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Doornbos MM, Zandee GL, Bjelland C. Men's mental health - Conceptualization, effects, and coping. Arch Psychiatr Nurs 2024; 50:100-107. [PMID: 38789221 DOI: 10.1016/j.apnu.2024.03.014] [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: 11/11/2022] [Revised: 10/30/2023] [Accepted: 03/10/2024] [Indexed: 05/26/2024]
Abstract
Men are predisposed to suffer with unaddressed depression and anxiety. This study sought to empower men, in three urban, racially/ethnically diverse, underserved, and impoverished neighborhoods, for mental health self-care by capturing their perceptions of depression and anxiety. Using community-based participatory research, in the context of long-term partnerships between a department of nursing and these neighborhoods, the researchers recruited 50 men aged 23-83 years. Data were collected via six homogeneous, zoom-based focus groups composed of Black, Hispanic, and White men, respectively. The men identified themes pertaining to the conceptualization and devastating effects of depression and anxiety as well as coping strategies employed to mitigate the symptoms.
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Viduani A, Arenas DL, Benetti S, Wahid SS, Kohrt BA, Kieling C. Systematic Review and Meta-Synthesis: How Is Depression Experienced by Adolescents? A Synthesis of the Qualitative Literature. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00061-3. [PMID: 38340896 DOI: 10.1016/j.jaac.2023.11.013] [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] [Received: 06/01/2023] [Revised: 10/29/2023] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To systematically investigate how youth with lived experience report their experience of depression in terms of features of depression and in relation to themselves and their environment. METHOD We conducted a systematic review of qualitative research around the world that explored the subjective experience of depression among youth (age range, 10-24 years) who had self-reported, screened positive for, or received a formal diagnosis of the disorder. We used multiple databases to search for relevant studies published in any language up until March 2023. Studies were coded regarding features of depression reported by adolescents. We also used thematic synthesis to extract and synthesize descriptions of the lived experience of depression, and to develop analytic themes. The study was registered with PROSPERO, CRD42021218300. RESULTS We identified a total of 23,424 unique records, and included 39 studies in the final review, representing the views of 884 adolescents with lived experience of depression. Most of the studies were conducted in high-income countries (72.8%), and the majority of participants were female (65%). The most frequently reported features of depression were sadness (present in 92.3% of the studies), social withdrawal (76.9%), and loneliness (69.2%). In addition, we constructed 3 themes that aimed to synthesize youths' accounts of their perceptions and experiences of depression: (1) making sense; (2) factoring in culture and contextual influences; and (3) accessing support and care. CONCLUSION Some of the more commonly reported features of depression among youth are not explicitly included in the DSM/ICD diagnostic criteria but are highly relevant and closely connected to the experiences of adolescents. Moreover, contextual interpretations of depression may be more sensitive to capture representations and narratives of depression among youth. Thus, incorporating features of depression reported by adolescents could potentially increase accuracy of detection, promote collaborative work, and enhance therapeutic and care outcomes. STUDY PREREGISTRATION INFORMATION The lived experience of depression in adolescence: a systematic review of the qualitative literature; https://www.crd.york.ac.uk/prospero/; CRD42021218300.
