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Armoon B, Ghadipasha A, Mohammadi R, Lesage A, Harooni J, Griffiths MD. The global prevalence of mental health disorders among runaway and homeless youth: A meta-analysis. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02519-2. [PMID: 38995408 DOI: 10.1007/s00787-024-02519-2] [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: 01/12/2024] [Accepted: 07/01/2024] [Indexed: 07/13/2024]
Abstract
A meta-analysis was performed to identify the pooled prevalence of mental health disorders (MHDs) among runaway and homeless youth (RHY). Relevant studies published between December 1, 1985, and October 1, 2023, were identified in the PubMed, Scopus, Web of Science, and Cochrane Library databases. A preliminary screening of 11,266 papers resulted in the inclusion of 101 studies. The pooled-prevalence estimates were obtained using a random-effects model. The findings showed varying lifetime prevalence rates of MHDs: 47% (conduct disorders and psychological distress), 43% (depression), 34% (major depressive disorders), 33% (post-traumatic stress disorder), 27% (personality disorders), 25% (attention-deficit/hyperactivity disorder), 23% (bipolar disorders), 22% (anxiety), 21% (oppositional defiant disorders), 15% (anorexia), 15% (adjustment disorders), 14% (dysthymia), 11% (schizophrenia), 9% (obsessive-compulsive disorders), and 8% (gambling disorder). The current prevalence rates were: 31% (depression), 23% (major depressive disorder), 23% (anxiety), 21% (post-traumatic stress disorder), 16% (attention-deficit/hyperactivity disorder), 15% (bipolar disorder), 13% (personality disorders), 13% (oppositional defiant disorders), 8% (schizophrenia), and 6% (obsessive-compulsive disorders). Regular screening and the implementation of evidence-based treatments and the promotion of integration and coordination between mental health services for adolescent minors and young adults with other service systems are recommended.
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Affiliation(s)
- Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Amir Ghadipasha
- Firoozabadi Hospital, Iran University of Medical Science, Tehran, Iran
| | - Rasool Mohammadi
- Social Determinants of Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Alain Lesage
- Centre de Recherche de L'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada
| | - Javad Harooni
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
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Armoon B, Mohammadi R, Griffiths MD. The Global Prevalence of Non-suicidal Self-injury, Suicide Behaviors, and Associated Risk Factors Among Runaway and Homeless Youth: A Meta-analysis. Community Ment Health J 2024; 60:919-944. [PMID: 38451378 DOI: 10.1007/s10597-024-01245-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/29/2024] [Indexed: 03/08/2024]
Abstract
A meta-analysis was performed to determine pooled prevalence of non-suicidal self-injury (NSSI), suicide behaviors (including ideation, attempts), and associated risk factors among runaway and homeless youth (RHY). The databases PubMed, Scopus, Web of Science, and Cochrane Library were searched for relevant studies published from January 1995 to May 2023. Initially, 8465 papers were screened, resulting in 69 included studies. The results showed that among RHY, lifetime prevalence rates were 42% for NSSI, 38% for suicidal ideation, and 27% for suicide attempts. Lifetime prevalence of NSSI and suicide behaviors was higher among adolescent minors (aged 12-17 years) compared to young adults (aged 18-24 years). Also, NSSI and suicide behaviors were associated with having a childhood history of physical and sexual abuse. Developing an impactful community-based suicide prevention campaign tailored for RHY appears warranted. Peer groups and mentorship programs would provide invaluable support for young individuals, as supportive friendships protect against NSSI.
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Affiliation(s)
- Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.
| | - Rasool Mohammadi
- Social Determinants of Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
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Senapati RE, Jena S, Parida J, Panda A, Patra PK, Pati S, Kaur H, Acharya SK. The patterns, trends and major risk factors of suicide among Indian adolescents - a scoping review. BMC Psychiatry 2024; 24:35. [PMID: 38195413 PMCID: PMC10775453 DOI: 10.1186/s12888-023-05447-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/06/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Adolescence is an essential stage for the development of mental health, and suicide is among the leading cause of mortality for adolescents around the world. In India, the suicide rate among adolescents has been increasing in recent years. The scoping review was conducted to map the evidence and address gaps by examining the existing pattern, and trends, and identify the major risk factors of suicide among Indian adolescents. METHODS The study was conducted as per the Arksey and O'Malley scoping review framework and the Joanna Briggs Institute Reviewers' manual. The systematic search was performed using electronic databases such as PubMed, Google Scholar, EMBASE, and PsycINFO, by using specific keywords. After the screening, 35 articles were identified according to the inclusion criteria. RESULTS The evidence on the trends of suicide among adolescents showed that the suicide rate has shown an alarming increase in recent years. The evidence pattern showed that hanging and poisoning were the commonly selected methods used by adolescents. The most commonly reported risk factors were mental health problems (54.28%), negative or traumatic familiar issues (34.28%), academic stress (22.85%), social/lifestyle factors (20%), violence (22.85%), economic distresses (8.75%), relationship factor (8.75%). CONCLUSION By synthesizing and summarising the patterns, trends, and key risk factors of suicide among Indian adolescents, this scoping review provides a broad understanding of the literature already in existence. In order to effectively tackle these issues, the finding highlights the urgent need for extensive and targeted suicide prevention measures.
