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Ametaj AA, Denckla CA, Stevenson A, Stroud RE, Hall J, Ongeri L, Milkias B, Hoffman J, Naisanga M, Akena D, Kyebuzibwa J, Kwobah EK, Atwoli L, Gichuru S, Teferra S, Alemayehu M, Zingela Z, Stein DJ, Pretorius A, Newton CR, Mwema RM, Kariuki SM, Koenen KC, Gelaye B. Cross-cultural equivalence of the Kessler Psychological Distress Scale (K10) across four African countries in a multi-national study of adults. SSM - MENTAL HEALTH 2024; 5:100300. [PMID: 38706931 PMCID: PMC11064105 DOI: 10.1016/j.ssmmh.2024.100300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
The Kessler Psychological Distress Scale (K10) has been widely used to screen psychological distress across many countries. However, its performance has not been extensively studied in Africa. The present study sought to evaluate and compare measurement properties of the K10 across four African countries: Ethiopia, Kenya, Uganda, and South Africa. Our hypothesis is that the measure will show equivalence across all. Data are drawn from a neuropsychiatric genetic study among adult participants (N = 9179) from general medical settings in Ethiopia (n = 1928), Kenya (n = 2556), Uganda (n = 2104), and South Africa (n = 2591). A unidimensional model with correlated errors was tested for equivalence across study countries using confirmatory factor analyses and the alignment optimization method. Results displayed 30 % noninvariance (i.e., variation) for both intercepts and factor loadings across all countries. Monte Carlo simulations showed a correlation of 0.998, a good replication of population values, indicating minimal noninvariance, or variation. Items "so nervous," "lack of energy/effortful tasks," and "tired" were consistently equivalent for intercepts and factor loadings, respectively. However, items "depressed" and "so depressed" consistently differed across study countries (R2 = 0) for intercepts and factor loadings for both items. The K10 scale likely functions equivalently across the four countries for most items, except "depressed" and "so depressed." Differences in K10 items were more common in Kenya and Ethiopia, suggesting cultural context may influence the interpretation of some items and the potential need for cultural adaptations in these countries.
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Affiliation(s)
- Amantia A. Ametaj
- Institute of Health Equity and Social Justice, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T. H Chan School of Public Health, Boston, MA, 02115, USA
| | - Christy A. Denckla
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Anne Stevenson
- Department of Epidemiology, Harvard T. H Chan School of Public Health, Boston, MA, 02115, USA
- Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rocky E. Stroud
- Department of Epidemiology, Harvard T. H Chan School of Public Health, Boston, MA, 02115, USA
- Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Jasmine Hall
- Department of Epidemiology, Harvard T. H Chan School of Public Health, Boston, MA, 02115, USA
| | - Linnet Ongeri
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Barkot Milkias
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jacob Hoffman
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Unit on Risk and Resilience in Mental Disorders, South African Medical Research Council (SAMRC), Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Molly Naisanga
- Department of Psychiatry, Makerere University, Kampala, Uganda
| | - Dickens Akena
- Department of Psychiatry, Makerere University, Kampala, Uganda
| | | | - Edith K. Kwobah
- Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Lukoye Atwoli
- Department of Mental Health, Moi University School of Medicine, Eldoret, Kenya
- Department of Internal Medicine, Medical College East Africa, Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - Stella Gichuru
- Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret, Kenya
- Department of Internal Medicine, Medical College East Africa, Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - Solomon Teferra
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Melkam Alemayehu
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zukiswa Zingela
- Executive Dean’s Office, Faculty of Health Sciences, Nelson Mandela University, Gqeberha, South Africa
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Unit on Risk and Resilience in Mental Disorders, South African Medical Research Council (SAMRC), Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Adele Pretorius
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Charles R.J.C. Newton
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Unit, Kenya Medical Research Institute - Wellcome Trust Research Program, Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Rehema M. Mwema
- Neuroscience Unit, Kenya Medical Research Institute - Wellcome Trust Research Program, Kilifi, Kenya
| | - Symon M. Kariuki
- Neuroscience Unit, Kenya Medical Research Institute - Wellcome Trust Research Program, Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T. H Chan School of Public Health, Boston, MA, 02115, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Bizu Gelaye
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T. H Chan School of Public Health, Boston, MA, 02115, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Anyanwu MU, Demetrovics Z, Griffiths MD, Horváth Z, Czakó A, Bajunirwe F, Tamwesigire I. Problem Gambling Among Adolescents in Uganda: A Cross-sectional Survey Study. J Gambl Stud 2023; 39:971-985. [PMID: 37029857 PMCID: PMC10175322 DOI: 10.1007/s10899-023-10205-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2023] [Indexed: 04/09/2023]
Abstract
In recent years, gambling has evolved and grown substantially with new gambling activities and facilities being introduced, making gambling products and opportunities more available than ever before in Uganda. While the growth of gambling industry is considered to have a beneficial impact on the economy, it is increasingly becoming a social and public health issue especially among a minority of young people who experience problem gambling, which can damage personal, family, vocational, and academic pursuits. The present study estimated the prevalence of problem gambling and identified the socio-demographic, school, environmental and health risks of problem gambling among secondary school students in Mbarara Municipality, Uganda. A cross-sectional study was conducted among secondary school students in Mbarara Municipality. A total of 921 students from 12 schools were recruited using cluster sampling. An ordinal logistic regression model was used to explore the relationship between problem gambling and the socio-demographic, academic, environmental and health variables. Of 905 participants, 362 reported having ever gambled (40%), and 160 were classified as problem gamblers (17.7%; 44.2% among those who had ever gambled). Problem gambling was significantly associated with being male, being non-religious, other religion (African traditional religion), having employment (outside of school), distance to nearest gambling venue, parental gambling, peer gambling, substance use, risky sexual behavior, and psychological distress. The present study found a very high prevalence of problem gambling among Ugandan secondary school students. Therefore, there is need to institute public health measures towards raising awareness, prevention and treatment of problem gambling among Ugandan adolescents.
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Affiliation(s)
- Michael U Anyanwu
- Department of Community Health, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda
| | - Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Mark D Griffiths
- International Gaming Research Unit Psychology Department, Nottingham Trent University, Nottingham, UK.
| | - Zsolt Horváth
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Andrea Czakó
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Francis Bajunirwe
- Department of Community Health, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda
| | - Imelda Tamwesigire
- Department of Community Health, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda
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Frankham LJ, Thorsteinsson EB, Bartik W. The Impact of COVID-19 Related Distress on Antenatal Depression in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4783. [PMID: 36981691 PMCID: PMC10049555 DOI: 10.3390/ijerph20064783] [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: 12/13/2022] [Revised: 02/25/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Globally, the impact of COVID-19 on mental health has been significant. Pregnant women are known to be a vulnerable population in relation to mental health. In Australia, there was an unprecedented demand during the pandemic for mental health services, including services for pregnant women. Maternal mental health has unique and enduring features that can significantly shape a child's overall development and poor maternal mental health can have considerable social and economic costs. This cross-sectional study evaluated symptoms of antenatal depression and COVID-19-related distress in a sample of two hundred and sixty-nine pregnant women residing in Australia aged between 20 and 43 (M = 31.79, SD = 4.58), as part of a larger study. Social media advertising was used to recruit participants between September 2020 and November 2021. Prevalence rates for antenatal depression were found to be higher in this study (16.4%) compared with previous Australian prevalence rates (7%). COVID-19 distress in relation to having a baby during a COVID-19 outbreak significantly predicted symptoms of antenatal depression, B = 1.46, p < 0.001. Results from this study suggest that mothers and families may have increased mental health vulnerabilities as a consequence of the pandemic for some time yet.
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Lasater ME, Beebe M, Warren NE, Winch PJ, Soucko F, Keita M, Doumbia S, Murray SM. Reliability and validity of a perinatal depression screening instrument in rural Mali. SSM - MENTAL HEALTH 2022; 2:100059. [PMID: 36644110 PMCID: PMC9835090 DOI: 10.1016/j.ssmmh.2021.100059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background In order to reduce the burden of perinatal depression in low- and middle-income countries, health systems must be able to identify and treat women suffering from depression. The objective of our study was to develop a locally valid and reliable screening instrument for use in identifying pregnant women and mothers of young children with a local depression syndrome, dusukasi, in rural Mali. Methods We administered a locally adapted screening instrument containing items from the Edinburgh Postpartum Depression Scale (EPDS) and Hopkins Symptom Checklist (HSCL-25) to 180 pregnant women and mothers of children under age 2 in Sélingué, Mali to assess the instrument's psychometric properties and validity. Item Response Theory was used to develop an abbreviated version of the measure and the validity and psychometric properties of this shortened version were compared with the full-length scale. Results The full 28-item scale exhibited a single factor structure with good internal consistency (Cronbach's alpha = 0.92). Women who self-identified as suffering from dusukasi (n = 87) in a known groups analysis to assess construct validity had significantly higher depression and anxiety symptom scores (p < 0.0001) and functional impairment scores (p < 0.0001) compared to women not reporting dusukasi (n = 93). The shortened 16-item scale performed as well as the full scale in identifying women with dusukasi. Conclusions Construct validity of our adapted screening instrument was supported for identifying dusukasi in rural Malian women. Our methodology can be applied in other settings to develop similarly valid screening instruments for perinatal depression.
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Affiliation(s)
- Molly E. Lasater
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA,Corresponding author. 615 N. Wolfe St, Baltimore, MD, USA, 21205. (M.E. Lasater)
| | - Madeleine Beebe
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA
| | - Nicole E. Warren
- School of Nursing, Johns Hopkins University, 525 N Wolfe St, Baltimore, MD, 21205, USA
| | - Peter J. Winch
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA
| | - Fatoumata Soucko
- Department of Public Health, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Mali
| | - Mariam Keita
- Department of Public Health, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Mali
| | - Seydou Doumbia
- Department of Public Health, Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Mali
| | - Sarah M. Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA
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Psychometric properties and factor structure of the Kessler-10 among Ethiopian adults. J Affect Disord 2022; 303:180-186. [PMID: 35151678 PMCID: PMC8948279 DOI: 10.1016/j.jad.2022.02.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 01/08/2022] [Accepted: 02/09/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Many common mental disorders are underdiagnosed and undertreated in low-resource countries. The ten-item Kessler Psychological Distress Scale (K10) is a brief screening tool widely used to assess psychological distress. We evaluated the K10's performance in an Ethiopian population by assessing internal consistency and construct validity through factor structure. METHODS K10 survey responses and sociodemographic data were collected from 1928 adults, including patients and caregivers from a general medical setting, who served as controls of a large epidemiological study. RESULTS The K10 had good internal consistency, with a Cronbach's alpha of 0.83. Results from exploratory factor analyses showed that the K10 had a two-factor solution that accounted for approximately 66% of the variance. Confirmatory factor analyses demonstrated that a unidimensional model with correlated errors, informed by a theoretical model, was the best fitting model for the setting (comparative fit index of 0.90 and root mean square error of approximation of 0.10). LIMITATIONS We did not assess the K10's test-retest reliability or its criterion validity (i.e., agreement with a reference measure). CONCLUSIONS Based on internal consistency and construct validity, the K10 can effectively assess psychological distress among Ethiopian adults for population-based research and potentially clinical screening, consistent with previous findings in this setting. Further studies are needed to test its criterion validity against a reference measure of psychological distress.
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Socioemotional development in infants of pregnant women during the COVID-19 pandemic: the role of prenatal and postnatal maternal distress. Child Adolesc Psychiatry Ment Health 2022; 16:28. [PMID: 35361233 PMCID: PMC8969812 DOI: 10.1186/s13034-022-00458-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An upsurge in psychological distress was documented in pregnant women during the COVID-19 pandemic. We investigated with a longitudinal design whether prenatal and postnatal maternal distress during the COVID-19 pandemic was associated with lower infant socioemotional development. METHODS Pregnant women (N = 468, Mage = 30,00, 97.6% White) were recruited during the first COVID-19 mandatory lockdown in Quebec, Canada, from April 2nd to April 13th 2020 and were re-contacted at two months postpartum to complete self-reported measures of general (i.e. not specifically related to the COVID-19 pandemic) anxio-depressive symptoms and infant development. Structural equation modeling analyses were performed using maximum likelihood parameter estimation. RESULTS Higher maternal prenatal distress significantly contributed to poorer infant socioemotional development. A mediation model showed that postnatal distress significantly mediated the association between prenatal distress and infant socioemotional development, whereas the direct effect of prenatal distress was no longer significant. Prenatal and postnatal maternal distress accounted for 13.7% of the variance in infant socioemotional development. CONCLUSION Our results call for special means of clinical surveillance in mothers and for innovative (online) interventions aiming to support maternal mental health during pregnancy and after delivery.
