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Jandaghian-Bidgoli M, Kazemian E, Shaterian N, Abdi F. Focusing attention on the important association between food insecurity and psychological distress: a systematic review and meta-analysis. BMC Nutr 2024; 10:118. [PMID: 39243085 PMCID: PMC11378639 DOI: 10.1186/s40795-024-00922-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 08/20/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND Food insecurity has involved more than 750 million individuals worldwide. The association of food insecurity with socio-economic factors is also undeniable demand more consideration. Food insecurity will become a global priority by 2030. This systematic review and meta-analysis examined current literature concerning the association between food insecurity and psychological distress. METHODS Relevant researches were identified by searching databases including PubMed, EMBASE, Scopus, and Web of Science, ProQuest, and Cochrane Library up to June 2024 without language limitation. Then a snowball search was conducted in the eligible studies. The quality assessment was made through Newcastle-Ottawa Scale. RESULTS Data were available from 44 cross-sectional articles for systematic review and 17 eligible articles for meta-analysis with 2,267,012 and 1,953,636 participants, respectively. Findings support the growing segment of literature on the association between food insecurity and psychological distress. The highly represented groups were households with low income. Psychological and diabetic distress was directly associated with food insecurity as it increased the odds of distress to 329% (OR: 3.29; 95% CI: 2.46-4.40). Sleep problems, anxiety, depression, lower life satisfaction, obesity, and a higher rate of smoking were among the secondary outcomes. CONCLUSION Food insecurity was a common stressor that can have a negative impact on psychological well-being and even physical health. The findings should be considered in the public health and making policy-making process.
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Affiliation(s)
| | - Elham Kazemian
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Negin Shaterian
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Fatemeh Abdi
- Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
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Quarshie ENB, Oppong Asante K, Andoh-Arthur J, Akotia CS, Osafo J. To Keep the Law or to Repeal It: Views of Parliamentarians On the Call to Decriminalise Attempted Suicide in Ghana. OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:39-56. [PMID: 34967674 PMCID: PMC11017692 DOI: 10.1177/00302228211066683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We explored the views of members of parliament (MPs) in Ghana on the call to decriminalise attempted suicide. We applied reflexive thematic analysis to Parliamentary Hansards (2017-2020) on calls to decriminalise attempted suicide in Ghana. 11 MPs shared their stance for or against the call. We developed three major themes that entailed, often, opposing views: (1) deterrent effect of the law (against: the law punishes and deters to protect life; for: the law is insensitive and has ironic effects), (2) enforcement of the law (against: leave things as they are, the law is not enforced, anyway; for: crime is not self-inflicted) and (3) prioritisation of suicide prevention (against: focus on more pressing issues, but resource support systems; for: the law and legitimate support systems cannot co-exist). The findings indicate two needs: to extend suicide literacy to Ghanaian MPs, and to initiate a public/private member's bill on attempted suicide decriminalisation.
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Affiliation(s)
- Emmanuel Nii-Boye Quarshie
- School of Psychology, University of Leeds, Leeds, UK
- Department of Psychology, University of Ghana, Accra, Ghana
- Centre for Suicide and Violence Research, Accra, Ghana
| | - Kwaku Oppong Asante
- Department of Psychology, University of Ghana, Accra, Ghana
- Centre for Suicide and Violence Research, Accra, Ghana
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
| | - Johnny Andoh-Arthur
- Department of Psychology, University of Ghana, Accra, Ghana
- Centre for Suicide and Violence Research, Accra, Ghana
| | - Charity Sylvia Akotia
- Department of Psychology, University of Ghana, Accra, Ghana
- Centre for Suicide and Violence Research, Accra, Ghana
| | - Joseph Osafo
- Department of Psychology, University of Ghana, Accra, Ghana
- Centre for Suicide and Violence Research, Accra, Ghana
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Culbreth RE, Nielsen KE, Mobley K, Palmier J, Bukuluki P, Swahn MH. Life Satisfaction Factors, Stress, and Depressive Symptoms among Young Women Living in Urban Kampala: Findings from the TOPOWA Project Pilot Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:184. [PMID: 38397675 PMCID: PMC10887819 DOI: 10.3390/ijerph21020184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/19/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024]
Abstract
Young women living in Kampala, Uganda, often face adversities related to Social Determinants of Mental Health (SDoMH) including poverty, food scarcity, environmental stressors such as high levels of community violence, and lack of adequate healthcare access. Two consecutive pilot studies were conducted to assess the feasibility and acceptability of survey questions, wearable fitness trackers, and daily diaries before launching a larger prospective cohort study. Preliminary associations between SDoMH factors with depressive symptoms, stress levels, and life satisfaction were examined among the total sample of 60 women across two pilot studies. A total of 32.2% of respondents (out of n = 59) reported being depressed most or all of the time in the past 30 days. Frequent depressive symptoms correlated with food insecurity (χ2 = 5.38, df = 1, p = 0.02). Higher stress levels were significantly associated with lower overall life satisfaction scores (t = 2.74, df = 6.20, p = 0.03). Additionally, frequent depressive symptoms were associated with lower satisfaction scores in the living conditions and lifestyle domain (t = 2.22, df = 36.18, p = 0.03). However, overall life satisfaction scores and other domains (social relationships and personal independence) were not statistically associated with frequent depressive symptoms. Identifying the most impactful SDoMH factors among young women in Kampala can inform targeted approaches to improve mental health outcomes.
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Affiliation(s)
- Rachel E. Culbreth
- American College of Medical Toxicology, 10645 N. Tatum Blvd, Phoenix, AZ 85028, USA;
| | - Karen E. Nielsen
- School of Public Health, Georgia State University, 140 Decatur Street, Atlanta, GA 30303, USA;
| | - Kate Mobley
- School of Data Science and Analytics, College of Computing and Software Engineering, Kennesaw State University, Kennesaw, GA 30144, USA;
| | - Jane Palmier
- Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA 30144, USA;
| | - Paul Bukuluki
- School of Social Sciences, Makerere University, Kampala P.O. Box 7062, Uganda;
| | - Monica H. Swahn
- Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA 30144, USA;
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Tetteh J, Ekem-Ferguson G, Quarshie ENB, Dwomoh D, Swaray SM, Otchi E, Adomako I, Quansah H, Yawson AE. Food insecurity and its impact on substance use and suicidal behaviours among school-going adolescents in Africa: evidence from the Global School-Based Student Health Survey. Eur Child Adolesc Psychiatry 2024; 33:467-480. [PMID: 36859592 DOI: 10.1007/s00787-023-02168-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 02/14/2023] [Indexed: 03/03/2023]
Abstract
The study sought to assess the prevalence and factors associated with Food Insecurity (FI) and further quantify its impact on substance use and suicidal behaviours (ideation, planning, and repeated attempted suicide) among school-going adolescents in Africa. The study involved a secondary analysis of cross-sectional data from the Global School-Based Student Health Survey (GSHS) conducted in Africa. Substance use and suicidal behaviours were the main outcomes. We employed the Double Selection Least Absolute Shrinkage and Selection Operator Poisson regression (DSLASSOPM) model to assess risk factors associated with FI and further employed Coarsened Exact Matching involving DSLASSOPM to assess the influence of FI on the study outcomes. Meta-analysis was conducted to obtain between-country heterogeneity in the prevalence of FI and the prevalence ratio of substance use and suicidal behaviours. The study involved 34,912 school-going adolescents. The pooled 30-day prevalence estimate of FI was 11.1% (95% CI 9.1-18.6), ranging from 6.7% (95% CI 5.0-8.3) in Tanzania to 18.4% (95% CI 14.4-22.4) in Benin. The most common associated factors included the experience of insomnia and the number of times injured. The pooled prevalence ratio of substance use, suicidal ideation, suicidal planning, and repeated attempted suicide among adolescents experiencing food insecurity were 1.92(95% CI 1.69-2.16), 1.56(95% CI 1.46-1.66), 1.50 (95% CI 1.41-1.58), and 1.90 (95% CI 1.73-2.07) respectively. A considerable heterogeneity between the sub-regions prevalence ratio for suicidal ideation and planning was also observed (I2 = 0, p value > 0.05). The study observed a high prevalence of food insecurity in West Africa with negligible heterogeneity between the countries. A significant positive association between FI and the study outcomes (substance use and suicidal behaviours) was observed. The study recommends country-specific social and school-based health interventions to screen risk factors associated with food insecurity for early identification. Measures to achieve Sustainable Development Goal 2 (Zero Hunger) by 2030 are key in these African countries and is likely to yield demographic dividends through improvement in mental health among school-going adolescents.