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Affiliation(s)
- Rachel Elizabeth Senapati
- ICMR- Regional Medical Research Centre, NALCO Nagar, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India
| | - Susangita Jena
- ICMR- Regional Medical Research Centre, NALCO Nagar, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India
| | - Jayashree Parida
- ICMR- Regional Medical Research Centre, NALCO Nagar, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India
| | - Arpita Panda
- ICMR- Regional Medical Research Centre, NALCO Nagar, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India
| | | | - Sanghamitra Pati
- ICMR- Regional Medical Research Centre, NALCO Nagar, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India
| | - Harpreet Kaur
- Division of Epidemiology and Communicable Diseases (ECD-Tribal Health), Indian Council of Medical Research (ICMR), New Delhi, India
| | - Subhendu Kumar Acharya
- ICMR- Regional Medical Research Centre, NALCO Nagar, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India.
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Armoon B, Griffiths MD, Mohammadi R. The Global Distribution and Epidemiology of Psychoactive Substance Use and Injection Drug Use Among Street-Involved Children and Youth: A Meta-Analysis. Subst Use Misuse 2023; 58:746-764. [PMID: 36924274 DOI: 10.1080/10826084.2023.2181036] [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] [Indexed: 03/18/2023]
Abstract
Background: Globally, street-involved children and youth (SICY) who work and live on/of the streets are at higher risk of increased psychoactive substances and injecting drug use. Objectives: The present study aimed to identify the prevalence, distribution, sociodemographic factors, and risk-taking behaviors associated with psychoactive substances and injecting drug use among SICY. Methods: Studies in English published from December 1 1985 to July 1 2022, were searched for on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on psychoactive substances and injecting drug use among SICY. The pooled-prevalence estimates were obtained using a robust fixed-effects model. Results: The most commonly reported life-time and current psychoactive substance was tobacco followed by cannabis, LSD/ecstasy, cocaine, methamphetamine, heroin and injection drug use. The results showed that life-time and current prevalence of methamphetamine and cannabis use, as well as life-time prevalence of cocaine, LSD/ecstasy, heroin, tobacco, and injecting drug use increased as age rose while current prevalence of cocaine and tobacco use decreased as age rose. SICY who were male, homeless, had parents who had died, had history of substance use among family members or best friends, had experienced violence, had casual sex partners, had a history of working in the sex trade, and had unprotected sex were all related to psychoactive substance use and injecting drug use. Conclusions: Research examining this population suffers from lack of studies, therefore, improving the knowledge for interventions aimed at reducing risk behaviors, particularly those related to the transmission of sexually transmitted infections such as HIV is of great importance.
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Affiliation(s)
- Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Rasool Mohammadi
- Social Determinants of Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
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Swatantra Clinic: A descriptive study on the specialized child mental health service for children in difficult circumstances at a tertiary care center in India. Asian J Psychiatr 2021; 66:102864. [PMID: 34601290 DOI: 10.1016/j.ajp.2021.102864] [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: 08/07/2021] [Revised: 09/06/2021] [Accepted: 09/13/2021] [Indexed: 11/23/2022]
Abstract
In India, children in difficult circumstances, like institutionalized children have higher mental health morbidity and complex psychosocial concerns than the non-institutionalized children. To cater to the complex needs of these children referred by the Juvenile Justice System, a specialized service called 'Swatantra Clinic' was initiated by the Department of Child and Adolescent Psychiatry at the National Institute of Mental Health and Neurosciences, India. This article thereby aims to describe the psychosocial characteristics of these children, along with the array of specialized interventions provided during the first year of its inception in June 2018. It was found that majority of these children were girls and were from lower socio-economic, urban background, primarily referred for externalizing or internalizing concerns. The majority of them reported experiences of physical and verbal abuse along with family stressors and almost half of them had a diagnosable psychiatric condition. The nature of the psychosocial services rendered at the clinic mostly comprised of brief, individual and family counseling along with liaison work with various governmental agencies for rehabilitation services. These form the key components of a comprehensive, collaborative, time-bound and holistic care model to cater to the distinct psychosocial issues of this vulnerable population of children in low - middle resource settings. Policy implications are discussed.