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7
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Measuring psychological distress using the K10 in Kenya. J Affect Disord 2022; 303:155-160. [PMID: 35151672 PMCID: PMC7612413 DOI: 10.1016/j.jad.2022.02.012] [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: 05/28/2021] [Revised: 11/30/2021] [Accepted: 02/09/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND The Kessler psychological distress scale (K10) is a brief screening tool that assesses psychological distress in both clinical and epidemiological settings. Despite wide applicability of the K10 globally, there are no data on psychometric properties of the K10 in Kenya. This study investigated the reliability, factor structure, and construct validity of the K10 as a measure of psychological distress among adults in Kenya. METHODS A total of 2556 adults attending 11 outpatient clinics in the western and coastal regions of Kenya without a history or clinical diagnosis of psychotic disorders were included. Data were collected on demographic characteristics of the participants and the K10. Internal consistency was evaluated using Cronbach's alpha. Construct validity and factor structures of the K10 were evaluated using both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) approaches. RESULTS The mean K10 score was 3.4 and Cronbach's alpha was 0.85, indicating good internal consistency (reliability). EFA resulted in a two-factor solution that accounted for 67.6% of variance. CFA results indicated that a unidimensional model with correlated errors best fit the data. LIMITATIONS The K10 was only administered to a control group of our study population, which had low levels of psychological distress. CONCLUSION The K10 has good construct validity and reliability for use as a broad measure of psychological distress in Kenyan adults and may be useful in general medical setting to assess anxiety and depressive disorders.
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8
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Eapen V, Woolfenden S, Schmied V, Jalaludin B, Lawson K, Liaw ST, Lingam R, Page A, Cibralic S, Winata T, Mendoza Diaz A, Lam-Cassettari C, Burley J, Boydell K, Lin P, Masi A, Katz I, Dadich A, Preddy J, Bruce J, Raman S, Kohlhoff J, Descallar J, Karlov L, Kaplun C, Arora A, Di Mento B, Smead M, Doyle K, Grace R, McClean T, Blight V, Wood A, Raine KH. "Watch Me Grow- Electronic (WMG-E)" surveillance approach to identify and address child development, parental mental health, and psychosocial needs: study protocol. BMC Health Serv Res 2021; 21:1240. [PMID: 34789234 PMCID: PMC8596348 DOI: 10.1186/s12913-021-07243-0] [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] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/29/2021] [Indexed: 11/11/2022] Open
Abstract
Background The COVID-19 pandemic and the associated economic recession has increased parental psychosocial stress and mental health challenges. This has adversely impacted child development and wellbeing, particularly for children from priority populations (culturally and linguistically diverse (CALD) and rural/regional communities) who are at an already increased risk of health inequality. The increased mental health and psychosocial needs were compounded by the closure of in-person preventive and health promotion programs resulting in health organisations embracing technology and online services. Watch Me Grow- Electronic (WMG-E) – developmental surveillance platform- exemplifies one such service. WMG-E was developed to monitor child development and guide parents towards more detailed assessments when risk is identified. This Randomised Controlled Trial (RCT) aims to expand WMG-E as a digital navigation tool by also incorporating parents’ mental health and psychosocial needs. Children and families needing additional assessments and supports will be electronically directed to relevant resources in the ‘care-as-usual’ group. In contrast, the intervention group will receive continuity of care, with additional in-person assessment and ‘warm hand over’ by a ‘service navigator’ to ensure their needs are met. Methods Using an RCT we will determine: (1) parental engagement with developmental surveillance; (2) access to services for those with mental health and social care needs; and (3) uptake of service recommendations. Three hundred parents/carers of children aged 6 months to 3 years (recruited from a culturally diverse, or rural/regional site) will be randomly allocated to the ‘care-as-usual’ or ‘intervention’ group. A mixed methods implementation evaluation will be completed, with semi-structured interviews to ascertain the acceptability, feasibility and impact of the WMG-E platform and service navigator. Conclusions Using WMG-E is expected to: normalise and de-stigmatise mental health and psychosocial screening; increase parental engagement and service use; and result in the early identification and management of child developmental needs, parental mental health, and family psychosocial needs. If effective, digital solutions such as WMG-E to engage and empower parents alongside a service navigator for vulnerable families needing additional support, will have significant practice and policy implications in the pandemic/post pandemic period. Trial registration The trial (Protocol No. 1.0, Version 3.1) was registered with ANZCTR (registration number: ACTRN12621000766819) on July 21st, 2021 and reporting of the trial results will be according to recommendations in the CONSORT Statement.
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Affiliation(s)
- V Eapen
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia. .,South Western Sydney Local Health District, Liverpool, Australia.
| | - S Woolfenden
- Sydney Children's Hospital Randwick, Randwick, Australia
| | - V Schmied
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
| | - B Jalaludin
- South Western Sydney Local Health District, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - K Lawson
- School of Business, Western Sydney University, Sydney, Australia
| | - S T Liaw
- Population Child Health Research Group, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.,WHO Collaborating Centre for eHealth, University of New South Wales, Sydney, Australia
| | - R Lingam
- Population Child Health Research Group, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - A Page
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - S Cibralic
- Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - T Winata
- South Western Sydney Local Health District, Liverpool, Australia
| | - A Mendoza Diaz
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - C Lam-Cassettari
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - J Burley
- Population Child Health Research Group, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - K Boydell
- Black Dog Institute, Sydney, Australia
| | - P Lin
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia.,South Western Sydney Local Health District, Liverpool, Australia
| | - A Masi
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - I Katz
- Social Policy Research Centre, Faculty of Arts, Design, & Architecture, University of New South Wales, Sydney, Australia
| | - A Dadich
- School of Business, Western Sydney University, Sydney, Australia
| | - J Preddy
- Murrumbidgee Local Health District, Wagga Wagga, Australia
| | - J Bruce
- Murrumbidgee Local Health District, Wagga Wagga, Australia
| | - S Raman
- South Western Sydney Local Health District, Liverpool, Australia
| | - J Kohlhoff
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia.,Karitane, Carramar, Australia
| | - J Descallar
- Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - L Karlov
- South Western Sydney Local Health District, Liverpool, Australia
| | - C Kaplun
- Ingham Institute for Applied Medical Research, Liverpool, Australia.,TeEACH -Transforming early Education and Child Health Research Centre, Western Sydney University, Sydney, Australia
| | - A Arora
- School of Health Sciences, Western Sydney University, Sydney, Australia.,Sydney Local Health District, Camperdown, Australia
| | - B Di Mento
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - M Smead
- Murrumbidgee Local Health District, Wagga Wagga, Australia
| | - K Doyle
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - R Grace
- TeEACH -Transforming early Education and Child Health Research Centre, Western Sydney University, Sydney, Australia
| | | | - V Blight
- South Western Sydney Local Health District, Liverpool, Australia
| | - A Wood
- Karitane, Carramar, Australia
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Merson F, Newby J, Shires A, Millard M, Mahoney A. The temporal stability of the Kessler Psychological Distress Scale. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1080/00050067.2021.1893603] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Francis Merson
- Graduate School of Health, University of Technology, Ultimo, Australia
| | - Jill Newby
- School of Psychology, University of New South Wales, Sydney, Australia
- Prince of Wales Hospital, Black Dog Institute, Randwick, Australia
| | - Alice Shires
- Graduate School of Health, University of Technology, Ultimo, Australia
| | - Michael Millard
- Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital and School of Psychiatry, University of New South Wales, Darlinghurst, Australia
| | - Alison Mahoney
- Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital and School of Psychiatry, University of New South Wales, Darlinghurst, Australia
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10
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Bulut E, Brewster KL. Psychological distress in middle eastern immigrants to the United States: A challenge to the healthy migrant model? Soc Sci Med 2021; 274:113765. [PMID: 33639394 DOI: 10.1016/j.socscimed.2021.113765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/29/2020] [Accepted: 02/07/2021] [Indexed: 01/09/2023]
Abstract
RATIONALE AND OBJECTIVE Research has documented a robust mental health advantage among Asian and Latino immigrants to the United States relative to the native-born. The current investigation extended this line of research, asking whether Middle Eastern immigrants to the United States enjoy a similar mental health advantage. METHODS Drawing on pooled cross-sections from the 2007-2018 National Health Interview Surveys, we used OLS regression to examine psychological distress in Middle Eastern immigrants relative to both native-born Whites and immigrants from other global regions. We used statistical interactions to assess whether gender and period differences are contingent on region of birth. RESULTS Findings reveal that the average level of psychological distress is higher among Middle Eastern immigrants than among both U.S.-born Whites and immigrants from other regions. Despite changing circumstances of migration for Middle Easterners and implementation in the United States of anti-immigrant policies, we see no evidence that distress increased more among immigrants compared to native-born Whites. Results point to greater psychological distress among Middle Eastern women than their native-born White counterparts and women from other immigrant groups, as well as Middle Eastern men. In contrast, psychological distress levels for Middle Eastern and native-born White men were indistinguishable, suggesting that the Middle Eastern mental health disadvantage in the United States is borne solely by women. CONCLUSIONS Results show that the mental health advantage enjoyed by some immigrant groups does not extend to Middle Eastern women, contradicting the healthy migrant model and challenging the assumption of a uniform mental health advantage across immigrant groups.
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Affiliation(s)
- Elif Bulut
- Postdoctoral Fellow, Center for Demography & Population Health, Florida State University, USA.
| | - Karin L Brewster
- Professor of Sociology and Research Associate, Center for Demography & Population Health, Florida State University, USA.
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11
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Atuhaire C, Brennaman L, Cumber SN, Rukundo GZ, Nambozi G. The magnitude of postpartum depression among mothers in Africa: a literature review. Pan Afr Med J 2020; 37:89. [PMID: 33244352 PMCID: PMC7680231 DOI: 10.11604/pamj.2020.37.89.23572] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 05/21/2020] [Indexed: 11/12/2022] Open
Abstract
Introduction postpartum depression (PPD) continues to become one of the major maternal health challenges across the globe but there is a paucity of recent data on its magnitude in Africa. This study was motivated by the need to update the current magnitude of PPD in Africa based on various assessment tools. Methods a total of 21 articles met the study criteria. Fifteen articles used the EPDS and six used other assessment tools. Postpartum depression among studies that used EPDS tool ranged from 6.9% in Morocco to 43% in Uganda and 6.1% in Uganda to 44% in Burkina Faso among studies that used other depression assessment tools. Sensitivity and specificity results of the EPDS ranged from 75%-100% and 87%-98% respectively. Results a total of 21 articles met the study criteria. Fifteen articles used the EPDS and six used other assessment tools. Postpartum depression among studies that used EPDS tool ranged from 6.9% in Morocco to 43% in Uganda and 6.1% in Uganda to 44% in Burkina Faso among studies that used other depression assessment tools. Sensitivity and specificity results of the EPDS ranged from 75%-100% and 87%-98% respectively. Conclusion despite the limited dearth of literature, the magnitude of PPD in Africa remains high which suggests that PPD is still a neglected illness and calls for immediate interventions. EPDS is an effective tool with high sensitivity and specify in varying study contexts.
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Affiliation(s)
- Catherine Atuhaire
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Laura Brennaman
- Nova Southeastern University College of Nursing, Fort Myers Campus, 3650 Colonial Court, Fort Myers, Florida, United State of America
| | - Samuel Nambile Cumber
- Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, South Africa.,Office of the Dean, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.,School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Institute of Health and Care Sciences, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Godfrey Zari Rukundo
- Faculty of Medicine, Department of Psychiatry, Mbarara University of Science and Technology, Uganda
| | - Grace Nambozi
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda
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12
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Doran EL, Bartel AP, Ruhm CJ, Waldfogel J. California's paid family leave law improves maternal psychological health. Soc Sci Med 2020; 256:113003. [PMID: 32464413 DOI: 10.1016/j.socscimed.2020.113003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 02/26/2020] [Accepted: 04/18/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To study the effect of California's first in the nation paid family leave policy on maternal postpartum psychological distress for women overall and for disadvantaged groups. METHODS We use restricted data from 11 waves of the National Health Interview Survey, from 2000 to 2010, to examine mothers with children under the age of 12 months (n = 7379). Outcomes included three measures obtained from the six-item Kessler Psychological Distress Scale: an aggregated score and thresholds for mild and moderate psychological distress. For inference, we used synthetic control models, comparing mothers with infants in California to mothers with infants in the control group, pre-law and post-law. RESULTS Access to paid family leave was associated with a 0.636-point decrease (95% CI = -1.202, -0.070) in postpartum psychological distress symptoms among mothers with infants, representing a 27.6% decrease from the pre-treatment mean. It was also associated with a 9.1 percentage point reduction (95% CI = -17.8, -0.4) in mild postpartum distress, a 38.4% reduction from the pre-treatment mean. Populations that typically lack access to paid family leave, particularly single and younger mothers, may have seen even larger effects. CONCLUSIONS Paid family leave was associated with improved mental health for California mothers, suggesting that expansions of state or federal paid family leave policies have the potential to improve maternal postpartum health.
