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Djordjevic M, Farhang S, Shirzadi M, Mousavi SB, Bruggeman R, Malek A, Mohagheghi A, Ranjbar F, Shafiee-Kandjani AR, Jongsma HE, Veling W. Self-stigma, religiosity, and perceived social support in people with recent-onset psychosis in the Islamic Republic of Iran: Associations with symptom severity and psychosocial functioning. Int J Soc Psychiatry 2024; 70:542-553. [PMID: 38312047 PMCID: PMC11067409 DOI: 10.1177/00207640231221090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
AIMS Most evidence on psychosocial factors in recent-onset psychosis comes from high-income countries in Europe, Australia, Canada and the USA, while these factors are likely to differ under varying sociocultural and economic circumstances. In this study, we aimed to investigate associations of self-stigma, religiosity and perceived social support with symptom severity and psychosocial functioning in an Iranian cohort of people with recent-onset psychosis (i.e. illness duration of <2 years). METHODS We used baseline data of 361 participants (N = 286 [74%] male, mean age = 34 years [Standard Deviation = 10.0]) from the Iranian Azeri Recent-onset Acute Phase Psychosis Survey (ARAS). We included assessments of self-stigma (Internalized Stigma of Mental Illness, ISMI), religiosity (based on Stark & Glock), perceived social support (Multidimensional Scale of Perceived Social Support, MSPSS), symptom severity (Positive And Negative Syndrome Scale, PANSS) and psychosocial functioning (clinician-rated Global Assessment of Functioning Scale, GAF, and self-reported World Health Organization Disability Assessment Schedule 2.0, WHODAS 2.0). Descriptive analyses were employed to characterize the study sample. Covariate-adjusted ordinal and multivariable linear regression analyses were performed to investigate cross-sectional associations of baseline ISMI, religiosity and MSPSS with concurrent PANSS, GAF and WHODAS 2.0. RESULTS Higher self-stigma was associated with poorer self-reported functioning (B = 0.375 [95% Confidence Interval (CI): 0.186, 0.564]) and more severe concurrent symptoms (B = 0.436 [95% CI: 0.275, 0.597]). Being more religious was associated with poorer clinician-rated functioning (OR = 0.967 [95% CI: 0.944, 0.991]), but with less severe symptoms (B = -0.258 [95% CI: -0.427, -0.088]). Stronger social support was associated with poorer clinician-rated (OR = 0.956 [95% CI: 0.935, 0.978]) and self-reported functioning (B = 0.337 [95% CI: 0.168, 0.507]). CONCLUSION This study shows that self-stigma, religiosity and perceived social support were associated with symptom severity and clinician-rated as well as self-reported psychosocial functioning in an Iranian cohort of people with recent-onset psychosis. The findings extend previous evidence on these psychosocial factors to one of the largest countries in the Middle East, and suggest that it may be worthwhile to develop strategies aimed at tackling stigma around psychosis and integrate the role of religiosity and social support in mental ill-health prevention and therapy.
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Affiliation(s)
- M Djordjevic
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
| | - S Farhang
- Rob Giel Research Center, University Center for Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Iran
| | - M Shirzadi
- Clinical Research Development Center, Imam Khomeini, Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical
Sciences, Kermanshah, Iran
| | - SB Mousavi
- Department of Psychiatry, Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - R Bruggeman
- Rob Giel Research Center, University Center for Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
| | - A Malek
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Iran
| | - A Mohagheghi
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Iran
| | - F Ranjbar
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Iran
| | - AR Shafiee-Kandjani
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Iran
| | - HE Jongsma
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
| | - W Veling
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
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Ugwah-Oguejiofor CJ, Alkali YI, Inuwa AM, Pender GC, Chindo BA. Studies on neurobehavioural properties of Caralluma dalzielii N.E Br. aqueous aerial parts extract in mice. JOURNAL OF ETHNOPHARMACOLOGY 2024; 324:117774. [PMID: 38244951 DOI: 10.1016/j.jep.2024.117774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 01/22/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Caralluma dalzielii (Asclepiadiaceae) is a shrub used in folkloric medicine to treat epilepsy, pain and infertility in sub-Saharan Africa. Previous studies demonstrated its analgesic, antiulcer, anticonvulsant, and anti-inflammatory activities. AIM This study aimed to determine the neurobehavioural properties of Caralluma dalzielii aqueous aerial parts extract (CDAE) in mice using standard experimental models. MATERIALS AND METHODS Neurobehavioural activities of CDAE were evaluated (100, 200, and 400 mg/kg) in Swiss Albino mice using the beam walk, staircase, hole board, object recognition, open field assay, Y-maze and forced swimming tests. Phytochemical constituents were analysed using GC-MS. RESULTS CDAE significantly increased the mean number of head dips, recognition index and spontaneous alternation in hole board (14.03 at 400 mg/kg and 6.01 in distilled water group; p < 0.05), object recognition (68.16% at 400 mg/kg compared with 51.66% of distilled water group) and Y maze (9.16 at 400 mg/kg as against 4.66 of distilled water group; p < 0.05) tests respectively. It decreased the rearing counts as well as the peripheral and central square crossing in the staircase (4.2 at 400 mg/kg as against 7.87 of the distilled water group; p < 0.05) and open field tests (central, 0.81; peripheral, 1.66 at 400 mg/kg as against central, 5.23; peripheral 11.83 of the distilled water control group; p < 0.05), respectively. There were no significant effects on beam walk assays and forced swim tests. The GC-MS analysis identified a hundred compounds in CDAE. Some compounds which have been reported to possess neurobehavioural activity that were identified include 3,5-Dimethylpyrazole, 2-Amino-5-methylbenzoic acid, Acetophenone, and Tetrahydropyran. CONCLUSION CDAE demonstrated anxiolytic, anti-hyperactivity, and memory-improving effects in mice. The extract may possess GABAergic and glutamatergic properties. More studies are needed to confirm this. Isolation of the bioactive compounds is currently ongoing to unravel the bioactive constituents present in C. dalzielii extract.
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Affiliation(s)
- Chinenye Jane Ugwah-Oguejiofor
- Department of Pharmacology and Toxicology, Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria.
| | - Yusuf Ibrahim Alkali
- Department of Pharmacology and Toxicology, Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria.
| | - Abdulbaqee Muhammad Inuwa
- Department of Pharmacology and Toxicology, Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria.
| | - Gift Crucifix Pender
- Department of Pharmacology and Toxicology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P. O. Box 4285, Kigali, Rwanda.
| | - Ben A Chindo
- Department of Pharmacology and Toxicology, Faculty of Pharmaceutical Sciences, Kaduna State University, Kaduna, Nigeria.
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Meadows J, Mansour A, Gatto MR, Li A, Howard A, Bentley R. Mental illness and increased vulnerability to negative health effects from extreme heat events: a systematic review. Psychiatry Res 2024; 332:115678. [PMID: 38150812 DOI: 10.1016/j.psychres.2023.115678] [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: 07/05/2023] [Revised: 12/10/2023] [Accepted: 12/14/2023] [Indexed: 12/29/2023]
Abstract
RATIONALE Across countries, extreme heat events are projected to increase in frequency and intensity because of climate change. Exposure to extreme heat events can have a substantial negative impact on human health, and extant research suggests that individuals with mental illness are particularly vulnerable. To date, there has been no review of evidence regarding this vulnerability to inform response strategies and future research. OBJECTIVE A systematic review was undertaken to investigate mental illness as an effect modifier of the relationship between heat exposure and morbidity or mortality. METHODS Six databases (Medline, Embase, Global Health, PsychInfo, CINAHL and Scopus) were searched for studies published between the years 2000 to 2022. Twenty-two observational studies that met the inclusion criteria were investigated through narrative synthesis. The RoBANS tool, ROBIS and GRADE were used to assess the certainty of evidence including the risk of bias. RESULTS Individuals with mental illness experience worse morbidity and mortality outcomes compared to their counterparts without mental illness in all studies investigating high temperature over a single day. This did not hold for studies examining heatwaves, which reported mixed findings. CONCLUSIONS AND IMPLICATIONS People with diagnosed mental illness should be targeted for policy and service attention during high temperature days. Further research should investigate specific mental illness and adjust for a wider range of confounding factors.
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Affiliation(s)
- Julia Meadows
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia
| | - Adelle Mansour
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia
| | - Maria Rosa Gatto
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia
| | - Ang Li
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia
| | - Amber Howard
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia
| | - Rebecca Bentley
- Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health, Centre for Health Policy, University of Melbourne, Parkville, Victoria, Australia.
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Park T, Pierre-Louis J, Jean T, Barua P, Ilma TT, Pinanez MA, Ravenell J, Castor C, Gousse Y. COVID-19 knowledge and mental health impact assessment in Haiti. Glob Ment Health (Camb) 2024; 11:e19. [PMID: 38414724 PMCID: PMC10897491 DOI: 10.1017/gmh.2024.10] [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: 03/27/2023] [Revised: 01/04/2024] [Accepted: 01/11/2024] [Indexed: 02/29/2024] Open
Abstract
Mental health is a significant public health challenge globally, and one anticipated to increase following the COVID-19 pandemic. In many rural regions of developing nations, little is known about the prevalence of mental health conditions and factors that may help mitigate poor outcomes. This study assessed the impact of the COVID-19 pandemic on mental health and social support for residents of rural Haiti. Data were collected from March to May 2020. The Patient Health Questionnaire subscales for anxiety and depression, and the Perceived Stress Scale were utilized in addition to tailored questions specific to COVID-19 knowledge. Half (51.8%) of the 500 survey respondents reported COVID-19-related anxiety and worrying either daily or across a few days. Half (50.2%) also reported experiencing depression daily or across several days. Most (70.4%) did not have any social support, and 28.0% experienced some stress, with 13.4% indicating high perceived stress. Furthermore, 4.6% had suitable plumbing systems in their homes. The results were immediately actionable, informing the implementation of a mental health counseling program for youth following a loss of social support through school closures. Long-term investments must be made as part of public health responses in rural communities in developing nations, which remain under-studied.