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Santa Maria D, Lightfoot M, Nyamathi A, Businelle M, Paul M, Quadri Y, Padhye N, Jones J, Calvo Armijo M. A Nurse Case Management HIV Prevention Intervention (Come As You Are) for Youth Experiencing Homelessness: Protocol for a Randomized Wait-list Controlled Trial. JMIR Res Protoc 2021; 10:e26716. [PMID: 34018967 PMCID: PMC8178739 DOI: 10.2196/26716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/29/2021] [Accepted: 04/08/2021] [Indexed: 11/25/2022] Open
Abstract
Background Youth experiencing homelessness are more likely than housed youth to experience premature death, suicide, drug overdose, pregnancy, substance use, and mental illness. Yet while youth experiencing homelessness are 6 to 12 times more likely to become infected with HIV than housed youth, with HIV prevalence as high as 16%, many do not access the prevention services they need. Despite adversities, youth experiencing homelessness are interested in health promotion programs, can be recruited and retained in interventions and research studies, and demonstrate improved outcomes when programs are tailored and relevant to them. Objective The study aims to compare the efficacy of a nurse case management HIV prevention and care intervention, titled Come As You Are, with that of usual care among youth experiencing homelessness aged 16 to 25 years. Methods The study is designed as a 2-armed randomized wait-list controlled trial. Participants (n=450) will be recruited and followed up for 9 months after the intervention for a total study period of 12 months. Come As You Are combines nurse case management with a smartphone-based daily ecological momentary assessment to develop participant-driven HIV prevention behavioral goals that can be monitored in real-time. Youth in the city of Houston, Texas will be recruited from drop-in centers, shelters, street outreach programs, youth-serving organizations, and clinics. Results Institutional review board approval (Committee for the Protection of Human Subjects, University of Texas Health Science Center at Houston) was obtained in November 2018. The first participant was enrolled in November 2019. Data collection is ongoing. To date, 123 participants have consented to participate in the study, 89 have been enrolled, and 15 have completed their final follow-up. Conclusions There is a paucity of HIV prevention research regarding youth experiencing homelessness. Novel and scalable interventions that address the full continuum of behavioral and biomedical HIV prevention are needed. This study will determine whether a personalized and mobile HIV prevention approach can reduce HIV risk among a hard-to-reach, transient population of youth at high risk. International Registered Report Identifier (IRRID) DERR1-10.2196/26716
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Affiliation(s)
- Diane Santa Maria
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Marguerita Lightfoot
- Center for AIDS Prevention Studies and UCSF Prevention Research Center, University of California San Francisco, San Francisco, CA, United States
| | - Adey Nyamathi
- Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA, United States
| | - Michael Businelle
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Mary Paul
- Baylor College of Medicine, Houston, TX, United States
| | - Yasmeen Quadri
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Nikhil Padhye
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jennifer Jones
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Margarita Calvo Armijo
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, United States
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Development of a Family-Based Mental Health Program for Runaway Adolescents Using an Intervention Mapping Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217794. [PMID: 33114457 PMCID: PMC7663162 DOI: 10.3390/ijerph17217794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/16/2020] [Accepted: 10/22/2020] [Indexed: 12/02/2022]
Abstract
The mental health and related quality of life of runaway adolescents are global public health issues. As few intervention studies have considered the family contexts of runaway adolescents, we aimed to develop an intervention tailored specifically to the needs of this population using an Intervention Mapping protocol. First, a literature review and interviews with runaway adolescents and youth shelter workers were conducted to create a logic model of the problem. Second, the behavioral and environmental outcomes were set to adapt to stressful situations and enable families to become more resourceful in dealing with family adversity, based on the results of needs assessment. Performance objectives and changeable determinants were also created by reviewing the pertinent theories and studies. Third, theory- and evidence-based methods to influence changes in the determinants were identified. Fourth, we designed an eight-session family-based mental health program incorporating individual and family approaches for runaway adolescents. Fifth, we determined that mental health nurses at community mental health centers linked to youth shelters would serve as the program implementers. Finally, we planned a randomized controlled trial to evaluate the effects of our program on improving runaway adolescents’ mental health status and perceived family functioning.
