182, Cape Town, 8000, South Africa
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Ren Q, Li Y, Chen DG. Measurement invariance of the Kessler Psychological Distress Scale (K10) among children of Chinese rural-to-urban migrant workers. Brain Behav 2021; 11:e2417. [PMID: 34775684 PMCID: PMC8671765 DOI: 10.1002/brb3.2417] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Kessler Psychological Distress Scale (K10) is a 10-item screening tool designed for nonspecific psychological distress. The current study aims to identify a best-fitting factor structure of the K10, and to test its cross-gender measurement invariance based on the structure. METHODS Using convenience sampling, we included 339 (n = 192 for boys and 135 for girls) children of Chinese rural-to-urban migrant workers in Hangzhou, China. RESULTS Confirmatory factor analysis for ordered-categorical measures revealed a two-factor structure as the best-fitting model, in which five items (hopeless, depressed, effort, severely depressed, and worthless) loaded on depression and the other five items loaded on anxiety (tired, nervous, severely nervous, restless, and severely restless). The model held at different levels of the measurement invariance testing, that is, full measurement invariance was not rejected in our sample, suggesting that gender differences as assessed with K10 reflect true differences. Structural invariance testing showed that girls in our sample showed significantly higher levels of depression and anxiety than boys. CONCLUSION These findings support that the K10 is suitable for gender-comparative research among children of Chinese migrant workers. Using the K10 as a screening tool among this population should be promoted. Limitations and directions for future research were discussed.
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Affiliation(s)
- Qiang Ren
- Department of Sociology, Zhejiang University, 866 Yuhangtang Rd, Hangzhou, Zhejiang, 310027, China
| | - Yong Li
- Department of Social Work, California State University Bakersfield, 9001 Stockdale Hwy, Bakersfield, California, 93311, USA
| | - Ding-Geng Chen
- College of Health Solutions, Arizona State University, 550 N 3rd St, Phoenix, Arizona, 85004, USA
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Andersen LS, Saal W, Joska JA, Safren SA, Bantjes J, O'Cleirigh C, Witten JA, Lee JS, Kagee A. Improving Detection of Depression in People Living with HIV: Psychometric Properties of the South African Depression Scale (SADS). AIDS Behav 2021; 25:3630-3637. [PMID: 34143340 PMCID: PMC8563384 DOI: 10.1007/s10461-021-03305-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2021] [Indexed: 12/26/2022]
Abstract
Most measures developed in high income countries to screen for major depressive disorder (MDD) among people living with HIV (PWH) demonstrate suboptimal psychometric properties when utilized in non-western, resource limited settings due to their high false positive rates. For standardized MDD screening to be implementable in local settings, a measure is needed that reduces diagnostic burden by being highly sensitive while limiting false positives. This study sought to evaluate the ability of the locally developed South African Depression Scale (SADS) to screen for MDD in PWH in Cape Town. The SADS was administered along with the SCID-5-RV as gold standard to 236 PWH. It demonstrated good discriminating ability in detecting MDD with an area under the curve of 0.85. A cut-off of 27 yielded 78.2% sensitivity and 54.4% PPV. Given its robust psychometric properties, routine use of the SADS in community clinics to screen at-risk PWH, combined with evidence-based depression treatment, could improve the health outcomes and well-being of PWH in South Africa.ResumenLa mayoría de las medidas desarrolladas en países de ingresos altos para detectar el trastorno depresivo mayor (TDM) entre las personas que viven con el VIH (PVV) demuestran propiedades psicométricas subóptimas cuando se utilizan en entornos no occidentales de recursos limitados debido a sus altas tasas de falsos positivos. Para que la detección de TDM estandarizada sea implementable en entornos locales, se necesita una medida que reduzca la carga diagnóstica al ser altamente sensible mientras limita los falsos positivos. Este estudio trató de evaluar la capacidad de la Escala de Depresión Sudafricana (SADS, por sus siglas en inglés) desarrollada localmente para detectar TDM en PVV en Ciudad del Cabo. El SADS se administró junto con el SCID-5-RV como el test de referencia a 236 PWH. Demostró una buena capacidad discriminatoria en la detección de TDM con un área bajo la curva de 0,85. Un corte de 27 produjo un 78,2% de sensibilidad y un 54,4% de VPP. Dadas sus sólidas propiedades psicométricas, el uso rutinario del SADS en clínicas comunitarias para detectar las PVV en riesgo, combinado con un tratamiento de depresión basado en la evidencia, podría mejorar los resultados de salud y el bienestar de las PVV en Sudáfrica.
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Affiliation(s)
- Lena Skovgaard Andersen
- Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, University of Cape Town, Cape Town, Western Cape, South Africa.
- Department of Public Health, Section of Global Health, University of Copenhagen,, Copenhagen, Denmark.