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Affiliation(s)
- Taehwan Park
- Department of Pharmacy Administration and Public Health, St. John's University, Queens, NY, USA
| | | | - Tachel Jean
- Biomedical Program, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA
| | - Prachurjya Barua
- Biomedical Program, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA
| | - Taheera T Ilma
- Biomedical Program, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA
| | - Mariana A Pinanez
- Biomedical Program, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA
| | - Joseph Ravenell
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Chimene Castor
- Department of Nutritional Sciences, Howard University, Washington, DC, USA
| | - Yolene Gousse
- Department of Pharmacy Administration and Public Health, St. John's University, Queens, NY, USA
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Badini I, Jayaweera K, Pannala G, Adikari A, Siribaddana S, Sumathipala A, McAdams TA, Harber-Aschan L, Hotopf M, Rijsdijk FV, Zavos HMS. Associations between socioeconomic factors and depression in Sri Lanka: The role of gene-environment interplay. J Affect Disord 2023; 340:1-9. [PMID: 37467802 DOI: 10.1016/j.jad.2023.07.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/30/2023] [Accepted: 07/14/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Low socioeconomic status is a risk factor for depression. The nature and magnitude of associations can differ cross-culturally and is influenced by a range of contextual factors. We examined the aetiology of socioeconomic indicators and depression symptoms and investigated whether socioeconomic indicators moderate genetic and environmental influences on depression symptoms in a Sri Lankan population. METHODS Data were from a population-based sample of twins (N = 2934) and singletons (N = 1035) in Colombo, Sri Lanka. Standard of living, educational attainment, and financial strain were used to index socioeconomic status. Depression symptoms were assessed using the Revised Beck Depression Inventory. Structural equation modelling explored genetic and environmental influences on socioeconomic indicators and depression symptoms and moderation of aetiological influences on depression symptoms by socioeconomic status. RESULTS Depression symptoms were associated with lower standard of living, lower educational attainment, and financial strain. Sex differences were evident in the aetiology of standard of living, with a small contribution of genetic influences in females. Educational attainment was moderately heritable in both males and females. Total variance in depression was greater among less socioeconomically advantaged individuals. Modest evidence of moderation of the aetiology of depression by standard of living and education was observed. LIMITATIONS While the sample is representative of individuals living in Colombo District, it may not be representative of different regions of Sri Lanka. CONCLUSIONS The aetiology of depression varies across socioeconomic contexts, suggesting a potential mechanism through which socioeconomic disadvantage increases the risk for depression in Sri Lanka. Findings have implications for cross-cultural investigations of the role of socioeconomic factors in depression and for identifying targets for social interventions.
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Affiliation(s)
- Isabella Badini
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
| | - Kaushalya Jayaweera
- Institute for Research and Development in Health and Social Care, Colombo, Sri Lanka
| | - Gayani Pannala
- Institute for Research and Development in Health and Social Care, Colombo, Sri Lanka
| | - Anushka Adikari
- Institute for Research and Development in Health and Social Care, Colombo, Sri Lanka
| | | | - Athula Sumathipala
- Institute for Research and Development in Health and Social Care, Colombo, Sri Lanka; Research Institute for Primary Care & Health Sciences, Faculty of Medicine & Health Sciences, Keele University, Newcastle-under-Lyme, UK
| | - Tom A McAdams
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; Promenta Centre, University of Oslo, Norway
| | - Lisa Harber-Aschan
- Psychological Medicine Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Matthew Hotopf
- Psychological Medicine Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; NIHR Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust, King's College London, United Kingdom
| | - Fruhling V Rijsdijk
- Psychology Department, Faculty of Social Sciences, Anton de Kom University of Suriname
| | - Helena M S Zavos
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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Villarreal-Zegarra D, Reátegui-Rivera CM, Otazú-Alfaro S, Yantas-Alcantara G, Soto-Becerra P, Melendez-Torres GJ. Estimated impact of the COVID-19 pandemic on the prevalence and treatment of depressive symptoms in Peru: an interrupted time series analysis in 2014-2021. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1375-1385. [PMID: 36884090 PMCID: PMC9993377 DOI: 10.1007/s00127-023-02446-8] [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: 07/31/2022] [Accepted: 02/27/2023] [Indexed: 03/09/2023]
Abstract
PURPOSE The COVID-19 pandemic increased the burden of mental disorders worldwide. Peru has been one of the countries most affected by COVID-19, however, studies evaluating the medium and long-term consequences of the pandemic on Peruvians' mental health are recent and represent a new field of study in proliferation. We aimed to estimate the impact of the COVID-19 pandemic on the prevalence and treatment of depressive symptoms using nationally representative surveys in Peru. METHODS Our study is an analysis of secondary data. We carried out a time series cross-sectional analysis based on the National Demographic and Health Survey of Peru, collected using a complex sampling design. The Patient Health Questionnaire-9 was used to measure mild (5-9 points), moderate (10-14 points), and severe (15 points or more) depressive symptoms. The participants were men and women aged 15 years and older, living in urban and rural areas of all regions of Peru. The main statistical analysis used segmented regression with Newey-West standard errors, taking into account that each year of the evaluation was divided into four measures (quarter measure). RESULTS We included 259,516 participants. An average quarterly increase of 0.17% (95% CI 0.03-0.32%) in the prevalence of moderate depressive symptoms was identified after the onset of the COVID-19 pandemic (approximately an increase of 1583 new cases of moderate depressive symptoms by each quarter). The percentage of cases treated for mild depressive symptoms increased quarterly by an average of 0.46% (95% CI 0.20-0.71%) after the onset of the COVID-19 pandemic (approximately an increase of 1242 new cases treated for mild depressive symptoms by each quarter). CONCLUSION In Peru, increases in the prevalence of moderate depressive symptoms and the proportion of cases treated with mild depressive symptoms were found after the COVID-19 pandemic. Therefore, this study is a precedent for future research assessing the prevalence of depressive symptoms and the proportion of cases receiving treatment during the pandemic and post-pandemic years.
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Affiliation(s)
- David Villarreal-Zegarra
- Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru
- Instituto Peruano de Orientación Psicológica, Lima, Peru
| | - C. Mahony Reátegui-Rivera
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- Unidad de Telesalud, Universidad Nacional Mayor de San Marcos, Lima, Peru
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Thwin KM, Lin WT, Takehara S, Ogawa H. Socioeconomic, behavioral, and psychological factors related to oral health in Myanmar: A cross-sectional study. J Public Health Dent 2023; 83:340-346. [PMID: 37724855 DOI: 10.1111/jphd.12585] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/13/2023] [Accepted: 09/08/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVES This study aims to evaluate the effects of socioeconomic, behavioral, and psychological factors on oral health status and oral health-related quality of life in Myanmar adults. METHODS Data were from a convenience sample of Myanmar adults who are from a township health center in Yangon city. Face-to-face interviews using a paper-based questionnaire in the Myanmar language and clinical oral examinations were performed at the health center. Mann-Whitney U test and linear regressions were used to assess the association of socio-demographic, behavioral, and psychological variables with oral health outcomes. RESULTS In socio-demographic variables, significant associations were observed in individual income with periodontal pocket and OHIP-14, and history of COVID-19 infection with OHIP-14. However, there were no associations between behavioral factors and oral health outcomes. After adjustment for sex, age, educational level, and individual income, the depression subscale was statistically significant with the number of present teeth, decayed teeth, decayed, missing, and filled teeth, and OHIP-14. The anxiety subscale remained significant with periodontal pocket, but no stress subscale was associated with oral health outcomes. CONCLUSION The experiences of oral health status were high, and the oral health-related quality of life was unfavorable in Myanmar adults. A large proportion of them suffers from psychological distress. Additionally, individuals with lower income and who experienced a history of COVID-19 infection were susceptible to poor oral health-related quality of life. Psychological distress indicates a higher risk for oral health problems in Myanmar adults.
