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Garuma D, Lamba D, Abessa TG, Bonnechère B. Advancing public health: enabling culture-fair and education-independent automated cognitive assessment in low- and middle-income countries. Front Public Health 2024; 12:1377482. [PMID: 39005983 PMCID: PMC11239414 DOI: 10.3389/fpubh.2024.1377482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 06/10/2024] [Indexed: 07/16/2024] Open
Affiliation(s)
- Desalegm Garuma
- Department of Psychology, College of Education and Behavorial Sciences, Jimma University, Jimma, Ethiopia
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Dheeraj Lamba
- Department of Physiotherapy, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Teklu Gemechu Abessa
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
- Department of Special Needs and Inclusive Education, Jimma University, Jimma, Ethiopia
| | - Bruno Bonnechère
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
- Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, Hasselt University, Diepenbeek, Belgium
- Centre of Expertise in Care Innovation, Department of PXL–Healthcare, PXL University of Applied Sciences and Arts, Hasselt, Belgium
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Castro Monteiro F, de Oliveira Silva F, Josiane Waclawovsky A, Ferreira JVA, de Jesus-Moraleida FR, Schuch FB, Ward PB, Rosenbaum S, Morell R, Carneiro L, Camaz Deslandes A. Physical activity and sedentary behavior levels among individuals with mental illness: A cross-sectional study from 23 countries. PLoS One 2024; 19:e0301583. [PMID: 38669303 PMCID: PMC11051624 DOI: 10.1371/journal.pone.0301583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
People with mental illness tend to present low levels of physical activity and high levels of sedentary behavior. The study aims to compare these levels in mental illness patients, exploring the role of socioeconomic development and treatment setting. This cross-sectional study used accelerometers and the Simple Physical Activity Questionnaire (SIMPAQ) to assess physical activity and sedentary behavior in mental illness individuals living in 23 countries. Two-way ANOVAs were used to evaluate the interaction between socioeconomic development and the treatment settings on physical activity and sedentary behavior. A total of 884 (men = 55.3%) participants, mean age of 39.3 (SD = 12.8), were evaluated. A significant interaction between socioeconomic development and treatment settings was found in sedentary behavior (F = 5.525; p = 0.019; η2p = 0.009; small effect size). Main effects were observed on socioeconomic development (F = 43.004; p < 0.001; η2p = 0.066; medium effect size) and treatment setting (F = 23.001; p < 0.001; η2p = 0.036; small effect size) for sedentary behavior and physical activity: socioeconomic development (F = 20.888; p < 0.001; η2p = 0.033; small effect size) and treatment setting (F = 30.358; p < 0.001; η2p = 0.047; small effect size), showing that HIC patients were more active, while MIC patients were more sedentary. Moreover, despite of inpatients had presented higher levels of physical activity than outpatients, they also spent more time sitting. Socioeconomic development plays an important role in sedentary behavior in patients with mental disorders, warning the need to develop new strategies to reduce these levels in this population.