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Affiliation(s)
- John Tetteh
- Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
| | | | - Emmanuel Nii-Boye Quarshie
- Department of Psychology, School of Social Sciences, College of Humanities, University of Ghana, Accra, Ghana
| | - Duah Dwomoh
- Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana
| | | | - Elom Otchi
- Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
- Korle-Bu Teaching Hospital, Accra, Ghana
| | - Isaac Adomako
- Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Henry Quansah
- Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Alfred Edwin Yawson
- Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
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Doglikuu DBI, Annan JK, Asare S, Yawson H, Takyi O, Dzidzornu FA, Koram HO, Johnson EA. Household food insecurity, family size and their interactions on depression prevalence among teenage pregnant girls in Ghana, a population based cluster survey. BMC Womens Health 2023; 23:527. [PMID: 37803413 PMCID: PMC10559541 DOI: 10.1186/s12905-023-02674-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 09/25/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Household food insecurity is the situation where individuals and families have limited/uncertain access to nutritionally adequate and safe foods for healthy living. Family size is the number of persons in the family. Household food insecurity and family size are risk factors for depression. However, their synergistic and/or multiplicative effect on depression is not well investigated. This study investigated/examined household food insecurity, family size and their interaction on depression prevalence among teenaged pregnant girls in Ghana. METHODS Population based cluster survey was conducted among 225 teenaged pregnant girls in 20-electoral areas at Twifo-Atti-Morkwa district in the central region of Ghana. Simple random sampling was used to recruit study participants and structured questionnaire used to collect demographic variables. Household Food Insecurity Access Scale (HFIAS) and Revised Children's Anxiety and Depression Scale (RCADS-25) were used to collect data. Multinomial logistic regression models were used to analyzed the data. RESULTS Moderate and high depression prevalence reported among teenaged pregnant girls in Twifo-Atti-Morkwa district were 35.1(28.1-42.1) and 33.5 (26.5-40.5) respectively. Moderate family size (AOR = 1.08, 95%CI = 1.17-3.71) and large-family-size (AOR = 2.78, 95%CI = 3.98-10.19) were significant for depression. Moderate food insecurity (AOR = 0.12, 95%CI = 0.41 - 0.35) and high food insecurity (AOR = 0.27, 95%CI = 0.11-0.71) were significant for depression. Interaction between moderate food insecurity and moderate family size (AOR = 1.69, 95%CI = 2.79-17.51), interaction between high food insecurity and low family size (AOR = 1.24, 95%CI 1.57-11.41) and interaction between high food insecurity and large family size (AOR = 1.01, 95%CI = 1.72-14.57) were significant for depression among teenaged pregnant girls. CONCLUSION There is moderate and high depression prevalence among teenaged pregnant girls in Twifo-Atti-Morkwa district. Interaction between household food insecurity and family size are the major predictors for depression among the teenaged girls in the district. We therefore recommend that public health officers should be up with health education campaigns in the district to create awareness on the depression prevalence among teenaged girls, and urge them to come out and seek support to prevent the catastrophic effect of depression.
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Affiliation(s)
- Dominic Be-Ikuu Doglikuu
- Faculty of Health and Allied Sciences, Department of Nursing and Midwifery, Catholic University of Ghana, Sunyani-Fiapre, Bono Region, Ghana.
- Department of Registered Public Health Nursing, Ministry of Health, Twifo Praso Nursing and Midwifery Training College, Central Region, Twifo Praso, Ghana.
| | | | - Stephen Asare
- Department of Registered General Nursing, Ministry of Health, Twifo Praso Nursing and Midwifery Training College, Central Region, Twifo Praso, Ghana
- College of Health and Allied Sciences, Department of Adult Health, School of Nursing and Midwifery, University of Cape Coast, Central Region, Cape Coast, Ghana
| | - Hannah Yawson
- Department of Registered Midwifery, Ministry of Health, Twifo Praso Nursing and Midwifery Training College, Central Region, Twifo Praso, Ghana
- College of Postgraduates studies, Department of Curriculum development, School of Nursing and Midwifery, University of Cape Coast, Central Region, Cape Coast, Ghana
| | - Ohene Takyi
- Department of Registered General Nursing, Ministry of Health, Methodist Health Training Institute, Afosu-Campus, Afosu, Eastern Region, Ghana
| | - Francisca Akpene Dzidzornu
- Department of Registered Midwifery, Ministry of Health, Twifo Praso Nursing and Midwifery Training College, Central Region, Twifo Praso, Ghana
| | - Henrietta Oye Koram
- Department of Registered Midwifery, Ministry of Health, Twifo Praso Nursing and Midwifery Training College, Central Region, Twifo Praso, Ghana
| | - Edna Ayishetu Johnson
- Department of Registered Midwifery, Ministry of Health, Twifo Praso Nursing and Midwifery Training College, Central Region, Twifo Praso, Ghana
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Getahun GK, Gebremariam ZM, Haile K, Worku AD. Prevalence and associated determinants of suicidal ideation and attempt among people with severe mental disorders in Addis Ababa, Ethiopia a cross-sectional study. Prev Med Rep 2023; 35:102335. [PMID: 37519441 PMCID: PMC10374592 DOI: 10.1016/j.pmedr.2023.102335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 08/01/2023] Open
Abstract
Suicidal ideation and attempts are much more common in people with severe mental disorders than in the general population. As a result, the goal of this study was to look at suicidal ideation and attempts in people with severe mental disorders in Addis Ababa, Ethiopia, in 2022. Using a simple random sample technique, a facility-based cross-sectional study involving 423 patients with severe mental disorders was conducted. The factors associated with suicidal thoughts and attempts were identified using a bivariate and multivariate logistic regression analysis model. Significant factors were determined using a p-value of less than 0.05. The prevalence of suicidal ideation and attempt was 26.4% (95% CI: 22.3-30.99%) and 18.6% (95% CI: 15.2-22.7%), respectively. Moreover, suicidal thoughts were linked with being single (AOR = 2.1.1, 95% CI: 1.01, 4.72), having poor social support (AOR = 3.1, 95% CI: 1.05, 9.422), and having comorbid depression (AOR = 2.72, 95% CI: 1.62, 4.54). Suicidal attempt was also associated with secondary education (AOR = 4.06, 95% CI: 1.50, 10.98), illness duration (AOR = 2.48, 95% CI: 1.15, 5.35), hopelessness (AOR = 3.415, 95% CI: 2.114, 15.516), and the absence of positive symptoms (AOR = 0.37, 95% CI: 0.209, 0.683). A significant proportion of patients with severe mental disorders have contemplated or actually attempted suicide. Poor psychosocial support, a higher level of education, and comorbid depression were all linked to these issues. Therefore, controllable risk factors such as education, hopelessness, and psychosocial support should be prioritized and given particular emphasis.