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Affiliation(s)
- Kaung Myat Thwin
- Division of Preventive Dentistry, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Wa Than Lin
- Committee for Oral Health Education, Myanmar Dental Association, Yangon, Myanmar
| | - Sachiko Takehara
- Division of Preventive Dentistry, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hiroshi Ogawa
- Division of Preventive Dentistry, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Winters S, Sabasaba A, Fahey CA, Packel L, Katabaro E, Ndungile Y, Njau PF, McCoy SI. Increased prevalence of depression and anxiety among adults initiating antiretroviral therapy during the COVID-19 pandemic in Shinyanga region, Tanzania. AIDS Res Ther 2023; 20:36. [PMID: 37301833 PMCID: PMC10256977 DOI: 10.1186/s12981-023-00534-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Concerns about the interconnected relationship between HIV and mental health were heightened during the COVID-19 pandemic. This study assessed whether there were temporal changes in the mental health status of people living with HIV presenting for care in Shinyanga region, Tanzania. Specifically, we compared the prevalence of depression and anxiety before and during COVID-19, with the goal of describing the changing needs, if any, to person-centered HIV services. METHODS We analyzed baseline data from two randomized controlled trials of adults initiating ART in Shinyanga region, Tanzania between April-December 2018 (pre-COVID-19 period, n = 530) and May 2021-March 2022 (COVID-19 period, n = 542), respectively. We compared three mental health indicators that were similarly measured in both surveys: loss of interest in things, hopelessness about the future, and uncontrolled worrying. We also examined depression and anxiety which were measured using the Hopkins Symptom Checklist-25 in the pre-COVID-19 period and the Patient Health Questionnaire-4 in the COVID-19 period, respectively, and classified as binary indicators per each scale's threshold. We estimated prevalence differences (PD) in adverse mental health status before and during the COVID-19 pandemic, using stabilized inverse probability of treatment weighting to adjust for underlying differences in the two study populations. RESULTS We found significant temporal increases in the prevalence of feeling 'a lot' and 'extreme' loss of interest in things ['a lot' PD: 38, CI 34,41; 'extreme' PD: 9, CI 8,12)], hopelessness about the future [' a lot' PD: 46, CI 43,49; 'extreme' PD: 4, CI 3,6], and uncontrolled worrying [' a lot' PD: 34, CI 31,37; 'extreme' PD: 2, CI 0,4] during the COVID-19 pandemic. We also found substantially higher prevalence of depression [PD: 38, CI 34,42] and anxiety [PD: 41, CI 37,45]. CONCLUSIONS After applying a quasi-experimental weighting approach, the prevalence of depression and anxiety symptoms among those starting ART during COVID-19 was much higher than before the pandemic. Although depression and anxiety were measured using different, validated scales, the concurrent increases in similarly measured mental health indicators lends confidence to these findings and warrants further research to assess the possible influence of COVID-19 on mental health among adults living with HIV. Trial Registration NCT03351556, registered November 24, 2017; NCT04201353, registered December 17, 2019.
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Affiliation(s)
- Solis Winters
- School of Public Health, University of California, Berkeley, 2121 Berkeley Way, Berkeley, 94704, USA.
| | - Amon Sabasaba
- Health for a Prosperous Nation, Dar es Salaam, Tanzania
| | - Carolyn A Fahey
- School of Public Health, University of Washington, Seattle, USA
| | - Laura Packel
- School of Public Health, University of California, Berkeley, 2121 Berkeley Way, Berkeley, 94704, USA
| | | | | | | | - Sandra I McCoy
- School of Public Health, University of California, Berkeley, 2121 Berkeley Way, Berkeley, 94704, USA
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Koly KN, Tasnim Z, Ahmed S, Saba J, Mahmood R, Farin FT, Choudhury S, Ashraf MN, Hasan MT, Oloniniyi I, Modasser RB, Reidpath DD. Mental healthcare-seeking behavior of women in Bangladesh: content analysis of a social media platform. BMC Psychiatry 2022; 22:797. [PMID: 36529761 PMCID: PMC9760542 DOI: 10.1186/s12888-022-04414-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Mental health remains a highly stigmatized area of healthcare, and people often conceal their concerns rather than seek assistance or treatment. The Women Support Initiative Forum (WSIF) is a social media platform established in 2018 to provide expert and peer-led psychosocial support services to women of all ages in Bangladesh. The anonymous nature of the forum means that mental health concerns can be aired without fear of identification. METHOD A content analysis was conducted on the anonymous posts retrieved from the WSIF platform between 8th March 2020 and 7th July 2022. Around 1457 posts were initially selected for analysis which was reduced to 1006 after removing duplicates and non-relevant posts, such as queries about the addresses of the doctors and other non-mental health-related issues. A thematic analysis of the data was conducted using an inductive approach. RESULT The 1006 posts generated four themes and nine sub-themes. All the women mentioned mental health symptoms (n = 1006; 100%). Most also mentioned reasons for seeking mental healthcare (n = 818; 81.31%), healthcare-seeking behavior (n = 667; 66.30%), and barriers to seeking mental healthcare (n = 552; 54.87%). The majority of women described symptoms of stress, depression, and anxiety-like symptoms, which were aggregated under common mental health conditions. Mental health symptoms were ascribed to various external influences, including marital relationship, intrafamilial abuse, and insecurities related to the COVID-19 pandemic. A large proportion of posts were related to women seeking information about mental healthcare services and service providers (psychologists or psychiatrists). The analysis found that most women did not obtain mental healthcare services despite their externalized mental health symptoms. The posts identified clear barriers to women accessing mental health services, including low mental health literacy, the stigma associated with mental healthcare-seeking behavior, and the poor availability of mental health care services. CONCLUSION The study revealed that raising mass awareness and designing culturally acceptable evidence-based interventions with multisectoral collaborations are crucial to ensuring better mental healthcare coverage for women in Bangladesh.
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Affiliation(s)
- Kamrun Nahar Koly
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
| | - Zarin Tasnim
- grid.52681.380000 0001 0746 8691BRAC James P Grant School of Public Health, BRAC University, Dhaka, 1213 Bangladesh
| | - Sharmin Ahmed
- Department of Epidemiology, National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, 1212 Bangladesh
| | - Jobaida Saba
- grid.414142.60000 0004 0600 7174Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh ,grid.411808.40000 0001 0664 5967Department of Public Health and Informatics, Jahangirnagar University, Dhaka, 1342 Bangladesh
| | - Rudbar Mahmood
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - Faria Tasnim Farin
- grid.254444.70000 0001 1456 7807Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, Detroit, MI USA
| | - Sabrina Choudhury
- Department of Epidemiology, National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, 1212 Bangladesh
| | - Mir Nabila Ashraf
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - M. Tasdik Hasan
- grid.1002.30000 0004 1936 7857Action Lab, Department of Human Centred Computing, Faculty of Information Technology, Monash University, Melbourne, Australia ,grid.443034.40000 0000 8877 8140Department of Public Health, State University of Bangladesh, Dhaka, Bangladesh ,grid.10025.360000 0004 1936 8470Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
| | - Ibidunni Oloniniyi
- grid.10824.3f0000 0001 2183 9444Departmental of Mental Health, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria ,grid.459853.60000 0000 9364 4761Mental Health Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun Nigeria
| | - Rifath Binta Modasser
- grid.443005.60000 0004 0443 2564School of Public Health, Independent University Bangladesh (IUB), Bashundhara, Dhaka, 1229 Bangladesh
| | - Daniel D. Reidpath
- grid.440425.30000 0004 1798 0746Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Subang Jaya, Malaysia
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10
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Berto LF, Suemoto CK, Moreno AB, Fonseca MDJM, Nunes MAA, Molina MDCB, Barreto SM, de Fátima Haueisen Sander Diniz M, Lotufo PA, Benseñor IM, Brunoni AR. Increased Prevalence of Depression and Anxiety Among Subjects With Metabolic Syndrome in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). J Acad Consult Liaison Psychiatry 2022; 63:529-538. [PMID: 35718085 DOI: 10.1016/j.jaclp.2022.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 04/05/2022] [Accepted: 06/09/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND Metabolic syndrome (MetS) and common mental disorders are prevalent conditions. However, the relationship of MetS and its components with depression, anxiety, and common mental disorders has not been sufficiently addressed in low-/middle-income countries. OBJECTIVE To investigate whether depression, anxiety, and common mental disorders are associated with MetS and its components in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS A cross-sectional analysis of the ELSA-Brasil baseline visit (2008-2010) was performed. Adults without cardiovascular diseases had their MetS status defined by the National Cholesterol Education Program's Adult Treatment Panel III criteria. We assessed mental disorders using the Clinical Interview Schedule-Revised. We employed multiple logistic regression models adjusted for sociodemographic and behavioral factors. The dependent variables were mental disorders, and the independent variables were MetS and its components. We also performed analyses stratified by age and gender. RESULTS Our sample included 12,725 participants (54.9% women, mean age of 51.8 ± 8.9 y). MetS and depressive disorders were significantly associated (odds ratio [OR] = 1.55, 95% confidence interval [CI] 1.30-1.85). Increased abdominal circumference (OR = 1.54, 95% CI 1.29-1.84), diabetes mellitus (OR = 1.24, 95% CI 1.02-1.50), hypertriglyceridemia (OR = 1.33, 95% CI 1.11-1.60), and low high-density lipoprotein cholesterol (only when adjusted for sociodemographic factors) (OR = 1.25, 95% CI 1.02-1.52) were also associated with depression. This association remained significant for all stratified analyses. Finally, MetS was also significantly associated with anxiety disorders (OR = 1.19, 95% CI 1.07-1.32) and common mental disorders (OR = 1.27, 95% CI 1.17-1.39). CONCLUSIONS Our cross-sectional findings suggested that depression, anxiety, and common mental disorder are associated with MetS. Depression was also associated with abdominal obesity, elevated blood glucose, elevated triglycerides, and reduced high-density lipoprotein cholesterol, but not with hypertension.