| | - Wylene Saal
- Centre for Social Science Research, University of Cape Town & Department of Psychology, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | - John A Joska
- Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Steven A Safren
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Jason Bantjes
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | - Conall O'Cleirigh
- Department of Psychiatry, Behavioral Medicine Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Jasper S Lee
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Ashraf Kagee
- Department of Psychology, Stellenbosch University, Stellenbosch, Western Cape, South Africa
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Pengpid S, Peltzer K. Ethnic and Gender Disparities in Healthy Ageing among People 50 Years and Older in South Africa. Geriatrics (Basel) 2021; 6:79. [PMID: 34449634 PMCID: PMC8395815 DOI: 10.3390/geriatrics6030079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE this study aimed to determine the prevalence and correlates of healthy ageing in older adults living in the community in South Africa. METHODS the cross-sectional sample consisted of 3734 individuals (≥50 years) from the cross-sectional South African National Health and Nutrition Survey (SANHANES-1) in 2011-2012. Healthy ageing was assessed using a multidimensional concept, which includes five components: (1) absence of major illness, (2) absence of disability, (3) good mental health, (4) social engagement and (5) well-being or good health. RESULTS in general, 36.6% had a healthy ageing, including 73.3% had no major diseases, 87.1% were free of disability, 62.3% had good mental health, 73.0% were socially engaged and 64.0% had a high well-being. In the adjusted logistic regression analysis, male sex (Adjusted Odds Ratio-AOR: 1.33, 95% confidence interval-CI: 1.03-1.72), white population group (AOR: 3.46, 95% CI: 2.29-5.22) and coloured population group (AOR: 1.82, 95% CI: 1.34-2.47), were positively associated with healthy ageing, while increasing age (AOR: 0.96, 95% CI: 0.94-0.97), daily tobacco use (AOR: 0.56, 95% CI: 0.42-0.74), perceived underweight (AOR: 0.48, 95% CI: 0.34-0.66) and perceived overweight (AOR: 0.53, 95% CI: 0.34-0.81) were negatively associated with associated with healthy ageing. CONCLUSION almost two in five older adults in South Africa were successfully ageing. Factors associated with healthy ageing included, younger age, male sex, population group (Whites, Coloureds), not daily tobacco users, not having underweight and overweight.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand;
- Department of Research Administration and Development, University of Limpopo, Sovenga 0727, South Africa
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein 9300, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- Department of Human and Social Capabilities, Human Sciences Research Council, Pretoria 0001, South Africa
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DeAtley T, Workman L, Theron G, Bélard S, Prins M, Bateman L, Grobusch MP, Dheda K, Nicol MP, Sorsdahl K, Kuo C, Stein DJ, Zar HJ. The child ecosystem and childhood pulmonary tuberculosis: A South African perspective. Pediatr Pulmonol 2021; 56:2212-2222. [PMID: 33765350 PMCID: PMC8477372 DOI: 10.1002/ppul.25369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 02/18/2021] [Accepted: 02/21/2021] [Indexed: 11/08/2022]
Abstract
INTRODUCTION This study investigates drivers of childhood pulmonary tuberculosis (PTB) using a childhood ecosystem approach in South Africa. An ecosystem approach toward identifying risk factors for PTB may identify targeted interventions. METHODS Data were collected as part of a prospective cohort study of children presenting at a primary care facility or tertiary hospital with possible TB. Characterization of the childhood ecosystem included proximal, medial, and distal determinants. Proximal determinants included child characteristics that could impact PTB outcomes. Medial determinants included relational factors, such as caregiver health, which might impact interactions with the child. Distal determinants included macro-level determinants of disease, such as socioeconomic status and food insecurity. Children who started on TB treatment were followed for up to 6 months. Multivariate regression models tested independent associations between factors associated with PTB in children. RESULTS Of 1202 children enrolled, 242 (20%) of children had confirmed PTB, 756 (63%) were started on TB treatment, and 444 (37%) had respiratory conditions other than TB. In univariate analyses, childhood malnutrition and caregiver smoking were associated with treated or confirmed PTB. In multivariate analyses, proximal factors, such as male gender and hospitalization, as well as low socioeconomic status as a distal factor, were associated with PTB. CONCLUSIONS Interventions may need to target subgroups of children and families with elevated proximal, medial, and distal risk factors for PTB. Screening for risk factors, such as caregiver's health, may guide targeting. The provision of social protection programs to bolster economic security may be an important intervention for attenuating childhood exposure to risk factors.
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Affiliation(s)
- Teresa DeAtley
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Lesley Workman
- Department of Paediatrics and Child Health, Red Cross Childrens Hospital and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Grant Theron
- Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, SA-MRC Centre for Tuberculosis Research, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | - Sabine Bélard
- Department of Paediatrics and Child Health, Red Cross Childrens Hospital and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, Western Cape, South Africa
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité—Universitätsmedizin, Berlin, Germany
| | - Margaretha Prins
- Department of Paediatrics and Child Health, Red Cross Childrens Hospital and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Lindy Bateman
- Department of Paediatrics and Child Health, Red Cross Childrens Hospital and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Martin P. Grobusch
- Center of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Amsterdam, The Netherlands
- Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Keertan Dheda
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine and UCT Lung Institute & South African MRC/UCT Centre for the Study of Antimicrobial Resistance, University of Cape Town, Cape Town, Western Cape, South Africa
- Faculty of Infectious and Tropical Diseases, Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, UK
| | - Mark P. Nicol
- Division of Infection and Immunity, Division of Medical Microbiology, School of Biomedical Sciences, University of Western Australia, Perth, Australia
- University of Cape Town and National Health Laboratory Services, Cape Town, Western Cape, South Africa
| | - Katherine Sorsdahl
- Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Caroline Kuo
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
- Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Dan J. Stein
- Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Heather J. Zar
- Department of Paediatrics and Child Health, Red Cross Childrens Hospital and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, Western Cape, South Africa
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Akuffo KO, Sewpaul R, Darrah S, Dukhi N, Kumah DB, Agyei-Manu E, Addo EK, Asare AK, Osei Duah I, Reddy P. Vision loss, vision difficulty and psychological distress in South Africa: results from SANHANES-1. BMC Psychol 2021; 9:66. [PMID: 33926560 PMCID: PMC8082762 DOI: 10.1186/s40359-021-00558-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/25/2021] [Indexed: 11/10/2022] Open
Abstract
Background Psychological distress in vision impairments and blindness is a complex issue and a major public health concern. Sudden adjustments in routine lifestyle and career aspirations in such persons culminate in and/or aggravate their level of stress. Yet, psychological distress in persons with visual difficulties and vision loss in South Africa is poorly understood. We investigated the association between psychological distress and self-reported vision difficulties as well as clinician-assessed vision loss using data from the South African National Health and Nutrition Examination Survey (SANHANES-1). Methods Data was analysed on participants aged ≥ 15 years who participated in the SANHANES-1 clinical examinations and interviews. Data on demographic, socio-economic, and health status variables were gathered using a structured questionnaire. Psychological distress was assessed using the Kessler psychological distress scale (K10). Vision assessment was conducted by clinicians adhering to standard protocols as well as by participants’ subjective response to vision-related questions. Vision loss was defined as presenting visual acuity worse than Snellen 6/12 in the better eye. Bivariate and multiple logistic regressions were used to examine the association between vision parameters and psychological distress. Results The analytic sample comprised 6859 participants with mean age of 38.4 years (60.8% females). The prevalence of psychological distress was 19.9%. After adjusting for demographics, socioeconomic, health risk and eye care variables, self-reported myopia (mild adjusted odds ratio [AOR] = 1.9, 95% CI 1.3–2.7; moderate AOR = 2.4, 95% CI 1.6–3.7; severe AOR = 3.6, 95% CI 1.8–7.3) and self-reported hyperopia (mild AOR = 1.7, 95% CI 1.2–2.5; moderate AOR = 2.4, 95% CI 1.5–3.8; severe AOR = 3.5, 95% CI 1.8–6.8) were significantly associated with psychological distress. While psychological distress was higher in patients with clinician assessed vision loss than those with normal vision, the association was not statistically significant after adjusting for confounders (AOR: 1.0, 95% CI 0.7–1.4). Conclusions Persons who self-reported vision difficulty experienced a higher prevalence of psychological distress. Therefore, comprehensive psychological care is needed for patients with eye disease or vision difficulties as part of a governmental strategy to provide mental health care for all South Africans.