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Affiliation(s)
- Genanew Kassie Getahun
- Kotebe Metropolitan University, Menelik II Medical and Health Science College, Addis Ababa, Ethiopia
| | | | - Kalkidan Haile
- Amhara Public Health Institute, Public Health Emergency Management Directorate, Resilience and Recovery Team, Bahirdar, Ethiopia
| | - Asmamaw Deguale Worku
- Public Health Emergency Management, Addis Ababa Health Bureau, Addis Ababa, Ethiopia
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Komesuor J, Meyer-Weitz A. Factors associated with mental health of internal migrants (Kayayei) in Agbogbloshie-Ghana. BMC Womens Health 2023; 23:449. [PMID: 37626390 PMCID: PMC10464014 DOI: 10.1186/s12905-023-02582-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The United Nations (UN) Sustainable Development Goal (SDG) Eight (8) advocates for decent work and improved economic outcomes for all. However, internal migrant workers in Ghana, especially female head porters, commonly known as "Kayayei", work in exploitative and hazardous conditions exposing them to physical and mental health risks. Yet, mental health among this vulnerable group of migrants has not been given the needed attention it deserves in the country. We, therefore, examined the factors associated with mental health challenges among internal migrants (Kayayei) in Ghana. METHODS A cross-sectional study among a systematic random sample of 352 Kayayei was conducted in Agbogbloshie-Accra, Ghana. An interviewer-administered questionnaire was used to collect data on the factors impacting the mental health of Kayayei. The study used binary logistic regression in predicting factors impacting mental health distress at a 0.05 level of significance and 95% confidence interval. RESULTS The prevalence of depression, anxiety, and stress were, 305 (86.6%), 332 (94.4), and 149 (42.4), respectively, with 147(41.1%) of respondents having all three mental health issues. The difficult nature of work significantly predicted depression, anxiety, and stress. Respondents who perceived their work as very difficult were 4.3 times, (aOR = 4.36, 95% CI = 2.17, 8.76, p = < 0.001), 3.66 times (aOR = 3.66, 95% CI = 1.37, 9.76, p = 0.009), and 1.73 times (aOR, = 1.73, 95% CI = 1.04, 2.85, p = < 0.009) more likely to be depressed, anxious, and stressed respectfully as compared to those who rate their work as just difficult. CONCLUSION The majority of the Kayayei suffered from mental health distress (depression, anxiety, and Stress) due to their work circumstances. This study suggests that the Ghana Labour Commission must extend the Labour Act 2003(Act 651) to cover the informal sector and create awareness among the Kayayei community to know their rights and report any abuse to law enforcement agencies. It is also suggested that the government, NGOs, and other benevolent organisations train the Kayayei to attain alternative and sustained livelihoods that will not negatively impact their mental health as has been found in the current study. Finally, the government should fully implement the 2012 Mental Health Act to increase awareness and access to quality mental health care.
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Affiliation(s)
- Joyce Komesuor
- School of Public Health, University of Health and Allied Sciences, Ho, Ghana.
| | - Anna Meyer-Weitz
- School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa
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Knettel BA, Knippler E, Martinez A, Sardana S, Agor D, Mwobobia J, Ledbetter L, Amiri I, Relf MV, Goldston DB. A scoping review of counseling interventions for suicide prevention in Africa: Few studies address this life-saving aspect of mental health treatment. J Affect Disord 2023; 328:183-190. [PMID: 36806597 PMCID: PMC10068682 DOI: 10.1016/j.jad.2023.02.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 02/05/2023] [Accepted: 02/11/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Nearly 800,000 people die by suicide each year, with 77 % occurring in low- and middle-income countries. Suicide is underestimated in many African settings due to challenges in data collection, stigma, and policies that promote silence; nonetheless, rates of suicide in Africa are consistently higher than global averages. METHODS We conducted a scoping review of counseling interventions assessing suicide outcomes among adults in Africa using MEDLINE, Embase, PsycINFO, African Index Medicus, CABI Global Health, and Proquest databases. Study screening and data extraction was informed by the JBI Manual for Evidence Synthesis. RESULTS Of 2438 abstracts reviewed, 33 studies met criteria for full-text review and 13 were included in the analysis. Interventions served several populations, including people living with HIV, out of school youth, university students, and women undergoing obstetric fistula repair. There was a near-equal split in individual versus group counseling modalities and the use of professional versus lay counselors. The majority of interventions had primary outcomes focused on other mental health or social variables with a secondary focus on suicide. Mechanisms of change for suicide prevention were poorly articulated. LIMITATIONS The review was limited to English-language studies conducted after 2001 and excluded qualitative studies and those with fewer than 10 participants. CONCLUSIONS There is a clear paucity of research in this area, particularly in the lack of randomized clinical trials and studies with suicide prevention as their primary outcome. Researchers should seek to develop or adapt evidence-based, culturally-resonant interventions to reduce the burden of suicide on the African continent.
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Affiliation(s)
- Brandon A Knettel
- Duke University School of Nursing, Durham, NC, USA; Duke Global Health Institute, Duke University, Durham, NC, USA.
| | - Elizabeth Knippler
- Duke University School of Nursing, Durham, NC, USA; Duke Center for AIDS Research, Duke University, Durham, NC, USA
| | - Alyssa Martinez
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Srishti Sardana
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
| | - David Agor
- University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, NC, USA
| | - Judith Mwobobia
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Leila Ledbetter
- Duke University Medical Center Library and Archives, Durham, NC, USA
| | - Ismail Amiri
- Duke Global Health Institute, Duke University, Durham, NC, USA; Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Michael V Relf
- Duke University School of Nursing, Durham, NC, USA; Duke Global Health Institute, Duke University, Durham, NC, USA
| | - David B Goldston
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
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Fadare O, Zanello G, Srinivasan C. Stressor or succour? Examining the association between conflict, livestock assets, and farmers' mental health in Nigeria. ECONOMICS AND HUMAN BIOLOGY 2023; 49:101234. [PMID: 36848719 DOI: 10.1016/j.ehb.2023.101234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 02/11/2023] [Accepted: 02/12/2023] [Indexed: 05/08/2023]
Abstract
Farmers are disproportionately vulnerable to violent attacks in the conflict situation in Nigeria, with potential traumatising effects due to the destruction of agricultural livelihoods. In this study, we conceptualise the links between conflict exposure, livestock assets, and depression, using a cross-sectional nationally representative survey of 3021 Nigerian farmers to quantify the relationships. We highlight three main findings. First, conflict exposure is significantly associated with farmers exhibiting depressive symptoms. Second, holding higher herds of livestock, more cattle, and more sheep and goats while exposed to conflict is associated with higher risk of depression. Third, keeping more poultry is negatively associated with depressive symptoms. Finally, this study accentuates the significance of psychosocial support for farmers in conflict situations. The relationships between different livestock species and farmers' mental health may interest further research in strengthening the evidence.
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Affiliation(s)
- Olusegun Fadare
- School of Agriculture, Policy and Development, University of Reading, Whiteknights, Reading RG6 6EU, UK.
| | - Giacomo Zanello
- School of Agriculture, Policy and Development, University of Reading, Whiteknights, Reading RG6 6EU, UK.
| | - Chittur Srinivasan
- School of Agriculture, Policy and Development, University of Reading, Whiteknights, Reading RG6 6EU, UK.