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Affiliation(s)
- Laura F Berto
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil.
| | - Claudia K Suemoto
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil; Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Arlinda B Moreno
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria de Jesus M Fonseca
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Angélica A Nunes
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Maria Del Carmen B Molina
- Postgraduate Program in Public Health, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Sandhi M Barreto
- Department of Preventive and Social Medicine, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria de Fátima Haueisen Sander Diniz
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Paulo A Lotufo
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil; Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, São Paulo, Brazil; Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Isabela M Benseñor
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil; Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, São Paulo, Brazil; Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Andre R Brunoni
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil; Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, São Paulo, Brazil; Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
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11
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Kayiteshonga Y, Sezibera V, Mugabo L, Iyamuremye JD. Prevalence of mental disorders, associated co-morbidities, health care knowledge and service utilization in Rwanda - towards a blueprint for promoting mental health care services in low- and middle-income countries? BMC Public Health 2022; 22:1858. [PMID: 36199102 PMCID: PMC9533613 DOI: 10.1186/s12889-022-14165-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 09/02/2022] [Indexed: 11/21/2022] Open
Abstract
Background In order to respond to the dearth of mental health data in Rwanda where large-scale prevalence studies were not existing, Rwanda Mental Health Survey was conducted to measure the prevalence of mental disorders, associated co-morbidities and knowledge and utilization of mental health services nationwide within Rwanda. Methods This cross-sectional study was conducted between July and August 2018, among the general population, including survivors of the 1994 Genocide against the Tutsi. Participants (14–65 years) completed the Mini-International Neuropsychiatric Interview (Version 7.0.2), sociodemographic and epilepsy-related questionnaires. General population participants were selected first by random sampling of 240 clusters, followed by systematic sampling of 30 households per cluster. Genocide survivors within each cluster were identified using the 2007–2008 Genocide Survivors Census. Results Of 19,110 general survey participants, most were female (n = 11,233; 58.8%). Mental disorders were more prevalent among women (23.2%) than men (16.6%) (p < 0.05). The most prevalent mental disorders were major depressive episode (12.0%), panic disorder (8.1%) and post-traumatic stress disorder (PTSD) (3.6%). Overall, 61.7% had awareness of mental health services while only 5.3% reported to have used existing services. Of the 1271 genocide survivors interviewed, 74.7% (n = 949) were female; prevalence of any mental disorder was 53.3% for women and 48.8% for men. Most prevalent disorders were major depressive episode (35.0%), PTSD (27.9%) and panic disorder (26.8%). Among genocide survivors, 76.2% were aware of availability of mental health services, with 14.1% reported having used mental health services. Conclusions Despite high prevalence of mental disorders among the general population and genocide survivors, utilization of available mental health services was low. A comprehensive approach to mental health is needed for prevention of mental illness and to promote mental healthcare services. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14165-x.
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Affiliation(s)
| | - Vincent Sezibera
- Department of Clinical Psychology, Center for Mental Health, College of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda
| | - Lambert Mugabo
- Center for Mental Health, University of Rwanda, Kigali, Rwanda
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12
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Ramaswamy S, Sagar JV, Seshadri S. A transdisciplinary public health model for child and adolescent mental healthcare in low- and middle-income countries. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2022; 3:100024. [PMID: 37384265 PMCID: PMC10305986 DOI: 10.1016/j.lansea.2022.100024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Despite the high burden of child and adolescent mental health problems in LMICs, attributable to poverty and childhood adversity, access to quality mental healthcare services is poor. LMICs, due to paucity of resources, also contend with shortage of trained mental health workers and paucity of standardized intervention modules and materials. In the wake of these challenges, and given that child development and mental health concerns cut across a plethora of disciplines, sectors and services, public health models need to incorporate integrated approaches to responding to the mental health and psychosocial care needs of vulnerable children. This article presents a working model for convergence, and the practice of transdisciplinary Public Health, in order to address the gaps and challenges in child and adolescent mental healthcare in LMICs. Located in a state tertiary mental healthcare institution, this national level model reaches (child care) service providers and stakeholders, duty-bearers, and citizens (namely parents, teachers, protection functionaries, health workers and other interested parties) through capacity building initiatives and tele-mentoring services, public discourse series, developed for a South Asian context and delivered in diverse languages. Role of Funding Source The Ministry of Women and Child Development, Government of India, provides financial support to the SAMVAD initiative.
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Affiliation(s)
- Sheila Ramaswamy
- SAMVAD, Department of Child & Adolescent Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - John Vijay Sagar
- Department of Child & Adolescent Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Shekhar Seshadri
- Department of Child & Adolescent Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore, India
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13
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Stanley N, Chinwe ES. Prevalence of Mental Disorders in Abakaliki, Ebonyi State, Southeastern Nigeria. J Am Psychiatr Nurses Assoc 2022; 28:306-318. [PMID: 32857645 DOI: 10.1177/1078390320951910] [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: 11/17/2022]
Abstract
BACKGROUND Increasing psychological stressors have posed challenges to the well-being of the people across the globe and greatly affected the functionality and economic output of the individuals and the society. Nigeria has no existing mental health registry. Data on the prevalence of mental disorders are not readily available owing to lack of mental health registry. Hence, this study assessed the prevalence of mental disorders in Abakaliki metropolis, Ebonyi State. AIM To determine the prevalence of mental disorders and associated factors among the residents of Abakaliki metropolis, Ebonyi State. METHOD This cross-sectional descriptive research study involved 400 participants. Questionnaires adapted from world mental health diagnostic interview and General Health Questionnaire 12 were used for data collection. Data were analyzed using descriptive statistics and hypotheses tested using chi-square test at significance level of .05. RESULTS The prevalence of mental disorders among the respondents was 70% depressive disorders and 52.3% substance use disorders-tranquilizers (34.9%) and stimulants (15.8%) were the commonly used, while 85.3% suffered anxiety disorders. These were common among age range of 19 to 28 years-those with higher education and the unemployed. More females had mental disorders except substance use disorders, which was higher in males (53.4%). There was no significant relationship between mental disorders and the demographic variables, but significant relationship was found to exist between individuals' age and anxiety disorder. CONCLUSION Mental disorders, such as depression, anxiety, and substance use disorders, are common among the respondents and, therefore, calls for urgent attention of the government to improve the mental health of the people.
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Affiliation(s)
- Njaka Stanley
- Njaka Stanley, RN, RPHN, BNSC, MSc, Ebonyi State University, Abakaliki, Ebonyi, Nigeria
| | - Ezeruigbo S Chinwe
- Ezeruigbo S. Chinwe, PhD, MSC, RN, RM, BSC, Ebonyi State University, Abakaliki, Ebonyi, Nigeria
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14
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Sanguinetti RD, Soriano JE, Squair JW, Cragg JJ, Larkin-Kaiser KA, McGirr A, Phillips AA. National survey of mental health and suicidal thoughts in people with spinal cord injury. Spinal Cord 2022; 60:444-450. [PMID: 35347266 DOI: 10.1038/s41393-022-00783-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Retrospective cross-sectional epidemiological study. OBJECTIVES Previous studies have quantified longitudinal psychological morbidity in individuals with spinal cord injury (SCI) relative to uninjured individuals. However, there is limited information regarding how lifestyle and socioeconomic factors are associated with mental health conditions in individuals with SCI. This study aims to quantify and compare mental health and suicidal thoughts in people with and without SCI, and examine the associations between mental health, suicidal thoughts, sex, age, lifestyle, and socioeconomic factors. SETTING Canada. METHODS The 2010 Canadian Community Health Survey (n > 40,000) was used, which includes several measures assessing mental health and suicidal thoughts. Bivariate and multivariate logistic regressions were performed and odds ratios with corresponding 95% confidence intervals were estimated. Sensitivity analyses were performed to evaluate the effect of covariates on reported effect sizes. RESULTS People with SCI had higher odds of having mood (3.6) and anxiety disorders (2.5), suicidal thoughts (2.3), self-perceived stress (1.9), and depression (4.4); in addition to lower odds of having good self-perceived mental health (0.24) and satisfaction with life (0.25). These differences persisted after adjusting for age, sex, lifestyle, and socioeconomic factors. Lower household income, fruit and vegetable consumption, and physical activity levels, and increased smoking use were associated with poorer mental health in individuals with SCI. CONCLUSIONS Mental health is poorer in those with SCI when compared with the general population. Those with SCI exhibit a unique profile of lifestyle and socioeconomic factors that are associated with poorer mental health and increased suicidal thoughts.
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Affiliation(s)
| | - Jan Elaine Soriano
- Departments of Physiology and Pharmacology Cardiac Sciences & Clinical Neurosciences, Libin Cardiovascular Institute of Alberta, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Jordan W Squair
- Departments of Physiology and Pharmacology Cardiac Sciences & Clinical Neurosciences, Libin Cardiovascular Institute of Alberta, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,MD/PhD Training Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jacquelyn J Cragg
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.,International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Kelly A Larkin-Kaiser
- Departments of Physiology and Pharmacology Cardiac Sciences & Clinical Neurosciences, Libin Cardiovascular Institute of Alberta, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Alexander McGirr
- Department of Psychiatry, Hotchkiss Brain Institute, Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB, Canada
| | - Aaron A Phillips
- Departments of Physiology and Pharmacology Cardiac Sciences & Clinical Neurosciences, Libin Cardiovascular Institute of Alberta, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
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15
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A multifactorial model for the etiology of neuropsychiatric disorders: the role of advanced paternal age. Pediatr Res 2022; 91:757-770. [PMID: 33674740 DOI: 10.1038/s41390-021-01435-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/07/2021] [Accepted: 02/02/2021] [Indexed: 12/21/2022]
Abstract
Mental or neuropsychiatric disorders are widespread within our societies affecting one in every four people in the world. Very often the onset of a mental disorder (MD) occurs in early childhood and substantially reduces the quality of later life. Although the global burden of MDs is rising, mental health care is still suboptimal, partly due to insufficient understanding of the processes of disease development. New insights are needed to respond to this worldwide health problem. Next to the growing burden of MDs, there is a tendency to postpone pregnancy for various economic and practical reasons. In this review, we describe the current knowledge on the potential effect from advanced paternal age (APA) on development of autism spectrum disorder, schizophrenia, attention-deficit/hyperactivity disorder, bipolar disorder, obsessive-compulsive disorder, and Tourette syndrome. Although literature did not clearly define an age cut-off for APA, we here present a comprehensive multifactorial model for the development of MDs, including the role of aging, de novo mutations, epigenetic mechanisms, psychosocial environment, and selection into late fatherhood. Our model is part of the Paternal Origins of Health and Disease paradigm and may serve as a foundation for future epidemiological research designs. This blueprint will increase the understanding of the etiology of MDs and can be used as a practical guide for clinicians favoring early detection and developing a tailored treatment plan. Ultimately, this will help health policy practitioners to prevent the development of MDs and to inform health-care workers and the community about disease determinants. Better knowledge of the proportion of all risk factors, their interactions, and their role in the development of MDs will lead to an optimization of mental health care and management. IMPACT: We design a model of causation for MDs, integrating male aging, (epi)genetics, and environmental influences. It adds new insights into the current knowledge about associations between APA and MDs. In clinical practice, this comprehensive model may be helpful in early diagnosis and in treatment adopting a personal approach. It may help in identifying the proximate cause on an individual level or in a specific subpopulation. Besides the opportunity to measure the attributed proportions of risk factors, this model may be used as a blueprint to design prevention strategies for public health purposes.