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Affiliation(s)
- Kwadwo Owusu Akuffo
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Ronel Sewpaul
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa
| | - Samson Darrah
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Natisha Dukhi
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa
| | - David Ben Kumah
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eldad Agyei-Manu
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Usher Institute for Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Emmanuel Kofi Addo
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Ophthalmology and Visual Sciences, Moran Eye Centre, University of Utah, Salt Lake City, Utah, USA.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, USA
| | - Akosua Kesewah Asare
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
| | - Isaiah Osei Duah
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Priscilla Reddy
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa.,Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
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Identification of Workplace Bullying: Reliability and Validity of Indonesian Version of the Negative Acts Questionnaire-Revised (NAQ-R). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083985. [PMID: 33920092 PMCID: PMC8070247 DOI: 10.3390/ijerph18083985] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/02/2021] [Accepted: 04/08/2021] [Indexed: 01/07/2023]
Abstract
Bullying can pose a risk to health and safety, including the risk for damage to the emotional, psychosocial, mental, or physical health of employees in the workplace. Since bullying has a detrimental impact on victims and organizations, several studies on this issue had been conducted using the Negative Acts Questionnaire-Revised (NAQ-R), which is one of the most widely used tools to assess and minimize the occurrence of workplace bullying. However, this tool has not been validated for the Indonesian contexts. In this study, the author tested the reliability and constructed validity of the Indonesian version of NAQ-R. A total of 3140 participants were recruited in this study from various companies from different industries. NAQ-R, Psychosocial Distress (K10), and Satisfaction with Life Scale (SWLS) were administrated through an online survey. The results showed that 22 items yielded three model factors, i.e., person-related bullying, work-related bullying, and intimidation towards a person. Cronbach’s alpha coefficients for the total and sub-scales of the Indonesian NAQ-R was acceptable, ranging from 0.721 to 0.897. This study confirmed that the Indonesian version of NAQ-R has an internal consistency reliability, and the concurrent and construct validity are at acceptable levels. Thus, this tool can be used as the screening instrument in assessing workplace bullying.
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van Niekerk RL, van Gent MM. Mental health and well-being of university staff during the coronavirus disease 2019 levels 4 and 5 lockdown in an Eastern Cape university, South Africa. S Afr J Psychiatr 2021; 27:1589. [PMID: 33824757 PMCID: PMC8008007 DOI: 10.4102/sajpsychiatry.v27i0.1589] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 01/28/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The mental health of university staff members is often neglected and might have been exacerbated during the coronavirus disease 2019 (COVID-19) pandemic. AIM The aim of this study was to determine the mental health and well-being of staff members in an Eastern Cape university just after levels 4 and 5 lockdowns (01 June 2020) in South Africa. SETTING The university was closed during lockdown and staff members had to work from home, trying to save the 2020 academic year. METHODS A cross-sectional exploratory survey of a sample of 280 staff members (response rate = 27.75%), with a mean age of 48.84 ± 10.17 years, completed the Kessler Psychological Distress Scale (K10) and Mental Health Continuum - Short Form (MHC-SF). RESULTS A number (27.6%) of staff members reported psychological distress, whilst the majority (60%) was flourishing during lockdown. Socio-economic collapse, contracting the virus and the completion of the academic year were their biggest worries. Whilst a strong negative correlation between psychological distress and mental well-being (MWB) was observed (r = -0.595), age had an inverse correlation with psychological distress (r = -0.130) and a positive correlation with MWB (r = 0.153). Female staff members, staff members with comorbidities and workers in the administration and service sections were significantly more likely to report psychological distress. The mental health of female staff members and members with comorbidities were almost two times more at risk for psychological distress. CONCLUSION The mental health and well-being of some university staff members were at an increased risk during lockdown.
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Affiliation(s)
- Rudolph L van Niekerk
- Department of Human Movement Sciences, Faculty of Health Sciences, Fort Hare University, Alice, South Africa
| | - Maria M van Gent
- Department of Human Movement Sciences, Faculty of Health Sciences, Fort Hare University, Alice, South Africa
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Court R, Centner CM, Chirehwa M, Wiesner L, Denti P, de Vries N, Harding J, Gumbo T, Maartens G, McIlleron H. Neuropsychiatric toxicity and cycloserine concentrations during treatment for multidrug-resistant tuberculosis. Int J Infect Dis 2021; 105:688-694. [PMID: 33684562 PMCID: PMC8126338 DOI: 10.1016/j.ijid.2021.03.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/19/2021] [Accepted: 03/02/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Cycloserine, or its structural analogue terizidone, has been associated with neuropsychiatric toxicity (psychosis, depression, and neuropathy). Prospective clinical data on the incidence of and risk factors for neuropsychiatric toxicity in TB patients treated with cycloserine are limited. METHODS A prospective evaluation of neuropsychiatric toxicity was performed using validated screening tools in patients with multidrug-resistant tuberculosis treated with terizidone. Cox proportional hazard modelling was performed to explore the effects of clinical variables and measures of cycloserine pharmacokinetics in plasma. RESULTS A total 144 participants were recruited: 86 were male and 58 were female; their median age was 35.7 years and 91 (63%) were HIV-infected. Fifty-five (38%) participants developed at least one neuropsychiatric event (30 cases per 100 person-months): 50 (35%) neuropathy, 14 (10%) depression, and 11 (8%) psychosis. Neuropathy was independently associated with cycloserine clearance ((adjusted hazard ratio 0.34 (aHR), P = 0.03)) and high-dose pyridoxine (200 mg vs 150 mg daily, aHR: 2.79, P = 0.01). CONCLUSIONS A high incidence of early neuropsychiatric toxicity was observed in this cohort of patients treated with terizidone. Cycloserine clearance and higher doses of pyridoxine are associated with incident or worsening peripheral neuropathy.
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Affiliation(s)
- Richard Court
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
| | - Chad M Centner
- Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa.
| | - Maxwell Chirehwa
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
| | - Lubbe Wiesner
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
| | - Paolo Denti
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
| | | | | | - Tawanda Gumbo
- Quantitative Preclinical and Clinical Sciences Department, Praedicare, Dallas, TX, USA.