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Psychological Distress Increases 30-Fold Among People with HIV in the First Year on ART in Nigeria-a Call for Integrated Mental Health Services. Int J Behav Med 2023; 30:38-48. [PMID: 35226343 PMCID: PMC8883753 DOI: 10.1007/s12529-022-10068-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Few studies have longitudinally assessed psychological distress among people with HIV (PWH) initiating ART in resource-limited settings. METHOD Baseline, 6-month, and 12-month psychological distress were measured in a Nigerian cohort newly initiating therapy; the relationship between baseline factors and psychological distress at 12 months was assessed; and the association between psychological distress at 12 months and care retention or immunologic failure was determined. RESULTS Among 563 patients, median age was 38 years (IQR: 33-46 years), 62% were female, and 51% were married. Psychological distress increased from 3% at baseline to 34% at 12 months. Age (aOR 1.28, 95% CI 1.06-1.56), female sex (aOR 2.89, 95% CI 1.93-4.33), lack of disclosure (aOR 4.32, 95% CI 2.48-7.51), and time on ART (6 months [aOR 6.91, 95% CI 3.14-15.18] and 12 months [aOR 32.63, 95% CI 16.54-64.36]) were associated with psychological distress while being married (OR 0.42, 95% CI 0.30-0.61) was associated with reduced odds. Tweve-month psychological distress was associated with increased risk of immunologic failure (aOR 2.22, 95% CI 1.31-3.82). CONCLUSION The risk of psychological distress increased 30-fold in the first year on therapy in PWH in Nigeria.
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Iyanda AE, Krishnan B, Adeusi TJ. Epidemiology of suicidal behaviors among junior and senior high school adolescents: Exploring the interactions between bullying victimization, substance use, and physical inactivity. Psychiatry Res 2022; 318:114929. [PMID: 36332504 DOI: 10.1016/j.psychres.2022.114929] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 10/17/2022] [Accepted: 10/23/2022] [Indexed: 11/19/2022]
Abstract
Suicide is a pandemic among global youths and adolescents. Still, there is insufficient evidence to show whether the interactions between bullying victimization, physical inactivity, substance use, and mental health illness aggravate suicidal behaviors among high school students. Based on the Global School-Based Student Health Survey, we analyzed the individual and interaction impacts of bullying victimization, physical inactivity, substance use, and suicidal behaviors among 3,632 adolescents. The 12-month prevalence of suicidal thoughts and plans among senior high school students was over fifty percent. Junior high school students had higher rates of suicide attempts and bullying victimization than senior high school students. Multivariate results indicate that bullying victimization, substance use, and physical inactivity were significantly associated with suicidal thoughts, plans, and attempts among high school students. The interaction of physical inactivity and alcohol was significantly associated with suicidal thoughts in junior high school. In contrast, the interaction of bullying and alcohol was associated with suicidal plans among senior high school adolescents. We hope the findings from this study will generate interventions toward reducing the suicide epidemic in Ghana.
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Affiliation(s)
| | - Bargavi Krishnan
- Department of Human Sciences, Prairie View A&M University, Prairie View, Texas 77446
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Multiple aspects of energy poverty are associated with lower mental health-related quality of life: A modelling study in three peri-urban African communities. SSM - MENTAL HEALTH 2022; 2:100103. [PMID: 36688234 PMCID: PMC9792378 DOI: 10.1016/j.ssmmh.2022.100103] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 04/20/2022] [Accepted: 04/20/2022] [Indexed: 02/01/2023] Open
Abstract
Objective Over 900 million people in sub-Saharan Africa (SSA) live in energy poverty, relying on cooking polluting fuels (e.g. wood, charcoal). The association between energy poverty and mental/physical health-related quality of life (HRQoL) among women in SSA, who are primarily tasked with cooking, is unknown. Methods Females (n = 1,150) from peri-urban Cameroon, Kenya and Ghana were surveyed on their household energy use and mental/physical health status using the standardized Short-Form 36 (SF-36) questionnaire. Random effects linear regression linked household energy factors to SF-36 mental (MCS) and physical component summary (PCS) scores. A binary outcome of 'likely depression' was derived based on participants' MCS score. Random effects Poisson regression with robust error variance assessed the relationship between household energy factors and odds of likely depression. Results The prevalence of likely depression varied by a factor of four among communities (36%-Mbalmayo, Cameroon; 20%-Eldoret, Kenya; 9%-Obuasi, Ghana). In the Poisson model (coefficient of determination (R2) = 0.28), females sustaining 2 or more cooking-related burns during the previous year had 2.7 (95%CI:[1.8,4.1]) times the odds of likely depression as those not burned. Females cooking primarily with charcoal and wood had 1.6 times (95%CI:[0.9,2.7]) and 1.5 times (95%CI:[0.8,3.0]) the odds of likely depression, respectively, as those primarily using liquefied petroleum gas. Women without electricity access had 1.4 (95%CI:[1.1,1.9]) times the odds of likely depression as those with access. In the MCS model (R2 = 0.23), longer time spent cooking was associated with a lower average MCS score in a monotonically increasing manner. In the PCS model (R2 = 0.32), women injured during cooking fuel collection had significantly lower (-4.8 95%CI:[-8.1,-1.4]) PCS scores. Conclusion The burden of energy poverty in peri-urban communities in SSA extends beyond physical conditions. Experiencing cooking-related burns, using polluting fuels for cooking or lighting and spending more time cooking are potential risk factors for lower mental HRQoL among women.
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Ainamani HE, Gumisiriza N, Bamwerinde WM, Rukundo GZ. Gardening activity and its relationship to mental health: Understudied and untapped in low-and middle-income countries. Prev Med Rep 2022; 29:101946. [PMID: 35991326 PMCID: PMC9389296 DOI: 10.1016/j.pmedr.2022.101946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 07/30/2022] [Accepted: 08/05/2022] [Indexed: 11/01/2022] Open
Abstract
There is increasing awareness among researchers and health practitioners from high income countries about the potential mental health benefits of participating in gardening activities and spending substantial time in green spaces. However, this phenomenon is not well established in low- and middle-income countries. In this commentary, we discuss the evidence base surrounding the potential mental health benefits of participating in gardening activity and spending substantial time in a green space. We hope to stimulate discourse about incorporating these activities into mental health prevention in low- and middle-income countries.
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Affiliation(s)
- Herbert E. Ainamani
- Department of Mental Health, Kabale University School of Medicine, P. O. Box 317, Kabale, Uganda
| | - Nolbert Gumisiriza
- Department of Mental Health, Kabale University School of Medicine, Kabale, Uganda
| | - Wilson M. Bamwerinde
- Department of Environment and Natural Resources, Kabale University, Kabale, Uganda
| | - Godfrey Z. Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
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Khan S, Scorza P, Lovero KL, dos Santos P, Fumo W, Camara B, Oquendo MA, Wainberg ML, Fejo M, Duarte CS. Women's mental health in Mozambique: is maternity a protective factor? Glob Ment Health (Camb) 2022; 9:38-44. [PMID: 36618727 PMCID: PMC9806954 DOI: 10.1017/gmh.2022.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 12/16/2021] [Accepted: 01/02/2022] [Indexed: 01/11/2023] Open
Abstract
Backgroud Globally, women have been shown to have high rates of common mental disorders (CMDs). In low and middle-income countries (LMICs), women face significant challenges related to maternity. However, no study has compared mental health problems among pregnant/post-partum women, childless women of childbearing age, and women with children in a low-income country. We sought to compare the frequency of CMD and suicide risk in a sample of women presenting or accompanying patients in primary care in two Mozambican semi-urban settings. Methods We administered the MINI International Neuropsychiatric Interview to 853 women, of whom 220 (25.8%) were pregnant/post-partum, 177 (20.8%) were non-pregnant and childless, and 456 (53.5%) were non-pregnant and with children more than 1-year-old. Logistic regression models compared the likelihood of a psychiatric disorder across groups, adjusting for sociodemographic and chronic-illness covariates. Results We found a high frequency of CMD and suicide risk among all women in this low-income context sample. In adjusted models, no differences in rates of depression, anxiety, or panic disorder were observed among groups. However, suicide risk was higher in women without children than pregnant/post-partum women. Conclusion The frequency of CMD among women of childbearing age in our study was higher than documented rates in high-income countries and other LMIC. Additionally, we found that motherhood was not protective and that pregnancy and the postpartum period were not stages of increased risk for most disorders. This highlights the need to expand mental health services not only for perinatal women but all women of childbearing age in this and possibly similar settings.