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16
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D’Orta I, Eytan A, Saraceno B. Improving mental health care in rural Kenya: A qualitative study conducted in two primary care facilities. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2022. [DOI: 10.1080/00207411.2022.2041265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Isabella D’Orta
- Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - Ariel Eytan
- Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - Benedetto Saraceno
- Lisbon Institute of Global Mental Health, Universidade Nova de Lisboa, Lisbon, Portugal
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17
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Yudkin JS, Bakshi P, Craker K, Taha S. The Comprehensive Communal Trauma Intervention Model (CCTIM), an Innovative Transdisciplinary Population-Level Model for Treating Trauma-Induced Illness and Mental Health in Global Vulnerable Communities: Palestine, a Case Study. Community Ment Health J 2022; 58:300-310. [PMID: 33811577 DOI: 10.1007/s10597-021-00822-9] [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: 02/11/2020] [Accepted: 03/27/2021] [Indexed: 10/21/2022]
Abstract
This paper explores how Western medicine may not fully understand and address post-traumatic stress disorder (PTSD) and other trauma-induced illnesses in a culturally appropriate manner in marginalized communities and offers a theoretical framework to develop comprehensive, effective, and sustainable solutions that comprehensively address and treat the trauma on both a collective and individual level. Focused on Palestinians, this paper discusses the collective trauma Palestinians experienced and how it manifests in transgenerational effects on the body and mind that may be post-traumatic stress disorder (PTSD) or perhaps another distinct condition that is yet to be codified in the Western medical lexicon. It describes local alternatives to Western medical diagnostic tools like the "ease to disease" diagnostic scale and the sociopolitical context-in this case, the Palestinian fight for karamah, or dignity-from which such alternatives arise. Based on these findings, a novel theoretical framework, the comprehensive communal trauma intervention model (CCTIM), a truly transdisciplinary population-level model for treating mental health in vulnerable communities globally, is proposed. It articulates the need to address the root cause of collective trauma, make modifications to the healthcare system, and cultivate strategic equity-oriented and research-based partnerships.
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Affiliation(s)
- Joshua S Yudkin
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Sciences Center At Houston School of Public Health, 6011 Harry Hines Blvd, Dallas, TX, 75235, USA.
| | - Parul Bakshi
- George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, 63130, USA
| | - Kelsey Craker
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Sciences Center At Houston School of Public Health, 6011 Harry Hines Blvd, Dallas, TX, 75235, USA
| | - Sari Taha
- Medicine, An-Najah National Universities, Nablus, Palestine, Israel
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18
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Vijayakumar L, Ray S, Fernandes TN, Pathare S. A descriptive mapping review of suicide in vulnerable populations in low and middle countries. Asia Pac Psychiatry 2021; 13:e12472. [PMID: 33817993 DOI: 10.1111/appy.12472] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION In 2016, low-and-middle income countries (LMICs) accounted for 79% of the global suicide deaths. In LMICs, vulnerable groups-women, sexual minorities and refugees, and internally displaced persons (IDPs)-are at high risk of suicidal ideation, attempts and deaths by suicide, but information for designing targeted interventions for them is fragmented and missing, making it difficult to address gaps in the existing system. This review highlights these gaps by mapping: (a) risk factors associated with suicides and suicidal behavior including challenges in implementing targeted programmes for vulnerable groups; and (b) recommendations for effective suicide prevention interventions and strategies in LMICs as documented in the literature. METHODS A descriptive mapping review of literature was conducted. Three electronic databases-PubMed, Google Scholar, and Refworld-were searched for specific keywords. The researchers mapped and reviewed 34 studies on suicide and suicide prevention across three main vulnerable groups. RESULTS This review highlighted the need for gender-specific interventions for women and sexual minorities, addressing gender-based discrimination, access to healthcare, abuse and violence, while for refugees and IDPs, critical concerns are monitoring and understanding suicidal behaviors and to address psychological and emotional responses to resettlement. CONCLUSION In LMICs, specific and unique socio-cultural and environmental factors may increase the risk of vulnerable groups to suicidal behaviors. In order to develop effective and comprehensive suicide prevention strategies, it is crucial to evaluate these differential risk factors and develop culturally appropriate and sensitive interventions and strategies.
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Affiliation(s)
- Lakshmi Vijayakumar
- Department of Psychiatry, VHS, SNEHA (Suicide Prevention Agency), Chennai, India.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Somidha Ray
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
| | | | - Soumitra Pathare
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
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19
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Perquier F, Hetrick S, Rodak T, Jing X, Wang W, Cost KT, Szatmari P, Aitken M. Association of parenting with suicidal ideation and attempts in children and youth: protocol for a systematic review and meta-analysis of observational studies. Syst Rev 2021; 10:232. [PMID: 34391481 PMCID: PMC8364684 DOI: 10.1186/s13643-021-01727-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 06/01/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Suicide is a leading cause of death in children and youth, with suicidal thoughts and suicide attempts (referred to as non-fatal suicidal behaviors (NFSB)) being among its strongest predictors. Positive parenting (e.g., warmth, responsiveness), negative parenting (e.g., control, hostility), and parent-child relationship quality (e.g., trust, communication) have been reported to be associated with differences in NFSB in this population. To date, no comprehensive systematic review has considered together the wide range of parenting factors studied in relation to NFSB, and no meta-analysis of existing findings has been conducted. The present study will critically appraise and synthesize the existing evidence from observational studies that examine the relationships between parenting factors and (i) suicidal ideation and (ii) suicide attempt in children and youth. METHODS Studies will be retrieved from APA PsycInfo, MEDLINE, CINAHL, Embase, Scopus, and the Cochrane Library databases. Retrospective, cross-sectional, and longitudinal studies, conducted in clinical and population settings, among youth aged less than 25 years and published as articles and dissertations in English or French will be eligible. Two reviewers will select articles using the Covidence Software after title and abstract screening and full-text assessment, will extract information using double data entry, and will appraise studies' quality using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Any disagreements will be discussed with a third reviewer. Publication bias will be evaluated using funnel plots and Egger's test. In addition to a narrative summary of results, meta-analyses will be conducted using results from at least three studies. Three-level random effect models will allow to derive pooled estimates from dependent effect sizes (from the same sample or study). In case of significant heterogeneity, moderation analyses will be performed considering participants' characteristics and methodological aspects of studies. The results will be reported according to the PRISMA guidelines, and the certainty of evidence will be assessed using the GRADE approach. DISCUSSION In highlighting parenting factors associated with NFSB and in estimating the overall strength of these associations in children and youth, our results will inform further intervention and prevention strategies designed for young people experiencing NFSB and their families. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020165345.
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Affiliation(s)
- Florence Perquier
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
| | - Sarah Hetrick
- Department of Psychological Medicine, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
- Centre for Youth Mental Health, University of Melbourne, Locked Bag 10, Melbourne, VIC 3052 Australia
| | - Terri Rodak
- CAMH Education, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada
| | - Xin Jing
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
| | - Wei Wang
- Centre for Addiction and Mental Health, 1001 Queen St W, Toronto, ON M6J 1H4 Canada
| | - Katherine T. Cost
- Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Burton Wing, Toronto, ON M5G 1X8 Canada
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
- Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Burton Wing, Toronto, ON M5G 1X8 Canada
| | - Madison Aitken
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M6J 1H4 Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
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20
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Doukani A, van Dalen R, Valev H, Njenga A, Sera F, Chibanda D. A community health volunteer delivered problem-solving therapy mobile application based on the Friendship Bench 'Inuka Coaching' in Kenya: A pilot cohort study. Glob Ment Health (Camb) 2021; 8:e9. [PMID: 34026239 PMCID: PMC8127638 DOI: 10.1017/gmh.2021.3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 12/22/2020] [Accepted: 01/13/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Sub-Saharan Africa (SSA) has the largest care gap for common mental disorders (CMDs) globally, heralding the use of cost-cutting approaches such as task-shifting and digital technologies as viable approaches for expanding the mental health workforce. This study aims to evaluate the effectiveness of a problem-solving therapy (PST) intervention that is delivered by community health volunteers (CHVs) through a mobile application called 'Inuka coaching' in Kenya. METHODS A pilot prospective cohort study recruited participants from 18 health centres in Kenya. People who self-screened were eligible if they scored 8 or higher on the Self-Reporting Questionnaire-20 (SRQ-20), were aged 18 years or older, conversant in written and spoken English, and familiar with the use of smart mobile devices. The intervention consisted of four PST mobile application chat-sessions delivered by CHVs. CMD measures were administered at baseline, 4-weeks (post-treatment), and at 3-months follow-up assessment. RESULTS In all, 80 participants consented to the study, of which 60 participants (female, n = 38; male, n = 22) completed their 4-week assessments, and 52 participants completed their 3-month follow-up assessment. The results showed a significant improvement over time on the Self-Reporting Questionnaire-20 (SRQ-20). Higher-range income, not reporting suicidal ideation, being aged over 30 years, and being male were associated with higher CMD symptom reduction. CONCLUSION To our knowledge, this report is the first to pilot a PST intervention that is delivered by CHVs through a locally developed mobile application in Kenya, to which clinically meaningful improvements were found. However, a randomised-controlled trial is required to robustly evaluate this intervention.
