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Skinner T, Brown A, Teixeira-Pinto A, Farnbach SF, Glozier N, Askew DA, Gee G, Cass A, Hackett ML. Sensitivity and specificity of Aboriginal-developed items to supplement the adapted PHQ-9 screening measure for depression: results from the Getting it Right study. Med J Aust 2024. [PMID: 39140407 DOI: 10.5694/mja2.52406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 02/13/2024] [Indexed: 08/15/2024]
Abstract
OBJECTIVE To determine the psychometric properties of an Aboriginal and Torres Strait Islander-developed depressive symptom screening scale. DESIGN Prospective diagnostic accuracy study. SETTING Ten primary health care services or residential alcohol and other drug rehabilitation services in Australia that predominantly serve Aboriginal and Torres Strait Islander peoples. PARTICIPANTS 500 adults (18 years or older) who identified as Aboriginal and/or Torres Strait Islander and were able to communicate sufficiently to respond to questionnaire and interview questions. Recruitment occurred between 25 March 2015 and 2 November 2016. MAIN OUTCOME MEASURE Criterion validity of seven Aboriginal and Torres Strait Islander-developed items, using the adapted Patient Health Questionnaire 9 (aPHQ-9) and depression module of the Mini International Neuropsychiatric Interview (MINI) 6.0.0 as the criterion standards. RESULTS The seven-item scale had good internal consistency (α = 0.83) and correlated highly with the aPHQ-9 (ρ = 0.76). All items were significantly associated with diagnosis of a current major depressive episode. Discriminant function and decision tree analysis identified three items forming a summed scale that classified 85% of participants correctly. These three items showed equivalent sensitivity and specificity to the aPHQ-9 when compared with the MINI-identified diagnosis of a current major depressive episode. CONCLUSION Three items developed by and for Aboriginal and Torres Strait Islander people may provide effective, efficient and culturally appropriate screening for depression in Aboriginal and Torres Strait Islander health care contexts.
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Affiliation(s)
- Timothy Skinner
- Australian Centre for Behavioural Research in Diabetes, Deakin University, Geelong, VIC
- Institute of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Alex Brown
- Aboriginal Health Research, South Australian Health and Medical Research Institute, Adelaide, SA
- University of South Australia, Adelaide, SA
| | - Armando Teixeira-Pinto
- University of Sydney, Sydney, NSW
- Centre for Kidney Research, Westmead Millennium Institute for Medical Research, Sydney, NSW
| | - Sara F Farnbach
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
| | | | | | - Graham Gee
- Victorian Aboriginal Health Service Cooperative, Melbourne, VIC
- Murdoch Children's Research Institute, Melbourne, VIC
| | - Alan Cass
- Menzies School of Health Research, Darwin, NT
| | - Maree L Hackett
- George Institute for Global Health, Sydney, NSW
- University of Central Lancashire, Preston, UK
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Meldrum K, Wallace V, Webb T, Ridgway L, Quigley R, Strivens E, Russell SG. A Delphi study and development of a social and emotional wellbeing screening tool for Australian First Nations Peoples living in the Torres Strait and Northern Peninsula Area of Australia. PLoS One 2024; 19:e0306316. [PMID: 38935759 PMCID: PMC11210860 DOI: 10.1371/journal.pone.0306316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 06/14/2024] [Indexed: 06/29/2024] Open
Abstract
Tools screening depression and anxiety developed using the Western biomedical paradigm are still used with First Nations Peoples globally, despite calls for cross-cultural adaption. Recent work by this research team found that tools used to screen for depression and anxiety were inappropriate for use with Australian First Nations Peoples living in the Torres Strait and Northern Peninsula Area of Australia. The objective of this Delphi study, the second phase of a broader four-phase project, was to gain consensus from an expert mental health and/or social and emotional wellbeing (SEWB) panel to inform the development of an appropriate screening tool. This Delphi study took place between March and May 2023. Three sequential rounds of anonymous online surveys delivered using QualtricsTM were planned, although only two were needed to reach 75% consensus. The first round sought consensus on whether a new screening tool needed to be developed or whether existing tools could be used. The second round achieved consensus. Twenty-eight experts (47% response rate) participated across the two Delphi rounds. In the second round, 83% of these experts agreed or strongly agreed that a new screening tool, using the holistic First Nations concept of social and emotional wellbeing, be developed. Ninety-four percent of them agreed that it should take a Yarning approach. These findings enabled the development of a new SEWB screening tool that adopted a Yarning (narrative) approach designed for use in primary care and geriatric settings in the region. The new tool has four different Yarning areas: Community engagement and behaviour; Stress worries; Risk; and Feeling strong. Guidelines for tool use are integrated as well as Summary and Recommendation sections. At a macro-level this project responds to the need for new screening tools that are underpinned by First Nations worldviews.