| | - Gary Maartens
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa; Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
| | - Helen McIlleron
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa; Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
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Sy KTL, Tariq S, Ramjee G, Blanchard K, Leu CS, Kelvin EA, Exner TM, Gandhi AD, Lince-Deroche N, Mantell JE, O’Sullivan LF, Hoffman S. Predictors of antiretroviral therapy initiation in eThekwini (Durban), South Africa: Findings from a prospective cohort study. PLoS One 2021; 16:e0246744. [PMID: 33606712 PMCID: PMC7895397 DOI: 10.1371/journal.pone.0246744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 01/25/2021] [Indexed: 01/08/2023] Open
Abstract
Despite expanded antiretroviral therapy (ART) eligibility in South Africa, many people diagnosed with HIV do not initiate ART promptly, yet understanding of the reasons is limited. Using data from an 8-month prospective cohort interview study of women and men newly-diagnosed with HIV in three public-sector primary care clinics in the eThekwini (Durban) region, South Africa, 2010-2014, we examined if theoretically-relevant social-structural, social-cognitive, psychosocial, and health status indicators were associated with time to ART initiation. Of 459 diagnosed, 350 returned to the clinic for their CD4+ test results (linkage); 153 (33.3%) were ART-eligible according to treatment criteria at the time; 115 (75.2% of those eligible) initiated ART (median = 12.86 weeks [95% CI: 9.75, 15.97] after linkage). In adjusted Cox proportional hazard models, internalized stigma was associated with a 65% decrease in the rate of ART initiation (Adjusted hazard ratio [AHR] 0.35, 95% CI: 0.19-0.80) during the period less than four weeks after linkage to care, but not four or more weeks after linkage to care, suggesting that stigma-reduction interventions implemented shortly after diagnosis may accelerate ART uptake. As reported by others, older age was associated with more rapid ART initiation (AHR for 1-year age increase: 1.04, 95% CI: 1.01-1.07) and higher CD4+ cell count (≥300μL vs. <150μL) was associated with a lower rate of initiation (AHR 0.38, 95% CI: 0.19-0.80). Several other factors that were assessed prior to diagnosis, including stronger belief in traditional medicine, higher endorsement of stigma toward people living with HIV, food insecurity, and higher psychological distress, were found to be in the expected direction of association with ART initiation, but confidence intervals were wide and could not exclude a null finding.
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Affiliation(s)
- Karla Therese L. Sy
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States of America
| | - Shema Tariq
- Institute for Global Health, University College London, London, United Kingdom
| | - Gita Ramjee
- South African Medical Research Council, HIV Prevention Research Unit, Durban, South Africa
| | - Kelly Blanchard
- Ibis Reproductive Health, Cambridge, Massachusetts and Johannesburg, South Africa
| | - Cheng-Shiun Leu
- Division of Gender, Sexuality, and Health, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, New York, United States of America
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Elizabeth A. Kelvin
- Department of Epidemiology & Biostatistics, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, New York, United States of America
- CUNY Institute for Implementation Science in Population Health, City University of New York, New York, New York, United States of America
| | - Theresa M. Exner
- Division of Gender, Sexuality, and Health, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, New York, United States of America
| | - Anisha D. Gandhi
- Division of Gender, Sexuality, and Health, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, New York, United States of America
| | - Naomi Lince-Deroche
- Ibis Reproductive Health, Cambridge, Massachusetts and Johannesburg, South Africa
| | - Joanne E. Mantell
- Division of Gender, Sexuality, and Health, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, New York, United States of America
| | | | - Susie Hoffman
- Division of Gender, Sexuality, and Health, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, New York, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
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Owoo NS, Lambon-Quayefio MP. Mixed methods exploration of Ghanaian women's domestic work, childcare and effects on their mental health. PLoS One 2021; 16:e0245059. [PMID: 33529183 PMCID: PMC7853525 DOI: 10.1371/journal.pone.0245059] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 12/21/2020] [Indexed: 11/18/2022] Open
Abstract
This research paper aims to understand the effects of time spent in domestic work, including childcare, on women’s mental health in Ghana. The paper adopted a triangulation convergence mixed methods approach. The quantitative information was sourced from two waves (2009/ 2014) of the Ghana Socioeconomic Panel Survey (GSEPS) while qualitative information was obtained from in-depth interviews with couples and key informants from five (5) regions, representing diverse ethnic backgrounds, in Ghana. Employing fixed effects regressions and a multinomial logistic regression model with fixed effects, we find that domestic work contributes to poorer mental health outcomes among women. These results are consistent, even when we correct for potential self-selectivity of women into domestic work. We also examine whether the relationship is differentiated between women of higher and lower socioeconomic status. We find that women from wealthier households who spend increasing time in domestic work have higher odds of mental distress. These results are supported by the qualitative data- women indicate increasing stress levels from domestic work and while some husbands acknowledge the situation of their overburdened wives and make attempts, however minor, to help, others cite social norms and cultural expectations that act as a deterrent to men’s assistance with domestic work. Efforts should be made to lessen the effects of social and cultural norms which continue to encourage gendered distributions of domestic work. This may be done through increased education, sensitization and general re-socialization of both men and women about the need for more egalitarian divisions of household work.
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Affiliation(s)
- Nkechi S. Owoo
- Department of Economics, University of Ghana, Accra, Ghana
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Badenhorst M, Runciman P, Brown JC, Swartz L, Derman WE. Promotion of Para athlete well-being in South Africa (the PROPEL studies): Profiles and prevalence of psychological distress. J Sci Med Sport 2021; 24:616-621. [PMID: 33431317 DOI: 10.1016/j.jsams.2020.12.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 12/12/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES There is a paucity of research investigating mental health in Para athletes. The aim of this study was to describe mental health concerns of a representative sample of South African Para athletes. DESIGN A descriptive, cross-sectional survey was conducted at the 2019 National Championships for athletes with impairments. METHODS Mental health was measured with the Trait component of the State/Trait Anxiety Inventory (STAI-T), and the Kessler Psychological Distress Scale (K-10). Between-group differences were analysed using the Mann-Whitney U test or one-way ANOVA. RESULTS A total of 125 athletes were included. The average score for the STAI-T was 39 (±9) units, whilst a quarter (25%) of all athletes scored ≥45. The mean K-10 questionnaire score was 20 (±6) units. K-10 scores indicated that 12 % of athletes may meet formal definitions for anxiety and/or depressive disorders (score of ≥28), while 76 % of athletes have a high level of subclinical symptoms (score of ≥16). On average, females (36 ± 9) had better STAI-T scores than males (40 ± 9; p = 0.02) and married athletes (33 ± 9) had better scores than unmarried athletes (40 ± 9; p = 0.002). K-10 scores were also significantly better in married than in unmarried athletes (p = 0.002), but there was no difference between sexes. Neither the K-10 nor STAI-T was associated with level of competition, sport code or impairment type. CONCLUSIONS The study identified a high prevalence of psychological distress and anxiety among South African Para athletes, compared to the general population. There is a need to further understand factors contributing to mental health in this population.
