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Hetlevik Ø, Smith-Sivertsen T, Haukenes I, Ruths S, Baste V. Young adults with depression: A registry-based longitudinal study of work-life marginalisation. The Norwegian GP-DEP study. Scand J Public Health 2024; 52:590-597. [PMID: 37066887 PMCID: PMC11292960 DOI: 10.1177/14034948231165089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/17/2023] [Accepted: 03/06/2023] [Indexed: 04/18/2023]
Abstract
AIMS To explore the association between a depression diagnosis in young adulthood and risk of marginalisation at age 29 years, among those who had completed upper secondary school and those who had not completed at age 21. METHODS In a longitudinal cohort study based on nationwide registers we followed 111,558 people from age 22-29 years. Outcomes were risk of marginalisation and educational achievement at age 29. Exposure was a diagnosed depression at ages 22-26 years. Comorbid mental and somatic health conditions, gender and country of origin were covariates. Relative risks were estimated with Poisson regression models, stratified by educational level at age 21. RESULTS For people who had not completed upper secondary school at age 21 years, a depression diagnosis at age 22-26 increased the risk of low income (relative risk = 1.33; 95% confidence interval = 1.25-1.40), prolonged unemployment benefit (1.46; 1.38-1.55) and social security benefit (1.56; 1.41-1.74) at age 29 compared with those with no depression. Among those who had completed upper secondary school at age 21 years, depression increased the risk of low income (1.71; 1.60-1.83), prolonged unemployment benefit (2.17; 2.03-2.31), social security benefit (3.62; 2.91-4.51) and disability pension (4.43; 3.26-6.01) compared with those with no depression. Mental comorbidity had a significant impact on risk of marginalisation in both groups. CONCLUSIONS Depression in one's mid-20s significantly increases the risk of marginalisation at age 29 years, and comorbid mental health conditions reinforce this association. Functional ability should be given priority in depression care in early adulthood to counteract marginalisation.
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Affiliation(s)
- Øystein Hetlevik
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- Research Unit for General Practice, NORCE Norwegian Research Centre, Norway
| | - Tone Smith-Sivertsen
- Research Unit for General Practice, NORCE Norwegian Research Centre, Norway
- Division of Psychiatry, Haukeland University Hospital, Norway
| | - Inger Haukenes
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- Research Unit for General Practice, NORCE Norwegian Research Centre, Norway
| | - Sabine Ruths
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- Research Unit for General Practice, NORCE Norwegian Research Centre, Norway
| | - Valborg Baste
- Research Unit for General Practice, NORCE Norwegian Research Centre, Norway
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Norway
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Hunduma G, Dessie Y, Geda B, Yadeta TA, Deyessa N. Prevalence and correlates of internalizing and externalizing mental health problems among in-school adolescents in eastern Ethiopia: a cross-sectional study. Sci Rep 2024; 14:3574. [PMID: 38347112 PMCID: PMC10861546 DOI: 10.1038/s41598-024-54145-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/08/2024] [Indexed: 02/15/2024] Open
Abstract
Adolescent's mental health issues are a major social burden and a significant public health issue, but they have not received enough attention in Ethiopia. Therefore, this study aimed to determine the prevalence and correlates of internalizing and externalizing mental health problems among in-school adolescents in the Harari region, eastern Ethiopia. A cross-sectional study was conducted among 3227 in-school adolescents. Multistage sampling was used to select schools and eligible students to participate in the study. A guided, self-administered strength and difficulty questionnaire measured mental health problems. Data were double-entered, validated, and cleaned using EpiData 3.1 and analyzed using STATA version 17. Ordinal logistic regression analysis was performed to estimate the adjusted odds ratio between mental health problems and their correlates. Statistical significance was set at p-value < 0.05. The magnitudes of mental health problems among in-school adolescents by subscale was 24.17% (95% CI 22.72; 25.67) for internalizing and 11.93% (95% CI 10.85; 13.09) for externalizing problems. A high internalizing problem score was associated with females, rural residents, alcohol users, attending public schools, those bullied at school, and those in the lowest wealth index. Likewise, the likelihood of a high externalizing problem score was high among alcohol users, adolescents whose fathers are uneducated, rural, and bullied at school. The study suggests that mental health problems are prevalent among in-school adolescents in Ethiopia, especially internalizing problems. The study also identifies several risk factors associated with internalizing and externalizing problems, such as wealth index, school types, alcohol use, bullying, and rural residence. These factors may indicate the need for more mental health awareness and support programs for adolescents in Ethiopia. This highlights that schools and communities should prioritize mental health awareness and support programs for adolescents. These programs should be tailored to address the specific needs of the population, such as rural residents, those in the lowest wealth index, and those who have experienced bullying.
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Affiliation(s)
- Gari Hunduma
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Biftu Geda
- School of Nursing and Midwifery, College of Health and Medical Sciences, Madda Walabu University, Shashamene, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Negussie Deyessa
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Sorsdahl K, Van Der Westhuizen C, Hornsby N, Jacobs Y, Poole M, Neuman M, Weiss HA, Myers B. Project ASPIRE: A feasibility randomized controlled trial of a brief intervention for reducing risk of depression and alcohol-related harms among South African adolescents. Psychother Res 2024; 34:96-110. [PMID: 36736329 DOI: 10.1080/10503307.2023.2169083] [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: 07/01/2022] [Accepted: 01/07/2023] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Brief interventions could reduce adolescents' risk of depression and alcohol-related harms, but evidence of their feasibility and acceptability for low-and middle-income countries is lacking. To address this gap, we conducted a feasibility trial of the ASPIRE intervention, a four-session multi-component counselling intervention for South African adolescents. METHOD We recruited 117 adolescents who met our inclusion criteria. Participants were randomly assigned to the ASPIRE intervention or a comparison condition. Outcomes were assessed at baseline, six-week, and three-month post-randomization time points. Primary outcomes were based on feasibility of study procedures and intervention delivery (assessed on seven predetermined progression criteria). Clinical outcomes (risk of depression and alcohol harms) were secondary. RESULTS Despite modifications to all study procedures arising from Covid-19 restrictions, five of the seven key progression criteria were fully met, including: feasibility of data collection and outcome measures, counsellor competencies, randomization and blinding, adverse advents, and acceptability of the intervention. The progression criterion for recruitment and intervention retention were not fully met. CONCLUSION Findings suggest that the ASPIRE intervention was generally feasible to deliver and acceptable to adolescents. However, modifications to the trial design and intervention delivery are needed to optimize the validity of a definitive randomized controlled trial of the ASPIRE intervention.