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Affiliation(s)
- Asmae Doukani
- Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, LondonWC1E 7HT, UK
| | - Robin van Dalen
- Inuka Foundation, Rapsodieplantsoen 11, 1312EJAlmere, Netherlands
| | - Hristo Valev
- Philips Research, High Tech Campus 34, 5656AEEindhoven, Netherlands
| | - Annie Njenga
- Inuka Foundation, Rapsodieplantsoen 11, 1312EJAlmere, Netherlands
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications “G. Parenti”, University of Florence, Florence, Italy
| | - Dixon Chibanda
- Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, LondonWC1E 7HT, UK
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21
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Lambert JE, Denckla C. Posttraumatic stress and depression among women in Kenya's informal settlements: risk and protective factors. Eur J Psychotraumatol 2021; 12:1865671. [PMID: 34992747 PMCID: PMC8725741 DOI: 10.1080/20008198.2020.1865671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 11/04/2022] Open
Abstract
Background: Approximately 56% of Kenya´s population resides in informal settlements (UN-Habitat, 2016). Female residents experience a range of psychosocial stressors including chronic poverty and high rates of interpersonal violence. Despite evidence that this population has some of the worst physical health outcomes in the country (APHRC, 2014), few studies have evaluated their mental health status and its correlates. Objective: The purpose of this study was to identify risk and protective factors associated with mental health problems (posttraumatic stress & depression) among women living in informal settlements in Kenya. Hypothesized risk factors included economic stress, a history of experiencing childhood abuse and sexual violence, as well as partner-perpetrated psychological and physical abuse. Hypothesized protective factors were supportive relationships with family members and friends and having a sense community connection. Method: Local community health workers were trained to collect data via individual interviews using validated measures. Participants were recruited using systematic random sampling in two informal settlements in Nakuru County. We used path analysis to test the hypothesized model among a sample of 301 women. Results: The model had an excellent fit (χ2 = 13.391, df = 8, p =.099; GFI =.99; CFI =.99; RMSEA =.05) and explained 25% of the variance in PTSS and 28% of the variance in depression. All predictor variables except support from friends were statistically significant in the expected direction. Specifically, economic stress, childhood abuse, sexual violence, as well as physical and psychological abuse from one´s partner had significant positive associations with PTSS and depression. Having supportive family members and a sense of being part of the community had significant negative associations with symptoms. Conclusions: Results highlight the importance of addressing intimate partner and other forms of interpersonal violence in these settings and hold implications for tailoring interventions for this marginalized population.
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Affiliation(s)
- Jessica E. Lambert
- International Rehabilitation Department, DIGNITY- Danish Institute Against Torture, Copenhagen, Denmark
| | - Christy Denckla
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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22
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Khan R, Waqas A, Mustehsan ZH, Khan AS, Sikander S, Ahmad I, Jamil A, Sharif M, Bilal S, Zulfiqar S, Bibi A, Rahman A. Predictors of Prenatal Depression: A Cross-Sectional Study in Rural Pakistan. Front Psychiatry 2021; 12:584287. [PMID: 34566707 PMCID: PMC8461022 DOI: 10.3389/fpsyt.2021.584287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 07/30/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To determine the prevalence and association of prenatal depression with socioeconomic, demographic and personal factors among pregnant women living in Kallar Syedan, Rawalpindi, Pakistan. Methods: Five hundred women in the second and third trimester of pregnancy, living in Kallar Syedan, a rural area of district Rawalpindi Pakistan, were included in the study. Depression was assessed using "Patient health questionnaire" (PHQ9) in Urdu, with a cut-off score of 10. Multi-dimensional scale of perceived social support (MSPSS) was used to assess perceived social support. Life Events and Difficulties Schedule (LEDS) were used to measure stressful life events in past 1 year. Tool to assess intimate partner violence (IPV) was based on WHO Multi Country Study on "Women's Health and Domestic Violence against Women." Results: Prevalence of prenatal depression was found to be 27%. Number of pregnancies was significantly associated with prenatal depression (p < 0.01). Women living in a joint family and those who perceived themselves as moderately satisfied or not satisfied with their life in the next 4 years were found to be depressed (p < 0.01, OR 6.9, CI 1.77-26.73). Depressive symptomatology in women who experienced more than five stressful life events in last 1 year was three times higher (p < 0.001, OR 3.2, CI 1.68-5.98) than in women with 1-2 stressful events. Women who were supported by their significant others or their family members had 0.9 times (p < 0.01, OR 0.9, CI 0.85-0.96) less chance of getting depressed. Pregnant women who were psychologically abused by their partners were 1.5 times more depressed (p < 0.05 CI 1.12-2.51). Odds of having depression was also high in women who had less mean score of MSSI (p < 0.05, OR 1.1, CI 1.01-1.09). Women who had suitable accommodation had 0.5 times less chance of having depression than others (p < 0.05, OR 0.5, CI 0.27-0.92). Conclusion: Over a quarter of the women in the study population reported prenatal depression, which were predicted predominantly by psychosocial variables.
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Affiliation(s)
- Rukhsana Khan
- Department of Community Medicine Fazaia Medical College, Air University, Islamabad, Pakistan
| | - Ahmed Waqas
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom.,Human Development Research Foundation, Islamabad, Pakistan
| | - Zille Huma Mustehsan
- Department of Community Medicine Fazaia Medical College, Air University, Islamabad, Pakistan
| | - Amna Saeed Khan
- Department of Community Medicine Fazaia Medical College, Air University, Islamabad, Pakistan
| | - Siham Sikander
- Human Development Research Foundation, Islamabad, Pakistan.,Health Services Academy, Islamabad, Pakistan
| | - Ikhlaq Ahmad
- Human Development Research Foundation, Islamabad, Pakistan.,Health Services Academy, Islamabad, Pakistan
| | - Anam Jamil
- Human Development Research Foundation, Islamabad, Pakistan
| | - Maria Sharif
- Human Development Research Foundation, Islamabad, Pakistan
| | - Samina Bilal
- Human Development Research Foundation, Islamabad, Pakistan
| | | | - Amina Bibi
- Human Development Research Foundation, Islamabad, Pakistan
| | - Atif Rahman
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
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23
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Pitchik HO, Chung EO, Fernald LCH. Cross-cultural research on child development and maternal mental health in low-and middle-income countries. Curr Opin Behav Sci 2020; 36:90-97. [PMID: 33195763 PMCID: PMC7665078 DOI: 10.1016/j.cobeha.2020.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Helen O Pitchik
- Division of Epidemiology, School of Public Health, University of California, 2121 Berkeley Way, Berkeley, California, 94720, United States
| | - Esther O Chung
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, Chapel Hill, North Carolina, 27599, United States
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 West Franklin Street, Chapel Hill, North Carolina, 27516, United States
| | - Lia C H Fernald
- Division of Community Health Sciences, School of Public Health, University of California, 2121 Berkeley Way, Room 5302, Berkeley, California, 94720, United States
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24
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Assanangkornchai S, Nontarak J, Aekplakorn W, Chariyalertsak S, Kessomboon P, Taneepanichskul S. Socio-economic inequalities in the association between alcohol use disorder and depressive disorder among Thai adults: a population-based study. BMC Psychiatry 2020; 20:553. [PMID: 33228577 PMCID: PMC7685597 DOI: 10.1186/s12888-020-02958-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 11/16/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Previous evidence indicates significant associations between depressive disorders and alcohol use disorder (AUD) and their strong links with social conditions. This study aims to investigate the association between major depressive episode (MDE) and AUD across various socio-economic groups. METHODS We analysed data from the 2014 Thai National Health Examination Survey containing a random sample of 13,177 adults aged > 20 years from the general population. The Alcohol Use Disorder Identification Test was used to classify respondents into non-problem drinking (score 0-7), hazardous drinking (score 8-15), and harmful-dependent drinking (score 16-40). MDE was identified using questions based on the DSM-IV. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated using multinomial logistic regression to determine the strength of associations between MDE as a predictor and AUD as an outcome variable across different socio-economic levels. RESULTS The prevalence of MDE, hazardous, and harmful-dependent drinking was 2.5, 10.3, and 1.9%, respectively. The association between MDE and AUD was modified by wealth index, education level and area of residence. AORs for the association between MDE and harmful-dependent drinking were high among those in the highest (AOR = 8.68, 95% CI: 5.34, 14.11) and lowest (AOR = 7.14, 95% CI: 3.71, 13.73) levels of wealth index but not significant among those in the middle level (AOR = 1.78, 95% CI: 0.74, 4.25). Education had the strongest effect on the relationship between MDE and harmful-dependent drinking (AOR = 16.0, 95% CI: 10.30, 24.90 among those completing secondary school or higher and AOR = 1.44, 95% CI: 0.63, 3.33 among those completing primary school only). The association between MDE and harmful-dependent drinking was higher among people who lived in urban areas (AOR = 8.50, 95% CI: 5.50, 13.13) compared to those living in rural areas (AOR = 4.73, 95% CI: 3.31, 6.77). CONCLUSION Socio-economic factors modify the association between alcohol use disorder and major depressive disorder among Thai people.
