Patterns of psychiatric morbidity among children and adolescents presenting to an outpatient child and adolescent mental health service (CAMHS) in a Teaching Hospital in Colombo, Sri Lanka-Challenges and implications for service development

The effect of internalized stigmatization on care burden in adolescent psychiatric patients and their parents

Introduction

The purpose of this study was to determine the effect of internalized stigma perceived by adolescents with mental disorders and their families, on the burden of care on their families.

Methods

The study was conducted in a descriptive and correlational desing with adolescents and their parents who applied to the child and adolescent psychiatry outpatient clinic between March 1 and June 1, 2022. A total 101 adolescents and 101 parents who met the sampling criteria and agreed to participate in the study. Only 1 parent per adolescent was included in the study.

Results

It was found that the mean age of the adolescents was 15.05  ±  (1.80), 57.4% were female and 56.4% were secondary school graduates, and 26.7% of the adolescents, all of whom were unemployed, were diagnosed with a mood disorder, 50.5% had received outpatient treatment previously, and 22.8% had chronic diseases. It was found that the mean age of the parents who participated in the study was 45.53  ±  (6.48), 77.1% were female and 28.7% were secondary school graduates. Also, 22.8% of the parents had a chronic disease, 28.7% had a chronic disease in their family and 32.7% had another family member in need of care, and 17.0% of the parents had received training on mental disorders previously. It was found that the parents' total means ZBI score was 42.74  ±  (11.92). When the ZBI total scores were examined in terms of sociodemographic variables, no significant differences were found between the groups according to the variables. There was only a weak, positive and significant relationship between the age of the parents and in the present study, it was found that adolescents with mental disorders and their families experienced internalized stigmatization and this stigmatization increased the care burden on parents.

Discussion

Mental health and psychiatric nurses can facilitate this population's access to treatment by planning and implementing psychosocial interventions to reduce the internalized stigma of children and adolescents and their families.

Maximizing Pharmacological Treatment Adherence of Children and Adolescents: A Randomized Controlled Study

The aim of the current randomized controlled study was to evaluate treatment adherence of children and adolescents who visited an outpatient psychiatry clinic and started medication for the first time, with telehealth application. This study was performed with parents of patients who visited the clinic from October 1, 2020, to March 31, 2021. Data were collected using a personal information form, Medication Control Form, and Morisky Medication Adherence Scale via telephone after verbal and written consent were obtained. It was found that 96.7% of participants in the experimental group had high medication adherence, whereas 93.3% of participants in the control group had low medication adherence. Results show that telehealth application is effective in maximizing adherence to treatment among children and adolescents. [Journal of Psychosocial Nursing and Mental Health Services, 61(1), 16-24.].

Assessment of mental health problems among adolescents in Sri Lanka: Findings from the cross-sectional Global School-based Health Survey

Background and Aims

Mental health condition among adolescents is a leading cause of health-related disability in Sri Lanka. The study aims to estimate the prevalence and evaluate the associated risk factors in three major mental health domains-loneliness, anxiety and suicidal ideation-among Sri Lankan adolescents.

Methods

We conducted a secondary analysis of cross-sectional data of 3262 adolescents from the Global School-based Health Survey (GSHS) conducted by the WHO in 2016. We modeled the binary outcome variables using multivariable logistic regression models with exposures representing demography, food habits, personal hygiene, behavior, substance abuse, parental and social engagement of the respondents.

Results

We estimated the prevalence of loneliness, anxiety and suicidal ideation as 30.8% (95% CI: 29.3, 32.5), 20.2% (95% CI: 18.8, 21.6) and 3.7% (95% CI: 3.1, 4.4), respectively, and the overall prevalence as 40.3% (95% CI: 38.6, 42.0). Mental health problems were more prevalent among females than males. Engagement with parents and close friends, adequate nutritional intake and physically active lifestyles reduced the risk of common mental health problems. Exposure variables like food insecurity, truancy, second-hand smoking, physical fight, and being bullied increased adolescents' risk of reported psychological problems.

Conclusions

We conclude that the prevalence of mental health problems in the Sri Lankan adolescent population was higher than the global average. Results suggest that future policy decisions to mitigate mental health problems among Sri Lankan adolescents should incorporate an integrated approach involving the individual, family and community to promote positive home and school environments combined with an active and healthy lifestyle.

Knowledge/understanding, perception and attitude towards attention-deficit/hyperactivity disorder (ADHD) among community members and healthcare professionals in Indonesia

BACKGROUND

Collaboration between community and healthcare professionals plays an essential role in ADHD care. Therefore, this study aims to identify the level of knowledge/understanding, perception and attitude among community members, primary school teachers, medical students, general practitioners, pediatricians and psychologists in Indonesia regarding ADHD and its association with several related factors.

METHODS

A cross-sectional study utilizing valid questionnaires to assess the level of knowledge/understanding, perception and attitude regarding ADHD among each respondent group was employed. 1,536 subjects participated in this study. Data was gathered and analyzed using the SPSS version 20.0 for Mac. A chi-square test was used to establish the associations. The value of p < 0.05 was considered statistically significant in this study.

RESULTS

Most of the participants showed poor to very poor levels of knowledge/understanding (community members = 56.8%, teachers = 58.9%, medical students = 60.4%, general practitioners = 54.9%, pediatricians = 65.6%, psychologists = 52.1%). The similar results were also found for perception and attitude levels. Several associations were found between practice experience and the level of knowledge/understanding, perception and attitude towards ADHD among general practitioners and psychologists (p < 0.05); educational level and level of attitude among community members and medical students (p < 0.05); practice experience and the knowledge/understanding level in the teachers group (p < 0.05); practice experience and the perception level among pediatricians (p < 0.05).

CONCLUSIONS

Further education regarding ADHD should be considered either through online media or formal education in order to achieve a better management of ADHD.