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Affiliation(s)
- K Sorsdahl
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry & Mental Health, University of Cape Town, Rondebosch, South Africa
| | - C Van Der Westhuizen
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry & Mental Health, University of Cape Town, Rondebosch, South Africa
| | - N Hornsby
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Y Jacobs
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - M Poole
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry & Mental Health, University of Cape Town, Rondebosch, South Africa
| | - M Neuman
- MRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - H A Weiss
- MRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - B Myers
- Curtin enAble Institute, Curtin University, Perth, Australia
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, South Africa
- Department of Psychiatry & Mental Health, University of Cape Town, Rondebosch, South Africa
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Kaligis F, Ismail RI, Wiguna T, Prasetyo S, Gunardi H, Indriatmi W, Pasaribu MM, Pandia V, Minayati K, Magdalena CC, Nurraga GW, Pramatirta B, Calvin N, Sourander A. Effectiveness of an online mental health strengthening module to build resilience and overcome stress for transitional aged medical students. Front Digit Health 2023; 5:1207583. [PMID: 37860040 PMCID: PMC10582941 DOI: 10.3389/fdgth.2023.1207583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/22/2023] [Indexed: 10/21/2023] Open
Abstract
Introduction Transitional-aged youths (17-to-24-years-old) are prone to mental-health problems. Students in higher education, especially medical students, are more exposed to stressors and thus need training to increase resilience. However, there have been limited mental-health strengthening modules specifically developed for medical students of transitional age, and none in Indonesia. This study intends to test the effectiveness of an online mental-health strengthening module in altering resilience. Methods A pragmatic randomized trial with repeated measurements was employed to evaluate biopsychosocial outcomes of resilience. The intervention module was delivered in 4 weeks to 105 eligible students. Participants were divided into intervention group (n = 52) and control group (n = 53). Outcomes were measured in the 4th, 8th, and 12th weeks. Primary outcome was resilience level as measured by Connor-Davidson Resilience Scale (CD-RISC). Perceived Stress Scale (PSS), Depression Anxiety Stress Scale (DASS) were utilized to measure stress, depression and anxiety. Knowledge and attitude toward mental-health were also measured through validated questionnaires. Stress levels of participants were measured biologically by measuring salivary cortisol and alpha-amylase levels at the baseline and 12th-week. Results Compared to the control group, there were no significant difference in resilience score of the intervention group compared to control group [F(1, 103) = 2.243, P = .137]; however, there was a significant main effect of time [F(3, 309) = 18.191, P < .001] and interaction effect between intervention and time in resilience score [F(3, 309) = 5.056, P = .002]. Additionally, compared to the control group, there were significant increases in knowledge [F(1, 103) = 66.805, P < .001], attitudes and behavior towards mental-health [F(1, 103) = 5.191, P = .025], and a significant decrease in stress perception score [F(1, 103) = 27.567, P < .001]. The mean salivary delta cortisol during pre-test and post-test at week 12 in the intervention group showed significant difference (P < .001). However, there was no significant difference in the mean delta salivary alpha-amylase between pre-test and post-test at week 12, both in the intervention and control groups. Conclusion The mental-health strengthening module was accepted and applicable to first-year medical students and was found to be effective in increasing resilience from various biopsychosocial aspects. It is also advisable to have similar modules throughout the medical school to maintain sustainability.
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Affiliation(s)
- Fransiska Kaligis
- Department of Psychiatry, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- Doctoral Program in Medical Sciences, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Raden Irawati Ismail
- Department of Psychiatry, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Tjhin Wiguna
- Department of Psychiatry, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | | | - Hartono Gunardi
- Department of Child Health, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Wresti Indriatmi
- Doctoral Program in Medical Sciences, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Department of Dermatovenereology, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Merci Monica Pasaribu
- Department of Clinical Pathology, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Veranita Pandia
- Department of Psychiatry, Faculty of Medicine Universitas Padjajaran—Hasan Sadikin Hospital, Bandung, Indonesia
| | - Kusuma Minayati
- Department of Psychiatry, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Clarissa Cita Magdalena
- Department of Psychiatry, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Garda Widhi Nurraga
- Department of Psychiatry, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Billy Pramatirta
- Department of Psychiatry, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Nicholas Calvin
- Department of Psychiatry, Faculty of Medicine Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Andre Sourander
- Department of Child Psychiatry, University of Turku, Turku, Finland
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Mthiyane N, Rapulana AM, Harling G, Copas A, Shahmanesh M. Effect of multi-level interventions on mental health outcomes among adolescents in sub-Saharan Africa: a systematic review. BMJ Open 2023; 13:e066586. [PMID: 37788931 PMCID: PMC10551963 DOI: 10.1136/bmjopen-2022-066586] [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: 07/28/2022] [Accepted: 08/09/2023] [Indexed: 10/05/2023] Open
Abstract
OBJECTIVE In sub-Saharan Africa (SSA), multiple factors contribute to the considerable burden of mental health disorders among adolescents, highlighting the need for interventions that address underlying risks at multiple levels. We reviewed evidence of the effectiveness of community or family-level interventions, with and without individual level interventions, on mental health disorders among adolescents in SSA. DESIGN Systematic review using the Grades of Recommendation, Assessment, Development and Evaluation approach. DATA SOURCES A systematic search was conducted on Cochrane Library, MEDLINE, EMBASE, PSYCINFO and Web of Science up to 31 March 2021. ELIGIBILITY CRITERIA Studies were eligible for inclusion in the review if they were randomised controlled trials (RCTs) or controlled quasi-experimental studies conducted in sub-Saharan African countries and measured the effect of an intervention on common mental disorders in adolescents aged 10-24 years. DATA EXTRACTION AND SYNTHESIS We included studies that assessed the effect of interventions on depression, anxiety, post-traumatic stress disorder and substance abuse. Substance abuse was only considered if it was measured alongside mental health disorders. The findings were summarised using synthesis without meta-analysis, where studies were grouped according to the type of intervention (multi-level, community-level) and participants. RESULTS Of 1197 studies that were identified, 30 studies (17 RCTs and 3 quasi-experimental studies) were included in the review of which 10 delivered multi-level interventions and 20 delivered community-level interventions. Synthesised findings suggest that multi-level interventions comprise economic empowerment, peer-support, cognitive behavioural therapy were effective in improving mental health among vulnerable adolescents. Majority of studies that delivered interventions to community groups reported significant positive changes in mental health outcomes. CONCLUSIONS The evidence from this review suggests that multi-level interventions can reduce mental health disorders in adolescents. Further research is needed to understand the reliability and sustainability of these promising interventions in different African contexts. PROSPERO REGISTRATION NUMBER CRD42021258826.