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Affiliation(s)
- Marelise Badenhorst
- Institute of Sport and Exercise Medicine (ISEM), Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa; International Olympic Committee (IOC) Research Centres, South Africa.
| | - Phoebe Runciman
- Institute of Sport and Exercise Medicine (ISEM), Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa; International Olympic Committee (IOC) Research Centres, South Africa; Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - James Craig Brown
- Institute of Sport and Exercise Medicine (ISEM), Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa; International Olympic Committee (IOC) Research Centres, South Africa
| | - Leslie Swartz
- Department of Psychology, Faculty of Arts & Social Sciences, Stellenbosch University, South Africa
| | - Wayne Elton Derman
- Institute of Sport and Exercise Medicine (ISEM), Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa; International Olympic Committee (IOC) Research Centres, South Africa
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Silva BFPD, Santos-Vitti L, Faro A. Kessler Psychological Distress Scale: Internal Structure and Relation to Other Variables. PSICO-USF 2021. [DOI: 10.1590/1413-82712021260108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract This study aimed to present validity evidence based on internal structure of the Kessler Scale of Psychological Distress (K10), to show its relations with the Perceived Stress Scale (PSS-10), and to present a social distribution of distress in the present sample. Participated in the study 717 residents of Aracaju, State of Sergipe, by means of household data collection. A sociodemographic questionnaire, K10, and PSS-10 were used as instruments. Exploratory Factor Analysis was performed using the Factor software, which indicated the scale unidimensionality, explaining 69.9% of the variance. Cronbach’s alpha was 0.93, and the model adjustment indices were satisfactory. A positive and statistically significant association between K10 and PSS-10 was observed. Regarding the social distribution, the levels of distress were higher in women, patients with chronic diseases, users of controlled drugs, and unemployed participants. It was concluded that K10 presented robust psychometric properties for the detection of distress in general population.
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Madoro D, Mengistu N, Molla W. Association of Conflict-Affected Environment on Ethiopian Students' Mental Health and Its Correlates During COVID-19 Era. Neuropsychiatr Dis Treat 2021; 17:3283-3292. [PMID: 34785898 PMCID: PMC8579870 DOI: 10.2147/ndt.s338073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 10/22/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Ethiopia has seen the largest number of conflict-induced displacement. Mental disturbance has been identified as a major public health concern among conflict-affected people, including students. Due to the effect of continuous unfold of the COVID-19 epidemic in the conflicted affected setting, the mental health problem tends to be increased. This creates a double burden for students from conflict affected setting after school re-opening. As a result, the goal of this research was to evaluate the mental health impact and its correlates in students from conflict affected setting, Ethiopia. OBJECTIVE To assess the association of conflict-affected environment on Ethiopian students' mental health and its correlates during COVID-19 era. METHODS From April 1 to 30, 2021, an institutional-based cross-sectional survey was undertaken. A total sample of 795 students were participated through a systematic random sampling technique. The Kessler Psychological Distress Scale was used to assess mental distress (K10). The correlation between outcome and explanatory variables was investigated using bivariate and multivariate logistic regression analyses. RESULTS A total of 795 people were examined, with a 100% response rate. Mental distress was reported about 59.4% with a 95% CI of 57% to 62.9%. Conflicted related sexual abuse (AOR = 4.1, 95% CI 2.37 to 6.94), witnessed shooting (AOR = 3.49, 95% CI 2.7 to 5.89), threat to security and safety (AOR = 2.23, 95% CI 1.29 to 3.87), being female (AOR = 3.01, 95% CI 1.61 to 5.44), and poor academic performance (AOR = 2.1, 95% CI 1.08 to 4.08) were found to be substantially correlated. CONCLUSION Students from conflict-affected areas are at high risk of mental distress. Therefore, the ministry of health, ministry of education of Ethiopia and humanitarian organizations should work collaboratively in providing consistent school-based psychosocial support and appropriate intervention for students.
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Affiliation(s)
- Derebe Madoro
- Dilla University, College of Medicine and Health Science, Department of Psychiatry, Dilla, Ethiopia
| | - Nebiyu Mengistu
- Dilla University, College of Medicine and Health Science, Department of Psychiatry, Dilla, Ethiopia
| | - Wondwosen Molla
- Dilla University, College of Medicine and Health Science, Department of Midwifery, Dilla, Ethiopia
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Peltzer K, Pengpid S. Tobacco use and associated mental symptoms and health risk behaviours amongst individuals 15 years or older in South Africa. S Afr J Psychiatr 2020; 26:1499. [PMID: 33240550 PMCID: PMC7669997 DOI: 10.4102/sajpsychiatry.v26.i0.1499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 08/05/2020] [Indexed: 11/01/2022] Open
Abstract
Background Tobacco use may deteriorate mental health and increase health risk behaviours. Aim The aim of this investigation was to identify associations between tobacco use and mental illness symptoms and health risk behaviours in individuals 15 years or older in South Africa. Setting Community-based national population sample in South Africa. Methods Cross-sectional data were analysed from the 'South African National Health and Nutrition Examination Survey (SANHANES-1) 2012', using a sample of 15 310 individuals 15 years or older (median age 33 years). Measures included information on tobacco use, sociodemographic factors, mental symptoms and health risk behaviour. Results Compared to non-tobacco users, daily tobacco users were associated with psychological distress and post-traumatic stress disorder (PTSD) in adjusted logistic regression analysis, and with sleeping problems in unadjusted analysis. Past tobacco use, less than daily, and daily tobacco use were highly associated with a drinking problem. In terms of dietary variables, less than daily and daily tobacco use increased the odds of inadequate fruit intake and salty food intake, and daily tobacco use decreased the odds of fast food consumption. Past tobacco use, less than daily, and daily tobacco use were inversely associated with physical inactivity, and daily tobacco use was associated with not always washing hands before eating. Conclusions The study showed that compared to non-tobacco users, daily tobacco users had significantly poorer mental health (psychological distress and PTSD) and increased odds for several health risk behaviours (drinking problem, inadequate fruit intake, salty food consumption and not always washing hands before eating) as compared to non-tobacco users.
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Affiliation(s)
- Karl Peltzer
- Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa
| | - Supa Pengpid
- Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa.,ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
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Zhang L, Li Z. A Mokken scale analysis of the Kessler-6 screening measure among Chinese older population: findings from a national survey. BMC Geriatr 2020; 20:361. [PMID: 32962656 PMCID: PMC7507816 DOI: 10.1186/s12877-020-01771-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 09/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aging population increases rapidly across the world. Timely and effective screening of their mental-health problems is important to individuals, families, and the whole society. The Kessler-6 screening measure (K6) is a very popular instrument for non-specific psychological distress. However, few studies have focused on the psychometric properties of this instrument in the older population. METHODS The present study employed Mokken scale analysis to evaluate its dimensionality and structure. This study also used differential item functioning (DIF) to examine whether the same structure existed across sex in a national representative sample of old Chinese people. Data were drawn from a public data set, the 2010 China Family Panel Studies (CFPS2010), and responses from a total of 6450 participants aged 60 years old and above (3136 males and 3314 females) were included in the final analysis. RESULTS Mokken scale analysis supported the unidimensional structure of the K6. Differential item functioning (DIF) analysis revealed that two of the six items ("Hopeless" and "Everything was an effort") were marked for DIF based on the Chi-square. However, their impacts were negligible in terms of McFadden's pseudo R2. CONCLUSIONS The K6 demonstrates adequate psychometric properties in the old Chinese population. The sum of all six items can be used as an indicator of non-specific psychological distress. Differences in the indicator across sex should be considered as a real difference in psychological distress between the female and the male.