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Dhawan A, Mishra AK, Ambekar A, Chatterjee B, Agrawal A, Bhargava R. Estimating the size of substance using street children in Delhi using Respondent-Driven Sampling (RDS). Asian J Psychiatr 2020; 48:101890. [PMID: 31841817 DOI: 10.1016/j.ajp.2019.101890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/02/2019] [Accepted: 12/04/2019] [Indexed: 10/25/2022]
Abstract
Street children as a population sub-group exist in significant numbers in the developing world and have been reported to be vulnerable to adverse health and risk behaviours that include physical and sexual risk behaviour. However, the estimation of prevalence for various psychoactive substances among the street children in a representative sample has not been attempted in the developing country like India. This is challenging due to the absence of an appropriate sampling frame, the population living in isolation, hiding their identity and concealing their behaviour. Use of psychoactive substances in street children is riddled with these challenges. The present investigation describes the findings from size estimation study on a representative sample of street child (n = 766) in Delhi, by implementing the Respondent Driven Sampling Methodology (RDS). The weighted prevalence for three commonest substances was found as Tobacco (31.1 %), alcohol (13.5 %) and inhalants (11.3 %) used during the last one year with the estimated number as -Tobacco (21,770), Alcohol (9450) and Inhalants (5600). Almost one third of street children were using some substance. Also, a large majority of ever users were also using substances currently. The study demonstrates successfully the implementation of RDS for the estimation of the prevalence of psychoactive substances in a representative manner. A large majority of street children use psychoactive substances, and there is a need for more of such studies in other metropolitan cities so that local level interventions and planning can be done for treatment and prevention of psychoactive substances among the street children. The important public health implications had been discussed.
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Affiliation(s)
- Anju Dhawan
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India.
| | - Ashwani Kumar Mishra
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India.
| | - Atul Ambekar
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India.
| | - Biswadip Chatterjee
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India.
| | - Alok Agrawal
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India.
| | - Rachna Bhargava
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India.
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Santa Maria D, Daundasekara SS, Hernandez DC, Zhang W, Narendorf SC. Sexual risk classes among youth experiencing homelessness: Relation to childhood adversities, current mental symptoms, substance use, and HIV testing. PLoS One 2020; 15:e0227331. [PMID: 31899781 PMCID: PMC6941897 DOI: 10.1371/journal.pone.0227331] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 12/17/2019] [Indexed: 12/26/2022] Open
Abstract
The aim of this study was to determine whether there are meaningful subgroups with different types of sexual risk behaviors among youth experiencing homelessness and examine the associations between potential classes and other risk variables. A latent class analysis was used to identify classes of youth according to sexual risk behaviors and sexual assault. A two-class solution was found to be the best fit for the data-Lower and Higher Risk groups. The Higher Risk class had significantly higher levels of synthetic marijuana and alcohol use, mental health diagnoses, and were more likely to have been tested for HIV than the Lower Risk group. Youth were more likely to be in the Higher Risk group if they were cisgender female or lesbian, gay, bisexual, or questioning (LGBQ). Nearly all youth (10/11) who reported having HIV infection were in the Higher Risk group. The Lower Risk group were sexually active but had lower rates of risk behaviors and sexual assault. Youth who were not sexually active had the lowest rates of marijuana and alcohol use as well as HIV testing. Health and social service providers should be aware of the added risks for stress, mental distress, mental health diagnoses, and substance use among youth who also report higher risk sexual behaviors and treat as needed.
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Affiliation(s)
- Diane Santa Maria
- Department of Research, Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Saumali S. Daundasekara
- Department of Health and Human Performance, University of Houston, Houston, TX, United States of America
| | - Daphne C. Hernandez
- Department of Research, Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Wei Zhang
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Sarah C. Narendorf
- University of Houston, Graduate College of Social Work, Houston, TX, United States of America
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Shein-Szydlo J, Sukhodolsky DG, Kon DS, Tejeda MM, Ramirez E, Ruchkin V. A Randomized Controlled Study of Cognitive-Behavioral Therapy for Posttraumatic Stress in Street Children in Mexico City. J Trauma Stress 2016; 29:406-414. [PMID: 27602880 DOI: 10.1002/jts.22124] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 03/23/2016] [Accepted: 04/22/2016] [Indexed: 11/09/2022]
Abstract
The study aimed to evaluate cognitive-behavioral therapy (CBT) for posttraumatic stress (PTS), depression, anxiety, and anger in street children by a randomized controlled trial of CBT versus a waitlist control. It was conducted in 8 residential facilities for street children in Mexico City, with assessments at baseline, posttreatment, and 3 months later. Children who reported at least moderate posttraumatic stress, and fulfilled the study requirement were enrolled in the study (N = 100, 12-18 years old, 36 boys). There were 51 children randomized to CBT and 49 to the waitlist condition. Randomization was stratified by gender. CBT consisted of 12 individual 1-hour sessions administered weekly by 2 trained, master's-level clinicians. Outcome measures included self-reports of PTS, depression, anxiety, and anger; global improvement was assessed by the independent evaluator. Compared to participants in the waitlist condition participants in CBT showed a significant reduction in all symptoms, with effects sizes of 1.73 to 1.75. At follow up there was attrition (n = 36), and no change from posttreatment scores. The study did find statistically significant improvement in symptoms in the CBT group compared to the waitlist condition; symptoms remained stable at 3 months. The study found that CBT for trauma in a sample of street children provided a reduction of a broad range of mental health symptoms.