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Affiliation(s)
- Nondumiso Mthiyane
- Africa Health Research Institute, Durban, South Africa
- Institute for Global Health, University College London, London, UK
| | - Antony M Rapulana
- Africa Health Research Institute, Durban, South Africa
- School of Laboratory Medicine and Medical Science, University of KwaZulu-Natal, Durban, South Africa
| | - Guy Harling
- Africa Health Research Institute, Durban, South Africa
- Institute for Global Health, University College London, London, UK
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology & Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Andrew Copas
- Institute for Global Health, University College London, London, UK
| | - Maryam Shahmanesh
- Africa Health Research Institute, Durban, South Africa
- Institute for Global Health, University College London, London, UK
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Zhang R, Zhang CQ, Gu D. Prospective associations between adherence to 24-hour movement guidelines and mental well-being in Chinese adolescents. J Sports Sci 2023; 41:1735-1743. [PMID: 38189370 DOI: 10.1080/02640414.2023.2292422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 11/29/2023] [Indexed: 01/09/2024]
Abstract
Most evidence regarding the relationships between adherence to 24-hour movement guidelines and adolescent mental health have been derived from cross-sectional studies or have ignored positive mental health indicators. The current prospective study examined the associations between adherence to 24-hour movement guidelines and changes in mental well-being among Chinese adolescents over three months. 816 Chinese adolescents (Mage = 14.76 years; SD = 0.81) completed baseline and follow-up scales of 24-hour movement behaviours, mental well-being, and covariates. Linear mixed-effects models were used for data analyses, with adjustments for covariates and mental well-being at baseline. There was a significant improvement in mental well-being across the three months, and the improvement in mental well-being was positively associated with meeting any single guidelines and both physical activity and sleep guidelines but not adherence to all three guidelines. Meeting both physical activity and sleep recommendations appears to exert more significant benefits on mental well-being than meeting one or two other recommendations. An integrative approach to mental health promotion by focusing on 24-hour movement behaviours (at least physical activity and sleep) may be more effective than focusing on a single behaviour alone.
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Affiliation(s)
- Ru Zhang
- School of Physical Education & Sports Science, South China Normal University, Guangzhou, China
| | - Chun-Qing Zhang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Dacheng Gu
- School of Physical Education & Health, Nanning Normal University, Nanning, China
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Magis - A magical adventure: Using a mobile game to deliver an ACT intervention for elementary schoolchildren in classroom settings. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023; 27:26-33. [PMID: 36471822 PMCID: PMC9714081 DOI: 10.1016/j.jcbs.2022.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/05/2022]
Abstract
Studies of the effects of the COVID-19 pandemic have shown that this health emergency has affected especially young people. Supporting the well-being of children is thus particularly urgent. However, the high prevalence of ill-being among children requires novel approaches to providing help. Health care resources are limited, and many children did not receive support even before the pandemic. The current study presents a novel approach to delivering brief interventions for school-aged children. A mobile game based on acceptance and commitment therapy was used to increase psychological flexibility and well-being among 10 to 12-year-old schoolchildren. A sample of 106 students played the game in four weekly sessions as part of normal teaching practice in school. The effectiveness of the brief game intervention was examined as a universal intervention among the whole sample and among subgroups created on the basis of baseline psychological flexibility (i.e., based on the need for an intervention). The results show that higher psychological flexibility was associated with less emotional and behavioral problems, higher health-related quality of life, mood, and school satisfaction, and less loneliness (r = 0.46-0.63). While a significant effect was not detected in the whole sample, the subsample of children with initially high psychological inflexibility benefitted from participating in the intervention (Cohen's d = 0.35). These preliminary findings suggest that the brief game-based intervention can increase psychological flexibility among children when the need for an intervention is considered. Further research is necessary to examine the stability of improvements in psychological flexibility.
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Roberts KJ, Smith C, Cluver L, Toska E, Zhou S, Boyes M, Sherr L. Adolescent Motherhood and HIV in South Africa: Examining Prevalence of Common Mental Disorder. AIDS Behav 2022; 26:1197-1210. [PMID: 34570313 PMCID: PMC8940800 DOI: 10.1007/s10461-021-03474-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2021] [Indexed: 01/25/2023]
Abstract
The mental health of adolescents (10–19 years) remains an overlooked global health issue, particularly within the context of syndemic conditions such as HIV and pregnancy. Rates of pregnancy and HIV among adolescents within South Africa are some of the highest in the world. Experiencing pregnancy and living with HIV during adolescence have both been found to be associated with poor mental health within separate explorations. Yet, examinations of mental health among adolescents living with HIV who have experienced pregnancy/parenthood remain absent from the literature. As such, there exists no evidence-based policy or programming relating to mental health for this group. These analyses aim to identify the prevalence of probable common mental disorder among adolescent mothers and, among adolescents experiencing the syndemic of motherhood and HIV. Analyses utilise data from interviews undertaken with 723 female adolescents drawn from a prospective longitudinal cohort study of adolescents living with HIV (n = 1059) and a comparison group of adolescents without HIV (n = 467) undertaken within the Eastern Cape Province, South Africa. Detailed study questionnaires included validated and study specific measures relating to HIV, adolescent motherhood, and mental health. Four self-reported measures of mental health (depressive, anxiety, posttraumatic stress, and suicidality symptomology) were used to explore the concept of likely common mental disorder and mental health comorbidities (experiencing two or more common mental disorders concurrently). Chi-square tests (Fisher’s exact test, where appropriate) and Kruskal Wallis tests were used to assess differences in sample characteristics (inclusive of mental health status) according to HIV status and motherhood status. Logistic regression models were used to explore the cross-sectional associations between combined motherhood and HIV status and, likely common mental disorder/mental health comorbidities. 70.5% of participants were living with HIV and 15.2% were mothers. 8.4% were mothers living with HIV. A tenth (10.9%) of the sample were classified as reporting a probable common mental disorder and 2.8% as experiencing likely mental health comorbidities. Three core findings emerge: (1) poor mental health was elevated among adolescent mothers compared to never pregnant adolescents (measures of likely common mental disorder, mental health comorbidities, depressive, anxiety and suicidality symptoms), (2) prevalence of probable common mental disorder was highest among mothers living with HIV (23.0%) compared to other groups (Range:8.5–12.8%; Χ2 = 12.54, p = 0.006) and, (3) prevalence of probable mental health comorbidities was higher among mothers, regardless of HIV status (HIV & motherhood = 8.2%, No HIV & motherhood = 8.2%, Χ2 = 14.5, p = 0.002). Results identify higher mental health burden among adolescent mothers compared to never-pregnant adolescents, an increased prevalence of mental health burden among adolescent mothers living with HIV compared to other groups, and an elevated prevalence of mental health comorbidities among adolescent mothers irrespective of HIV status. These findings address a critical evidence gap, highlighting the commonality of mental health burden within the context of adolescent motherhood and HIV within South Africa as well as the urgent need for support and further research to ensure effective evidence-based programming is made available for this group. Existing antenatal, postnatal, and HIV care may provide an opportunity for mental health screening, monitoring, and referral.