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Affiliation(s)
- Lisong Zhang
- School of Sociology and Population, Nanjing University of Posts and Telecommunications, 9 Wenyuan Road, Qixia District, Nanjing, 210023, Jiangsu, China
| | - Zhongquan Li
- School of Social and Behavioral Sciences, Nanjing University, 163 Xianlin Avenue, Qixia District, Nanjing, 210023, Jiangsu, China.
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Knoetze R, Lachman A, Moxley K, Chetty S. Caregiver anxiety and the association with acute postoperative pain in children undergoing elective ambulatory surgery in a lower-middle-income country setting. Paediatr Anaesth 2020; 30:990-997. [PMID: 32592506 DOI: 10.1111/pan.13954] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 05/26/2020] [Accepted: 06/17/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Moderate to severe postoperative pain complicates surgeries performed on children in upper-income countries. The successful management of postoperative pain in children requires a biopsychosocial approach. Situational anxiety and anxiety disorders among caregivers influence a child's perioperative experience. This study aims to determine whether there is an association between caregiver's preoperative anxiety and children's postoperative pain in a lower-middle-income country (LMIC) setting. METHODS In this cross-sectional, descriptive study, we recruited 76 children aged 4-12 years, undergoing elective ambulatory tonsillectomy or adenotonsillectomy. Primary caregivers completed validated measures of anxiety (the Beck Anxiety Inventory [BAI] and the Kessler Psychological Distress Scale [K10]) prior to the children undergoing surgery. Postoperative pain was measured using the Wong-Baker Faces Pain Rating Scale 4 hours after surgery. RESULTS Caregiver anxiety was found in 31.7% of participants using the K10 and in 42.1% using the BAI. Moderate to severe postoperative pain was reported by 51% of children. There was a statistically significant correlation of moderate strength between anxiety scores of caregivers and children's self-reported postoperative pain scores (r = .47 for K10, r = .44 for BAI, P < .001 for both). Two median quantile regression models confirmed that K10 was positively associated with caregiver anxiety (WBFS) with slope = 0.16 and pseudo R2 = 0.25 (P = .002, 95CI: 0.06-0.26) as was BAI with slope = 0.12 and pseudo R2 = 0.22 (P = .013 95CI: 0.03-0.22). CONCLUSIONS This study showed that preoperative caregiver anxiety is significantly associated with postoperative pain in children undergoing elective, ambulatory surgery in a LMIC setting (correlation of moderate strength). Interventions aimed at reducing caregiver anxiety should become an important component of the biopsychosocial management of postoperative pain in children.
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Affiliation(s)
- Reynard Knoetze
- Department of Anaesthesiology and Critical Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anusha Lachman
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Karis Moxley
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sean Chetty
- Department of Anaesthesiology and Critical Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Andersen LS, Joska JA, Magidson JF, O'Cleirigh C, Lee JS, Kagee A, Witten JA, Safren SA. Detecting Depression in People Living with HIV in South Africa: The Factor Structure and Convergent Validity of the South African Depression Scale (SADS). AIDS Behav 2020; 24:2282-2289. [PMID: 31965430 PMCID: PMC8021389 DOI: 10.1007/s10461-020-02787-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Screening measures for depression developed in high-income countries have not always demonstrated strong psychometric properties in South Africa and with people living with HIV (PLWH). The present study explored the psychometric properties of the 16-item South African Depression Scale (SADS) comprised of idioms of distress specific to isiXhosa culture in PLWH. The SADS was administered to 137 Xhosa-speaking PLWH who met diagnostic criteria for major depressive disorder (MDD) together with the Hamilton Depression Scale (HAM-D) and the Center for Epidemiological Studies Depression Scale (CES-D). We conducted exploratory factor analysis, correlation, and reliability statistics. Four factors of the SADS emerged: Sadness, lethargy/burdened, anhedonia/withdrawal, and cognitive/somatic. All factors correlated significantly with the HAM-D and CES-D. Internal consistency of the overall measure was high (α = .89). The SADS promises to be a robust measure of depression in isiXhosa-speaking PLWH in South Africa likely due to the inclusion of local idioms of distress.
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Affiliation(s)
- L S Andersen
- HIV Mental Health Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
| | - J A Joska
- HIV Mental Health Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - J F Magidson
- Department of Psychology, University of Maryland, College Park, MA, USA
| | - C O'Cleirigh
- Behavioral Medicine Service, Massachusetts General Hospital/Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - J S Lee
- Department of Psychology, University of Miami, Florida, USA
| | - A Kagee
- Department of Psychology, Stellenbosch University, Western Cape, South Africa
| | - J A Witten
- HIV Mental Health Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - S A Safren
- Department of Psychology, University of Miami, Florida, USA
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Mughal AY, Devadas J, Ardman E, Levis B, Go VF, Gaynes BN. A systematic review of validated screening tools for anxiety disorders and PTSD in low to middle income countries. BMC Psychiatry 2020; 20:338. [PMID: 32605551 PMCID: PMC7325104 DOI: 10.1186/s12888-020-02753-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 06/23/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Anxiety and post-traumatic stress disorder (PTSD) contribute significantly to disability adjusted life years in low- to middle-income countries (LMICs). Screening has been proposed to improve identification and management of these disorders, but little is known about the validity of screening tools for these disorders. We conducted a systematic review of validated screening tools for detecting anxiety and PTSD in LMICs. METHODS MEDLINE, EMBASE, Global Health and PsychINFO were searched (inception-April 22, 2020). Eligible studies (1) screened for anxiety disorders and/or PTSD; (2) reported sensitivity and specificity for a given cut-off value; (3) were conducted in LMICs; and (4) compared screening results to diagnostic classifications based on a reference standard. Screening tool, cut-off, disorder, region, country, and clinical population were extracted for each study, and we assessed study quality. Accuracy results were organized based on screening tool, cut-off, and specific disorder. Accuracy estimates for the same cut-off for the same screening tool and disorder were combined via meta-analysis. RESULTS Of 6322 unique citations identified, 58 articles including 77 screening tools were included. There were 46, 19 and 12 validations for anxiety, PTSD, and combined depression and anxiety, respectively. Continentally, Asia had the most validations (35). Regionally, South Asia (11) had the most validations, followed by South Africa (10) and West Asia (9). The Kessler-10 (7) and the Generalized Anxiety Disorder-7 item scale (GAD-7) (6) were the most commonly validated tools for anxiety disorders, while the Harvard Trauma Questionnaire (3) and Posttraumatic Diagnostic Scale (3) were the most commonly validated tools for PTSD. Most studies (29) had the lowest quality rating (unblinded). Due to incomplete reporting, we could meta-analyze results from only two studies, which involved the GAD-7 (cut-off ≥10, pooled sensitivity = 76%, pooled specificity = 64%). CONCLUSION Use of brief screening instruments can bring much needed attention and research opportunities to various at-risk LMIC populations. However, many have been validated in inadequately designed studies, precluding any general recommendation for specific tools in LMICs. Locally validated screening tools for anxiety and PTSD need further evaluation in well-designed studies to assess whether they can improve the detection and management of these common disorders. TRIAL REGISTRATION PROSPERO registry number CRD42019121794 .