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Affiliation(s)
- Saida Khan
- Department of Mental Health, Ministry of Health, Av. Eduardo Mondlane/Av. Salvador Allende P.O. Box 1613, Maputo, Mozambique
- Department of Psychiatry, Universidade Federal de São Paulo, Rua Major Marrigliano, 241, São Paulo, São Paulo, Brazil
| | - Pamela Scorza
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Dr. Unit #24, New York, New York, USA
| | - Kathryn L. Lovero
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Dr. Unit #24, New York, New York, USA
| | - Palmira dos Santos
- Department of Mental Health, Ministry of Health, Av. Eduardo Mondlane/Av. Salvador Allende P.O. Box 1613, Maputo, Mozambique
| | - Wilza Fumo
- Department of Mental Health, Ministry of Health, Av. Eduardo Mondlane/Av. Salvador Allende P.O. Box 1613, Maputo, Mozambique
- Department of Psychiatry, Universidade Federal de São Paulo, Rua Major Marrigliano, 241, São Paulo, São Paulo, Brazil
| | - Barbara Camara
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Dr. Unit #24, New York, New York, USA
| | - Maria A. Oquendo
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street Suite 200, Philadelphia, Pennsylvania, USA
| | - Milton L. Wainberg
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Dr. Unit #24, New York, New York, USA
| | - Marcelo Fejo
- Department of Psychiatry, Universidade Federal de São Paulo, Rua Major Marrigliano, 241, São Paulo, São Paulo, Brazil
| | - Cristiane S. Duarte
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Dr. Unit #24, New York, New York, USA
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Levels of depression, anxiety, and psychological distress among Ugandan adults during the first wave of the COVID-19 pandemic: cross-sectional evidence from a mobile phone-based population survey. Glob Ment Health (Camb) 2022; 9:274-284. [PMID: 36618739 PMCID: PMC9807010 DOI: 10.1017/gmh.2022.28] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 05/02/2022] [Accepted: 05/14/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES Policy measures to slow the spread of coronavirus disease 2019 (COVID-19), such as curfews and business closures, may have negative effects on mental health. Populations in low- and middle-income countries (LMICs) may be particularly affected due to high rates of poverty and less comprehensive welfare systems, but the evidence is scarce. We evaluated predictors of depression, anxiety, and psychological distress in Uganda, which implemented one of the world's most stringent lockdowns. METHODS We conducted a mobile phone-based cross-sectional survey from December 2020 through April 2021 among individuals aged 18 years or over in Uganda. We measured depression, anxiety, and psychological distress using the Patient Health Questionnaire (PHQ)-2, the Generalized Anxiety Disorder (GAD)-2, and the PHQ-4. We applied linear regression to assess associations between experiences of COVID-19 (including fear of infection, social isolation, income loss, difficulty accessing medical care, school closings, and interactions with police) and PHQ-4 score, adjusted for sociodemographic characteristics. RESULTS 29.2% of 4066 total participants reported scores indicating moderate psychological distress, and 12.1% reported scores indicating severe distress. Distress was most common among individuals who were female, had lower levels of education, and lived in households with children. Related to COVID-19, PHQ-4 score was significantly associated with difficulty accessing medical care, worries about COVID-19, worries about interactions with police over lockdown measures, and days spent at home. CONCLUSIONS There is an urgent need to address the significant burden of psychological distress associated with COVID-19 and policy responses in LMICs. Pandemic mitigation strategies must consider mental health consequences.
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Bukuluki P, Kisaakye P, Wandiembe SP, Besigwa S. Suicide ideation and psychosocial distress among refugee adolescents in Bidibidi settlement in West Nile, Uganda. DISCOVER PSYCHOLOGY 2021. [PMCID: PMC8488914 DOI: 10.1007/s44202-021-00003-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
This study investigated the factors associated with suicidal ideation and psychological distress among Sudanese refugees (aged 10–19 years) in Bidibidi refugee settlement, Yumbe district, Uganda. The analysis is based on cross-sectional data collected as part of the implementation of a project on sexual and reproductive health in Bidibidi refugee settlement. Data were collected from 284 South Sudanese adolescents in July 2020. We estimated the prevalence of psychological distress and suicidal ideation, and their associated profiles. Odds ratios and their 95% Confidence Intervals based on a logistic regression model were used to assess the effect of different potential factors on the risk profiles for suicidal ideation and psychological distress. The prevalence of psychological distress (on KS-6 scale) was estimated to be 12.3% (95%CI: 8.7, 16.7%). The risk for psychological distress is low among male adolescents (AOR = 0.51; 95%CI: 0.23, 1.02), older adolescents, (AOR = 0.12; 95%CI: 0.04, 0.40), and adolescents with a friend or family members they can confide in (AOR = 0.33; 95%CI: 0.11, 0.96). Both suicidal ideation and psychological distress are very high among the female adolescents. Familial and individual interventions can be potentially useful for female adolescents who have a high risk of suicide and psychological distress.
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Affiliation(s)
- Paul Bukuluki
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
| | - Peter Kisaakye
- Department of Population Studies, School of Statistics and Planning, Mathematics Building, Makerere University Main Campus, P O Box 7062, Kampala, Uganda
| | - Symon Peter Wandiembe
- Department of Statistical Methods, School of Statistics and Planning, Makerere University, Kampala, Uganda
| | - Samuel Besigwa
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
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Hossain A, Ahmed B, Rahman T, Sammonds P, Zaman S, Benzadid S, Jakariya M. Household food insecurity, income loss, and symptoms of psychological distress among adults following the Cyclone Amphan in coastal Bangladesh. PLoS One 2021; 16:e0259098. [PMID: 34727102 PMCID: PMC8562802 DOI: 10.1371/journal.pone.0259098] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 10/12/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Cyclone Amphan swept into Bangladesh's southwestern coast at the end of May 2020, wreaking havoc on food security and economic stability, as well as possibly worsening mental health. We studied the prevalence of post-cyclone stressors in adults following the cyclone and its association with symptoms of psychological distress. METHODS We conducted a cross-sectional study in a coastal district of Bangladesh. A five-item brief symptom rating scale was used to measure the symptoms of psychological distress. Household food insecurity was measured using the USAID Household Food Insecurity Access Scale questionnaire. We estimated adjusted prevalence ratios (aPRs) using robust log-linear models adjusted for potential confounders. RESULTS A total of 478 adults (mean [SD] age, 37.0[12.6] years; 169[35.4%] women) participated in the study. The prevalence of moderate-to-severe psychological symptoms and suicidal ideation was 55.7% and 10.9%, respectively. Following the cyclone, 40.8% of the adults reported severe food insecurity, and 66% of them reported moderate-to-severe mental health symptoms. Also, 54.4% of women and 33.7% of men reported severe food insecurity in the households. Moreover, 25.5% of respondents reported no income or a significant income loss after the cyclone, and 65.5% of them had moderate-to-severe psychological symptoms. Also, 13.8% of respondents reported housing displacement because of severely damaged houses, and 68.2% of them reported moderate-to-severe psychological symptoms. The high prevalence of mental health symptoms was found in women (aPR = 1.41, 95% CI = 1.06-1.82), people with severe food insecurity (aPR = 1.63, 95% CI = 1.01-2.64), and people who lost jobs or lost a major income source (aPR = 1.25, 95% CI = 1.02-1.54). CONCLUSION Following cyclone Amphan, many low-income individuals saw their income drop drastically while others were unemployed and living with severe food insecurity. The result suggests gender inequalities in food-security after the cyclone. Immediate action is needed to ensure household food-security for reducing the burden of mental illness. Rising opportunities of paid-jobs and decreasing income-loss, especially for the poor people, can have a protective impact on psychological distress. However, due to the high prevalence of severe psychological symptoms, long-term mental health services are required among the population of coastal Bangladesh.