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Affiliation(s)
- Elizabeth L Doran
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA.
| | - Ann P Bartel
- Columbia Business School, 3022 Broadway, 623 Uris Hall New York, NY, 10027, USA
| | - Christopher J Ruhm
- Frank Batten School of Leadership and Public Policy University of Virginia 235 McCormick Rd.P.O. Box 400893 Charlottesville, VA, 22904, USA
| | - Jane Waldfogel
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
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13
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Wang Y, Xu L, Qin W, Zhang J, Xia Y, Jing X, Lu L, Jiao A, Li Y. Gender Difference in General Self-Efficacy among Young-Old Elderly Aged 60-74 in Rural Shandong China: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E5070. [PMID: 31842316 PMCID: PMC6950069 DOI: 10.3390/ijerph16245070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study aims to explore the determinants of general self-efficacy (GSE) among young-old elderly, with focus on examining the gender difference of general self-efficacy. METHODS Data were collected from the 2017 Survey of the Shandong Elderly Family Health Service, which was conducted by Shandong University. T-test was used to examine the gender difference in GSE. Univariate models and adjusted multiple linear regression model were used to explore the determinants of GSE by gender. RESULTS The females' GSE score was lower than that of male participants (26.1 ± 8.1 vs. 28.7 ± 7.7), and there was a significant gender difference (t = 10.877, p < 0.001). Multiple linear regression model showed that some factors are common significant determinants of GSE such as age, education level, activity of daily living (ADL), self-rated health, mental health, personality, and whether participants have intimate friends and interpersonal relationships. Hypertension and frequent communication with children were specific determinants of GSE among male young-old. Personal income was a specific determinant of female participants. CONCLUSION Some influencing factors of GSE in both genders are identical, the others are different. More attention should be paid for the poor young-old females, young-old males with hypertension, and disabled young-old people.
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Affiliation(s)
- Yali Wang
- School of Public Health, Shandong University, Jinan 250012, China; (Y.W.); (W.Q.); (J.Z.); (Y.X.); (X.J.); (L.L.); (A.J.); (Y.L.)
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
- Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan 250012, China
| | - Lingzhong Xu
- School of Public Health, Shandong University, Jinan 250012, China; (Y.W.); (W.Q.); (J.Z.); (Y.X.); (X.J.); (L.L.); (A.J.); (Y.L.)
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
- Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan 250012, China
| | - Wenzhe Qin
- School of Public Health, Shandong University, Jinan 250012, China; (Y.W.); (W.Q.); (J.Z.); (Y.X.); (X.J.); (L.L.); (A.J.); (Y.L.)
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
- Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan 250012, China
| | - Jiao Zhang
- School of Public Health, Shandong University, Jinan 250012, China; (Y.W.); (W.Q.); (J.Z.); (Y.X.); (X.J.); (L.L.); (A.J.); (Y.L.)
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
- Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan 250012, China
| | - Yu Xia
- School of Public Health, Shandong University, Jinan 250012, China; (Y.W.); (W.Q.); (J.Z.); (Y.X.); (X.J.); (L.L.); (A.J.); (Y.L.)
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
- Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan 250012, China
| | - Xiang Jing
- School of Public Health, Shandong University, Jinan 250012, China; (Y.W.); (W.Q.); (J.Z.); (Y.X.); (X.J.); (L.L.); (A.J.); (Y.L.)
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
- Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan 250012, China
| | - Lu Lu
- School of Public Health, Shandong University, Jinan 250012, China; (Y.W.); (W.Q.); (J.Z.); (Y.X.); (X.J.); (L.L.); (A.J.); (Y.L.)
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
- Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan 250012, China
| | - An’an Jiao
- School of Public Health, Shandong University, Jinan 250012, China; (Y.W.); (W.Q.); (J.Z.); (Y.X.); (X.J.); (L.L.); (A.J.); (Y.L.)
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
- Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan 250012, China
| | - Yaozu Li
- School of Public Health, Shandong University, Jinan 250012, China; (Y.W.); (W.Q.); (J.Z.); (Y.X.); (X.J.); (L.L.); (A.J.); (Y.L.)
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
- Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan 250012, China
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Al-Thani MA, Khaled SM. "Toxic pleasures": A study of eating out behavior in Arab female university students and its associations with psychological distress and disordered eating. Eat Behav 2018; 31:125-130. [PMID: 30261365 DOI: 10.1016/j.eatbeh.2018.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 08/27/2018] [Accepted: 08/31/2018] [Indexed: 12/20/2022]
Abstract
University years are a critical period in which young people establish independence and adopt lasting health behaviors. The aim of this study was to estimate the associations between eating out, psychological distress, and disordered eating behaviors among young Arab females in Qatar a rapidly developing small nation. A cross-sectional probability-based survey of 1615 Qatar University's female students assessed the frequency of eating out (main independent variable) and other eating behaviors in relation to two main dependent variables, disordered eating and psychological distress, which were measured using the Eating Attitudes Test and the Kessler Psychological Distress Scale, respectively. Multivariable logistic-regression analyses were used to estimate these two main associations with and without adjustment for other potential confounding variables, including the main effects of psychological distress and disordered eating on each other. Of the students, 45% reported eating out 3 times or more a week. Furthermore, approximately 18% screened positive for disordered eating and 33% reported high levels of psychological distress in the past 30 days. After adjustment for other variables, eating out 5 times or more a week was not significantly associated with the odds of disordered eating (OR 1.21, p = 0.32). However, eating out 5 times or more per week was significantly associated with odds of having psychological distress (OR 1.46, p = 0.03). Both psychological distress and disordered eating were strongly associated with each other (OR 2.58, p < 0.001).
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Affiliation(s)
- Maryam A Al-Thani
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar.
| | - Salma M Khaled
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar
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15
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Prenatal depression, fetal neurobehavior, and infant temperament: Novel insights on early neurodevelopment from a socioeconomically disadvantaged Indian cohort. Dev Psychopathol 2018; 30:725-742. [PMID: 30068420 DOI: 10.1017/s0954579418000615] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This article extends the research focusing on the early origins of psychopathology into the prenatal period, by exploring the association between maternal prenatal depression and offspring (fetal and infant) neurobehavior. The sample is recruited from a rural population in South India where women in the third trimester of pregnancy were assessed for depression and the heart rate responses of their fetuses to extrinsically applied vibroacoustic stimuli were studied. At 2 months postbirth, infant temperament and cortisol responsivity to immunization were assessed. The association between maternal prenatal depression and fetal responsivity to vibroacoustic stimulation, and infant responsivity to immunization, was U shaped with higher levels of responsivity noted in the offspring of mothers with very high and very low depression scores, and lower levels noted in the offspring of mothers with moderate depression scores. Maternal prenatal depression was not associated with infant temperament. The findings highlight the importance of environmental influences in the developmental origins of neurobehavior, suggesting that such differences, not evident at baseline, may emerge upon exposure to stressors. The study also emphasizes the need for further investigation in low- and middle-income contexts by providing preliminary evidence of the differing patterns of association observed between high- and low-income populations.
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16
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Vissoci JRN, Vaca SD, El-Gabri D, de Oliveira LP, Mvungi M, Mmbaga BT, Haglund M, Staton C. Cross-cultural adaptation and psychometric properties of the Kessler Scale of Psychological Distress to a traumatic brain injury population in Swahili and the Tanzanian Setting. Health Qual Life Outcomes 2018; 16:147. [PMID: 30053816 PMCID: PMC6062865 DOI: 10.1186/s12955-018-0973-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 07/09/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND To evaluate the psychometric properties of a Swahili version of the Kessler Psychological Distress scale in an injury population in Tanzania. METHODS Swahili version of the Kessler Psychological Distress scale was developed by translation and back-translation by a panel of native speakers of both English and Swahili. The translated instruments were administered to a sample of Tanzanian adults from a traumatic brain injury registry. The content validity, construct validity, reliability, internal structure, and external reliability were analyzed using standard statistical methods. RESULTS Both translated versions of the Kessler Psychological Distress scale were found to be reliable (>0.85) for all tested versions. Confirmatory factor analysis of one and two factor solution showed adequate results. Kessler Psychological Distress scale scores were strongly correlated to depression and quality of life (R>0.50). CONCLUSIONS This paper presents the first Swahili adaptations of the Kessler Psychological Distress scale as well as the first validation of these questionnaires in Tanzania. The instrument was found to have acceptable psychometric properties, resulting in a new useful tool for medical and social research in this setting.
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Affiliation(s)
- Joao Ricardo Nickenig Vissoci
- Duke Emergency Medicine, Duke University Medical Center, 8 Duke University Medical Center Greenspace, Durham, NC, 27703, USA.
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA.
- Department of Neurosurgery, Duke University, Durham, NC, USA.
| | | | - Deena El-Gabri
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | | | - Mark Mvungi
- Kilimanjaro Christian Medical Center, Moshi, Tanzania
| | - Blandina Theophil Mmbaga
- Kilimanjaro Christian Medical Center, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Michael Haglund
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- Department of Neurosurgery, Duke University, Durham, NC, USA
| | - Catherine Staton
- Duke Emergency Medicine, Duke University Medical Center, 8 Duke University Medical Center Greenspace, Durham, NC, 27703, USA
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
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17
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Lace JW, Merz ZC, Grant AF, Emmert NA, Zane KL, Handal PJ. Validation of the K6 and its depression and anxiety subscales for detecting nonspecific psychological distress and need for treatment. CURRENT PSYCHOLOGY 2018. [DOI: 10.1007/s12144-018-9846-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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18
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van Heyningen T, Honikman S, Tomlinson M, Field S, Myer L. Comparison of mental health screening tools for detecting antenatal depression and anxiety disorders in South African women. PLoS One 2018; 13:e0193697. [PMID: 29668725 PMCID: PMC5906008 DOI: 10.1371/journal.pone.0193697] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 02/18/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Antenatal depression and anxiety disorders are highly prevalent in low and middle-income countries. Screening of pregnant women in primary care antenatal settings provides an opportunity for entry to care, but data are needed on the performance of different screening tools. We compared five widely-used questionnaires in a sample of pregnant women in urban South Africa. METHOD Pregnant women attending a primary care antenatal clinic were administered five tools by trained research assistants: the Edinburgh Postnatal Depression Scale (EPDS), the Patient Health Questionnaire (PHQ-9), the Kessler Psychological Distress scale (K10) and a shortened 6-item version (K6), the Whooley questions and the two-item Generalised Anxiety Disorder scale (GAD-2). Following this, a registered mental health counsellor administered the MINI Plus, a structured clinical diagnostic interview. The Area Under the Curve (AUC) from Receiver Operator Characteristic curve analysis was used to summarise screening test performance and Cronbach's α used to assess internal consistency. RESULTS Of 376 participants, 32% were diagnosed with either MDE and/or anxiety disorders. All five questionnaires demonstrated moderate to high performance (AUC = 0.78-0.85). The EPDS was the best performing instrument for detecting MDE and the K10 and K6 for anxiety disorder. For MDE and/or anxiety disorders, the EPDS had the highest AUC (0.83). Of the short instruments, the K10 (AUC = 0.85) and the K6 (AUC = 0.85) performed the best, with the K6 showing good balance between sensitivity (74%) and specificity (85%) and a good positive predictive value (70%). The Whooley questions (AUC = 0.81) were the best performing ultra-short instrument. Internal consistency ranged from good to acceptable (α = 0.89-0.71). However, the PPV of the questionnaires compared with the diagnostic interview, ranged from 54% to 71% at the optimal cut-off scores. CONCLUSIONS Universal screening for case identification of antenatal depression and anxiety disorders in low-resource settings can be conducted with a number of commonly used screening instruments. Short and ultra-short screening instruments such as the K6 and the Whooley questions may be feasible and acceptable for use in these settings.