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Affiliation(s)
| | | | - Aline Josiane Waclawovsky
- Psychiatry Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Federal University of Santa Maria, Santa Maria, Brazil
| | | | | | - Felipe Barreto Schuch
- Psychiatry Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Federal University of Santa Maria, Santa Maria, Brazil
| | - Philip B. Ward
- School of Psychiatry, UNSW Sydney, Australia and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Simon Rosenbaum
- School of Psychiatry, UNSW Sydney, Australia and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Rachel Morell
- Mindgardens Neuroscience Network, Sydney Australia Discipline of Mental Health and Psychiatry, UNSW Sydney Australia, Sydney, Australia
| | - Lara Carneiro
- Physical Education Department, College of Education, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
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Gebreegziabhere Y, Habatmu K, Cella M, Alem A. The Ethiopian Cognitive Assessment battery in Schizophrenia (ECAS): a validation study. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2024; 10:42. [PMID: 38582925 PMCID: PMC10998832 DOI: 10.1038/s41537-024-00462-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 03/15/2024] [Indexed: 04/08/2024]
Abstract
Cognitive impairment is common in people with schizophrenia (PWS). To detect the presence and its consequences, cognitive measures with sound psychometric properties are needed. However, these are lacking especially in low-income countries. Hence, we developed the Ethiopian Cognitive Assessment battery in Schizophrenia (ECAS). In this study, we evaluated the psychometric properties of the ECAS in a cross-sectional study involving 350 PWS. Confirmatory factor analysis demonstrated a one-factor solution. ECAS score correlated significantly but weakly with a disability measure (r = -0.13, p = 0.02) and symptom dimensions of PANSS (r between -0.12 and -0.29, p < 0.05), except for positive symptoms (r = -0.10, p > 0.05). Years of education (β = 0.12, 95% CI (0.09, 0.14), p < 0.001), male sex (β = 0.22, 95% CI (0.05, 0.39)), age β = -0.02, 95% CI (-0.03, -0.01), and medication side effects (β = -0.03, 95% CI (-0.06, -0.01), p = 0.021) were significantly associated with the composite score of ECAS. The Item Response Theory analysis showed that the tool best functions among participants with moderate cognitive impairment (difficulty coefficient between -1.12 and 0.27). The Differential Item Functioning analyses showed that education had a positive contribution on Digit Symbol Substitution Test (MH OR = 2.64, 95% CI (1.34, 5.20)). The results showed that ECAS is valid in assessing cognition in PWS in low-resource settings.
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Affiliation(s)
- Yohannes Gebreegziabhere
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
- Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia.
| | - Kassahun Habatmu
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, Addis Ababa, Ethiopia
| | - Matteo Cella
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK
| | - Atalay Alem
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Zhang Z, Tan J, Luo Q. Associations between breakfast skipping and outcomes in neuropsychiatric disorders, cognitive performance, and frailty: a Mendelian randomization study. BMC Psychiatry 2024; 24:252. [PMID: 38566068 PMCID: PMC10988815 DOI: 10.1186/s12888-024-05723-1] [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: 02/09/2024] [Accepted: 03/27/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Prior studies have identified a correlation between breakfast skipping and a heightened risk of mental health issues. This investigation aimed to employ a Two-Sample Mendelian Randomization (MR) approach to explore the potential causal links between breakfast skipping and various psychiatric, neurological disorders, cognitive performance, and frailty. METHODS Utilizing data from genome-wide association studies within European demographics, this research scrutinized the association between breakfast habits and several neuropsychiatric conditions and physical health outcomes, including Alzheimer's disease (AD), Attention Deficit Hyperactivity Disorder (ADHD), Bipolar Disorder (BD), Major Depressive Disorder (MDD), Narcolepsy, Insomnia, cognitive performance, and frailty. In this MR analysis, the Inverse Variance Weighted (IVW) method was primarily utilized for evaluation. Outcomes were reported as Odds Ratios (OR) and regression coefficients (β), and underwent validation through False Discovery Rate (FDR) corrections, thereby offering a rigorous evaluation of the effects of breakfast habits on both mental and physical health dimensions. RESULTS Findings demonstrate a significant causal link between skipping breakfast and an increased risk of ADHD (OR = 2.74, 95%CI: 1.54-4.88, PFDR = 0.003) and MDD (OR = 1.7, 95%CI: 1.22-2.37, PFDR = 0.005). Conversely, no substantial causal associations were identified between breakfast skipping and AD, BD, narcolepsy, or insomnia (PFDR > 0.05). Moreover, a notable causal relationship was established between skipping breakfast and a reduction in cognitive performance (β = -0.16, 95%CI: -0.29-0.04, PFDR = 0.024) and an increase in frailty (β = 0.29, 95%CI: 0.12-0.45, PFDR = 0.003). CONCLUSION The MR analysis reveals that skipping breakfast is associated with an increased risk of ADHD, MDD, decreased cognitive performance, and greater frailty, while showing no associations were found with AD, BD, narcolepsy, or insomnia. These findings warrant further investigation into the underlying mechanisms and emphasize the importance of regular breakfast consumption for mental and physical well-being.