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Affiliation(s)
- Ahmed Hossain
- Department of Public Health, North South University, Dhaka, Bangladesh
- Global Health Institute, North South University (NSU), Bashundhara, Dhaka, Bangladesh
- Health Management BD Foundation, Sector 6, Uttara, Dhaka, Bangladesh
| | - Bayes Ahmed
- Institute for Risk and Disaster Reduction (IRDR), University College London (UCL), London, United Kingdom
- Department of Disaster Science and Management, Faculty of Earth and Environmental Sciences, University of Dhaka, Dhaka, Bangladesh
| | - Taifur Rahman
- Department of Public Health, North South University, Dhaka, Bangladesh
- Health Management BD Foundation, Sector 6, Uttara, Dhaka, Bangladesh
| | - Peter Sammonds
- Institute for Risk and Disaster Reduction (IRDR), University College London (UCL), London, United Kingdom
| | - Shamrita Zaman
- Institute for Risk and Disaster Reduction (IRDR), University College London (UCL), London, United Kingdom
| | - Shadly Benzadid
- Department of Public Health, North South University, Dhaka, Bangladesh
- Health Management BD Foundation, Sector 6, Uttara, Dhaka, Bangladesh
| | - Md. Jakariya
- Department of Public Health, North South University, Dhaka, Bangladesh
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The Mental Health Outcomes of Food Insecurity and Insufficiency in West Africa: A Systematic Narrative Review. Behav Sci (Basel) 2021; 11:bs11110146. [PMID: 34821607 PMCID: PMC8614760 DOI: 10.3390/bs11110146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 10/17/2021] [Accepted: 10/19/2021] [Indexed: 11/29/2022] Open
Abstract
(1) Background: Food insufficiency is a global pandemic affecting many people, especially those residing in developing countries. African countries have been affected by food insufficiency, which is mostly caused by drought or wars. Famine or food insufficiency has been reported to have an impact on the psychological health and quality of life of people affected. This review assessed the mental health outcomes of famine and food insufficiency in West Africa. (2) Methods: A search of the published literature was conducted using PubMed, PsycExtra, Medline, and PsycINFO databases. The search was limited to papers published in English between the years 2010 and 2020. Two reviewers independently screened the titles and abstracts of the retrieved papers using pre-defined inclusion and exclusion criteria and a third reviewer resolved conflicts. Data were extracted and appraised using a data extraction form and an appraisal checklist. (3) Results: A total of 81 papers were identified through the journal databases search. Out of the seven papers that met the inclusion criteria, six papers used cross-sectional designs and one paper used an experimental design. The six papers used quantitative approach for data collection, while the one paper used a qualitative technique. The evidence synthesized from this review indicated that exposure to food insecurity or insufficiency is associated with increased psychological distress including anxiety, sleeplessness, intellectual disability, general mental, and emotional instability. (4) Conclusions: This review strongly highlights the need for further research across the sub-region. It further suggests that famine and food insufficiency are associated with significant mental health problems in adults and impacts the cognitive and intellectual development of children. Although there is paucity of literature about famine and its impact on mental health in West Africa, these findings are important for developing social policy initiatives for increasing food supply and mental health interventions for all ages.
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Factors Associated with Suicidal Behavior in Farmers: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126522. [PMID: 34204344 PMCID: PMC8296393 DOI: 10.3390/ijerph18126522] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 04/29/2021] [Accepted: 04/29/2021] [Indexed: 11/17/2022]
Abstract
This review aimed to investigate the factors associated with suicidal behavior in farmers in the scientific literature. Two researchers participated independently in searching databases, specifically PubMed/MEDLINE, LILACS, Web of Science, Scopus, PsycINFO, and SciELO. Only observational studies were included. The quality of the selected studies was assessed with a critical assessment checklist for cross-sectional analytical and case-control studies, prepared by the Joanna Briggs Institute. Data related to the publication were collected (author and year; city/country); methodological design; sample/population (gender; average age), outcome, measuring instrument and factors associated with suicidal behavior. A total of 14 studies were included in the systematic review, and factors associated with farmers' behavior in mental health (depression), seasonal impacts (drought), and work exposures (herbicides and insecticides) were identified. However, heterogeneity was found in terms of the method, measurement of suicidal behavior, and associated factors, which indicates the need for further studies.
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Abstract
PURPOSE OF REVIEW Food insecurity is the lack of sufficient food in quantity and/or quality. Psychological distress includes mental health issues such as depression and anxiety. This review provides current information on research examining the association between food insecurity and psychological distress. RECENT FINDINGS Among studies published in the previous 5 years, food insecurity was significantly and positively associated with multiple indicators of psychological distress. This included cross-sectional and longitudinal studies, as well as primary data collection and secondary data analyses, from countries of varying income levels. Articles also provided evidence within various populations, such as adults of all ages, college students, those living with chronic disease, and parents. Food insecurity and psychological distress are interconnected health issues. Future research should consider a number of important gaps in the literature, with the most important being the development of interventions to improve food insecurity and psychological health concurrently.
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Affiliation(s)
- Candice A Myers
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
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Cavazos-Rehg P, Byansi W, Doroshenko C, Neilands TB, Anako N, Sensoy Bahar O, Kasson E, Nabunya P, Mellins CA, Ssewamala FM. Evaluating potential mediators for the impact of a family-based economic intervention (Suubi+Adherence) on the mental health of adolescents living with HIV in Uganda. Soc Sci Med 2021; 280:113946. [PMID: 34020312 DOI: 10.1016/j.socscimed.2021.113946] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/26/2021] [Accepted: 04/14/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Many adolescents living with HIV in sub-Saharan Africa (SSA) experience poverty and have access to limited resources, which can impact HIV and mental health outcomes. Few studies have analyzed the impact of economic empowerment interventions on the psychosocial wellbeing of adolescents living with HIV in low resource communities, and this study aims to examine the mediating mechanism(s) that may explain the relationship between a family economic empowerment intervention (Suubi + Adherence) and mental health outcomes for adolescents (ages 10-16 at enrollment) living with HIV in Uganda. METHOD We utilized data from Suubi + Adherence, a large-scale six-year (2012-2018) longitudinal randomized controlled trial (N = 702). Generalized structural equation models (GSEMs) were conducted to examine 6 potential mediators (HIV viral suppression, food security, family assets, and employment, HIV stigma, HIV status disclosure comfort level, and family cohesion) to determine those that may have driven the effects of the Suubi + Adherence intervention on adolescents' mental health. RESULTS Family assets and employment were the only statistically significant mediators during follow-up (β from -0.03 to -0.06), indicating that the intervention improved family assets and employment which, in turn, was associated with improved mental health. The proportion of the total effect mediated by family assets and employment was from 42.26% to 71.94%. CONCLUSIONS Given that mental health services provision is inadequate in SSA, effective interventions incorporating components related to family assets, employment, and financial stability are crucial to supporting the mental health needs of adolescents living with HIV in under-resourced countries like Uganda. Future research should work to develop the sustainability of such interventions to improve long-term mental health outcomes among this at-risk group.