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Affiliation(s)
- Janet Shein-Szydlo
- Centro de Investigación en Psicoterapia Psicoanalítica AC, CIPPAC, Mexico City, Mexico
| | - Denis G Sukhodolsky
- Child Study Center, Yale University Medical School, New Haven, Connecticut, USA
| | | | | | - Esteli Ramirez
- Procuraduría de la Defensa del Menor y la Familia, Querétaro, Mexico City, Mexico
| | - Vladislav Ruchkin
- Child Study Center, Yale University Medical School, New Haven, Connecticut, USA. .,Child and Adolescent Psychiatry Unit, Division of Neuroscience, Uppsala University, Uppsala, Sweden. .,Säter Forensic Psychiatric Clinic, Säter, Sweden.
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Ko M, Hong M, Kim YE, Ha J, Lee SM, Kim HS. Depression, Attachment and Addiction Problems in Runaway Youths. Soa Chongsonyon Chongsin Uihak 2016. [DOI: 10.5765/jkacap.2016.27.3.181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Miae Ko
- Department of Psychiatry, Seonam University School of Medicine, Myongji Hospital, Goyang, Korea
| | - Minha Hong
- Department of Psychiatry, Seonam University School of Medicine, Myongji Hospital, Goyang, Korea
| | - Young-Eun Kim
- Department of Preventive Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Juwon Ha
- Yonsei Forest Mental Health (Psychiatry) Clinic, Seoul, Korea
| | - Sang Min Lee
- Department of Psychiatry, Konyang University College of Medicine, Konyang University Hospital, Daejeon, Korea
| | - Hyun-Soo Kim
- Department of Psychiatry, Seonam University School of Medicine, Myongji Hospital, Goyang, Korea
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Dhawan A, Chopra A, Ambekar A, Ray R. Treatment Seeking Behavior of Inhalant Using Street Children: Are We Prepared to Meet Their Treatment Needs. Indian J Psychol Med 2015; 37:282-7. [PMID: 26664076 PMCID: PMC4649816 DOI: 10.4103/0253-7176.162918] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
CONTEXT There is a lack of evidence for help and treatment seeking behavior of street children using inhalants. AIMS The present study was planned to provide a comprehensive understanding on the patterns, correlates of inhalant use and treatment seeking behavior of street children from Delhi, India. MATERIAL AND METHODS Participants were a purposive sample of 100 inhalant using street children below 18 years identified with the assistance of five community service organizations/nongovernmental organization working with street children in the city of Delhi. Information on a semi-structured questionnaire with items pertaining to the demographic and drug use parameters was collected by trained research staff in a one-to-one in field setting. STATISTICAL ANALYSIS All data were entered into SPSS 12.0, data quality checks performed and examined. RESULTS The sample had an average age of 12.8 ± 2.4 years (range 4-17 years), 96.5% reported regular past month and 87.0% past 24 h use of inhalants. The mean age of onset of inhalant use was 9.3 ± 2.8 years The substances most commonly reported were toluene from eraser fluid (by 83.0%), glues (34.0%) and petroleum products (3.0%); mean frequency of use was 9.8 times in a day. Of the sample, 18% used inhalants when they were alone, and the rest reported using with drug using network friends; 76% reported tolerance and mild withdrawal symptoms such as restlessness, anxiety, craving, irritability and lethargy. A variety of problems and perceived benefits due to inhalant use were reported; 46% inhalant users had never abstained from its use, and 77% reported never having sought any medical help. CONCLUSIONS Study findings provide a better contemporary understanding of inhalant abuse among Delhi street children. This information can assist in the formulation of a needs-based intervention for the inhalant using street children.