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Affiliation(s)
- Anna Viduani
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, and Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Daniel Luccas Arenas
- Hospital Materno-Infantil Presidente Vargas and Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Silvia Benetti
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, and Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | | | | | - Christian Kieling
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, and Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
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Wahid SS, Raza WA, Mahmud I, Kohrt BA. Climate-related shocks and other stressors associated with depression and anxiety in Bangladesh: a nationally representative panel study. Lancet Planet Health 2023; 7:e137-e146. [PMID: 36754469 DOI: 10.1016/s2542-5196(22)00315-1] [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] [Received: 12/22/2021] [Revised: 11/13/2022] [Accepted: 11/21/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Climate change has major implications for common mental disorders including depression and anxiety in vulnerable nations such as Bangladesh. However, knowledge gaps exist around national estimations of depression and anxiety, and the associations between the prevalence of these disorders with climate-related and sociodemographic risk factors. To address these gaps, this study analysed data from a nationally representative panel study in Bangladesh that examined climate-related and sociodemographic correlates of depression and anxiety. METHODS Two rounds of nationally representative household panel data were collected from urban and rural areas between August and September, 2019, and January and February, 2020. Households were selected for inclusion across 150 enumeration areas as the primary sampling units with use of a two-stage stratified random sampling design, and survey instruments were administered to the available adult member of the household. Depression and anxiety were measured with the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scales, respectively, and weighted prevalence estimates were calculated on the basis of the 2011 national population census. Data on temperature and humidity were collected from 43 weather stations and constructed as mean values for the 2-month period preceding each round of the survey. Self-reported exposure to flooding was collected for a 12-month recall period. We applied a weighted population average logistic model on the pooled sample of both surveys to analyse the associations between ambient temperature, humidity, exposure to flooding, seasonality, sociodemographic variables, and three outcome conditions (depression, anxiety, and co-occurring depression and anxiety; at the level of p<0·1). The models accounted for temporal and spatial heterogeneity. Standard errors were clustered at the level of each primary sampling unit. FINDINGS 3606 individuals were included with 3·5% dropout in the second survey round (pooled sample n=7086; age range 15-90 years; 2898 [40·9%] men and 4188 [59·1%] women). National weighted prevalence estimates were 16·3% (95% CI 14·7-17·8) for depression, 6·0% (4·7-7·3) for anxiety, and 4·8% (3·7-5·9) for co-occurring depression and anxiety. We observed no significant associations between overall seasonality (summer vs winter) and the odds of depression (adjusted odds ratio 3·14 [95% CI 0·52-19·13], p=0·22), anxiety (0·16 [0·02-1·41], p=0·10), or co-occurring depression and anxiety (0·13 [0·01-1·49], p=0·10). An increase in mean temperature of 1°C within the 2 months preceding the surveys was associated with increased odds of anxiety (1·21 [1·00-1·47], p=0·046) and increased odds of co-occurring depression and anxiety (1·24 [1·00-1·53], p=0·045), whereas increased temperature was not associated with depression (0·90 [0·77-1·04], p=0·15). An increase in mean humidity of 1 g/m3 was not associated with depression (0·99 [0·96-1·02], p=0·60) or anxiety (1·04 [0·99-1·09], p=0·13), but was associated with co-occurring depression and anxiety (1·06 [1·00-1·12], p=0·064). Exposure to flooding within the 12 months preceding the survey rounds was associated with increased odds of all outcome conditions (depression, 1·31 [1·00-1·70], p=0·047; anxiety, 1·69 [1·21-2·36], p=0·0020; and co-occurring depression and anxiety, 1·87 [1·31-2·68], p=0·0006). INTERPRETATION Climate-related shocks and other stressors have an important association with the burden of depression and anxiety in Bangladesh. Community-level interventions for common mental disorders need to be developed and assessed for safety, feasibility, and effectiveness in a Bangladeshi context. Further research on climate-related stressors is needed over different timespans and time intervals. FUNDING The World Bank.
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Affiliation(s)
- Syed Shabab Wahid
- Department of Global Health, Georgetown University, Washington, DC, USA
| | - Wameq Azfar Raza
- Health, Nutrition and Population Global Practice, The World Bank, Dhaka, Bangladesh.