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Affiliation(s)
| | - Colette Smith
- Institute for Global Health, University College London, London, UK
| | - Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Elona Toska
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
- Department of Sociology, University of Cape Town, Cape Town, South Africa
| | - Siyanai Zhou
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Mark Boyes
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Bentley, Perth, Australia
| | - Lorraine Sherr
- Institute for Global Health, University College London, London, UK
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Steventon Roberts K, Smith C, Toska E, Cluver L, Haag K, Wittesaele C, Langwenya N, Jochim J, Saal W, Shenderovich Y, Sherr L. Risk factors for poor mental health among adolescent mothers in South Africa. PSYCHOL HEALTH MED 2022; 27:67-84. [PMID: 36154770 DOI: 10.1080/13548506.2022.2124295] [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: 05/19/2022] [Accepted: 09/06/2022] [Indexed: 12/13/2022]
Abstract
In South Africa, high rates of adolescent pregnancy and HIV pose prominent public health challenges with potential implications for mental wellbeing. It is important to understand risk factors for mental health difficulties among adolescent mothers affected by HIV. This study aims to identify the prevalence of likely common mental disorder among adolescent mothers (both living with and not living with HIV) and explores hypothesised risk factors for likely common mental disorder. Cross-sectional data from adolescent mothers (10-19 years; n=1002) utilised within these analyses are drawn from a cohort of young mothers residing in the Eastern Cape Province, South Africa. All mothers completed a detailed questionnaire consisting of standardised measures of sociodemographic characteristics, mental health, and hypothesised risk factors. Logistic regression models were utilised to explore associations between hypothesised risk factors and likely common mental disorder. Risk factors were clustered within a hypothesised socioecological framework and entered into models using a stepwise sequential approach. Interaction effects with maternal HIV status were additionally explored. The prevalence of likely common mental disorder among adolescent mothers was 12.6%. Adolescent mothers living with HIV were more likely to report likely common mental disorder compared to adolescent mothers not living with HIV (16.2% vs 11.2%, X2=4.41, p=0.04). Factors associated with likely common mental disorder were any abuse exposure (OR=2.54 [95%CI:1.20-5.40], p=0.01), a lack of perceived social support (OR=4.09 [95%CI:2.48-6.74], p=<0.0001), and community violence exposure (OR=2.09 [95%CI:1.33-3.27], p=0.001). There was limited evidence of interaction effects between risk factors, and maternal HIV status. Violence exposure and a lack of perceived support are major risk factors for poor mental health among adolescent mothers in South Africa. Violence prevention interventions and social support may help to reduce risk. Identified risk factors spanning individual, interpersonal, and community levels have the potential to impact adolescent maternal mental health.
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Affiliation(s)
- Kathryn Steventon Roberts
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Institute for Global Health, University College London, London, UK
| | - Colette Smith
- Institute for Global Health, University College London, London, UK
| | - Elona Toska
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa
- Department of Sociology, University of Cape Town, Rondebosch, South Africa
| | - Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, South Africa
| | | | - Camille Wittesaele
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- London School of Hygiene and Tropical Medicine, London, UK
| | - Nontokozo Langwenya
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Janina Jochim
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Wylene Saal
- Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa
| | - Yulia Shenderovich
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - Lorraine Sherr
- Institute for Global Health, University College London, London, UK
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Raballo A, Poletti M, Valmaggia L, McGorry PD. Editorial Perspective: Rethinking child and adolescent mental health care after COVID-19. J Child Psychol Psychiatry 2021; 62:1067-1069. [PMID: 33368236 DOI: 10.1111/jcpp.13371] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/30/2020] [Indexed: 12/12/2022]
Abstract
While COVID-19 pandemic has allegedly passed its first peak in most western countries, health systems are progressively adapting to the 'new normality'. In child and adolescent mental health services (CAMHS), such organizational envisioning is needed to cope with the foreseeable psychological effects of prolonged social isolation induced by nation-wide public health measures such as school closure. CAMHS need to ensure flexible responses to the psychopathological consequences of evolving societal dynamics, as dramatically actualized by the unexpected COVID-19 pandemic. This would imply (a) shifting the focus of intervention from symptom reduction and containment of acute crises in a comparatively small number of severe cases to a broader preventive strategy, guided by a gradient of increasing intensity and specificity of treatment; (b) promoting smooth access pathways into services and encouraging participation of families; (c) adopting a transdiagnostic staging model to capture the developmental fluctuations from subsyndromal to syndromal states and back, with related changes in the intensity of the need of care; and (d) implementing digital tools to encourage help-seeking and compliance by digitally native youth.