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Affiliation(s)
- Anju Dhawan
- Department of Psychiatry, AIIMS, New Delhi, India
| | - Anita Chopra
- National Drug Dependence Treatment Centre, AIIMS, New Delhi, India
| | - Atul Ambekar
- National Drug Dependence Treatment Centre, AIIMS, New Delhi, India
| | - Rajat Ray
- National Drug Dependence Treatment Centre, AIIMS, New Delhi, India
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Jegannathan B, Dahlblom K, Kullgren G. ' Plue plun' male, ' kath klei' female: gender differences in suicidal behavior as expressed by young people in Cambodia. INTERNATIONAL JOURNAL OF CULTURE AND MENTAL HEALTH 2014; 7:326-338. [PMID: 24999370 PMCID: PMC4066927 DOI: 10.1080/17542863.2013.800568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 04/24/2013] [Indexed: 11/22/2022]
Abstract
Few studies from low- and middle-income countries use qualitative methodology to explore suicidal behavior among young people. In Cambodia, young people face the challenge of rapidly changing times and are vulnerable for suicidal behavior as revealed by research in transitional economies. This study seeks to gain a deeper understanding of the suicidal phenomena from a gender, psychosocial and cultural perspective. Six focus-group discussions were conducted among boys and girls, aged 15-19 years, in two secondary schools in a suburban area close to Phnom Penh, the capital city. The data was analyzed using thematic analysis approach. The participants highlighted the gender difference in suicidal behavior by describing the suicide-prone, acting-out male as 'plue plun', while suicide-prone females were described as caught in constricted, tunneled-thinking behavior, expressed as 'kath klei'. Parental attitude and family environment were also pointed out as the chief causes of discontent and there was a strong wish on the part of young people to find space for modern values within the traditional family. The young people's awareness of their challenges in everyday life suggests that school-based programs to prevent suicidal behavior ought to be gender-sensitive and peer-focused.
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Affiliation(s)
| | - Kjerstin Dahlblom
- Division of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Gunnar Kullgren
- Department of Clinical Sciences, Umeå University, Umeå, Sweden
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The health diagnoses of homeless adolescents: a systematic review of the literature. J Adolesc 2014; 37:531-42. [PMID: 24931556 DOI: 10.1016/j.adolescence.2014.04.003] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 03/17/2014] [Accepted: 04/13/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Homelessness during adolescence impacts negatively upon young people's physical and mental wellbeing. To be effective, programs aimed at addressing the health needs of this population must include knowledge of both the presenting and underlying acute and chronic conditions that characterise this high risk group of youth. METHODS We undertook a systematic review of the international literature for studies that used validated instruments and techniques to diagnose prevalence rates of physical and mental health disorders in homeless adolescents. RESULTS Twenty-one studies fulfilled the selection criteria. Of these, nine studies examined mental health diagnoses including depression, post-traumatic stress disorder, anxiety and substance abuse disorders. With one exception, the remaining twelve studies all related to sexually transmitted infections. CONCLUSION Homeless adolescents are diagnosed with widely varying rates of mental health disorders and high rates of sexually transmitted infection. Other likely chronic and acute physical conditions appear to be neglected in the published research.
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Embleton L, Mwangi A, Vreeman R, Ayuku D, Braitstein P. The epidemiology of substance use among street children in resource-constrained settings: a systematic review and meta-analysis. Addiction 2013; 108:1722-33. [PMID: 23844822 PMCID: PMC3776018 DOI: 10.1111/add.12252] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 01/11/2013] [Accepted: 05/13/2013] [Indexed: 11/30/2022]
Abstract
AIMS To compile and analyze critically the literature published on street children and substance use in resource-constrained settings. METHODS We searched the literature systematically and used meta-analytical procedures to synthesize literature that met the review's inclusion criteria. Pooled-prevalence estimates and 95% confidence intervals (CI) were calculated using the random-effects model for life-time substance use by geographical region as well as by type of substance used. RESULTS Fifty studies from 22 countries were included into the review. Meta-analysis of combined life-time substance use from 27 studies yielded an overall drug use pooled-prevalence estimate of 60% (95% CI = 51-69%). Studies from 14 countries contributed to an overall pooled prevalence for street children's reported inhalant use of 47% (95% CI = 36-58%). This review reveals significant gaps in the literature, including a dearth of data on physical and mental health outcomes, HIV and mortality in association with street children's substance use. CONCLUSIONS Street children from resource-constrained settings reported high life-time substance use. Inhalants are the predominant substances used, followed by tobacco, alcohol and marijuana.