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Affiliation(s)
- Thandi van Heyningen
- Perinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Division of Epidemiology & Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Simone Honikman
- Perinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Mark Tomlinson
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
- Lead investigator of the Centre of Excellence in Human Development, University Witwatersrand, Johannesburg, South Africa
| | - Sally Field
- Perinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Landon Myer
- Division of Epidemiology & Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Tol WA, Rees SJ, Tay AK, Tam N, da Costa Saldanha Segurado A, da Costa ZM, da Costa Soares ES, da Costa Alves A, Martins N, Silove DM. Cohort Profile: Maternal mental health and child development in situations of past violent conflict and ongoing adversity: the DILI birth cohort study. Int J Epidemiol 2018; 47:17-17h. [PMID: 29471471 DOI: 10.1093/ije/dyw130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2016] [Indexed: 11/12/2022] Open
Affiliation(s)
- W A Tol
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - S J Rees
- Psychiatry Research and Teaching Unit, University of New South Wales, and Academic Mental Health Unit, Sydney South West Local Health District, Sydney, NSW, Australia
| | - A K Tay
- Psychiatry Research and Teaching Unit, University of New South Wales, and Academic Mental Health Unit, Sydney South West Local Health District, Sydney, NSW, Australia
| | - N Tam
- Psychiatry Research and Teaching Unit, University of New South Wales, and Academic Mental Health Unit, Sydney South West Local Health District, Sydney, NSW, Australia.,Alola Foundation, Dili, Timor-Leste
| | | | - Z M da Costa
- Psychiatry Research and Teaching Unit, University of New South Wales, and Academic Mental Health Unit, Sydney South West Local Health District, Sydney, NSW, Australia.,Alola Foundation, Dili, Timor-Leste
| | - E S da Costa Soares
- Psychiatry Research and Teaching Unit, University of New South Wales, and Academic Mental Health Unit, Sydney South West Local Health District, Sydney, NSW, Australia.,Alola Foundation, Dili, Timor-Leste
| | - A da Costa Alves
- Psychiatry Research and Teaching Unit, University of New South Wales, and Academic Mental Health Unit, Sydney South West Local Health District, Sydney, NSW, Australia.,Alola Foundation, Dili, Timor-Leste
| | - N Martins
- Faculty of Medicine & Health Science, Universidade Nacional Timor Lorosa'e, Dili, Timor-Leste
| | - D M Silove
- Psychiatry Research and Teaching Unit, University of New South Wales, and Academic Mental Health Unit, Sydney South West Local Health District, Sydney, NSW, Australia
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Greco G, Skordis-Worrall J, Mills A. Development, Validity, and Reliability of the Women's Capabilities Index. JOURNAL OF HUMAN DEVELOPMENT AND CAPABILITIES 2018; 19:271-288. [PMID: 29973972 PMCID: PMC6021763 DOI: 10.1080/19452829.2017.1422704] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We report the results of a series of validity and reliability tests performed during the development of the Women's Capabilities Index (WCI) in Malawi. The WCI is a multidimensional measure based on Sen's capability framework for assessing women's quality of life. Construct validity was assessed by investigating the expected relationships of the dimensions with key socioeconomic characteristics. The majority of hypothesized associations were found to be statistically significant in the expected direction. This provides evidence that the index is measuring quality of life as intended in the conceptual model. Further evidence in support of the index's validity was given by the high degree of correlation between the WCI and another scale measuring comparable (but not identical) domains of quality of life. The results from the internal consistency and the test-retest repeatability also offered encouraging evidence on the reliability of the instrument. This is the first study to rigorously and comprehensively test for validity and reliability a capabilities index for a low-income setting. The results of the validity and reliability tests provide supportive evidence that a locally developed measure of capabilities can be used as a robust tool for the assessment of women's quality of life.
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Affiliation(s)
- Giulia Greco
- Department for global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Jolene Skordis-Worrall
- The Centre for Global Health Economics, Institute for Global Health, University College London, London, UK
| | - Anne Mills
- Department for global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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21
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Carta MG, Moro D, Wallet Oumar F, Moro MF, Pintus M, Pintus E, Minerba L, Sancassiani F, Pascolo-Fabrici E, Preti A, Bhugra DK. A Follow-Up on Psychiatric Symptoms and Post-Traumatic Stress Disorders in Tuareg Refugees in Burkina Faso. Front Psychiatry 2018; 9:127. [PMID: 29740352 PMCID: PMC5928199 DOI: 10.3389/fpsyt.2018.00127] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 03/26/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The aim of this study was to carry out a 2-year follow-up of refugees in a camp in Burkina Faso who had been interviewed previously. We also aimed to verify whether the general conditions in which they lived (e.g., protection by international organizations and the conclusion of negotiations and new hope of returning to Mali and reunification with surviving family members) would affect their mental health state. METHODS This is a cross-sectional study repeated over time on a cohort of refugees. People living in the Subgandé camp who had participated in the first survey in 2012 were identified using informational chains and approached for follow-up. Those who agreed were interviewed using the Short Screening Scale for post-traumatic stress disorder (PTSD) and the K6 scale, French versions, to measure general psychopathology and the level of impairment. RESULTS The second survey shows a dramatic decrease in psychopathological symptoms (positivity at K6 scale). Improvement was also conspicuous in the frequency of people with stress symptoms (positivity at Short Screening Scale for PTSD and simultaneous positivity to K6 scale). The frequency of people screened positive at the Short Screening Scale for PTSD had also decreased, but the level of improvement was not pronounced. CONCLUSION Our findings confirm that when physical conditions improve, psychological symptoms can also improve. Although in the studied sample psychological factors, such as the hope of returning to their own land and thus the possibility of maintaining ethnic cohesion, may have played a role, future research carried out with a proper methodology and sufficient resources to identify protective factors is needed.
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Affiliation(s)
- Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Daniela Moro
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Fadimata Wallet Oumar
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Maria Francesca Moro
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mirra Pintus
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Elisa Pintus
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Luigi Minerba
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Antonio Preti
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Dinesh Kumar Bhugra
- Health Service and Population Research Department (HSPRD), Institute of Psychiatry, King's College London, London, United Kingdom
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22
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Psychometric Properties of the Kessler 10 Scale in Chinese Parents of Children With Cancer. Cancer Nurs 2017; 40:297-304. [PMID: 27257800 DOI: 10.1097/ncc.0000000000000392] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The Kessler Psychological Distress Scale (K10) has been widely used in rating psychological distress in general and clinical populations. However, whether it can be used in parents of children with cancer is unknown. Still lacking is the evidence on its reliability and validity in culturally diverse groups. OBJECTIVE The aim of this study was to translate the K10 into Mandarin Chinese and test its psychometric properties (especially the factor structure) of the Chinese version (C-K10) in parents of children with cancer. METHODS By convenience sampling, 2 samples of parents of children with cancer (sample I, n = 206, and sample II, n = 103) were surveyed in Guangzhou, China. Sample I completed the C-K10, and the internal consistency reliability and exploratory factor analysis of the C-K10 were estimated. Sample II completed the C-K10, the State Subscale of State-Trait Anxiety Inventory, and the Zung Self-rating Depression Scale; confirmatory factor analysis and concurrent validity estimates were completed. RESULTS The C-K10 demonstrated strong internal consistency reliability (Cronbach's α = .93). Both exploratory and confirmatory factor analyses supported a 2-factor structure (ie, anxiety and depression). The concurrent validity was moderate with Pearson correlations greater than 0.50 (P < .001). CONCLUSION The C-K10 demonstrated very acceptable reliability and validity in screening psychological distress in Chinese parents of children with cancer. IMPLICATIONS FOR PRACTICE This study provides evidence that the C-K10 is a valid tool that can be used in clinical settings to screen for psychological distress in Chinese parents of children with cancer.
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Pigeon-Gagné É, Hassan G, Yaogo M, Ridde V. An exploratory study assessing psychological distress of indigents in Burkina Faso: a step forward in understanding mental health needs in West Africa. Int J Equity Health 2017; 16:143. [PMID: 28806966 PMCID: PMC5557325 DOI: 10.1186/s12939-017-0633-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 07/24/2017] [Indexed: 11/21/2022] Open
Abstract
Background Poverty is known as an important determinant of health, but empirical data are still missing on the relationships between poverty, other adverse living conditions, and psychological distress, particularly in low-income countries. This study aimed to assess mental health needs and psychological distress among the poorest in rural settings in Burkina Faso where food security and access to water, electricity, schooling, and healthcare are limited. Methods We randomly selected 2000 individuals previously identified as indigents by a community-targeting process. Interviewers visited participants (n = 1652) in their homes and completed a questionnaire on mental health variables that included presence and intensity of anxious, depressive, psychotic, and aggressive symptoms, as well as level of psychological distress. Descriptive statistics, Spearman correlations, and logistic regressions were performed. Results In all, 40.2% of the sample reported 10 or more anxious/depressive symptoms in the past 30 days, and 25.5% reported having experienced at least one psychotic symptom over their lifetime, 65.6% of whom had had those symptoms for many years. The number of anxious and depressive symptoms was significantly associated with the level of psychological distress (r = 0.423, p < .001). Predictors of distress level included: poor health condition (F(1) = 23.743, p <. 001), being a woman (F(1) = 43.926, p < .001), not having any income (F(1) = 16.185, p < .001), having begged for food in the past 30 days (F(1) = 12.387, p < .001), being illiterate, and being older (F(1) = 21.487, p < .001). Approximately one third of respondents reporting anxious/depressive or psychotic symptoms (28.2 and 30.0%, respectively) had not talked about their symptoms to anyone in their social network. Conclusions These results suggest alarmingly high levels of psychological distress and reported symptoms among the poorest in rural settings in Burkina Faso, which can be explained by their difficult living conditions. However, these results must be interpreted from a transcultural perspective to avoid decontextualized misinterpretations. Ethnographic works are needed to document the larger context within which these distress results can be analyzed.
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Affiliation(s)
- Émilie Pigeon-Gagné
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada.
| | - Ghayga Hassan
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada
| | - Maurice Yaogo
- Département Lettres et Sciences Humaines (LSH), Université Catholique de l'Afrique de l'Ouest, Unité Universitaire à Bobo-Dioulasso (UCAO-UUB), Bobo-Dioulasso, Burkina Faso
| | - Valéry Ridde
- Department of Social and Preventive Medicine, University of Montreal School of Public Health (ESPUM), Montreal, Canada.,University of Montreal Public Health Research Institute (IRSPUM), Montreal, Canada
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Gust DA, Gvetadze R, Furtado M, Makanga M, Akelo V, Ondenge K, Nyagol B, McLellan-Lemal E. Factors associated with psychological distress among young women in Kisumu, Kenya. Int J Womens Health 2017; 9:255-264. [PMID: 28496366 PMCID: PMC5422460 DOI: 10.2147/ijwh.s125133] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Attention to mental health issues is growing globally. In many countries, including Kenya, however, assessment of psychological distress, especially in rural areas, is limited. METHODS We analyzed data from young women screened for a longitudinal contraceptive ring study in Kisumu, Kenya. Multivariable regression analysis was used to assess factors associated with recent moderate and high psychological distress, as measured by the Kessler (K-6) psychological distress scale. RESULTS Among the 461 women screened, most (58.4%) were categorized as having moderate psychological distress, 20.8% were categorized as having low or no psychological distress, and 20.8% were categorized as having high psychological distress. Moderate psychological distress (vs low/no) was significantly more likely among women who reported a history of forced sex and were concerned about recent food insecurity. High (vs low/no) psychological distress was significantly more likely among women who reported a history of forced sex, who were concerned about recent food insecurity, and who self-reported a sexually transmitted infection. CONCLUSION To reduce psychological distress, a focus on prevention as well as care methods is needed. Girls need a path toward a healthy and productive adulthood with a focus on education, which would help them gain skills to avoid forced sex. Women would benefit from easy access to social services and supports that would help them with basic needs like food security among other things. A holistic or ecological approach to services that would address mental, educational, social, health, and economic issues may have the highest chance of having a long-term positive impact on public health.