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Affiliation(s)
- Anisa Y. Mughal
- The University of Pittsburgh School of Medicine, 3550 Terrace Street, Pittsburgh, PA 15213 USA
| | - Jackson Devadas
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, NC 27599 USA
| | - Eric Ardman
- University of Miami Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL 33136 USA
| | - Brooke Levis
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec H3A 1A2 Canada
- Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG UK
| | - Vivian F. Go
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, NC 27599 USA
| | - Bradley N. Gaynes
- Department of Psychiatry, University of North Carolina School of Medicine, 101 Manning Dr, Chapel Hill, NC 27514 USA
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Tesfaye G, Demlew D, G/tsadik M, Habte F, Molla G, Kifle Y, Gebreegziabher G. The prevalence and associated factors of alcohol use among pregnant women attending antenatal care at public hospitals Addis Ababa, Ethiopia, 2019. BMC Psychiatry 2020; 20:337. [PMID: 32600291 PMCID: PMC7325233 DOI: 10.1186/s12888-020-02747-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 06/19/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Alcohol use during pregnancy is a significant public health problem, ultimately affecting the neonatal offspring. Recent studies explore that no safe amount and safe time to drink alcohol during pregnancy. Even though drinking in pregnancy has a wide range of problems, a small number of scientific publications document on the magnitude of drinking alcohol during pregnancy in Sub-Saharan African countries including Ethiopia. The aim of this study was to assess prevalence and associated factors of alcohol use among pregnant women attending prenatal care at public hospitals, Addis Ababa, Ethiopia. METHODS Hospital based cross sectional study was employed from May 7 to June 6, 2019 at public hospitals, Addis Ababa. A total of 585 pregnant women participated in the study selected through systematic random sampling technique. Frequency of consumption was measured by using AUDIT. Frequency tables and graphs were used to describe the study variable. The association between variables analyzed with bi-variable and multivariable binary logistic regression. A statistical significance was declared at p value < 0.05 with 95% confidence interval. RESULT A total of 585 participants were included in the study with the response rate of 98.6%. The study showed that the prevalence of alcohol use among pregnant women were 37.1% with (95% CI, 33.2-41). Factors like no formal education [AOR = 3.22, 95%CI, 1.72, 6.02], pre-pregnancy alcohol use [AOR = 3.16, 95%CI, 2.03, 4.91], partner alcohol use [AOR = 3.43, 95%CI, 2.21, 5.32], and poor social support [AOR = 3.16, 95%CI, 1.88, 5.31] were statistically associated with alcohol use during pregnancy. CONCLUSION In this study the prevalence of alcohol use during pregnancy was high as compared to majority of other studies. This study observed that no formal education, pre-pregnancy alcohol use, partner alcohol use, and poor social support, were highly associated with alcohol use during pregnancy. Based on the findings of this study early management of alcohol use and problematic alcohol use is needed for pregnant women.
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Affiliation(s)
- Getaneh Tesfaye
- Department of Psychiatry, College of Health Sciences, Aksum University, Aksum, Ethiopia.
| | - Demeke Demlew
- grid.59547.3a0000 0000 8539 4635College of Medicine and Health, Department of Psychiatry, University of Gondar, Gondar, Ethiopia
| | | | | | - Gebeyaw Molla
- Department of Psychiatry, College of Health Sciences, Axum University, Aksum, Ethiopia
| | - Yohannes Kifle
- Department of Psychiatry, College of Health Sciences, Axum University, Aksum, Ethiopia
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Shon EJ. Measurement equivalence of the Kessler 6 Psychological Distress Scale for Chinese and Korean immigrants: Comparison between younger and older adults. Int J Methods Psychiatr Res 2020; 29:e1823. [PMID: 32172536 PMCID: PMC7301282 DOI: 10.1002/mpr.1823] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 02/09/2020] [Accepted: 02/26/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The Kessler 6 (K6) Psychological Distress Scale is a well-known instrument to screen for psychological distress of general populations. It is critical to perform the equivalence test of the K6 for Asian immigrant subgroups. METHODS The 2012 California Health Interview Survey data were used (N = 1,210; Chinese = 640, Koreans = 570). Among 1,210, 734 were younger (18-64 years) and 476 were older (65+) adults. It was examined whether parameters in the measurement model is equivalent across the two groups, using multiple-group analysis. The equivalence tests for Chinese and Koreans were separately performed based on different age groups (younger [18-64] vs. older [65+]). RESULTS The younger group had good model fit (X2 = 41.27 [df = 16, p = .001], X2 /df = 2.58, Comparative Fit Index [CFI] = 0.99, Goodness of Fit Index [GFI] = 0.98, root mean square error or approximation [RMSEA] = 0.05, standardized root mean residual [SRMR] = 0.03), and the older group also showed good model fit (X2 = 41.70 [df = 16, p < .001], X2 /df = 2.61, CFI = 0.98, GFI = 0.97, RMSEA = 0.06, SRMR = 0.04). The model for older group indicated measurement noninvariance between Chinese and Korean immigrants (ΔX2 = 17.86, Δdf = 5, p = .003, CFI = 0.972, ΔCFI = 0.009). The items "hopeless," "restless," and "depress," were significantly nonequivalent between the two groups. CONCLUSIONS Clinicians/researchers should be aware of the potential risk for misclassification when they screen psychological distress of Chinese or Korean older immigrants. Professionals should pay attention to cross-cultural comparability when interpreting results from the K6.