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Affiliation(s)
- Andrea Raballo
- Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Perugia, Italy.,Center for Translational, Phenomenological and Developmental Psychopathology, Perugia University Hospital, Perugia, Italy
| | - Michele Poletti
- Department of Mental Health and Pathological Addiction, Child and Adolescent Neuropsychiatry Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Lucia Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Patrick D McGorry
- Orygen, Parkville, VIC, Australia.,Center for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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11
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Roberts KJ, Smith C, Cluver L, Toska E, Sherr L. Understanding Mental Health in the Context of Adolescent Pregnancy and HIV in Sub-Saharan Africa: A Systematic Review Identifying a Critical Evidence Gap. AIDS Behav 2021; 25:2094-2107. [PMID: 33452658 PMCID: PMC7810185 DOI: 10.1007/s10461-020-03138-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2020] [Indexed: 11/28/2022]
Abstract
Adolescent (10-19 years) mental health remains an overlooked global health issue. Rates of adolescent pregnancy within sub-Saharan Africa are some of the highest in the world and occur at the epicentre of the global HIV epidemic. Both experiencing adolescent pregnancy and living with HIV have been found to be associated with adverse mental health outcomes, when investigated separately. Poor mental health may have implications for both parent and child. The literature regarding mental health within groups experiencing both HIV and adolescent pregnancy is yet to be summarised. This systematic review sought to identify (1) the prevalence/occurrence of common mental disorder amongst adolescents who are living with HIV and have experienced pregnancy, (inclusive of adolescent fathers) in sub-Saharan Africa (2) risk and protective factors for common mental disorder among this group, and (3) interventions (prevention/treatment) for common mental disorder among this group. A systematic search of electronic databases using pre-defined search terms, supplemented by hand-searching, was undertaken in September 2020. One author and an independent researcher completed a title and abstract screening of results from the search. A full-text search of all seemingly relevant manuscripts (both quantitative and qualitative) was undertaken and data extracted using pre-determined criteria. A narrative synthesis of included studies is provided. Quality and risk of bias within included studies was assessed using the Newcastle-Ottawa scale. A systematic keyword search of databases and follow-up hand searching identified 2287 unique records. Of these, thirty-eight full-text quantitative records and seven full-text qualitative records were assessed for eligibility. No qualitative records met the eligibility criteria for inclusion within the review. One quantitative record was identified for inclusion. This study reported on depressive symptomology amongst 14 pregnant adolescents living with HIV in Kenya, identifying a prevalence of 92.9%. This included study did not meet the high methodological quality of this review. No studies were identified reporting on risk and protective factors for common mental disorder, and no studies were found identifying any specific interventions for common mental disorder for this group, either for prevention or for treatment. The limited data identified within this review provides no good quality evidence relating to the prevalence of common mental disorder among adolescents living with HIV who have experienced pregnancy in sub-Saharan Africa. No data was available relating to risk and protective factors or interventions for psychological distress amongst this group. This systematic review identifies a need for rigorous evidence regarding the mental health of pregnant and parenting adolescents living with HIV, and calls for granular interrogation of existing data to further our understanding of the needs of this group. The absence of research on this topic (both quantitative and qualitative) is a critical evidence gap, limiting evidence-based policy and programming responses, as well as regional development opportunities.
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Affiliation(s)
| | - Colette Smith
- Institute for Global Health, University College London, London, UK
| | - Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Elona Toska
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
- Department of Sociology, University of Cape Town, Cape Town, South Africa
| | - Lorraine Sherr
- Institute for Global Health, University College London, London, UK
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12
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Wang H, Abbey C, She X, Rozelle S, Ma X. Association of Child Mental Health with Child and Family Characteristics in Rural China: A Cross-Sectional Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5107. [PMID: 34065853 PMCID: PMC8150989 DOI: 10.3390/ijerph18105107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/07/2021] [Accepted: 05/07/2021] [Indexed: 11/23/2022]
Abstract
Assessing the mental health problems encountered by school children and understanding the contributing factors are crucial to inform strategies aimed at improving mental health in low-resource contexts. However, few studies have investigated the mental health problems among disadvantaged children in poorer countries. This study examines the prevalence of mental health problems in rural China and their association with child and family characteristics. The study uses survey data from 9696 children in 120 rural primary schools and measures child mental health using the Strengths and Difficulties Questionnaire (SDQ). Overall, 17.9% of the sample children were found to be in the abnormal range of the SDQ total difficulties scores. The mean score was 12.93 (SD = 4.94). Abnormal scores were associated with child and family characteristics, including older child age (Odds Ratio, OR = 0.704, 95% CI: 0.611, 0.810; p < 0.001), gender (OR = 1.235, 95% CI: 1.112, 1.371; p < 0.001), and academic performance (OR = 0.421, 95% CI: 0.369, 0.480; p < 0.001). Reading time was found to be protective for mental health. Risk factors include excessive screen time (OR = 1.685, 95% CI: 1.409, 2.016; p < 0.001) and being bullied (OR = 3.695, 95% CI: 3.301, 4.136; p < 0.001). Our study suggests that future mental health illness prevention programs in rural China should consider targeting different aspects of children's social contexts.
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Affiliation(s)
- Huan Wang
- Stanford Center on China’s Economy and Institutions, Stanford University, Stanford, CA 94305, USA; (H.W.); (C.A.); (S.R.)
| | - Cody Abbey
- Stanford Center on China’s Economy and Institutions, Stanford University, Stanford, CA 94305, USA; (H.W.); (C.A.); (S.R.)
| | - Xinshu She
- Stanford School of Medicine, Stanford University, Stanford, CA 94305, USA;
| | - Scott Rozelle
- Stanford Center on China’s Economy and Institutions, Stanford University, Stanford, CA 94305, USA; (H.W.); (C.A.); (S.R.)
| | - Xiaochen Ma
- China Center for Health Development Studies, Peking University, Beijing 100871, China
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Woodgate RL, Tennent P, Legras N. Understanding Youth's Lived Experience of Anxiety through Metaphors: A Qualitative, Arts-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4315. [PMID: 33921770 PMCID: PMC8074263 DOI: 10.3390/ijerph18084315] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 12/26/2022]
Abstract
Living with anxiety can be a complex, biopsychosocial experience that is unique to each person and embedded in their contexts and lived worlds. Scales and questionnaires are necessary to quantify anxiety, yet these approaches are not always able to reflect the lived experience of psychological distress experienced by youth. Guided by hermeneutic phenomenology, our research aimed to amplify the voices of youth living with anxiety. Fifty-eight youth living with anxiety took part in in-depth, open-ended interviews and participatory arts-based methods (photovoice and ecomaps). Analysis was informed by van Manen's method of data analysis with attention to lived space, lived body, lived time, and lived relationships, as well as the meanings of living with anxiety. Youth relied on the following metaphors to describe their experiences: A shrinking world; The heavy, heavy backpack; Play, pause, rewind, forward; and A fine balance. Overall, youth described their anxiety as a monster, contributing to feelings of fear, loss, and pain, but also hope. The findings from this study can contribute to the reduction of barriers in knowledge translation by encouraging the use of narrative and visual metaphors as a communicative tool to convey youth's lived experience of anxiety to researchers, clinicians, and the public.