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Affiliation(s)
- Deborah A Gust
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention
| | - Roman Gvetadze
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention
| | | | - Mumbi Makanga
- HIV Research Branch, Kenya Medical Research Institute, Kisumu, Kenya
| | - Victor Akelo
- HIV Research Branch, Kenya Medical Research Institute, Kisumu, Kenya
| | - Kenneth Ondenge
- HIV Research Branch, Kenya Medical Research Institute, Kisumu, Kenya
| | - Beatrice Nyagol
- HIV Research Branch, Kenya Medical Research Institute, Kisumu, Kenya
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Batura N, Skordis-Worrall J, Thapa R, Basnyat R, Morrison J. Is the Job Satisfaction Survey a good tool to measure job satisfaction amongst health workers in Nepal? Results of a validation analysis. BMC Health Serv Res 2016; 16:308. [PMID: 27461030 PMCID: PMC4962514 DOI: 10.1186/s12913-016-1558-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 07/15/2016] [Indexed: 11/10/2022] Open
Abstract
Background Job satisfaction is an important predictor of an individual’s intention to leave the workplace. It is increasingly being used to consider the retention of health workers in low-income countries. However, the determinants of job satisfaction vary in different contexts, and it is important to use measurement methods that are contextually appropriate. We identified a measurement tool developed by Paul Spector, and used mixed methods to assess its validity and reliability in measuring job satisfaction among maternal and newborn health workers (MNHWs) in government facilities in rural Nepal. Methods We administered the tool to 137 MNHWs and collected qualitative data from 78 MNHWs, and district and central level stakeholders to explore definitions of job satisfaction and factors that affected it. We calculated a job satisfaction index for all MNHWs using quantitative data and tested for validity, reliability and sensitivity. We conducted qualitative content analysis and compared the job satisfaction indices with qualitative data. Results Results from the internal consistency tests offer encouraging evidence of the validity, reliability and sensitivity of the tool. Overall, the job satisfaction indices reflected the qualitative data. The tool was able to distinguish levels of job satisfaction among MNHWs. However, the work environment and promotion dimensions of the tool did not adequately reflect local conditions. Further, community fit was found to impact job satisfaction but was not captured by the tool. The relatively high incidence of missing responses may suggest that responding to some statements was perceived as risky. Conclusion Our findings indicate that the adapted job satisfaction survey was able to measure job satisfaction in Nepal. However, it did not include key contextual factors affecting job satisfaction of MNHWs, and as such may have been less sensitive than a more inclusive measure. The findings suggest that this tool can be used in similar settings and populations, with the addition of statements reflecting the nature of the work environment and structure of the local health system. Qualitative data on job satisfaction should be collected before using the tool in a new context, to highlight any locally relevant dimensions of job satisfaction not already captured in the standard survey.
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Kinzie E, Blake A, Alvares R, McCormick-Ricket I. Mental Health Screening in North Sulawesi, Indonesia: Kessler 6 pilot data and needs assessment results from the LearnToLive Indonesian Health Initiative. Asia Pac Psychiatry 2016; 8:118-26. [PMID: 26391808 DOI: 10.1111/appy.12211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 08/18/2015] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Communities around the world are increasing their focus on mental health and substance use disorders. However, the struggle to identify and treat patients remains great. The sequelae of these disorders, including severe chronic disability and suicide, are significant, and its impact is felt most in lower and middle-income countries. In the rural and underserved region of North Sulawesi, Indonesia, there are limited data published regarding the prevalence of depression, anxiety, and other symptoms of psychological distress. METHODS In order to characterize and quantify some specific areas of psychological distress, the LearnToLive Indonesian Health Initiative completed a retroactive review of Kessler 6 data from 697 people in rural communities of North Sulawesi. RESULTS Our results demonstrate a rate of near 10% for psychological distress, particularly with anxiety and depressive symptoms. We also found that the village of Sapa scored higher on most of the subcomponents of the screen compared with the other villages in the study. DISCUSSION While the Kessler 6 screening tool is not diagnostic, our results suggest significant mental health issues in need of further exploration and research. We found that these results exist in an environment with high stigma, limited education regarding mental illness, and limited outpatient services. The results from this analysis will hopefully guide future mental health education in the region and will ultimately assist in the development of the clinical infrastructure needed to effectively identify, treat, and manage mental health conditions.
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Affiliation(s)
- Erik Kinzie
- Department of Psychiatry, Tulane University School of Medicine, New Orleans, LA, USA.,Division of Mental and Behavioral Health, Our Lady of the Lake Regional Medical Center, Baton Rouge, LA, USA
| | | | - Ryan Alvares
- Department of Psychiatry, Tulane University School of Medicine, New Orleans, LA, USA
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Filippi V, Ganaba R, Calvert C, Murray SF, Storeng KT. After surgery: the effects of life-saving caesarean sections in Burkina Faso. BMC Pregnancy Childbirth 2015; 15:348. [PMID: 26694035 PMCID: PMC4688946 DOI: 10.1186/s12884-015-0778-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 12/07/2015] [Indexed: 11/10/2022] Open
Abstract
Background In African countries, caesarean sections are usually performed to save mothers and babies’ lives, sometimes in extremis and at considerable costs. Little is known about the health and lives of women once discharged after such surgery. We investigated the long-term effects of life-saving caesarean section on health, economic and social outcomes in Burkina Faso. Methods We conducted a 4 year prospective cohort study of women and their babies using mixed methods. The quantitative sample was selected in seven hospitals and included 950 women: 100 women with a caesarean section associated with near-miss complication (life-saving caesareans); 173 women with a vaginal birth associated with near-miss complication; and 677 women with uncomplicated vaginal childbirth. Structured interviews were conducted at 3 months, 6 months, 12 months and 3 and 4 years postpartum. These were supplemented by medical record data on delivery and physical examinations at 6 and 12 months postpartum. The lives and experiences of 21 women were documented ethnographically. Data were analysed with multivariable logistic regressions, using survival analysis and thematic analysis. Results The physical effects of life-saving caesareans appeared to be similar to women who had an uncomplicated childbirth, although 55 % of women with life-saving caesareans had another caesarean in their next pregnancy. The negative effects were generally economic, social and reproductive when compared to vaginal births, including increased debts (AOR = 3.91 (1.46–10.48) and sexual violence (AOR = 4.71 (1.04–21.3)) and lower fertility (AOR = 0.44 (0.24–0.80)) 4 years after life-saving caesareans. In the short and medium term, women with life-saving caesareans appeared to suffer increased psychological distress compared to uncomplicated births. They were more likely to use contraceptives (AOR = 5.95 (1.53–23.06); 3 months). Mortality of the index child was increased in both near-miss groups, independent of delivery mode. Ethnographic data suggest that these consequences are significant for Burkinabe women, whose well-being and social standing are mostly determined by their fertility, marriage strength and family links. Conclusions Life-saving caesareans have broad consequences beyond clinical sequelae. The recent policy to subsidise emergency obstetric care costs implemented in Burkina Faso should help avoid the majority of catastrophic costs, shown to be problematic for women undergoing emergency caesarean section.
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Affiliation(s)
| | | | - Clara Calvert
- London School of Hygiene and Tropical Medicine, London, UK.
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Kang YK, Guo WJ, Xu H, Chen YH, Li XJ, Tan ZP, Li N, Gesang ZR, Wang YM, Liu CB, Luo Y, Feng J, Xu QJ, Lee S, Li T. The 6-item Kessler psychological distress scale to survey serious mental illness among Chinese undergraduates: Psychometric properties and prevalence estimate. Compr Psychiatry 2015; 63:105-12. [PMID: 26555498 DOI: 10.1016/j.comppsych.2015.08.011] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 08/18/2015] [Accepted: 08/30/2015] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To evaluate the psychometric properties of the 6-item Kessler psychological distress scale (K6) in screening for serious mental illness (SMI) among undergraduates in a major comprehensive university in China. METHOD The K6 was self-completed by 8289 randomly sampled participants. A group of them (n=222) were re-assessed using K6 and interviewed using the Chinese version of Composite International Diagnostic Interview 3.1 (CIDI-3.1). RESULTS The test-retest reliability of the K6 scale was 0.79, the Cronbach's alpha was 0.84, and its area under the receiver operating curve (AUC) for diagnosing CIDI-3.1 SMI was 0.85 (95% CI=0.80-0.90). For the optimal cut-off of K6 (12/13), the sensitivity (SEN), specificity (SPE), positive predictive value (PPV), negative predictive value (NPV), and classification accuracy (AC) were 0.83, 0.79, 0.60, 0.93, and 0.80, respectively. The 12-month prevalence of SMI was estimated as 3.97% using this optimal cut-off. Binary logistic regression analysis (including gender, ethnicity, grade, number of siblings and family residency location) showed that only family residency location in rural areas compared to urban areas was significantly associated with more SMI. CONCLUSIONS This study documented the value of using the K6 for detecting SMI in Chinese undergraduate populations and supported its cross-cultural reliability and validity.
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Affiliation(s)
- Yu-kun Kang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Wan-jun Guo
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; State Key Laboratory of Biotherapy, Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
| | - Hao Xu
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, PR China
| | - Yue-hui Chen
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, PR China
| | - Xiao-jing Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Zheng-ping Tan
- Mental Health Education Center, Sichuan University, Chengdu, Sichuan, PR China
| | - Na Li
- Mental Health Education Center, Sichuan University, Chengdu, Sichuan, PR China
| | - Ze-Ren Gesang
- Mental Health Education Center, Sichuan University, Chengdu, Sichuan, PR China
| | - Ying-mei Wang
- Mental Health Education Center, Sichuan University, Chengdu, Sichuan, PR China
| | - Chang-bo Liu
- Mental Health Education Center, Sichuan University, Chengdu, Sichuan, PR China
| | - Ying Luo
- Mental Health Education Center, Sichuan University, Chengdu, Sichuan, PR China
| | - Jia Feng
- Mental Health Education Center, Sichuan University, Chengdu, Sichuan, PR China
| | - Qiu-jie Xu
- Mental Health Education Center, Sichuan University, Chengdu, Sichuan, PR China
| | - Sing Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, PR China
| | - Tao Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; State Key Laboratory of Biotherapy, Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; West China School of Public Health, Sichuan University, Chengdu, Sichuan, PR China
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Fernandes M, Stein A, Srinivasan K, Menezes G, Ramchandani PG. Foetal exposure to maternal depression predicts cortisol responses in infants: findings from rural South India. Child Care Health Dev 2015; 41:677-86. [PMID: 25131942 DOI: 10.1111/cch.12186] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/18/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Maternal depression during pregnancy is associated with an increased risk of adverse child outcomes. One potential mechanism is the influence of antenatal depression on the foetal hypothalamic-pituitary-adrenal axis. This can be observed as disturbances in baseline cortisol secretion during childhood. The influence of antenatal depression on infant cortisol reactivity to a stressor may provide further insight into this association. In addition, the dose-response relationship between foetal exposure to antenatal depression and infant cortisol reactivity is unclear. METHODS A consecutive sample of 133 pregnant women in their third trimester was recruited from an antenatal clinic in Karnataka, South India. Women were assessed for depression before and after birth on the Edinburgh Postnatal Depression Scale (EPDS) and the Kessler 10 Scale. Salivary cortisol response to immunization was measured in 58 infants at 2 months of age. We aimed (i) to investigate the association between antenatal depression and infant cortisol reactivity to immunization and (ii) to explore whether the relationship is dose-dependent. RESULTS Exposure to antenatal depression independently predicted elevated infant cortisol responses to immunization (β = 0.53, P = 0.04). The association was found to be U-shaped, for antenatal depression measured on the EPDS, with the infants exposed to the highest and lowest levels of maternal antenatal EPDS scores during intra-uterine life showing elevated cortisol responses to immunization (R(2) = 0.20, P = 0.02). Infants exposed to moderate levels of maternal antenatal depression showed the lowest cortisol response to immunization. CONCLUSIONS These findings suggest that the association between antenatal depression and infant cortisol reactivity is dose-dependent and U-shaped, implying that infants exposed to both low and high levels of maternal depression showed greater reactivity. The study provides the first evidence of such an association from a low-income setting.
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Affiliation(s)
- M Fernandes
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK
| | - A Stein
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - K Srinivasan
- St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India
| | - G Menezes
- Snehalaya Socio-Medical Relief Centre, Solur, Ramnagara, Karnataka, India
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Bhochhibhoya A, Collado M, Branscum P, Sharma M. The Role of Global Mental Health and Type-D Personality in Predicting Alcohol Use Among a Sample of College Students. ALCOHOLISM TREATMENT QUARTERLY 2015. [DOI: 10.1080/07347324.2015.1050932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Oddo VM, Mabli J. Association of participation in the supplemental nutrition assistance program and psychological distress. Am J Public Health 2015; 105:e30-5. [PMID: 25880949 PMCID: PMC4431109 DOI: 10.2105/ajph.2014.302480] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2014] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed whether households' participation in the Supplemental Nutrition Assistance Program (SNAP) was associated with improvements in well-being, as indicated by lower rates of psychological distress. METHODS We used longitudinal data for 3146 households in 30 states, collected between October 2011 and September 2012 for the SNAP Food Security survey, the largest longitudinal national survey of SNAP participants to date. Analyses compared households within days of program entry to the same households approximately 6 months later. We measured psychological distress in the past 30 days on a 6-item Kessler screening scale and used multivariable regression to estimate associations between SNAP participation and psychological distress. RESULTS A smaller percentage of household heads exhibited psychological distress after 6 months of participation in SNAP than at baseline (15.3% vs 23.2%; difference = -7.9%). In adjusted models, SNAP participation was associated with a decrease in psychological distress (adjusted relative risk = 0.72; 95% confidence interval = 0.66, 0.78). CONCLUSIONS Continuing support for federal nutrition programs, such as SNAP, may reduce the public health burden of mental illness, thus improving well-being among vulnerable populations.