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Affiliation(s)
- Zheng Zhang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jinglan Tan
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Luo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Liu X, Yin M, Li Z, Wang D. Psychosocial Correlates of Internalized Stigma Among Chinese Individuals With Severe Mental Illness. J Psychosoc Nurs Ment Health Serv 2024; 62:37-44. [PMID: 37527516 DOI: 10.3928/02793695-20230726-05] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
The current study aimed to examine internalized stigma and its psychosocial factors among people with severe mental illness in China. A cross-sectional study was performed with 202 adults diagnosed with schizophrenia, bipolar disorder, or schizoaffective disorder in Beijing, China. Participants were evaluated using the Chinese version of the Internalized Stigma of Mental Illness (ISMI) scale, Perceived Devaluation and Discrimination scale, and the Medical Outcomes Study Social Support Survey. Correlation analysis and multiple linear regression analysis demonstrated that 19.8% of participants had moderate-to-high ISMI scores, whereas the sample as a whole indicated a mild level of internalized stigma. A higher level of internalized stigma was associated with greater perceived discrimination, lower social support, lower family income, older age, and distancing coping. These factors may be important to consider for developing tailored interventions in the future. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 37-44.].
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Gebreegziabhere Y, Habatmu K, Cella M, Alem A. Development and Evaluation of a Cognitive Battery for People With Schizophrenia in Ethiopia. Schizophr Bull 2023:sbad178. [PMID: 38159078 DOI: 10.1093/schbul/sbad178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND AND HYPOTHESIS Cognitive difficulties significantly burdened people with schizophrenia (PWS). However, cognitive assessment is often unavailable in low- and middle-income counties (LMICs) due to a lack of validated and culturally adapted cognitive assessment tools. In this study, we developed and evaluated a culturally sensitive cognitive battery for PWS in Ethiopia. STUDY DESIGN This study was conducted in three phases. First, we selected appropriate tests through an instrument selection procedure and created a new battery. Then, we rigorously adapted the tests using culturally competent procedures, including cognitive interviewing and expert meetings. Finally, we tested the new battery in 208 PWS and 208 controls. We evaluated its psychometric properties using advanced statistical techniques, including Item Response Theory (IRT). STUDY RESULTS The Ethiopian Cognitive Assessment battery for Schizophrenia (ECAS) was developed from three different batteries. Participants reported tests were easy to complete, and the raters found them easy to administer. All tests had good inter-rater reliability, and the composite score had very high test-retest reliability (ICC = 0.91). One-factor structure better represented the data with excellent internal consistency (α = .81). ECAS significantly differentiated PWS from controls with 77% sensitivity and 62% specificity at a Z-score ≤0.12 cut-off value. IRT analysis suggested that the battery functions best among moderately impaired participants (difficulty between -0.06 and 0.66). CONCLUSIONS ECAS is a practical, tolerable, reliable, and valid assessment of cognition. ECAS can supplement current assessment tools in LAMICs for PWS and can be used to measure cognitive intervention outcomes.