| | - Iffat Mahmud
- Health, Nutrition and Population Global Practice, The World Bank, Dhaka, Bangladesh
| | - Brandon A Kohrt
- Division of Global Mental Health, George Washington University, Washington, DC, USA
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Harasym MC, Raju E, Ayeb-Karlsson S. A global mental health opportunity: How can cultural concepts of distress broaden the construct of immobility? GLOBAL ENVIRONMENTAL CHANGE : HUMAN AND POLICY DIMENSIONS 2022; 77:102594. [PMID: 36407678 PMCID: PMC9651962 DOI: 10.1016/j.gloenvcha.2022.102594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 07/28/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
(Im)mobility studies often focus on people on the move, neglecting those who stay, are immobile, or are trapped. The duality of the COVID-19 pandemic and the climate crisis creates a global mental health challenge, impacting the most structurally oppressed, including immobile populations. The construct of immobility is investigated in the context of socio-political variables but lacks examination of the clinical psychological factors that impact immobility. Research is beginning to identify self-reported emotions that immobile populations experience through describing metaphors like feeling trapped. This article identifies links in the literature between Cultural Concepts of Distress drawn from transcultural psychiatry and immobility studies. Feeling trapped is described in mental health research widely. Among (im)mobile people and non-mobility contexts, populations experience various mental health conditions from depression to the cultural syndrome, nervios. The connection of feeling trapped to CCD research lends itself to potential utility in immobility research. The conceptualisation can support broadening and deepening the comprehension of this global mental health challenge - how immobile populations' experience feeling trapped. To broaden the analytical framework of immobility and incorporate CCD, evidence is needed to fill the gaps on the psychological aspects of immobility research.
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Affiliation(s)
- Mary C Harasym
- United Nations University Institute for Environment and Human Security (UNU-EHS), Bonn, Germany
| | - Emmanuel Raju
- Global Health Section and Copenhagen Centre for Disaster Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- African Centre for Disaster Studies, North-West University, Potchefstroom, South Africa
| | - Sonja Ayeb-Karlsson
- Institute for Risk and Disaster Reduction, University College London (IRDR), University College London (UCL), London, UK
- United Nations University Institute for Environment and Human Security (UNU-EHS), Bonn, Germany
- School of Global Studies, University of Sussex, Falmer Brighton, UK
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Nichter M. From idioms of distress, concern, and care to moral distress leading to moral injury in the time of Covid. Transcult Psychiatry 2022; 59:551-567. [PMID: 35938212 DOI: 10.1177/13634615221115540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
In this invited commentary on the thematic issue of Transcultural Psychiatry on idioms of distress, concern, and care, I provide a brief overview of how my research agenda evolved over the years while conducting community and clinic-based research in South and Southeast Asia as well as North America. I then suggest areas where future research on idioms of distress, concern, care, and resilience will be needed among different demographics given social change and shifts in how we communicate face to face and in virtual reality, the impact of medicalization, pharmaceuticalization and bracket creep, changes in indigenous healing systems, and hybridization. I further call attention to the importance of conducting idioms guided research in occupational settings. Toward this end I highlight the moral distress health care workers in the U.S. have experienced during the Covid-19 pandemic and point out the importance of differentiating individual burnout from moral injury related to structural distress. I conclude by discussing the general utility of an idioms of distress perspective in the practice of cultural psychiatry and suggest that this perspective needs to be included in the training of all practitioners regardless of the system of medicine they practice. Doing so may enable the formation of mental health communities of practice in contexts where there are pluralistic health care arenas.
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Affiliation(s)
- Mark Nichter
- School of Anthropology, University of Arizona, Tucson, AZ, USA
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Wahid SS, Ottman K, Bohara J, Neupane V, Fisher HL, Kieling C, Mondelli V, Gautam K, Kohrt BA. Adolescent perspectives on depression as a disease of loneliness: a qualitative study with youth and other stakeholders in urban Nepal. Child Adolesc Psychiatry Ment Health 2022; 16:51. [PMID: 35739569 PMCID: PMC9229752 DOI: 10.1186/s13034-022-00481-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/19/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND There is a lack of research on the adolescent experience of depression in low- and middle-income countries. Criteria derived from research conducted primarily among adult Western populations inform current diagnostic standards for depression. These clinical categories are often used without exploration of their relevance to adolescent experience. Also, reliance on these categories may overlook