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Affiliation(s)
- Vanessa M Oddo
- Vanessa M. Oddo and James Mabli are with Mathematica Policy Research, Cambridge, MA. Vanessa M. Oddo is also with the Department of International Health, Program in Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Morrison J, Batura N, Thapa R, Basnyat R, Skordis-Worrall J. Validating a tool to measure auxiliary nurse midwife and nurse motivation in rural Nepal. HUMAN RESOURCES FOR HEALTH 2015; 13:30. [PMID: 25959298 PMCID: PMC4429816 DOI: 10.1186/s12960-015-0021-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 04/20/2015] [Indexed: 05/28/2023]
Abstract
BACKGROUND A global shortage of health workers in rural areas increases the salience of motivating and supporting existing health workers. Understandings of motivation may vary in different settings, and it is important to use measurement methods that are contextually appropriate. We identified a measurement tool, previously used in Kenya, and explored its validity and reliability to measure the motivation of auxiliary nurse midwives (ANM) and staff nurses (SN) in rural Nepal. METHOD Qualitative and quantitative methods were used to assess the content validity, the construct validity, the internal consistency and the reliability of the tool. We translated the tool into Nepali and it was administered to 137 ANMs and SNs in three districts. We collected qualitative data from 78 nursing personnel and district- and central-level stakeholders using interviews and focus group discussions. We calculated motivation scores for ANMs and SNs using the quantitative data and conducted statistical tests for validity and reliability. Motivation scores were compared with qualitative data. Descriptive exploratory analysis compared mean motivation scores by ANM and SN sociodemographic characteristics. RESULTS The concept of self-efficacy was added to the tool before data collection. Motivation was revealed through conscientiousness. Teamwork and the exertion of extra effort were not adequately captured by the tool, but important in illustrating motivation. The statement on punctuality was problematic in quantitative analysis, and attendance was more expressive of motivation. The calculated motivation scores usually reflected ANM and SN interview data, with some variation in other stakeholder responses. The tool scored within acceptable limits in validity and reliability testing and was able to distinguish motivation of nursing personnel with different sociodemographic characteristics. CONCLUSIONS We found that with minor modifications, the tool provided valid and internally consistent measures of motivation among ANMs and SNs in this context. We recommend the use of this tool in similar contexts, with the addition of statements about self-efficacy, teamwork and exertion of extra effort. Absenteeism should replace the punctuality statement, and statements should be worded both positively and negatively to mitigate positive response bias. Collection of qualitative data on motivation creates a more nuanced understanding of quantitative scores.
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Affiliation(s)
- Joanna Morrison
- Nick Simons Institute, Box 8975, EPC 1813, Sanepa, Lalitpur, Nepal.
| | - Neha Batura
- Institute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK.
| | - Rita Thapa
- Nick Simons Institute, Box 8975, EPC 1813, Sanepa, Lalitpur, Nepal.
| | - Regina Basnyat
- Nick Simons Institute, Box 8975, EPC 1813, Sanepa, Lalitpur, Nepal.
| | - Jolene Skordis-Worrall
- Institute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK.
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Ferdinand AS, Paradies Y, Kelaher M. Mental health impacts of racial discrimination in Australian culturally and linguistically diverse communities: a cross-sectional survey. BMC Public Health 2015; 15:401. [PMID: 25911973 PMCID: PMC4412110 DOI: 10.1186/s12889-015-1661-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 03/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Racial discrimination denies those from racial and ethnic minority backgrounds access to rights such as the ability to participate equally and freely in community and public life, equitable service provision and freedom from violence. Our study was designed to examine how people from racial and ethnic minority backgrounds in four Australian localities experience and respond to racial discrimination, as well as associated health impacts. METHODS Data were collected from 1,139 Australians regarding types of racial discrimination experienced, settings for these incidents, response mechanisms and psychological distress as measured by the Kessler 6 (K6) Psychological Distress Scale. RESULTS Age, education, religion, gender, visibility and rurality were all significantly associated with differences in the frequency of experiencing racial discrimination. Experiencing racial discrimination was associated with worse mental health. Mental health impacts were not associated with the type of discriminatory experience, but experiencing racial discrimination in shops and in employment and government settings was associated with being above the threshold for high or very high psychological distress. One out of twelve response mechanisms was found to be associated with lower stress following a discriminatory incident. CONCLUSIONS Study results indicate that poorer mental health was associated with the volume of discrimination experienced, rather than the type of experience. However, the impact of experiencing discrimination in some settings was shown to be particularly associated with high or very high psychological distress. Our findings suggest that interventions designed to prevent the occurrence of racism have more potential to increase mental health in racial and ethnic minority communities than interventions that work with individuals in response to experiencing racism.
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Affiliation(s)
- Angeline S Ferdinand
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | - Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalisation, Faculty of Arts and Education, Deakin University, Burwood, Australia.
| | - Margaret Kelaher
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
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Shawyer F, Enticott JC, Doherty AR, Block AA, Cheng IH, Wahidi S, Meadows GN. A cross-sectional survey of the mental health needs of refugees and asylum seekers attending a refugee health clinic: a study protocol for using research to inform local service delivery. BMC Psychiatry 2014; 14:356. [PMID: 25539842 PMCID: PMC4296526 DOI: 10.1186/s12888-014-0356-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 12/10/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Refugees and asylum seekers have high rates of risk factors for mental disorders. In recent years, Australia has experienced a rapid increase in asylum seeker arrivals, creating new challenges for services in areas with high settlement numbers. This paper describes the design, including analytic framework, of a project set in a refugee health service in the state of Victoria, Australia, as part of their response to meeting the mental health needs of their burgeoning local population of refugees and asylum seekers. In order to assist service planning, the primary aim of this study is to determine: 1) an overall estimate of the prevalence of psychiatric disorders; 2) the specific prevalence of post-traumatic stress disorder 3) the perceived need and unmet need for mental health treatment. The secondary aim of the study is to establish matched risk ratios based on an Australian-born matched comparison group from the 2007 National Survey of Mental Health and Well-Being. METHODS/DESIGN A cross-sectional survey is used to estimate the prevalence of psychiatric disorders in refugees and asylum seekers attending a local refugee health service. Measures include the Kessler Psychological Distress Scale-10, the Post-Traumatic Stress Disorder-8, the General-practice User's Perceived-need Inventory together with service utilisation questions from the National Survey of Mental Health and Well-Being. Data collected from refugees and asylum seekers (n = 130) is matched to existing data from Australian-born residents drawn from the 2007 National Survey of Mental Health and Well-Being (n = 520) to produce estimates of the risk ratio. DISCUSSION The paper describes a prototype for what is possible within regular services seeking to plan for and deliver high quality mental health care to refugees and asylum seekers. A novel project output will be the development and dissemination of an epidemiological methodology to reliably compare mental health status in a relatively small target sample with a matched comparator group.
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Affiliation(s)
- Frances Shawyer
- Department of Psychiatry, Monash University, Clayton, VIC, 3800, Australia.
| | - Joanne C Enticott
- Department of Psychiatry, Monash University, Clayton, VIC, 3800, Australia. .,Southern Academic Primary Care Research Unit, School of Primary Health Care, Monash University, Clayton, VIC, 3800, Australia.
| | - Anne R Doherty
- Mental Health Program, Monash Health, Dandenong, VIC, 3075, Australia.
| | - Andrew A Block
- General Medicine Program and Refugee Health, Monash Health, Dandenong, VIC, 3175, Australia. .,Department of Medicine, Monash University, Clayton, VIC, 3800, Australia.
| | - I-Hao Cheng
- Southern Academic Primary Care Research Unit, School of Primary Health Care, Monash University, Clayton, VIC, 3800, Australia.
| | - Sayed Wahidi
- Southern Academic Primary Care Research Unit, School of Primary Health Care, Monash University, Clayton, VIC, 3800, Australia.
| | - Graham N Meadows
- Department of Psychiatry, Monash University, Clayton, VIC, 3800, Australia. .,Mental Health Program, Monash Health, Dandenong, VIC, 3075, Australia. .,Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, 3010, Australia.
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Stolk Y, Kaplan I, Szwarc J. Clinical use of the Kessler psychological distress scales with culturally diverse groups. Int J Methods Psychiatr Res 2014; 23:161-83. [PMID: 24733815 PMCID: PMC6878546 DOI: 10.1002/mpr.1426] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 02/15/2013] [Accepted: 02/25/2013] [Indexed: 11/06/2022] Open
Abstract
The Kessler 10 (K10) and embedded Kessler 6 (K6) was developed to screen for non-specific psychological distress and serious mental illness in mental health surveys of English-speaking populations, but has been adopted in Western and non-Western countries as a screening and outcome measure in primary care and mental health settings. This review examines whether the original K6/K10's validity for culturally diverse populations was established, and whether the cultural equivalence, and sensitivity to change of translated or culturally adapted K6/K10s, has been demonstrated with culturally diverse client groups. Evidence for the original K6/K10's validity for culturally diverse populations is limited. Questions about the conceptual and linguistic equivalence of translated/adapted K6/K10s arise from reports of changes in item connotation and differential item functioning. Evidence for structural equivalence is inconsistent, as is support for criterion equivalence, with the majority of studies compromising on accuracy in case prediction. Research demonstrating sensitivity to change with culturally diverse groups is lacking. Inconsistent evidence for the K6/K10's cultural appropriateness in clinical settings, and a lack of clinical norms for either majority or culturally diverse groups, indicate the importance of further research into the psychological distress construct with culturally diverse clients, and the need for caution in interpreting K6/K10 scores.
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Affiliation(s)
- Yvonne Stolk
- Research Consultant, Victorian Foundation for Survivors of Torture, Brunswick, Vic., Australia
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Song Y, Miyaki K, Suzuki T, Sasaki Y, Tsutsumi A, Kawakami N, Shimazu A, Takahashi M, Inoue A, Kan C, Kurioka S, Shimbo T. Altered DNA methylation status of human brain derived neurotrophis factor gene could be useful as biomarker of depression. Am J Med Genet B Neuropsychiatr Genet 2014; 165B:357-64. [PMID: 24801253 PMCID: PMC4321058 DOI: 10.1002/ajmg.b.32238] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 04/14/2014] [Indexed: 12/15/2022]
Abstract
Brain-derived neurotrophic factor (BDNF) is involved in the survival, development, and synaptic plasticity of neurons. BDNF is believed to be associated with the pathophysiology of psychiatric disorders. Several studies have suggested the relevance of DNA methylation in its promoter region with depression. Here, we report different methylation statuses in groups with different depressive scores or undergoing different levels of job-stress. DNA samples were extracted from the saliva of 774 Japanese workers, and the methylation status was determined using the Illumina HumanMethylation 450 K Microarray. Depressive symptoms were measured using the Kessler's K6 questionnaire. Job-stress scales were assessed via a self-administered questionnaire. Independent DNA pools were formed based on K6 and job-strain scores, and the methylation levels were compared among these pools. The average DNA methylation rate was significantly decreased in the highest K6 score group compared to the lowest group (methylated signals, 14.2% vs. 16.5%, P = 2 · 16 × 10(-198)). This difference remained for the CpG island in the promoter region (10.4% vs. 5.8%, P = 3 · 67 × 10(-133)). Regarding the job-strain score, there was a slight increase in the methylation level of the whole gene in the group with the highest score compared to that with the lowest score; however, these groups showed no difference in the promoter region. Our results revealed significant changes in the DNA methylation status of the complete human BDNF gene in persons with depression compared to normal individuals, especially in the promoter region of exon 1. This indicates that DNA methylation in this gene is a promising biomarker for diagnosing depression.