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Affiliation(s)
- Yohannes Gebreegziabhere
- Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kassahun Habatmu
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, Addis Ababa, Ethiopia
| | - Matteo Cella
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK
| | - Atalay Alem
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Mwesiga EK, Ssemata AS, Gumikiriza J, Nanteza A, Nakitende AJ, Nakku J, Akena D, Nakasujja N. The association of cognitive impairment with quality of life and functional impairment in Ugandan first-episode psychosis patients: a cross sectional study. Health Qual Life Outcomes 2022; 20:113. [PMID: 35870969 PMCID: PMC9308281 DOI: 10.1186/s12955-022-02020-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Cognitive impairment is common in first-episode psychosis patients and often associated with poor quality of life and functional impairment. However, most literature on this association is from high income countries and not low resource countries like Uganda. We aimed to determine the association between cognitive impairment with quality of life and functional impairment in Ugandan first-episode psychosis patients. Methods At Butabika national psychiatric hospital of Uganda, we enrolled 94 first-episode psychosis patients aged 18–60 years with a confirmed first-episode of psychosis and no previous treatment with antipsychotic medication. Neuropsychological assessment was performed using the MATRICS consensus cognitive battery (MCCB). Quality of life and functional impairment were assessed using the brief version of the World Health Organisation Quality of Life scale (WHOQOL-BREF) and the MINI International Neuropsychiatric Inventory (MINI) respectively. Linear regression analyses determined the association between impairment in different cognitive domains with various quality of life and functional impairment domains while controlling for age, gender and level of education. Results High scores in the reasoning and problem solving cognitive domain were associated with better quality of life in the psychological domain of WHOQOL-BREF (p = 0.029). For functional impairment, high cognitive scores in the domains of speed of processing (p = 0.018), reasoning and problem solving (p = 0.015), working memory (p = 0.017) and visual learning and memory (p = 0.002) were associated with psychosis “having a greater impact on other members of the family” on the MINI. Higher scores in the social cognition domain were associated with “less aggressive and disruptive behaviour” (p = 0.003). Conclusion Cognitive impairment in Ugandan first-episode psychotic patients is associated with both poorer quality of life and functional impairment. Remediation of cognitive function may be a plausible intervention to improve outcomes in Ugandan first-episode psychosis patients.
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Khare C, Mueser KT, McGurk SR. The relationship between cognitive functioning, age and employment in people with severe mental illnesses in an urban area in India: A longitudinal study. Schizophr Res Cogn 2022; 29:100255. [PMID: 35542828 PMCID: PMC9079721 DOI: 10.1016/j.scog.2022.100255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/25/2022] [Accepted: 04/25/2022] [Indexed: 11/16/2022]
Abstract
Although there is substantial evidence of the association between cognitive impairment and work in people with severe mental illnesses (SMI) in developed countries, less is known about this relationship in developing countries such as India. Studies showing higher rates of employment in people with SMI in developing countries than developed ones raise the question of whether cognitive functioning is related to work status and characteristics of work (e.g., wages earned). We conducted a one-year follow-up study to investigate the relationship between employment and cognitive functioning, assessed with the Montreal Cognitive Assessment (MoCA), in 150 participants with SMI (92% schizophrenia) living in an urban area and receiving psychiatric outpatient treatment at a public hospital in India. The MoCA had good internal reliability and test-retest reliability over the one-year period. Better cognitive functioning was associated with younger age, shorter duration of illness, higher education, and male gender. Both younger and older participants with higher cognitive functioning at baseline were more likely to be employed at baseline and one year later. Work status at baseline and one year follow-up was consistently related to executive functions among younger participants, and to attention among older participants, suggesting changes over the course of illness in the importance of specific cognitive domains for achieving satisfactory work performance. The findings suggest that cognitive functioning is associated with employment in people with SMI in India. Attention to impaired cognitive functioning may be critical to improving employment outcomes in this population.
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Affiliation(s)
- Chitra Khare
- College of Health and Rehabilitation Sciences, Sargent College, Boston University, 635 Commonwealth Ave., Boston, MA 02215, USA
- Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave. West, Boston, MA 02215, USA
| | - Kim T. Mueser
- Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave. West, Boston, MA 02215, USA
- Department of Occupational Therapy, Boston University, Boston, MA 02215, USA
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Susan R. McGurk
- Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave. West, Boston, MA 02215, USA
- Department of Occupational Therapy, Boston University, Boston, MA 02215, USA
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
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