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Affiliation(s)
- Roberta Lynn Woodgate
- Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, 89 Curry Place, Winnipeg, Manitoba, MB R3T 2N2, Canada; (P.T.); (N.L.)
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Lappalainen R, Lappalainen P, Puolakanaho A, Hirvonen R, Eklund K, Ahonen T, Muotka J, Kiuru N. The Youth Compass -the effectiveness of an online acceptance and commitment therapy program to promote adolescent mental health: A randomized controlled trial. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2021. [DOI: 10.1016/j.jcbs.2021.01.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Sorsdahl K, van der Westhuizen C, Neuman M, Weiss HA, Myers B. Addressing the mental health needs of adolescents in South African communities: a protocol for a feasibility randomized controlled trial. Pilot Feasibility Stud 2021; 7:69. [PMID: 33726830 PMCID: PMC7961162 DOI: 10.1186/s40814-021-00803-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 02/16/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Like many low- and middle-income countries, almost half of the proportion of the South African population is under the age of 25. Given the peak age of onset for most mental health problems is in adolescence, it is vital that adolescents have access to mental health counselling. There are several initiatives to increase access to mental health counselling in South Africa, primarily through the integration of counselling for common mental disorders (CMD) into primary health care services, but adolescents (15-18 years of age) generally do not utilize these services. To address this gap, we will undertake a study to explore the feasibility of conducting a trial of the effectiveness of a community-based mental health counselling intervention for adolescents at-risk for a CMD. METHODS The study is a feasibility trial of the ASPIRE intervention, a four-session blended multi-component counselling intervention adapted for South African adolescents at risk for depression and alcohol use disorders. We will enrol 100 adolescents from community settings and randomly assign them to the ASPIRE intervention or a comparison condition. Feasibility measures, such as rates of recruitment, consent to participate in the trial and retention, will be calculated. Qualitative interviews with participants and counsellors will explore the acceptability of the intervention. The primary outcomes for a subsequent trial would be reductions in symptoms of depression and days of heavy drinking which will be measured at baseline, 6 weeks, and 3 months post-randomization. DISCUSSION This feasibility trial using a mixed-methods design will allow us to determine whether we can move forward to a larger effectiveness trial of the ASPIRE intervention. TRIAL REGISTRATION The trial is registered with the Pan African Clinical Trials Registry (PACTR20200352214510). Registered 28 February 2020-retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=9795.
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Affiliation(s)
- K Sorsdahl
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa.
| | - C van der Westhuizen
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
| | - M Neuman
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England
| | - H A Weiss
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England
| | - B Myers
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
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Waters L, Loton DJ, Grace D, Jacques-Hamilton R, Zyphur MJ. Observing Change Over Time in Strength-Based Parenting and Subjective Wellbeing for Pre-teens and Teens. Front Psychol 2019; 10:2273. [PMID: 31649593 PMCID: PMC6795758 DOI: 10.3389/fpsyg.2019.02273] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 09/23/2019] [Indexed: 01/22/2023] Open
Abstract
The focus of this study was on adolescent mental health. More specifically, the relationship between strength-based parenting (SBP) and subjective wellbeing (SWB) during adolescence was examined at three time points over 14 months (N = 202, M age = 12.97, SD age = 0.91, 48% female). SBP was positively related to life satisfaction and positive affect at each of the three time points, and was negatively related to negative affect. SBP and SWB both declined significantly over time. When examining the causal relationships between SBP and SWB, two different statistical models were applied: latent growth-curve models (LGM) and random-intercept cross-lagged panel models (RI-CLPM). The LGM revealed a strong positive relationship between changes in SBP and SWB. Specifically, this model showed that SBP at one time point predicted adolescent SWB at future time points. However, when the more stringent statistical test was completed through RI-CLPMs, no cross-lagged paths reached significance. Thus, while parenting is a significant predictor of wellbeing for pre-teens and teens in real time, it is not predictive of wellbeing at future time points. Parents, thus, cannot assume that their current levels of SBP are 'banked' by their children to support future wellbeing. Instead, SBP needs to be an ongoing, contemporary parenting practice. Furthermore, the fact that perceptions of SBP decline in this age bracket suggest that SBP interventions may be helpful in supporting adolescent mental health.
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Affiliation(s)
- Lea Waters
- Centre for Positive Psychology, The University of Melbourne, Melbourne, VIC, Australia
| | - Daniel J. Loton
- Centre for Positive Psychology, The University of Melbourne, Melbourne, VIC, Australia
| | - Dawson Grace
- Centre for Positive Psychology, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Michael J. Zyphur
- Centre for Positive Psychology, The University of Melbourne, Melbourne, VIC, Australia
- Department of Management and Marketing, The University of Melbourne, Melbourne, VIC, Australia
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17
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Suicidal behaviour among sexual-minority youth: a review of the role of acceptance and support. THE LANCET CHILD & ADOLESCENT HEALTH 2019; 3:190-198. [DOI: 10.1016/s2352-4642(18)30400-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 11/27/2018] [Accepted: 12/04/2018] [Indexed: 11/20/2022]
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18
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Finan LJ, Ohannessian CM, Gordon MS. Trajectories of depressive symptoms from adolescence to emerging adulthood: The influence of parents, peers, and siblings. Dev Psychol 2018; 54:1555-1567. [PMID: 30047776 DOI: 10.1037/dev0000543] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The primary purpose of this study was to examine whether social relationship factors are associated with trajectories of depressive symptoms from adolescence into emerging adulthood. Specifically, adolescent-parent communication with mothers and fathers, peer support, and sibling warmth and hostility were examined in relation to depressive symptoms for girls and boys. Adolescents (N = 372; Mage = 16.09; SD = .69; 55% female) from the Mid-Atlantic United States completed surveys in the spring of 2007, 2008, and 2009 and again in the fall of 2014 when they were emerging adults. Growth curve modeling results suggested that communication with mothers and fathers and peer support predicted lower levels of depressive symptoms in adolescence for girls. For boys, peer support predicted lower whereas sibling hostility predicted higher levels of depressive symptoms in adolescence. Further, adolescent-mother communication for girls and adolescent-father communication for boys predicted the decline in depressive symptoms into emerging adulthood. Both sibling warmth and hostility for girls, whereas only sibling hostility for boys, predicted less steep declines in depressive symptoms over time. Findings draw attention to differences in experiences with depressive symptoms by sex and the importance of social relationship factors in the lives of adolescents and emerging adults. Implications for intervention and prevention are discussed. (PsycINFO Database Record
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Affiliation(s)
| | | | - Mellissa S Gordon
- Department of Human Development Family Studies, University of Delaware
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19
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Anderson M, Werner-Seidler A, King C, Gayed A, Harvey SB, O’Dea B. Mental Health Training Programs for Secondary School Teachers: A Systematic Review. SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-018-9291-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Raballo A, Poletti M, McGorry P. Architecture of change: rethinking child and adolescent mental health. Lancet Psychiatry 2017; 4:656-658. [PMID: 28853403 DOI: 10.1016/s2215-0366(17)30315-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 07/24/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Andrea Raballo
- Department of Psychology, Psychopathology and Development Research, Norwegian University of Science and Technology (NTNU), Trondheim N-7491, Norway.