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Affiliation(s)
- Sawitri Assanangkornchai
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
| | - Jiraluck Nontarak
- grid.10223.320000 0004 1937 0490Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Wichai Aekplakorn
- grid.10223.320000 0004 1937 0490Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suwat Chariyalertsak
- grid.7132.70000 0000 9039 7662Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
| | - Pattapong Kessomboon
- grid.9786.00000 0004 0470 0856Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Surasak Taneepanichskul
- grid.7922.e0000 0001 0244 7875Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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25
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Paudyal P, Kulasabanathan K, Cassell JA, Memon A, Simkhada P, Wasti SP. Health and well-being issues of Nepalese migrant workers in the Gulf Cooperation Council countries and Malaysia: a systematic review. BMJ Open 2020; 10:e038439. [PMID: 33109656 PMCID: PMC7592279 DOI: 10.1136/bmjopen-2020-038439] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To summarise the evidence on health and well-being of Nepalese migrant workers in the Gulf Cooperation Council (GCC) countries and Malaysia. DESIGN Systematic review. DATA SOURCES EMBASE, MEDLINE, Scopus and Global Health databases. ELIGIBILITY CRITERIA Studies were eligible if they: (1) included Nepalese migrant workers aged 18 or older working in the GCC countries or Malaysia or returnee migrant workers from these countries; (2) were primary studies that investigated health and well-being status/issues; and (3) were published in English language before 8 May 2020. STUDY APPRAISAL All included studies were critically appraised using Joanna Briggs Institute study specific tools. RESULTS A total of 33 studies were eligible for inclusion; 12 studies were conducted in Qatar, 8 in Malaysia, 9 in Nepal, 2 in Saudi Arabia and 1 each in UAE and Kuwait. In majority of the studies, there was a lack of disaggregated data on demographic characteristics of Nepalese migrant workers. Nearly half of the studies (n=16) scored as 'high' quality and the rest (n=17) as 'moderate' quality. Five key health and well-being related issues were identified in this population: (1) occupational hazards; (2) sexual health; (3) mental health; (4) healthcare access and (5) infectious diseases. CONCLUSION To our knowledge, this is the most comprehensive review of the health and well-being of Nepalese migrant workers in the GCC countries and Malaysia. This review highlights an urgent need to identify and implement policies and practices across Nepal and destination countries to protect the health and well-being of migrant workers.
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Affiliation(s)
- Priyamvada Paudyal
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Kavian Kulasabanathan
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Jackie A Cassell
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Anjum Memon
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Padam Simkhada
- Department of Allied Health Professions, Sport and Exercise, Faculty of Health, University of Huddersfield, Huddersfield, UK
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26
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Patterson AS, Boadu NY, Clark M, Janes C, Monteiro N, Roberts JH, Shiffman J, Thomas D, Wipfli H. Investigating global mental health: Contributions from political science. Glob Public Health 2020; 15:805-817. [PMID: 32013785 DOI: 10.1080/17441692.2020.1724315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This article outlines an agenda for political science engagement with global mental health. Other social sciences have tackled the topic, investigating such questions as the link between poverty and mental health disorders. Political science is noticeably absent from these explorations. This is striking because mental health disorders affect one billion people globally, governments spend only about 2% of their health budgets on these disorders, and most people lack access to treatment. With its focus on power, political science could deepen knowledge on vulnerabilities to mental illness and explain weak policy responses. By illustrating how various forms of power pertaining to governance, knowledge, and moral authority work through the concepts of issue framing, collective action, and institutions, the article shows that political science can deepen knowledge on this global health issue. Political science can analyse how incomplete knowledge leads to contentious framing, thus hobbling advocacy. It can explain why states shirk their obligations in mental health, and it can question how incentives drive mental health mobilisation. The discipline can uncover how power undergirds institutional responses to global mental health at the international, national, and community levels. Political science should collaborate with other social sciences in research networks to improve policy outcomes.
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Affiliation(s)
- Amy S Patterson
- Department of Politics, University of the South, Sewanee, TN, USA
| | - Nana Yaa Boadu
- Office of International Affairs for the Health Portfolio, Public Health Agency of Canada, Canada
| | - Mary Clark
- Department of Political Science, Tulane University, USA
| | - Craig Janes
- School of Public Health and Health Systems, University of Waterloo, Canada
| | | | - Jan Hatcher Roberts
- WHO Collaborating Center for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, University of Ottawa, Canada
| | - Jeremy Shiffman
- Bloomberg School of Public Health, School of Advanced International Studies, Johns Hopkins University, USA
| | | | - Heather Wipfli
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, USA
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27
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Aye WT, Lien L, Stigum H, Win HH, Oo T, Bjertness E. The prevalence of mental distress and the association with education: a cross-sectional study of 18-49-year-old citizens of Yangon Region, Myanmar. BMC Public Health 2020; 20:94. [PMID: 31969142 PMCID: PMC6977249 DOI: 10.1186/s12889-020-8209-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 01/13/2020] [Indexed: 02/08/2023] Open
Abstract
Background Poor mental health is an important contributor to the global burden of disease. Mental health problems are often neglected in communities, and are scarcely studied in developing countries, including Myanmar. This study estimates the prevalence of mental distress by socio-demographic and health related factors, and the association between education and mental distress. As far as the authors are aware, this is the first population-based study in Myanmar estimating the prevalence of mental distress. Methods Between October and November 2016, a cross sectional study was conducted using a multi-stage sampling design with face-to-face interviews using the Hopkins Symptom Checklist (HSCL-10) for mental distress (symptoms of depression and anxiety). The multivariable analysis strategy was based on Directed Acyclic Graphs (DAGs), to identify confounders, mediators and colliders. Pearson’s chi-square was used for testing differences between proportions and multiple linear regression analysis was applied to explore the association between education (years at school) and mental distress (HSCL score). Results A random sample of 2391 (99.6% response) men and women aged 18–49 years participated in the study. The prevalence of mental distress was 18.0% (95% confidence interval (CI): 14.7–21.9), being higher among women (21.2%; 95% (CI): 16.6–26.6) than men (14.9%; 95% (CI): 11.4–19.2). Older-age, being separated or divorced and having a higher number of children were associated with increased mental distress. In linear regression analyses, adjusted for confounders (age, marital status and income), there was a significant negative association between years at school and mental distress among women and older men (> 30 years), but not among the youngest men. Conclusions The prevalence of mental distress is high, and there is an association between HSCL-10 score and education. Due to the scarcity of mental health services in Myanmar, the findings indicate a need for a mental health policy to handle the burden of mental health problems in Yangon, a burden which is probably high within the country.
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Affiliation(s)
- Win Thuzar Aye
- Department of Preventive and Social Medicine, University of Medicine, Yangon, Myanmar. .,Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway.
| | - Lars Lien
- National Norwegian advisory board for concurrent addiction and mental health problems. Innlandet Hospital Trust, Brumunddal and Faculty of Social and Health Sciences, Inland Norway University of Applied science, Elverum, Norway
| | - Hein Stigum
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Hla Hla Win
- University of Public Health, Yangon, Myanmar
| | - Tin Oo
- Department of Mental Health, University of Medicine 1, Yangon, Myanmar
| | - Espen Bjertness
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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28
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Nyundo A, Manu A, Regan M, Ismail A, Chukwu A, Dessie Y, Njau T, Kaaya SF, Smith Fawzi MC. Factors associated with depressive symptoms and suicidal ideation and behaviours amongst sub-Saharan African adolescents aged 10-19 years: cross-sectional study. Trop Med Int Health 2019; 25:54-69. [PMID: 31698526 DOI: 10.1111/tmi.13336] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study aimed to determine the burden of depression, suicidal ideation and suicidal behaviour amongst adolescents at sites in six sub-Saharan African countries and examine associated risk and protective factors. METHODS Household-based cross-sectional study involving male and female adolescents ages 10-19 years. A total of 7,662 adolescents from eight sites in six countries participated in the survey. Three sites were urban: Dar es Salaam (Tanzania), Harar (Ethiopia) and Ibadan (Nigeria); five were rural: Dodoma (Tanzania), Iganga/Mayuge (Uganda), Kersa (Ethiopia), Ningo Prampram (Ghana) and Nouna (Burkina Faso). Log-binomials models were used to estimate relative risks and confidence intervals for factors associated with depression and suicidal behaviour. This was supplemented using log-Poisson models as needed. RESULTS The prevalence of suicidal behaviour over the last 12 months ranged between 1.2% and 12.4% in the eight sites. Depressive symptoms and suicidal ideation/behaviours were associated with older age, female sex, food insecurity, poor access to health care and substance use. Depression was strongly associated with increased risk of suicidal behaviour at two sites where the multivariate model converged: Harar, Ethiopia (RR = 3.5, 95% CI 1.8, 7.0, P < 0.05) and Ibadan, Nigeria (RR = 3.7, 95% CI 2.2, 6.3, P < 0.0001). CONCLUSIONS Depressive symptoms and suicidal behaviour are common amongst sub-Saharan African adolescents at these 8 sites. Most factors associated with depressive symptoms are modifiable and preventable. Routine screening for depressive symptoms in services frequented by adolescents in these and similar communities would be crucial in early detection and prompt intervention.