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Affiliation(s)
- En-Jung Shon
- Department of Family Science and Social Work, College of Education, Health and Society, Miami University in Ohio, Oxford, Ohio, USA
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48
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Burden of Depression in Outpatient HIV-Infected adults in Sub-Saharan Africa; Systematic Review and Meta-analysis. AIDS Behav 2020; 24:1752-1764. [PMID: 31720956 DOI: 10.1007/s10461-019-02706-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Despite the substantial burden of HIV in Africa, and the knowledge that depression causes worse HIV outcomes, the burden of depression in people living with HIV in Africa is unknown. We searched Pubmed and four other databases using key terms: depression, Africa, HIV, and prevalence from 2008 to 2018. We summarized depression prevalence by country. We estimated the burden of depression using our prevalence data and 2018 UNAIDS HIV estimates. Our search yielded 70 articles across 16 African countries. The overall prevalence of major depression in those HIV-infected using a diagnostic interview was 15.3% (95% CI 12.5-17.1%). We estimate that 3.63 million (99.7% CI 3.15-4.19 million) individuals with HIV in Sub-Saharan Africa have major depression and provide country-level estimates. We estimate that 1.57 million (99.7% CI 1.37-1.82 million) DALYs are lost among people with depression and HIV in Sub-Saharan Africa. There is a significant burden of depression in Africans with HIV. Further work to screen for and treat depression in Sub-Saharan Africa is needed to improve HIV outcomes and achieve the 90-90-90 UNAIDS goals.
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Platt R, Weiss-Laxer NS, Creedon TB, Roman MJS, Cardemil EV, Cook B. Association between maternal and child mental health among US Latinos: variation by nativity, ethnic subgroup, and time in the USA. Arch Womens Ment Health 2020; 23:421-428. [PMID: 31222621 DOI: 10.1007/s00737-019-00982-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 06/05/2019] [Indexed: 12/17/2022]
Abstract
Few studies have examined the association between maternal and youth mental health among US Latinos, or its variation by nativity, country of origin, ethnic subgroup, and time in the mainland US. Using 2007-2014 Medical Expenditure Panel Survey data linking Latino youth (N = 15,686 aged 5-17 years) and their mothers, we estimated multivariate models of the relationship between probable maternal mental illness (a composite of measures) and youth mental health impairment (Columbia Impairment Scale). Children of mothers with probable mental illness were more than three times as likely to have impairment as children of mothers without mental illness (p < 0.01). In adjusted models, there was an 8.5-point (95% CI 5.1, 11.8) increased prevalence of child impairment associated with mother's probable mental illness among mainland US-born youth and mothers and a 6.0-point (95% CI 3.7, 8.3) increased prevalence among US-born youth of foreign/island-born mothers. There was no significant difference in the prevalence of youth impairment associated with maternal mental illness when both youth and mother were born outside of the mainland US. For the Puerto Rican subgroup, the association between maternal and youth mental health was greatest among island-born mothers and mainland US-born youth; for the Mexican subgroup, the link was strongest among US-born mothers and youth. While there were large point differences between those groups, the difference was not statistically significant. This study suggests a protective effect of island/foreign-born nativity on symptom association between Latino mothers and children. Considerations for future research and practice stemming from this finding are discussed.
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Affiliation(s)
- Rheanna Platt
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins University/Johns Hopkins Bayview Medical Center, 5500 East Lombard St, Room 1214, Baltimore, MD, 21224, USA.
| | - Nomi S Weiss-Laxer
- Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Timothy B Creedon
- The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA.,IBM Watson Health, Cambridge, MA, USA
| | - Maria Jose Sanchez Roman
- Health Equity Research Lab, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA.,Milken School of Public Health, George Washington University, Washington DC, USA
| | | | - Benjamin Cook
- Health Equity Research Lab, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
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50
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Hoffman S, Leu CS, Ramjee G, Blanchard K, Gandhi AD, O'Sullivan L, Kelvin EA, Exner TM, Mantell JE, Lince-Deroche N. Linkage to Care Following an HIV Diagnosis in Three Public Sector Clinics in eThekwini (Durban), South Africa: Findings from a Prospective Cohort Study. AIDS Behav 2020; 24:1181-1196. [PMID: 31677039 DOI: 10.1007/s10461-019-02688-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Linkage to care following an HIV diagnosis remains an important HIV care continuum milestone, even in the era of universal ART eligibility. In an 8-month prospective cohort study among 459 (309 women, 150 men) newly-diagnosed HIV-positive individuals in three public-sector clinics in Durban metropolitan region, South Africa, from 2010 to 2013, median time to return to clinic for CD4+ results (linkage) was 10.71 weeks (95% CI 8.52-12.91), with 54.1% 3-month cumulative incidence of linkage. At study completion (9.23 months median follow-up), 26.2% had not linked. Holding more positive outcome-beliefs about enrolling in care was associated with more rapid linkage [adjusted hazard ratio (AHR)each additional belief 1.31; 95% CI 1.05-1.64] and lower odds of never linking [adjusted odds ratio (AOR) 0.50; 95% CI 0.33-0.75]. Holding positive ARV beliefs was strongly protective against never linking to care. Age over 30 years (AHR 1.59; 95% CI 1.29-1.97) and disclosing one's HIV-positive status within 30 days of diagnosis (AHR 1.52; 95% CI 1.10-2.10) were associated with higher linkage rates and lower odds of never linking. Gender was not associated with linkage and did not alter the effect of other predictors. Although expanded access to ART has reduced some linkage barriers, these findings demonstrate that people's beliefs and social relations also matter. In addition to structural interventions, consistent ART education and disclosure support, and targeting younger individuals for linkage are high priorities.
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Affiliation(s)
- Susie Hoffman
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality, and Health, New York State Psychiatric Institute and Columbia University, 1051 Riverside Dr., Unit 15, New York, NY, 10032, USA.
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Cheng-Shiun Leu
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality, and Health, New York State Psychiatric Institute and Columbia University, 1051 Riverside Dr., Unit 15, New York, NY, 10032, USA
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Gita Ramjee
- HIV Prevention Research Unit, South African Medical Research Council, Durban, South Africa
| | - Kelly Blanchard
- Ibis Reproductive Health, Cambridge, MA, USA
- Ibis Reproductive Health, Johannesburg, South Africa
| | - Anisha D Gandhi
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality, and Health, New York State Psychiatric Institute and Columbia University, 1051 Riverside Dr., Unit 15, New York, NY, 10032, USA
| | - Lucia O'Sullivan
- Department of Psychology, University of New Brunswick, Fredericton, Canada
| | - Elizabeth A Kelvin
- Epidemiology & Biostatistics Program, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Theresa M Exner
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality, and Health, New York State Psychiatric Institute and Columbia University, 1051 Riverside Dr., Unit 15, New York, NY, 10032, USA
| | - Joanne E Mantell
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality, and Health, New York State Psychiatric Institute and Columbia University, 1051 Riverside Dr., Unit 15, New York, NY, 10032, USA
| | - Naomi Lince-Deroche
- Ibis Reproductive Health, Cambridge, MA, USA
- Ibis Reproductive Health, Johannesburg, South Africa
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