| | - Michele Poletti
- Department of Mental Health and Pathological Addiction, Reggio Emilia Local Health Trust, Reggio Emilia, Italy
| | - Patrick McGorry
- Orygen (The National Centre of Excellence in Youth Mental Health) and Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
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21
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Ross V, Kõlves K, De Leo D. Teachers' Perspectives on Preventing Suicide in Children and Adolescents in Schools: A Qualitative Study. Arch Suicide Res 2017; 21:519-530. [PMID: 27578394 DOI: 10.1080/13811118.2016.1227005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Given the important role teachers play as gatekeepers in school suicide prevention, this study explored teachers' perspectives on what should be done to improve current suicide prevention efforts. The study, in Queensland, Australia, was part of a large-scale survey examining teachers' knowledge, attitudes and experience of suicidality. One hundred and fifteen teachers responded to an online survey question regarding their views on the requirements for school suicide prevention. Qualitative analysis identified five themes from teachers' responses: awareness and stigma reduction, support services for students, education and training, bullying and the role of social media. The results of this study provide some profound insights into teachers' perspectives on suicide and highlight the critical need for improved suicide prevention efforts in schools.
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22
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Treuer T, Chan KLP, Kim BN, Kunjithapatham G, Wynchank D, Semerci B, Montgomery W, Novick D, Dueñas H. Lost in transition: A review of the unmet need of patients with attention deficit/hyperactivity disorder transitioning to adulthood. Asia Pac Psychiatry 2017; 9. [PMID: 27552649 DOI: 10.1111/appy.12254] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 07/18/2016] [Indexed: 01/19/2023]
Abstract
This review discusses the unmet needs of patients with attention deficit/hyperactivity disorder (ADHD) who are transitioning into adulthood. Although awareness and recognition of ADHD in children, adolescents, and adults have improved in recent years, there is often an interruption in management of the disorder when adolescent patients transition to adult health care services. This review has the following objectives: (1) to identify key issues patients with ADHD (with or without an early diagnosis) face during transition into adulthood; (2) to review the current clinical practice and country-specific approaches to the management of the transition into adulthood for patients with ADHD; (3) to discuss challenges facing clinicians and their patients when drug treatment for ADHD is initiated; (4) to review current ADHD guidelines on transition management in Hong Kong, Singapore, South Korea, Turkey, and Africa; and (5) to examine economic consequences associated with ADHD. The review suggests that the transition period to adult ADHD may be an underresearched and underserved area. The transition period plays an important role regarding how ADHD symptoms may be perceived and acted upon by adult psychiatrists. Further studies are needed to explore the characteristics of the transition period. If only a fraction of adolescents go on to have mental disorders during adulthood, especially ADHD, it is crucial to identify their characteristics to target appropriate interventions at the beginning of the course of illness. There continues to be low recognition of adult ADHD and a severe lack of medical services equipped to diagnose and care for patients with ADHD transitioning from child to adult services.
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Affiliation(s)
- Tamás Treuer
- Neuroscience Research, Eli Lilly and Company, Budapest, Hungary
| | | | - Bung Nyun Kim
- Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, South Korea
| | | | - Dora Wynchank
- PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands.,Medical Suite, The Village, Johannesburg, South Africa
| | | | - William Montgomery
- Global Patient Outcomes & Real World Evidence, Eli Lilly Australia Pty Ltd, West Ryde, New South Wales, Australia
| | - Diego Novick
- Global Patient Outcomes and Real World Evidence, Eli Lilly and Company, Windlesham, Surrey, UK
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Löve J, Hensing G, Söderberg M, Torén K, Waern M, Åberg M. Future marginalisation and mortality in young Swedish men with non-psychotic psychiatric disorders and the resilience effect of cognitive ability: a prospective, population-based study. BMJ Open 2016; 6:e010769. [PMID: 27515748 PMCID: PMC4985865 DOI: 10.1136/bmjopen-2015-010769] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Large-scale studies examining future trajectories of marginalisation and health in adolescents with mental illness are scarce. The aim of this study was to examine if non-psychotic psychiatric disorders (NPDs) were associated with future indicators of marginalisation and mortality. We also aimed to determine whether these associations might be mediated by education level and attenuated by high cognitive ability. DESIGN This is a prospective cohort study with baseline data from the Swedish Conscription register. SETTING The study was carried out in Sweden from 1969 to 2005. PARTICIPANTS All of the participants were 18-year-old men at mandatory conscription in Sweden between 1969 and 2005 (n=1 609 690). MEASURES NPDs were clinically diagnosed at conscription. Cognitive ability was measured by a standardised IQ test at conscription. National register data covered information on welfare support, long-term unemployment, disability pension (DP) and mortality over a period of 1-36 years. RESULTS NPD at the age of 18 years was a predictor of future welfare support, OR 3.73 (95% CI 3.65 to 3.80); long-term unemployment, OR 1.97 (95% CI 1.94 to 2.01); DP, HR 2.95 (95% CI 2.89 to 3.02); and mortality, HR 2.45 (2.33-2.52). The adjusted models suggested that these associations were not confounded by fathers' educational level, cognitive ability had only a minor attenuating effect on most associations and the mediating effect of own educational level was small. CONCLUSIONS The present study underlines a higher prevalence of future adversities in young men experiencing NPDs at the age of 18 years. It also indicates that higher cognitive ability may work as a potential resilience factor against future marginalisation and mortality.