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Affiliation(s)
- Lonnie Embleton
- College of Health Sciences, Department of Medicine, Moi University, Eldoret, Kenya
| | - Ann Mwangi
- College of Health Sciences, School of Medicine, Department of Behavioral Sciences, Moi University, Eldoret, Kenya
| | - Rachel Vreeman
- College of Health Sciences, School of Medicine, Department of Pediatrics, Moi University, Eldoret, Kenya
- School of Medicine, Department of Pediatrics, Indiana University, Indianapolis, IN, USA
| | - David Ayuku
- College of Health Sciences, School of Medicine, Department of Behavioral Sciences, Moi University, Eldoret, Kenya
| | - Paula Braitstein
- College of Health Sciences, Department of Medicine, Moi University, Eldoret, Kenya
- School of Medicine, Department of Medicine, Indiana University, Indianapolis, IN, USA
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada and
- Regenstrief Institute, Inc., Indianapolis, IN, USA
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Woan J, Lin J, Auerswald C. The health status of street children and youth in low- and middle-income countries: a systematic review of the literature. J Adolesc Health 2013; 53:314-321.e12. [PMID: 23706729 DOI: 10.1016/j.jadohealth.2013.03.013] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 02/06/2013] [Accepted: 03/14/2013] [Indexed: 10/26/2022]
Abstract
The health of the tens of millions of street children globally is understudied. We undertook a systematic review of the existing quantitative literature regarding the health status of street children and youth in low- and middle-income countries to summarize available knowledge, identify underexplored areas of research, and inform the future research agenda regarding the health of this population. A total of 108 articles met our inclusion criteria. Demographic data and structural factors associated with street life are summarized. Although data in specific regions or diseases are sparse, the literature review illustrates that youth's survival behaviors and the exposures associated with poor shelter have resulted in disproportionate morbidity in the areas of infectious illness, psychiatric disease, reproductive health, and perhaps to a lesser extent, growth. Vast areas of health that may disproportionately affect street children in childhood or later on as adults have not been investigated, including chronic diseases and cognitive deficits. Studies of specific diseases or conditions vary considerably by region. Strengths and limitations of the literature are discussed and principles for future research in this area are proposed.
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Affiliation(s)
- Jessica Woan
- University of Washington School of Medicine, Seattle, WA, USA
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Embleton L, Ayuku D, Atwoli L, Vreeman R, Braitstein P. Knowledge, attitudes, and substance use practices among street children in Western Kenya. Subst Use Misuse 2012; 47:1234-47. [PMID: 22780841 PMCID: PMC3749375 DOI: 10.3109/10826084.2012.700678] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The study describes the knowledge of and attitudes toward substance use among street-involved youth in Kenya, and how they relate to their substance use practices. In 2011, 146 children and youth ages 10-19 years, classified as either children on the street or children of the street were recruited to participate in a cross-sectional survey in Eldoret, Kenya. Bivariate analysis using χ² or Fisher's Exact Test was used to test the associations between variables, and multiple logistic regression analysis was used to identify independent covariates associated with lifetime and current drug use. The study's limitations and source of funding are noted.
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Affiliation(s)
- Lonnie Embleton
- Department of Medicine, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya
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McCarthy MD, Thompson SJ. Predictors of Trauma-Related Symptoms Among Runaway Adolescents. JOURNAL OF LOSS & TRAUMA 2010. [DOI: 10.1080/15325020903375842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Towe VL, ul Hasan S, Zafar ST, Sherman SG. Street life and drug risk behaviors associated with exchanging sex among male street children in Lahore, Pakistan. J Adolesc Health 2009; 44:222-8. [PMID: 19237107 PMCID: PMC2671069 DOI: 10.1016/j.jadohealth.2008.09.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2008] [Revised: 08/11/2008] [Accepted: 09/11/2008] [Indexed: 11/17/2022]
Abstract
BACKGROUND Throughout the developing world, children living on urban streets is a byproduct of economic deprivation. In Lahore, Pakistan, there are an estimated 5,000-7,000 street children. PURPOSE The study examined HIV risk behaviors and factors associated with exchanging sex among male street children in Lahore, Pakistan. METHODS The survey was conducted from August 2003 to March 2004 among 565 registrants, ages 5-19, of Project Smile, a program that aimed to enhance the lives of street children in Lahore. We analyzed the frequency of and correlates of recent (past 3 months) sex exchange for money, drugs, or goods. Multivariate log-binomial regression was used to evaluate the independent effect of covariates on exchange sex. RESULTS Approximately 40% of participants reported having exchanged sex during the past 3 months. In multivariate analysis, the factors associated with exchanging sex were living on the street for longer than 48 months (Prevalence Ratio [PR]=1.36, 95% Confidence Interval [CI]: 0.99-1.85), reporting ever having used drugs (PR=1.87, 1.10-3.16), cutting one's self (PR=1.66, 95% CI: 1.26-2.19), and having heard of HIV/AIDS (PR=1.36, 95% CI: 1.03-1.80) after adjusting for demographic and street life variables. CONCLUSIONS We found high rates of sex exchange among a sample of street children in Lahore, Pakistan. The finding that children who have heard about HIV/AIDS are more likely to exchange sex suggests that children at HIV risk talk about HIV, but accuracy of their conversations is unclear. Street children in Pakistan are in great need of HIV education and safe alternatives for generating income.