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Affiliation(s)
- Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA.
| | - William Byansi
- Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Christine Doroshenko
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA
| | - Torsten B Neilands
- University of California, San Francisco, School of Medicine, 533 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Nnenna Anako
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA; Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Ozge Sensoy Bahar
- Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Erin Kasson
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA
| | - Proscovia Nabunya
- Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Claude A Mellins
- Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Fred M Ssewamala
- Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130, USA
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Trudell JP, Burnet ML, Ziegler BR, Luginaah I. The impact of food insecurity on mental health in Africa: A systematic review. Soc Sci Med 2021; 278:113953. [PMID: 33971482 DOI: 10.1016/j.socscimed.2021.113953] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/30/2021] [Accepted: 04/15/2021] [Indexed: 11/18/2022]
Abstract
In 2018, 676.1 million people in Africa (52.5% of the population) were moderately or severely food insecure. This exceptionally high prevalence continues to increase as Africa experiences conflict, climate change, and economic declines. When Sustainable Development Goal 2.1 set out to end hunger and ensure access to sufficient food, particularly for vulnerable populations, by 2030, food insecurity emerged as a global priority. Food insecurity has been hypothesized to negatively impact mental health, a stigmatized area of health in Africa for which care is often inaccessible. This systematic review examines existing literature on the relationship between food insecurity and mental health in Africa, where progress remains to be made on both fronts. A systematic search of seven databases (EMBASE, Web of Science, CINAHL, PsychINFO ProQuest, Medline Ovid, Scopus, and Nursing and Allied Health) was conducted. Results were limited to studies examining food insecurity and mental health, written in English and published between January 2000 and May 2020. After title, abstract, full-text review, and quality appraisal using tools from the National Heart, Lung, and Blood Institute, 64 studies remained. Findings were summarized using a narrative synthesis approach. Studies unanimously highlighted that food insecurity is associated with poor mental health. This relationship was dose-responsive and independent of the measured mental health outcome. Two highly represented groups in the literature were women around pregnancy and people affected by HIV/AIDS. Factors which mediated the relationship included age, sex, social interactions, physical health, seasonality, and rural residence. The findings suggest that the relationship is likely amplified in specific populations such as women and seniors, and interventions which target livelihood as opposed to income may be more effective. Further research is needed which compares food insecurity's effect on mental health between at-risk populations, in order to guide resource allocation and context-specific policy making.
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Affiliation(s)
- John Paul Trudell
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, Ontario, N6A 3K7, Canada
| | - Maddison L Burnet
- Faculty of Health Sciences, Western University, 1151 Richmond Street, London, Ontario, N6A 3K7, Canada
| | - Bianca R Ziegler
- Department of Geography, Western University, 1151 Richmond Street, London, Ontario, N6A 3K7, Canada; Environment Health and Hazards Lab, Western University, 1151 Richmond Street, London, Ontario, N6A 3K7, Canada.
| | - Isaac Luginaah
- Department of Geography, Western University, 1151 Richmond Street, London, Ontario, N6A 3K7, Canada; Environment Health and Hazards Lab, Western University, 1151 Richmond Street, London, Ontario, N6A 3K7, Canada
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Bukuluki P, Wandiembe S, Kisaakye P, Besigwa S, Kasirye R. Suicidal Ideations and Attempts Among Adolescents in Kampala Urban Settlements in Uganda: A Case Study of Adolescents Receiving Care From the Uganda Youth Development Link. FRONTIERS IN SOCIOLOGY 2021; 6:646854. [PMID: 34368292 PMCID: PMC8334726 DOI: 10.3389/fsoc.2021.646854] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/26/2021] [Indexed: 05/21/2023]
Abstract
There is an increasing recognition that suicidal ideation is a major public health concern in sub-Saharan Africa. We employed a case study design, taking a case study of adolescents currently under the care of Uganda Youth Development Link (UYDEL). The data analyzed were collected from 219 female and male adolescents (13-19 years) recruited through UYDEL in Kampala, Uganda. A Poisson regression model with robust variance was used to assess the risk factors associated with suicidality. The prevalence of suicidal ideation in the past 4 weeks and attempt within the past 6 months among adolescents was 30.6% (95% CI: 24.8, 38.0%) and 24.2% (95% CI: 18.7, 30.4%), respectively. The most stressful precursors of suicidal ideation or attempt included financial difficulties (59.5%), family breakdown or conflicts (37.4%), and trauma (23.1%). Suicidal ideation in the past 1 week preceding the survey was as high as 13.3% (95% CI: 9.0, 18.6%), of which 75.0% (95% CI: 55.1%, 89.3%) had a suicide plan. Prevalence of suicidal ideation in the past 4 weeks was significantly higher among respondents with moderate psychological distress [Prevalence Ratio (PRR) = 2.74; 95% CI: 0.96, 7.84] and severe psychological distress (PRR = 4.75; 95% CI: 1.72, 13.08) but lower among adolescents who knew where to obtain professional psychological care (PRR = 0.51; 95% CI: 0.30, 0.87). Similarly, suicidal attempt was significantly higher among respondents with moderate psychological distress (PRR = 4.72; 95% CI: 1.01, 12.03) and severe psychological distress (PRR = 11.8; 95% CI: 4.66, 32.37), and who abuse drugs or substances (PRR = 2.13; 95% CI: 1.13, 4.01). Therefore, suicidal ideation is a major public health issue among adolescents living in poor urban settlements in Kampala, Uganda. Psychological distress due to financial difficulties, unemployment, and family breakdown are major facilitators of suicidality among adolescents in urban poor settlements in Kampala. Interventions aimed at preventing suicide among vulnerable adolescents in urban settlements in Kampala, Uganda should incorporate this unique risk factor profile.
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Affiliation(s)
- Paul Bukuluki
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
- *Correspondence: Paul Bukuluki
| | - Symon Wandiembe
- Department of Statistical Methods, School of Statistics and Planning, Makerere University, Kampala, Uganda
| | - Peter Kisaakye
- Department of Population Studies, School of Statistics and Planning, Makerere University, Kampala, Uganda
| | - Samuel Besigwa
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
| | - Rogers Kasirye
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
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Abstract
Background: Despite recent media reports showing disturbing trends of police suicides in Ghana, no published studies are available from the country. Aims: We sought to estimate the prevalence and describe some of the correlates of suicidal behaviors among police officers in the Greater Accra Region of Ghana. Method: We surveyed a convenience sample of 268 police officers, using the Suicide Behavior Questionnaire-Revised to assess suicidal ideation, planning, threat, and attempt. Results: Whereas lifetime suicidal ideation (28%), planning (3%), threat (21.6%), and 12-month suicidal ideation (26.9%) were reported, no participating police officer reported ever attempting suicide. Moonlighting showed the strongest statistically significant association with 12-month suicidal ideation, while age, marital status, and job satisfaction also emerged as statistically significant correlates of suicidal ideation. Limitations: The busy nature of police work precluded random selection. The criminalized and tabooed status of attempted suicide in Ghana might have led participants to provide guarded and socially desirable responses. Conclusion: Intervention efforts are needed to prevent the onset of suicidal ideation and possible transition to suicide among police officers in Ghana.