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Affiliation(s)
- J Löve
- Section for Social Medicine and Epidemiology, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - G Hensing
- Section for Social Medicine and Epidemiology, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - M Söderberg
- Occupational and Environmental Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - K Torén
- Occupational and Environmental Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - M Waern
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - M Åberg
- Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Department of Primary Health Care, Institute of Medicine, All at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Schmidt SJ, Schimmelmann BG. [Progress, challenges and new perspectives in psychotherapy research in children and adolescents]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2015; 43:85-90. [PMID: 25769761 DOI: 10.1024/1422-4917/a000337] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Stefanie J Schmidt
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern
| | - Benno G Schimmelmann
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern
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25
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Wasserman D, Hoven CW, Wasserman C, Wall M, Eisenberg R, Hadlaczky G, Kelleher I, Sarchiapone M, Apter A, Balazs J, Bobes J, Brunner R, Corcoran P, Cosman D, Guillemin F, Haring C, Iosue M, Kaess M, Kahn JP, Keeley H, Musa GJ, Nemes B, Postuvan V, Saiz P, Reiter-Theil S, Varnik A, Varnik P, Carli V. School-based suicide prevention programmes: the SEYLE cluster-randomised, controlled trial. Lancet 2015; 385:1536-44. [PMID: 25579833 DOI: 10.1016/s0140-6736(14)61213-7] [Citation(s) in RCA: 305] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Suicidal behaviours in adolescents are a major public health problem and evidence-based prevention programmes are greatly needed. We aimed to investigate the efficacy of school-based preventive interventions of suicidal behaviours. METHODS The Saving and Empowering Young Lives in Europe (SEYLE) study is a multicentre, cluster-randomised controlled trial. The SEYLE sample consisted of 11,110 adolescent pupils, median age 15 years (IQR 14-15), recruited from 168 schools in ten European Union countries. We randomly assigned the schools to one of three interventions or a control group. The interventions were: (1) Question, Persuade, and Refer (QPR), a gatekeeper training module targeting teachers and other school personnel, (2) the Youth Aware of Mental Health Programme (YAM) targeting pupils, and (3) screening by professionals (ProfScreen) with referral of at-risk pupils. Each school was randomly assigned by random number generator to participate in one intervention (or control) group only and was unaware of the interventions undertaken in the other three trial groups. The primary outcome measure was the number of suicide attempt(s) made by 3 month and 12 month follow-up. Analysis included all pupils with data available at each timepoint, excluding those who had ever attempted suicide or who had shown severe suicidal ideation during the 2 weeks before baseline. This study is registered with the German Clinical Trials Registry, number DRKS00000214. FINDINGS Between Nov 1, 2009, and Dec 14, 2010, 168 schools (11,110 pupils) were randomly assigned to interventions (40 schools [2692 pupils] to QPR, 45 [2721] YAM, 43 [2764] ProfScreen, and 40 [2933] control). No significant differences between intervention groups and the control group were recorded at the 3 month follow-up. At the 12 month follow-up, YAM was associated with a significant reduction of incident suicide attempts (odds ratios [OR] 0·45, 95% CI 0·24-0·85; p=0·014) and severe suicidal ideation (0·50, 0·27-0·92; p=0·025), compared with the control group. 14 pupils (0·70%) reported incident suicide attempts at the 12 month follow-up in the YAM versus 34 (1·51%) in the control group, and 15 pupils (0·75%) reported incident severe suicidal ideation in the YAM group versus 31 (1·37%) in the control group. No participants completed suicide during the study period. INTERPRETATION YAM was effective in reducing the number of suicide attempts and severe suicidal ideation in school-based adolescents. These findings underline the benefit of this universal suicide preventive intervention in schools. FUNDING Coordination Theme 1 (Health) of the European Union Seventh Framework Programme.
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Affiliation(s)
- Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden.
| | - Christina W Hoven
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA; Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Camilla Wasserman
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA; Department of Medicine and Health Science, University of Molise, Campobasso, Italy
| | - Melanie Wall
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ruth Eisenberg
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden
| | - Ian Kelleher
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden
| | - Marco Sarchiapone
- Department of Medicine and Health Science, University of Molise, Campobasso, Italy; National Institute for Health, Migration and Poverty, Rome, Italy
| | - Alan Apter
- Feinberg Child Study Centre, Schneider Children's Medical Centre, Tel Aviv University, Tel Aviv, Israel
| | - Judit Balazs
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary; Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Julio Bobes
- Department of Psychiatry, Centro de Investigación Biomédica en Red de Salud Mental, University of Oviedo, Oviedo, Spain
| | - Romuald Brunner
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | | | - Doina Cosman
- Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Christian Haring
- Institute for Clinical Evaluation, Department for Psychiatry and Psychotherapy B, State Hospital Hall, Tyrol, Austria
| | - Miriam Iosue
- Department of Medicine and Health Science, University of Molise, Campobasso, Italy
| | - Michael Kaess
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Jean-Pierre Kahn
- Department of Psychiatry, Nancy University Hospital, Nancy, France
| | - Helen Keeley
- National Suicide Research Foundation, Cork, Ireland
| | - George J Musa
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Bogdan Nemes
- Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Vita Postuvan
- Slovene Center for Suicide Research, Andrej Marusic Institute, University of Primorska, Koper, Slovenia
| | - Pilar Saiz
- Department of Psychiatry, Centro de Investigación Biomédica en Red de Salud Mental, University of Oviedo, Oviedo, Spain
| | - Stella Reiter-Theil
- Department of Clinical Ethics, Psychiatric Hospitals of the University of Basel, University Hospital Basel, Basel, Switzerland
| | - Airi Varnik
- Estonian-Swedish Mental Health and Suicidology Institute, Tallinn, Estonia; Tallinn University, Tallinn, Estonia
| | - Peeter Varnik
- Estonian-Swedish Mental Health and Suicidology Institute, Tallinn, Estonia; Tallinn University, Tallinn, Estonia
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden
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