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Affiliation(s)
- Azan Nyundo
- Department of Psychiatry and Mental Health, School of Medicine, University of Dodoma, Dodoma, Tanzania
| | - Adom Manu
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Mathilda Regan
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Abbas Ismail
- Department of Statistics, University of Dodoma, Dodoma, Tanzania
| | - Angela Chukwu
- Department of Statistics, University of Ibadan, Ibadan, Nigeria
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Tasiana Njau
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Sylvia F Kaaya
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Mary C Smith Fawzi
- Department of Global Health and Social Medicine, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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29
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Ghebrehiwet S, Baul T, Restivo JL, Kelkile TS, Stevenson A, Gelaye B, Fekadu A, Hailemariam M, Girma E, Teferra S, Canelos V, Henderson DC, Borba CPC. Gender-specific experiences of serious mental illness in rural Ethiopia: A qualitative study. Glob Public Health 2019; 15:185-199. [PMID: 31630624 DOI: 10.1080/17441692.2019.1680723] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Considerable variation in the gender-specific prevalence of serious mental illness (SMI) has been reported in low- and middle-income countries (LMICs). In the rural setting of Butajira, Ethiopia, the male-to-female prevalence ratio of schizophrenia was reported to be 5:1. This qualitative study explores gender-specific experiences of SMI and the extent to which sociocultural factors may explain the observed difference in prevalence estimates. Using purposive sampling, 39 in-depth interviews were conducted with community members from Butajira, a rural district in South Central Ethiopia. Transcripts were analysed using thematic analysis to elicit community perspectives on cultural explanatory models of SMI and experiences in this region. Gender-specific experiences were reported to differ due to visibility of symptoms, community responses, and varying levels of family support towards individuals with SMI. Overall, respondents described how various sociocultural factors subject women with SMI to higher levels of physical and social isolation compared to men, greatly affecting community health workers' ability to identify and provide care to women with mental illness. Future case detection methods should involve family members as they interact with women with SMI early on in the development of their symptoms and play an essential role in their path to mental health care.
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Affiliation(s)
| | - Tithi Baul
- Department of Psychiatry, Boston Medical Center, Boston, USA
| | - Juliana L Restivo
- Department of Global Health, Boston University School of Public Health, Boston, USA
| | | | - Anne Stevenson
- Broad Institute, Stanley Center for Psychiatric Research, Cambridge, USA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Abebaw Fekadu
- Department of Psychiatry, College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.,Global Health & Infection Department, Brighton and Sussex Medical School, Brighton, UK.,Department of Psychological Medicine, Centre for Affective Disorders, King's College London, Institute of Psychiatry, London, UK
| | - Maji Hailemariam
- College of Human Medicine, Division of Public Health, Michigan State University, Flint, USA
| | - Eshetu Girma
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Solomon Teferra
- Department of Psychiatry, College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - David C Henderson
- Department of Psychiatry, Boston Medical Center, Boston, USA.,Boston University School of Medicine, Boston, USA
| | - Christina P C Borba
- Department of Psychiatry, Boston Medical Center, Boston, USA.,Boston University School of Medicine, Boston, USA
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30
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Archer E, Turner R. Measuring empathy in a group of South African undergraduate medical students using the student version of the Jefferson Scale of Empathy. Afr J Prim Health Care Fam Med 2019; 11:e1-e5. [PMID: 31170794 PMCID: PMC6556929 DOI: 10.4102/phcfm.v11i1.1956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 01/09/2019] [Accepted: 01/15/2019] [Indexed: 01/10/2023] Open
Abstract
Background Patient-centred care is a model of care that demands healthcare providers change their focus from the disease to the patient and his or her perceived physical and psycho-social needs. This model requires healthcare workers to listen actively and to have effective communication skills and well-developed levels of empathy. Aim The aim of this study was to determine the suitability of the Jefferson Scale for Empathy (JSE-S) as a valid test for empathy in third-year medical students at a South African university and also to determine the baseline level of empathy in this same group of students. Setting The study took place at a medical school in the Western Cape, South Africa. This medical degree (MB ChB) is a 6-year programme. Students are first exposed to patients within their second year of training, but it is during their third-year that they start their clinical rotations. We wanted to test whether our empathy training would give students the necessary skills and enable them to establish good empathic communication habits in order to prevent a fall in empathy during this vulnerable period. Methods This article explores the suitability of the student version of the JSE-S as a valid test for empathy, within the South African medical school context. We briefly discuss the psychometrics and the scores against what is already known in countries like ours, specifically, developing nations where cultural and language differences exist in the student populations. Furthermore, we explore whether the JSE-S is a valid scale for pre- and post-intervention measurement of medical student empathy within our context and discuss the limitations of self-assessment. We also report on baseline levels of empathy in third-year medical students. Results Two hundred and six third-year medical students (69% females) completed the JSE-S prior to the intervention. Females and students aged 25 years and older had significantly higher scores than males and those 22 years old or less. The mean JSE was 109.98 (SD = 12.54), which is lower than most internationally reported scores. The Cronbach’s alpha coefficient was 0.81, indicating scale reliability and consistency, but graded item response testing highlighted variance in three reverse-scored questions. Conclusion The JSE-S is an appropriate and valid scale for measuring levels of empathy in undergraduate medical students in South Africa. However, language may need to be clarified in the negatively phrased items.
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Affiliation(s)
- Elize Archer
- Centre for Health Professions Education, Faculty of Medicine and Health Sciences, University of Stellenbosch, Parow.
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de Vries E, Rincon CJ, Tamayo Martínez N, Rodriguez N, Tiemeier H, Mackenbach JP, Gómez-Restrepo C, Guarnizo-Herreño CC. Housing index, urbanisation level and lifetime prevalence of depressive and anxiety disorders: a cross-sectional analysis of the Colombian national mental health survey. BMJ Open 2018; 8:e019065. [PMID: 29880561 PMCID: PMC6009503 DOI: 10.1136/bmjopen-2017-019065] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To study socioeconomic inequalities in mental health in rural and urban Colombia, a country with a history of internal conflict and large socioeconomic inequalities. Recent survey data are available to study this understudied topic in a middle-income country. METHODS Using data from 9656 respondents from the 2015 Colombian Mental Health survey, we investigated the association between lifetime prevalence of depressive and anxiety disorders and quality of dwellings and access to public services housing score (HS). We calculated the relative index of inequality (RII) and slope index of inequality (SII) for HS in urban and rural areas, adjusting for potential confounders and mediating factors. OUTCOMES The lifetime prevalence of anxiety and depression (combined) was 9.6% in urban versus 6.9% in rural areas (p<0.001). HS was not associated with prevalence of anxiety and depression in urban settings, whereas a higher HS (poorer housing quality) was associated with fewer mental disorders in rural areas in both univariate and multivariate models (multivariate RIIurban0.96 (95% CI 0.51 to 1.81); RIIrural0.11 (95% CI 0.04 to 0.32)). In rural areas, the prevalence of mental health problems was 12% points lower in persons living in the poorest quality dwellings than in those living in high-quality dwellings (SII -0.12 (95% CI -0.18 to -0.06)). Interestingly, within rural areas, persons living in 'populated centres' (small towns, villages) had a higher lifetime prevalence of any mental health disorder (9.8% (95% CI 6.9 to 13.6)) compared with those living in more isolated, dispersed areas (6.0% (95% CI 4.6 to 7.7)). INTERPRETATION In rural Colombia, those living in the poorest houses and in dispersed areas had a lower prevalence of mental health problems. Further understanding of this phenomenon of a seemingly inverse association of prevalence of mental disorders with poverty and/or urbanisation in rural areas is needed. Particularly, considering the progressive urbanisation process in Colombia, it is important to monitor mental health in populations migrating to the cities.
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Affiliation(s)
- Esther de Vries
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Carlos Javier Rincon
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Nathalie Tamayo Martínez
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Nelcy Rodriguez
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Johan P Mackenbach
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Carlos Gómez-Restrepo
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
- Department of Psychiatry and Mental Health, Hospital Universitario San Ignacio, Bogota, Colombia
| | - Carol C Guarnizo-Herreño
- Departamento de Salud Colectiva, Facultad de Odontología, Universidad Nacional de Colombia, Bogota, Colombia
- Department of Epidemiology and Public Health, University College London, London, UK
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Barros FC, Matijasevich A, Santos IS, Horta BL, da Silva BGC, Munhoz TN, Fazel S, Stein A, Pearson RM, Anselmi L, Rohde LA. Social inequalities in mental disorders and substance misuse in young adults : A birth cohort study in Southern Brazil. Soc Psychiatry Psychiatr Epidemiol 2018; 53:717-726. [PMID: 29721592 PMCID: PMC6003971 DOI: 10.1007/s00127-018-1526-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 04/25/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE To investigate the association between mental disorders and substance misuse at 30 years of age with gender, socioeconomic position at birth, and family income trajectories. METHODS The 1982 Pelotas Birth Cohort was used; all 5914 children born alive at hospital were originally enrolled (99.2% of all city births). In 2012, 3701 subjects were located and interviewed (68% retention rate). Mental disorders and substance misuse were assessed, and their prevalence analysed according to gender, socioeconomic status at birth, and four different income trajectories: always poor, never poor, poor at birth/non-poor at age 30, and non-poor at birth/poor at age 30. RESULTS While women presented higher prevalence of mental disorders, substance misuse was much more frequent among men. Individuals in the lowest income quintile at birth presented 2-5 times more mental disorders and substance misuse than those in the highest quintile. Young adults who were always poor or were not poor at birth but were poor at 30 years of age had a higher prevalence of mental disorders than the other groups. CONCLUSIONS The high rates of mental disorders and lifetime suicide attempts in young adults, especially those who were always poor or became poor after childhood, suggest that recent socioeconomic-related stressful situations may have a higher impact on the current mental health than events earlier in life. However, we could not identify at what specific ages socioeconomic changes were more important.
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Affiliation(s)
- Fernando C. Barros
- Post-Graduate Course in Health and Behavior, Catholic University of Pelotas, Rua Mal. Deodoro, 1160, 96020-220 Pelotas, RS Brazil
| | - Alicia Matijasevich
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil ,Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Iná S. Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Bernardo L. Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Tiago N. Munhoz
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Rebecca M. Pearson
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Luciana Anselmi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Luis Augusto Rohde
- Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, National Institute of Developmental Psychiatry for Children and Adolescents, Porto Alegre, Brazil
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