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Affiliation(s)
- Vivian L Towe
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland 21205, USA.
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Vijayakumar L, Kumar MS. Trained volunteer-delivered mental health support to those bereaved by Asian tsunami--an evaluation. Int J Soc Psychiatry 2008; 54:293-302. [PMID: 18720890 DOI: 10.1177/0020764008090283] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION While mental health consequences following the Asian December 2004 tsunami have been studied, its impact on the survivors who lost close family members deserves attention. We investigated the usefulness of trained volunteer-delivered mental health support for the bereaved persons. METHOD Non-randomized control design involving all adults aged 18 years or above who lost at least one close family member during tsunami from two geographically different coastal areas in Chennai, India. From the intervention and control sites, 45 and 57 participants were recruited respectively for the study. One year after baseline assessment, all 102 participants in intervention and control sites were interviewed. RESULTS Participants receiving interventions on a consistent basis from trained volunteers were less likely to report depressive symptoms and general psychological distress compared with participants who did not receive the above intervention. Regression analysis for predicting the effect of intervention on the difference between the baseline and follow-up in BDI as well as GHQ scores, found a significant association between intervention and the improvement in BDI (adjusted beta (SE): -0.53 (2.44); p = 0.000) and GHQ (adjusted beta (SE): -0.52 (1.81); p = 0.001) scores. Suicidal attempts were also significantly less in the intervention group (FET p = 0.02). CONCLUSION In settings where mental health professionals are limited in number, trained lay volunteers can offer empathetic listening, support and referrals that can be potentially beneficial.
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Pillai A, Patel V, Cardozo P, Goodman R, Weiss HA, Andrew G. Non-traditional lifestyles and prevalence of mental disorders in adolescents in Goa, India. Br J Psychiatry 2008; 192:45-51. [PMID: 18174509 DOI: 10.1192/bjp.bp.106.034223] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Adolescents comprise a fifth of the population of India, but there is little research on their mental health. We conducted an epidemiological study in the state of Goa to describe the current prevalence of mental disorders and its correlates among adolescents aged between 12 and 16 years. AIMS To estimate the prevalence and correlates of mental disorders in adolescents. METHOD Population-based survey of all eligible adolescents from six urban wards and four rural communities which were randomly selected. We used a Konkani translation of the Development and Well-Being Assessment to diagnose current DSM-IV emotional and behavioural disorders. All adolescents were also interviewed on socio-economic factors, education, neighbourhood, parental relations, peer and sexual relationships, violence and substance use. RESULTS Out of 2,684 eligible adolescents, 2,048 completed the study. The current prevalence of any DSM-IV diagnosis was 1.81%; 95% CI 1.27-2.48. The most common diagnoses were anxiety disorders (1.0%), depressive disorder (0.5%), behavioural disorder (0.4%) and attention-deficit hyperactivity disorder (0.2%). Adolescents from urban areas and girls who faced gender discrimination had higher prevalence. The final multivariate model found an independent association of mental disorders with an outgoing 'non-traditional' lifestyle (frequent partying, going to the cinema, shopping for fun and having a boyfriend or girlfriend), difficulties with studies, lack of safety in the neighbourhood, a history of physical or verbal abuse and tobacco use. Having one's family as the primary source of social support was associated with lower prevalence of mental disorders. CONCLUSIONS The current prevalence of mental disorders in adolescents in our study was very low compared with studies in other countries. Strong family support was a critical factor associated with low prevalence of mental disorders, while factors indicative of adoption of a non-traditional lifestyle were associated with an increased prevalence.
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Abstract
OBJECTIVE Millions of children leave home in hope of finding a more tolerable life. The study tries to find out the kind of life they lead once out on the streets. METHODS Cross-sectional study of all street boys admitted to a Child Observation Home in New Delhi during specified 6 months. Questions regarding various aspects of survival on streets were asked. RESULTS Majority are forced to work in informal sector for survival with earnings well below the minimum wages. To escape from the exploitation and hardships, many begin abusing substances. The street experience leads to hopelessness for the future and suicidal tendencies. CONCLUSION After circumstances at home force these kids to escape, they are caught up in yet another world of exploitation, hunger, violence and abuse.
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Affiliation(s)
- Poornima Tiwari
- Department of Community Medicine, Vardhman Mahavir Medical College and Safdurjung Hospital, New Delhi, India.
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