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Affiliation(s)
- Yixuan Song
- Department of Clinical Research and Informatics, National Center for Global Health and MedicineTokyo, Japan
| | - Koichi Miyaki
- Department of Clinical Research and Informatics, National Center for Global Health and MedicineTokyo, Japan,*Correspondence to:, Koichi Miyaki, M.D., Ph.D., Department of Clinical Research and Informatics, National Center for Global Health and Medicine, Toyama 1-21-1, Shinjuku-ku, Tokyo, 162-8655, Japan., E-mail:
| | - Tomoko Suzuki
- Department of Clinical Research and Informatics, National Center for Global Health and MedicineTokyo, Japan
| | - Yasuharu Sasaki
- Department of Clinical Research and Informatics, National Center for Global Health and MedicineTokyo, Japan
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of MedicineSagamihara, Kanagawa, Japan
| | - Norito Kawakami
- Department of Mental Health, Tokyo University Graduate School of MedicineTokyo, Japan
| | - Akihito Shimazu
- Department of Mental Health, Tokyo University Graduate School of MedicineTokyo, Japan
| | - Masaya Takahashi
- Health Administration and Psychosocial Factor Research Group, National Institute of Occupational Safety and HealthKawasaki, Kanagawa, Japan
| | - Akiomi Inoue
- Department of Mental HealthInstitute of Industrial Ecological Sciences, University of Occupational and Environmental HealthKitakyushu, Fukuoka, Japan
| | - Chiemi Kan
- Department of Mental Health, Tokyo University Graduate School of MedicineTokyo, Japan
| | - Sumiko Kurioka
- Department of Health Policy and Management, University of Occupational and Environmental HealthKitakyushu, Fukuoka, Japan
| | - Takuro Shimbo
- Department of Clinical Research and Informatics, National Center for Global Health and MedicineTokyo, Japan
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Maternal depression and foetal responses to novel stimuli: insights from a socio-economically disadvantaged Indian cohort. J Dev Orig Health Dis 2014; 5:178-82. [DOI: 10.1017/s2040174414000129] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Maternal stress during pregnancy has pervasive effects on stress responsivity in children. This study is the first to test the hypothesis that maternal prenatal depression, as observed in South India, may be associated with how foetuses respond to a potentially stressful stimulus. We employed measures of foetal heart rate at baseline, during exposure to a vibroacoustic stimulus, and post-stimulation, to study patterns of response and recovery in 133 third trimester foetuses of depressed and non-depressed mothers. We show that the association between maternal depression and foetal stress responsivity is U-shaped with foetuses of mothers with high and low depression scores demonstrating elevated responses, and poorer recovery, than foetuses of mothers with moderate levels. The right amount of intra-uterine stimulation is important in conditioning foetuses towards optimal regulation of their stress response. Our results imply that, in certain environmental contexts, exposure to moderate amounts of intra-uterine stress may facilitate this process.
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Sweetland AC, Belkin GS, Verdeli H. Measuring depression and anxiety in sub-saharan Africa. Depress Anxiety 2014; 31:223-32. [PMID: 23780834 PMCID: PMC4109689 DOI: 10.1002/da.22142] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 04/03/2013] [Accepted: 05/10/2013] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Despite being one of the leading causes of disability worldwide, fewer than 10% of depressed individuals in low-resource settings have access to treatment. Mounting evidence suggests that nonspecialist workers are capable of providing counseling and case management at the community level. They often use brief psychiatric screening instruments as clinical tools to identify cases and monitor symptoms over time. In order for such tools to be used in diverse settings, they must demonstrate adequate reliability and validity in addition to cross-cultural relevance. To be used to guide routine care they also need to be flexibly adapted and sensitive to change. The goal of this paper is to assess the cross-cultural validity of brief psychiatric screening instruments in sub-Saharan Africa, identify best practices, and discuss implications for clinical management and scale-up of mental health treatment in resource-poor settings. METHOD Systematic review of studies assessing the validity of screening instruments for depression, anxiety, and mental distress in sub-Saharan Africa using Medline and PsycINFO. RESULTS Sixty-five studies from 16 countries assessing the validity of brief screening instruments for depression, anxiety, and/or mental distress. CONCLUSIONS Despite evidence of underlying universality in the experience of depression and anxiety in sub-Saharan Africa, differences in the salience, manifestation, and expression of symptoms suggest the need for the local adaptation of instruments. Rapid ethnographic assessment has emerged as a promising, low-cost, and efficient strategy for doing so.
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Affiliation(s)
- Annika C. Sweetland
- Columbia University College of Physicians and Surgeons, Department of Psychiatry,Correspondence to: Annika C. Sweetland, Research Foundation for Mental Hygiene, New York State Psychiatric Institute, 1051 Riverside Drive, Box 24, New York, NY 10032.
| | - Gary S. Belkin
- New York University School of Medicine, Department of Psychiatry
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Khan A, Chien CW, Burton NW. A new look at the construct validity of the K6 using Rasch analysis. Int J Methods Psychiatr Res 2014; 23:1-8. [PMID: 24431150 PMCID: PMC6878522 DOI: 10.1002/mpr.1431] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Accepted: 08/29/2012] [Indexed: 11/08/2022] Open
Abstract
The Kessler six-item psychological distress (K6) scale is widely used to screen for mental disorders; however, information is lacking on the rating scale performance or dimensionality structure of the scale. This study used a population based sample (n = 7596) to evaluate the construct validity of the K6 scale using Rasch partial credit analysis. The analysis showed that almost all of the five-point rating scales in the K6 items were used appropriately to differentiate psychological distress of the study participants. The analysis provided evidence of unidimensionality of the scale, although items 1 (so sad) and 3 (restless or fidgety) might offer a potential second off-dimensional component. All items appeared to fit the Rasch model's expectation as demonstrated by the acceptable item fit statistics. The study participants demonstrated valid response patterns when answering K6 items, except for some who were younger or had higher psychological distress. This study using Rasch analysis confirms the construct validity of the K6 scale and suggests that the K6 is a useful and valid instrument for assessing psychological distress in the mid-aged general population. Further research can facilitate better understanding about the unidimensionality of the scale. Copyright © 2014 John Wiley & Sons, Ltd.
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Affiliation(s)
- Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia
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The value of screening in patient populations with high prevalence of a disorder. BMC Med 2014; 12:14. [PMID: 24472627 PMCID: PMC3904156 DOI: 10.1186/1741-7015-12-14] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 01/03/2014] [Indexed: 11/10/2022] Open
Abstract
Thombs and colleagues have shown that screening consecutive attendees in primary care settings in high income countries for depression is not worthwhile. However, it is dangerous to generalize from high income countries such as the USA to the rest of the world. The positive predictive value of any screening test for depression is affected by the prevalence of the disorder in the population being considered. Populations with an increased prevalence of depression, such as those with chronic physical disorders, or with a history of depression or other mental health problems may benefit from screening, even in high income countries. Populations in low and middle income countries (LMIC) may also benefit from screening if they are experiencing severe social adversity, including poverty. Two examples are given, in which screening with a brief screening questionnaire was followed by collaborative stepped care, to the considerable benefit of the patients in LMIC. Please see related article: http://www.biomedcentral.com/1741-7015/12/13.
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Tsai AC, Scott JA, Hung KJ, Zhu JQ, Matthews LT, Psaros C, Tomlinson M. Reliability and validity of instruments for assessing perinatal depression in African settings: systematic review and meta-analysis. PLoS One 2013; 8:e82521. [PMID: 24340036 PMCID: PMC3858316 DOI: 10.1371/journal.pone.0082521] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 10/22/2013] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND A major barrier to improving perinatal mental health in Africa is the lack of locally validated tools for identifying probable cases of perinatal depression or for measuring changes in depression symptom severity. We systematically reviewed the evidence on the reliability and validity of instruments to assess perinatal depression in African settings. METHODS AND FINDINGS Of 1,027 records identified through searching 7 electronic databases, we reviewed 126 full-text reports. We included 25 unique studies, which were disseminated in 26 journal articles and 1 doctoral dissertation. These enrolled 12,544 women living in nine different North and sub-Saharan African countries. Only three studies (12%) used instruments developed specifically for use in a given cultural setting. Most studies provided evidence of criterion-related validity (20 [80%]) or reliability (15 [60%]), while fewer studies provided evidence of construct validity, content validity, or internal structure. The Edinburgh postnatal depression scale (EPDS), assessed in 16 studies (64%), was the most frequently used instrument in our sample. Ten studies estimated the internal consistency of the EPDS (median estimated coefficient alpha, 0.84; interquartile range, 0.71-0.87). For the 14 studies that estimated sensitivity and specificity for the EPDS, we constructed 2 x 2 tables for each cut-off score. Using a bivariate random-effects model, we estimated a pooled sensitivity of 0.94 (95% confidence interval [CI], 0.68-0.99) and a pooled specificity of 0.77 (95% CI, 0.59-0.88) at a cut-off score of ≥ 9, with higher cut-off scores yielding greater specificity at the cost of lower sensitivity. CONCLUSIONS The EPDS can reliably and validly measure perinatal depression symptom severity or screen for probable postnatal depression in African countries, but more validation studies on other instruments are needed. In addition, more qualitative research is needed to adequately characterize local understandings of perinatal depression-like syndromes in different African contexts.
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Affiliation(s)
- Alexander C. Tsai
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jennifer A. Scott
- Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
- Division of Women’s Health, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Harvard Humanitarian Initiative, Cambridge, Massachusetts, United States of America
| | - Kristin J. Hung
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Jennifer Q. Zhu
- Harvard College, Cambridge, Massachusetts, United States of America
| | - Lynn T. Matthews
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Christina Psaros
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Mark Tomlinson
- Centre for Public Mental Health, Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
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Carta MG, Oumar FW, Moro MF, Moro D, Preti A, Mereu A, Bhugra D. Trauma- and stressor related disorders in the tuareg refugees of a cAMP in burkina faso. Clin Pract Epidemiol Ment Health 2013; 9:189-95. [PMID: 24285982 PMCID: PMC3841965 DOI: 10.2174/1745017901309010189] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 10/13/2013] [Accepted: 10/13/2013] [Indexed: 11/22/2022]
Abstract
Background: Post-traumatic stress disorder (PTSD) is reported to be common among refugees. We set out to explore risk of Trauma- and Stress-or-Related Disorders and the associated burden of psychological distress in a refugee camp of Malian Refugees in Burkina Faso. Methods: One out of five persons living in the camp was selected randomly and interviewed using the French version of the Short Screening Scale for PTSD and the validated K6 scale to measure psychiatric morbidity. Results: Around 60% of the interviewed sample (N=408) met the criteria for Trauma- and Stress-or-Related Disorders and also reported severe mental distress on K6 scores. Women aged 40 and over were found to be at higher risk of Trauma- and Stress-or-Related Disorders whereas young people (39 or younger) scored higher on K6 ratings. Around 83% of the surveyed subjects had a family member killed in the war, 91% a relative in the war, more than 80% had a family member suffering from physical injuries, and 90% reported problems with food and housing. The frequency of these life events was not surprisingly higher in persons with Trauma- and Stress-or-Related Disorders, with the death of a family member and severe problems with food being specifically related to them.Conclusion: These results point to important psychological suffering in a population that is often ignored by the media and international political authorities. Immediate steps are required to provide urgent legal and humanitarian protection to those who are forced to flee their homes and cross international borders because of disasters.
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Affiliation(s)
- M G Carta
- Department of Public Health, Clinical and Molecular Medicine, Cittadella, Universitaria di Monserrato, 09042 Monserrato, Calgiari, Italy
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Stewart RC, Umar E, Tomenson B, Creed F. Validation of screening tools for antenatal depression in Malawi--a comparison of the Edinburgh Postnatal Depression Scale and Self Reporting Questionnaire. J Affect Disord 2013; 150:1041-7. [PMID: 23769290 DOI: 10.1016/j.jad.2013.05.036] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 05/15/2013] [Accepted: 05/19/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND The detection of antenatal depression in resource-limited settings such as Malawi, Africa, is important and requires an accurate and practical screening tool. It is not known which questionnaire would be most suitable for this purpose. METHOD A rigorously translated and modified Chichewa version of the Edinburgh Postnatal Depression Scale (EPDS) was developed. The Chichewa EPDS and an existing Chichewa version of the Self Reporting Questionnaire (SRQ) were validated in women attending an antenatal clinic in rural Malawi, using DSM-IV major and major-or-minor depressive episode as the gold standard diagnoses, determined with Structured Clinical Interview for DSM-IV (SCID). Weighted test characteristics for each possible cut-off were calculated and Receiver Operator Characteristic (ROC) curves derived. RESULTS The participants were 224 pregnant women, 92 of whom were interviewed using the SCID. The area under the ROC curve (AUC) for detection of current major depressive disorder for the EPDS was 0.811 (95% CI 0.734-0.889) and for the SRQ was 0.833 (95% CI 0.770-0.897). AUC for major-or-minor depressive disorder for the EPDS was 0.767 (95% CI 0.695-0.839) and for the SRQ was 0.883 (95% CI 0.839-0.927). These were not significant differences. Internal consistency was high for both the SRQ (Cronbach's alpha 0.825) and the EPDS (Cronbach's alpha 0.904). LIMITATIONS Inter-rater reliability testing was not done. The relatively small sample size resulted in wide confidence intervals around AUCs. The study was conducted amongst antenatal clinic attenders only, limiting generalisability to all pregnant women in this setting. CONCLUSION The Chichewa versions of the EPDS and SRQ both show utility as brief screening measures for detection of antenatal depression in rural Malawi.