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Affiliation(s)
- Emmanuel Nii-Boye Quarshie
- School of Psychology, University of Leeds, UK.,Centre for Suicide and Violence Research (CSVR), Accra, Ghana
| | | | - Francis Annor
- Centre for Suicide and Violence Research (CSVR), Accra, Ghana.,Department of Psychology, University of Ghana, Accra, Ghana
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Hoang MT, Do KN, Pham HQ, Nguyen CT, Ha GH, Vu GT, Tran BX, Latkin C, Ho RCM, Ho CS. Psychological distress among mountainous farmers in Vietnam: a cross-sectional study of prevalence and associated factors. BMJ Open 2020; 10:e038490. [PMID: 32764088 PMCID: PMC7412583 DOI: 10.1136/bmjopen-2020-038490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Psychological distress has been known as a major health problem among farmers across the world. In Vietnam, approximately 50% of farmers have lived in rural and mountainous areas. Yet, little has been known about how psychological distress impacts mountainous farmers' health. OBJECTIVES This study aimed to examine the prevalence and risk factors related to psychological distress among mountainous farmers in Vietnam. DESIGN AND SETTING A cross-sectional study was performed from August to September 2018 in Moc Chau district, Vietnam. A structured questionnaire and face-to-face interviews were used for data collection. PARTICIPANTS A random sample of 197 farmers aged at least 18 years, spoke Vietnamese, was not suffering from severe diseases and residing in Moc Chau at the time of the survey were recruited. PRIMARY AND SECONDARY OUTCOME MEASURES The Kessler Psychological Distress Scale (K6) was employed to measure psychological distress. The tobit and logistic regressions were applied to indicate associated factors. RESULTS The prevalence of psychological distress was 38.2% (95% CI 31.3% to 45.5%). Having a greater comorbidities (OR=6.17; 95% CI 1.44 to 26.43), drinking alcohol (OR=3.86; 95% CI 1.02 to 14.59) and obtaining health information from health workers (OR=3.77; 95% CI 1.22 to 11.66) were positively associated with the prevalence of psychological distress. By contrast, being overweight (OR=0.29; 95% CI 0.09 to 0.93), adopting books as the primary source of health information (OR=0.11; 95% CI 0.01 to 0.8), and receiving a higher number of home visits by community health workers (CHWs) (OR=0.38; 95% CI 0.14 to 0.99) were negatively associated with the prevalence of psychological distress. CONCLUSION This study highlighted a high prevalence of psychological distress among mountainous farmers. Providing routine psychological and physical health screening, developing CHWs to provide clinical support and raising health awareness are critical implications for reducing psychological distress in this population.
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Affiliation(s)
- Men Thi Hoang
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Pharmacy, Duy Tan University, Da Nang, Viet Nam
| | - Khanh Nam Do
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Medicine, Duy Tan University, Da Nang, Viet Nam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Medicine, Duy Tan University, Da Nang, Viet Nam
| | - Giang Hai Ha
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Pharmacy, Duy Tan University, Da Nang, Viet Nam
| | - Giang Thu Vu
- Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh, Viet Nam
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - Carl Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| | - Cyrus Sh Ho
- Department of Psychological Medicine, National University Hospital, Singapore
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Abstract
PURPOSE OF REVIEW Food insecurity is the lack of sufficient food in quantity and/or quality. Psychological distress includes mental health issues such as depression and anxiety. This review provides current information on research examining the association between food insecurity and psychological distress. RECENT FINDINGS Among studies published in the previous 5 years, food insecurity was significantly and positively associated with multiple indicators of psychological distress. This included cross-sectional and longitudinal studies, as well as primary data collection and secondary data analyses, from countries of varying income levels. Articles also provided evidence within various populations, such as adults of all ages, college students, those living with chronic disease, and parents. Food insecurity and psychological distress are interconnected health issues. Future research should consider a number of important gaps in the literature, with the most important being the development of interventions to improve food insecurity and psychological health concurrently.
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Affiliation(s)
- Candice A. Myers
- Pennington Biomedical Research Center, Baton Rouge, 70808, Louisiana, USA,Corresponding author at: Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA, , Tel: (225) 763-2849
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Lillie M, Gallis JA, Hembling J, Owusu RK, Ali M, Abubakr-Bibilazu S, Aborigo R, Adam H, McEwan E, Awoonor-Williams JK, Baumgartner JN. Prevalence and Correlates of Depression Among Pregnant Women Enrolled in a Maternal and Newborn Health Program in Rural Northern Ghana: a Cross-sectional Survey. GLOBAL SOCIAL WELFARE : RESEARCH, POLICY & PRACTICE 2020; 7:131-140. [PMID: 32509505 PMCID: PMC7252621 DOI: 10.1007/s40609-020-00170-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Women in many sub-Saharan African countries are at elevated risk of depression during pregnancy. However, there are still gaps in the estimates of antenatal depression and associated risk factors in very low-resource settings such as Northern Ghana. This study describes the prevalence of depression among rural pregnant women, participating in a maternal and child health program, in Ghana, and examines associated risk factors for depression. Pregnant women who were registered for group-based maternal and child health community programs were recruited for study participation from 32 communities in two rural districts in Northern Ghana (n = 374). Baseline surveys were conducted and depression was assessed using the Patient Health Questionnaire (PHQ-9). Bivariate and multivariable analyses used a modified Poisson and generalized estimating equations (GEE) model. Of the women in our study population, 19.7% reported symptoms indicative of moderate to severe depression (PHQ-9 score ≥ 10), with 14.1% endorsing suicidal ideation in the last 2 weeks. Bivariate analyses revealed that lower hopefulness, moderate and severe hunger, experiences of emotional, physical, and/or sexual intimate partner violence (IPV), and insufficient social support from female relatives were associated with symptoms indicating moderate to severe depression. In the multivariable analyses, low hopefulness, household hunger, emotional IPV, physical and/or sexual IPV, and insufficient female relative support remained significantly associated with depression. Antenatal depression is associated with unmet basic needs and safety. Perinatal mental health programming must take an ecological perspective and address personal, familial, and community-level factors.
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Affiliation(s)
| | - John A. Gallis
- Duke Department of Biostatistics and Bioinformatics, Durham, NC USA
| | - John Hembling
- Catholic Relief Services Head Quarters, Baltimore, MD USA
| | | | - Mohammed Ali
- Catholic Relief Services Country Office, Tamale, Ghana
| | | | | | - Haliq Adam
- Catholic Relief Services Country Office, Tamale, Ghana
| | - Elena McEwan
- Catholic Relief Services Head Quarters, Baltimore, MD USA
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Zelalem A, Gebremariam Kotecho M, Adamek ME. "The Ugly Face of Old Age": Elders' Unmet Expectations for Care and Support in Rural Ethiopia. Int J Aging Hum Dev 2020; 92:215-239. [PMID: 32223564 DOI: 10.1177/0091415020911900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
As migration, urbanization, and aging accelerate in developing nations, traditional family supports for elders are diminishing. With these trends in mind, hermeneutic phenomenology was used to examine the experiences of 10 rural Ethiopian elders of age 70 and older. Narrative data from in-depth interviews revealed three prominent themes: the "good old days," drained happiness, worry and pessimism. Elders felt devalued by their children, grandchildren, and youth in general. Compared to how they treated their own parents, elders believed that their children's sense of filial obligation was weak and unreliable. Interactions were described as undermining, embarrassing, and abusive. Elders were pessimistic about the prospect of reliable caregivers, even expressing a wish to die before they become dependent on others for care. Despite such challenges, participants viewed aging as a privilege. New cooperative models of community-based care are needed to ensure that elders in developing nations can expect adequate care throughout their lives.
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Affiliation(s)
| | - Messay Gebremariam Kotecho
- 37602 School of Social Work, Addis Ababa University, Ethiopia.,Department of Social Work, University of Johannesburg University, SA
| | - Margaret E Adamek
- 10668 School of Social Work, Indiana University, Indianapolis, IN, USA
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29
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Anum A, Washington-Nortey M, Dzokoto V. Strategic planning in LAMIC mental health research: A Ghana case study. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2020. [DOI: 10.1080/00207411.2020.1719621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Adote Anum
- Department of Psychology, University of Ghana, Accra, Ghana
| | | | - Vivian Dzokoto
- Department of African American Studies, Virginia Commonwealth University, Richmond, Virginia, USA
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