other symptoms of depression that manifest in non-western settings. Cross-cultural qualitative work with adults in non-Western settings has suggested some differences with experience of depression and symptoms that are most relevant to service users. Research into adolescent experiences of depression is warranted to inform the development of effective interventions. METHODS Qualitative interviews were conducted in Nepal with adolescents with depressive symptoms (n = 9), healthy adolescents (n = 3), parents (n = 6), teachers (n = 10), social workers (n = 14), primary (n = 6) and mental (n = 6) healthcare providers, and policymakers (n = 6). Two focus groups were conducted with parents (n = 12) of depressed and non-depressed adolescents. Data were analyzed according to the framework approach methodology. RESULTS Loneliness was the hallmark experience that stood out for all adolescents. This was connected with 5 other clusters of symptoms: low mood and anhedonia; disturbances in sleep and appetite, accompanied by fatigue; irritability and anger; negative self-appraisals including hopelessness and self-doubt; and suicidality. Adolescents distinguished depression from other forms of stress, locally referred to as tension, and described depression to involve having "deep tension." Perceived causes of depression included (1) Family issues: neglectful or absent parents, relationship problems, and family discord; (2) Peer relationships: romantic problems, bullying, and friendship problems; and (3) Social media: social comparison, popularity metrics, cyberbullying, and leaking of personal information. CONCLUSIONS Consistent with other cross-cultural studies, loneliness was a core element of the adolescent experience of depression, despite its absence as a primary symptom in current psychiatric diagnostic classifications. It is important to note that among youth, symptoms were clustered together and interrelated (e.g., sleep and appetite changes were connected with fatigue). This calls for the need for more cross-cultural qualitative research on experience of depression among adolescents, and potential for modification of diagnostic criteria and prevention and treatments to focus on the experience of loneliness.
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Affiliation(s)
- Syed Shabab Wahid
- grid.213910.80000 0001 1955 1644Department of International Health, Georgetown University, Washington, DC USA
| | - Katherine Ottman
- grid.253615.60000 0004 1936 9510Division of Global Mental Health, George Washington University, Washington, DC USA
| | - Jyoti Bohara
- Transcultural Psychosocial Organization Nepal (TPO Nepal), Baluwatar, Kathmandu, Nepal
| | - Vibha Neupane
- Transcultural Psychosocial Organization Nepal (TPO Nepal), Baluwatar, Kathmandu, Nepal
| | - Helen L. Fisher
- grid.13097.3c0000 0001 2322 6764Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,grid.13097.3c0000 0001 2322 6764ESRC Centre for Society and Mental Health, King’s College London, London, UK
| | - Christian Kieling
- grid.414449.80000 0001 0125 3761Department of Psychiatry, Universidade Federal do Rio Grande do Sul and Child & Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS Brazil
| | - Valeria Mondelli
- grid.13097.3c0000 0001 2322 6764Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King’s College London, London, UK
| | - Kamal Gautam
- Transcultural Psychosocial Organization Nepal (TPO Nepal), Baluwatar, Kathmandu, Nepal.
| | - Brandon A. Kohrt
- grid.253615.60000 0004 1936 9510Division of Global Mental Health, George Washington University, Washington, DC USA
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Kohrt BA, Kaiser BN. Measuring mental health in humanitarian crises: a practitioner's guide to validity. Confl Health 2021; 15:72. [PMID: 34565416 PMCID: PMC8474916 DOI: 10.1186/s13031-021-00408-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/15/2021] [Indexed: 12/16/2022] Open
Abstract
Background There are ongoing methodological advances in measuring mental health in humanitarian crises. This Special Section describes numerous innovations. Here we take a practitioner's view in understanding the key issues related to assessment of mental health in humanitarian contexts and how the innovations contribute to the field. Main body In this guide for practitioners, we address the following issues: (1) clarifying the intended purpose of conducting mental health assessment in humanitarian crises: why is this information collected and for what intended purposes?; (2) determining what type of tool should be selected and the types of psychometric properties that are important for tools serving this particular purpose; (3) when a validated tool is not available, considering how qualitative and quantitative methods should be used to generate information on validity; and finally, (4) how to report on validity and its implications for interpreting information for humanitarian practitioners, governments, care providers, and other stakeholders supporting people affected by humanitarian emergencies. Conclusion Ultimately, mental health assessment tools are not independent of the group with which they were designed, nor are the psychometric properties of the tools or their utility universal across purposes. Therefore, organizations and stakeholders will optimize their positive impact when choosing tools wisely, appropriately adapting and validating tools, and providing guidance on how to interpret those findings to best serve populations in need.
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