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Affiliation(s)
- Robert C Stewart
- Institute of Brain, Behaviour and Mental Health, University of Manchester, UK.
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Wang KS, Wang L, Zheng S, Wu LY. Associations of smoking status and serious psychological distress with chronic obstructive pulmonary disease. INTERNATIONAL JOURNAL OF HIGH RISK BEHAVIORS & ADDICTION 2013; 2:59-65. [PMID: 24971276 PMCID: PMC4070146 DOI: 10.5812/ijhrba.10333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 05/26/2013] [Accepted: 06/09/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) has been a major public health problem due to its high prevalence, morbidity, and mortality. Smoking is a major risk factor for COPD, while serious psychological distress (SPD) is prevalent among COPD patients. However, no study focusing on the effect of SPD on COPD has been so far conducted, while few studies have focused on the associations of SPD and behavioral factors with COPD by smoking status. OBJECTIVES This study aimed to examine the associations of SPD and behavioral factors (such as smoking and physical activity) with COPD. MATERIALS AND METHODS Weighted logistic regression models were used for the analysis of 1,248 cases and 39,995 controls from the 2005 California Health Interview Survey (CHIS). RESULTS The prevalence of SPD was 10% in cases and 4% in controls, respectively. The percentages of past and current smoking were higher in cases than controls (50% vs. 24% and 27% vs. 15%, respectively). After adjusting for other factors, smoking (OR = 4.56, 95% CI = 3.41-6.11 and OR = 3.24, 95% CI = 2.57-4.08 for current and past smoking, respectively), physical activity (OR = 0.69, 95% CI = 0.55-0.87), obesity (OR = 1.25, 95% CI = 1.03-1.52), older age (OR = 2.86, 95% CI = 2.15-3.82, and OR = 5.97, 95% CI = 4.42-8.08 for middle-aged and elder groups, respectively), SPD (OR = 2.11, 95% CI = 1.47-3.04), employment (OR = 0.62, 95% CI = 0.51-0.76), race (OR = 0.35, 95% CI = 0.23-0.54, OR = 0.59, 95% CI = 0.36-0.97, and OR = 0.47, 95% CI=0.29-0.75 for Latino, Asian, and African American, respectively) and lower federal poverty level (OR=1.89, 95% CI = 1.35-2.63, OR = 1.65, 95% CI = 1.27-2.14, and OR = 1.39, 95% CI = 1.12-1.72 for 0-99% FPL, 100-199% FPL and 200-299% FPL, respectively) were all associated with COPD (P < 0.05). Age group, SPD, race, and employment showed significant interactions with smoking status. Stratified by smoking status, aging was the only risk factor for COPD in the never smoking group; whereas, lack of physical activity, older age, SPD, race, unemployment, and lower federal poverty level were associated with COPD in the smoking groups. CONCLUSIONS Smoking and aging were major risk factors for COPD, while lack of physical activity and SPD were strongly associated with COPD in the smoking groups.
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Affiliation(s)
- Ke-Sheng Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, USA
- Corresponding author: Ke-Sheng Wang, Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, P.O. Box: 70259, Lamb Hall, Johnson City, USA. Tel.: +1-4234394481, Fax: +1-4234394606, E-mail:
| | - Liang Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, USA
| | - Shimin Zheng
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, USA
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Wang L, Wang KS. Age differences in the associations of behavioral and psychosocial factors with stroke. Neuroepidemiology 2013; 41:94-100. [PMID: 23774713 DOI: 10.1159/000350018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 02/13/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Stroke remains a major public health burden. Few studies have focused on the age differences in the associations of behavioral and psychosocial factors with stroke while no study focusing on the effect of severe psychological distress (SPD) on stroke has been conducted. The aim of this study was to examine the age differences in these risk factors for stroke as young (18-44 years), middle aged (45-64 years), and elderly (65 years or older). METHODS A total of 1,258 adults with stroke and 39,985 controls were selected from the 2005 California Health Interview Survey. Multiple logistic regression analyses were used to estimate the associations of the factors with stroke at different ages. RESULTS The prevalence of SPD was 10% in cases and 3.6% in controls, respectively. Overall, current smoking, lack of physical activity, alcohol consumption, SPD, type II diabetes, male, older age, and unemployment were all associated with a higher prevalence of stroke. Practically, we found that smoking and SPD were associated with the prevalence of stroke in young adults, lack of physical activity was associated with the prevalence of stroke in middle-aged adults, and lack of physical activity and SPD were associated with the prevalence of stroke in the elderly. CONCLUSIONS Appropriate intervention for reducing stroke and eliminating its disparities may be developed separately at each age.
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Affiliation(s)
- Liang Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA.
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Wang L, Wang KS. Age differences in the association of severe psychological distress and behavioral factors with heart disease. PSYCHIATRY JOURNAL 2013; 2013:979623. [PMID: 24236290 PMCID: PMC3820083 DOI: 10.1155/2013/979623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 02/19/2013] [Accepted: 02/21/2013] [Indexed: 12/21/2022]
Abstract
Few studies have examined the risk factors of serious psychological distress (SPD) and behavioral factors for heart disease separately stratified as young (18-44 years), middle aged (45-64 years), and elderly (65 years or older). A total of 3,540 adults with heart disease and 37,703 controls were selected from the 2005 California Health Interview Survey. Data were weighted to be representative and adjusted for potential undercoverage and nonresponse biases. Multiple logistic regression models were used to estimate the associations of the factors with heart disease at different ages. The prevalence of SPD was 8% in cases and 4% in controls, respectively. For young adults, SPD and higher federal poverty level (FPL) were associated with an increased risk of heart disease while for middle-aged adults, SPD, past smoking, lack of physical activity, obesity, male, and unemployment were associated with an increased risk of heart disease. In addition, SPD, past smoking, lack of physical activity, obesity, male, unemployment, White, and lower FPL were associated with an increased risk of heart disease in elderly. Our findings indicate that risk factors for heart disease vary across all ages. Intervention strategies that target risk reduction of heart disease may be tailored accordingly.
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Affiliation(s)
- Liang Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, P.O. Box 70259, Lamb Hall, Johnson City, TN 37614-1700, USA
| | - Ke-Sheng Wang
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, P.O. Box 70259, Lamb Hall, Johnson City, TN 37614-1700, USA
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Akena D, Joska J, Obuku EA, Stein DJ. Sensitivity and specificity of clinician administered screening instruments in detecting depression among HIV-positive individuals in Uganda. AIDS Care 2013; 25:1245-52. [PMID: 23398282 DOI: 10.1080/09540121.2013.764385] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Depressive disorders are highly prevalent in Africa where diseases such as HIV/AIDS are common. The aim of this study was to assess the validity of commonly used depression screening instruments in a setting characterized by low literacy, where patients may not be able to self-administer depression scales. We explored the validity of the Patient Health Questionaire-9 (PHQ-9), Centre for Epidemiological Surveys for Depression (CES-D), and the Kessler-10 (K-10), using the Mini International Neuropsychiatric Instrument (MINI) as a gold standard in 368 persons living with HIV/AIDS (PLWHA) in Uganda. The shorter versions of the K-10 and PHQ-9 were extracted to assess their performance in comparison to the longer versions. We used STATA 11.2 to analyze the data. The prevalence of a MINI defined depression in this patient sample was 17.4%. The three instruments all performed well, with areas under the curve (AUC) ranging from 0.82 to 0.96. The PHQ-9 showed the best performance characteristics with an AUC of 0.96, a sensitivity of 91.6%, and specificity 81.2%. The extracted versions performed more modestly. All three instruments showed good properties as screening tools; the PHQ-9 has particularly high sensitivity and specificity, and so can be considered useful for screening HIV-positive patients for depression.
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Affiliation(s)
- Dickens Akena
- a Department of Psychiatry and Mental Health , University of Cape Town , Cape Town , South Africa
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Anand SS, Vasudevan A, Gupta M, Morrison K, Kurpad A, Teo KK, Srinivasan K. Rationale and design of South Asian Birth Cohort (START): a Canada-India collaborative study. BMC Public Health 2013; 13:79. [PMID: 23356884 PMCID: PMC3585827 DOI: 10.1186/1471-2458-13-79] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 10/18/2012] [Indexed: 12/31/2022] Open
Abstract
Background People who originate from the Indian subcontinent (South Asians) suffer among the highest rates of type 2 diabetes in the world. Prior evidence suggests that metabolic risk factors develop early in life and are influenced by maternal and paternal behaviors, the intrauterine environment, and genetic factors. The South Asian Birth Cohort Study (START) will investigate the environmental and genetic basis of adiposity among 750 South Asian offspring recruited from highly divergent environments, namely, rural and urban India and urban Canada. Methods Detailed information on health behaviors including diet and physical activity, and blood samples for metabolic parameters and DNA are collected from pregnant women of South Asian ancestry who are free of significant chronic disease. They also undergo a provocative test to diagnose impaired glucose tolerance and gestational diabetes. At delivery, cord blood and newborn anthropometric indices (i.e. birth weight, length, head circumference and skin fold thickness) are collected. The mother and growing offspring are followed prospectively and information on the growth trajectory, adiposity and health behaviors will be collected annually up to age 3 years. Our aim is to recruit a minimum of 750 mother-infant pairs equally divided between three divergent environments: rural India, urban India, and Canada. Summary The START cohort will increase our understanding of the environmental and genetic determinants of adiposity and related metabolic abnormalities among South Asians living in India and Canada.
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Affiliation(s)
- Sonia S Anand
- McMaster University, 1280 Main St West MDCL 3200, L8S 4K1, Hamilton, ON, Canada.
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Akena D, Joska J, Obuku EA, Amos T, Musisi S, Stein DJ. Comparing the accuracy of brief versus long depression screening instruments which have been validated in low and middle income countries: a systematic review. BMC Psychiatry 2012; 12:187. [PMID: 23116126 PMCID: PMC3534406 DOI: 10.1186/1471-244x-12-187] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Accepted: 10/30/2012] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Given the high prevalence of depression in primary health care (PHC), the use of screening instruments has been recommended. Both brief and long depression screening instruments have been validated in low and middle income countries (LMIC), including within HIV care settings. However, it remains unknown whether the brief instruments validated in LMIC are as accurate as the long ones. METHODS We conducted a search of PUBMED, the COCHRANE library, AIDSLINE, and PSYCH-Info from their inception up to July 2011, for studies that validated depression screening instruments in LMIC. Data were extracted into tables and analyzed using RevMan 5.0 and STATA 11.2 for the presence of heterogeneity. RESULTS Nineteen studies met our inclusion criteria. The reported prevalence of depression in LMIC ranged from 11.1 to 53%. The area under curve (AUC) scores of the validated instruments ranged from 0.69-0.99. Brief as well as long screening instruments showed acceptable accuracy (AUC≥0.7). Five of the 19 instruments were validated within HIV settings. There was statistically significant heterogeneity between the studies, and hence a meta-analysis could not be conducted to completion. Heterogeneity chi-squared = 189.23 (d.f. = 18) p<.001. CONCLUSION Brief depression screening instruments in both general and HIV-PHC are as accurate as the long ones. Brief scales may have an edge over the longer instruments since they can be administered in a much shorter time. However, because the ultra brief scales do not include the whole spectrum of depression symptoms including suicide, their use should be followed by a detailed diagnostic interview.
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Affiliation(s)
- Dickens Akena
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
| | - John Joska
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Taryn Amos
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Seggane Musisi
- Department of Psychiatry, Makerere University, Kampala, Uganda
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Schwarz AG, McVeigh KH, Hoven C, Kerker BD. Racial and Ethnic Differences in Depression by Partner Status and the Presence of Children in the Household. Womens Health Issues 2012; 22:e553-61. [DOI: 10.1016/j.whi.2012.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Revised: 07/18/2012] [Accepted: 07/19/2012] [Indexed: 11/30/2022]
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