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Affiliation(s)
- Kathryn Meldrum
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Valda Wallace
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Torres Webb
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Lynne Ridgway
- North Coast Neuropsychology, East Ballina, New South Wales, Australia
| | - Rachel Quigley
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Edward Strivens
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Sarah G. Russell
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
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Thong JJA, Ting RSK, Takeuchi T, Jobson L, Phipps ME. A qualitative study exploring the epistemology of suffering within a Malaysian Indigenous tribe. Transcult Psychiatry 2024:13634615231225158. [PMID: 38356281 DOI: 10.1177/13634615231225158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Despite the universal nature of suffering, few studies have examined how Indigenous ethnic minorities in non-western regions understand and respond to adversity. This study explored the epistemology of suffering among the Temiar ethnic group of Peninsular Malaysia using participant observation and semi-structured interviews. Interview transcripts of 43 participants were coded through inductive thematic analysis and a consensual qualitative approach. Three-tier themes were defined and named after subsequent analysis of core ideas and domains in the data. Major adversities reported included a lack of basic needs, lack of land-rights and unjust treatment from authorities, destruction of the forest environment and livelihood, and lack of accessibility and facilities, which were attributed to authorities' negligence of responsibilities, increasing human-animal conflict, environmental threats and imposed lifestyle changes. Faced with adversity, the Temiar endeavoured to survive by working crops and gathering forest resources. They utilized resources from family, fellow villagers, external agencies and spiritual-religious traditions. Theoretical mapping of attribution styles into the Ecological Rationality Framework revealed predominantly external-focused and concrete-perceptual rationalities privileged by strong-ties societies. These findings pointed to the resilience of a strong-ties community while adapting to the systemic suffering and risk factors stemming from a rationality mismatch with modernization and globalization trends. To conclude, we advocate for culture-sensitive mental health and psychiatric practices, as well as sustainable development for the well-being of Indigenous communities locally and globally.
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Affiliation(s)
- Justine Jian-Ai Thong
- Department of Psychology, Monash University Malaysia
- Department of Psychology, HELP University, Malaysia
| | | | | | - Laura Jobson
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Australia
| | - Maude Elvira Phipps
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia
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4
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Meldrum K, Wallace V, Webb T, Ridgway L, Quigley R, Strivens E, Russell S. Developing an appropriate depression and anxiety screening tool for use with Australian First Nations peoples living in the Torres Strait and Northern Peninsula Area of Australia: Protocol for a Delphi study. PLoS One 2023; 18:e0292162. [PMID: 38060486 PMCID: PMC10703283 DOI: 10.1371/journal.pone.0292162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/13/2023] [Indexed: 12/18/2023] Open
Abstract
Tools that screen for depression and anxiety developed using the Western biomedical paradigm are still used with First Nations peoples globally, despite calls for cross-cultural adaption. Recent work by the research team found that tools used to screen for depression and anxiety were not appropriate for use with Australian First Nations peoples living in the Torres Strait and Northern Peninsula Area (NPA). of Australia. Consequently, the objective of this Delphi study is to gain consensus from an expert mental health panel to inform the development of an appropriate depression and anxiety screening tool(s). A Delphi study with Australian expert panellists will be used to reach consensus about whether an existing screening tool should be used or whether adaption or new tool development should take place. Three sequential rounds of anonymous online surveys will be used to reach consensus. The first round will seek consensus about the tool(s). Subsequent rounds will seek consensus on the development of the tool(s) identified in round one. Panellists will be identified using a combination of authorship of related publications, established national clinical or research profile in First Nations mental health, and/or by peer referral. Consensus will be reached when 75% of the panel agree. When agreement is not reached suggestions will be taken to the next round. If agreement is not achieved by the third round, the Steering Committee will make any outstanding decisions. Dissemination of the findings through continuing community engagement, conference presentations and publications will be led by Torres Strait Islander members of the research team.
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Affiliation(s)
- Kathryn Meldrum
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Valda Wallace
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Torres Webb
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Lynne Ridgway
- North Coast Neuropsychology, East Ballina, New South Wales, Australia
| | - Rachel Quigley
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Edward Strivens
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Sarah Russell
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
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5
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Liddle J, Langton M, Rose J, Rice S. Apmerrke Areye-kenhe Utnenge Rlterrke-irrirtne-tyenhenge. Early Interv Psychiatry 2023; 17:1222-1226. [PMID: 37956669 DOI: 10.1111/eip.13473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 11/15/2023]
Abstract
Arrurle-nge-ntyele researchers lhentere areye-le intelhe-ilepe-ileme apmerrke areye-akerte. Itne akaltye-arle-irreke apmerrke areye akwele urreme-urreme-irreme, utnenge alhwarrpe awelhemele. Kenhe alhentere nhenhe areye akaltye-irretyakenhe iwenhenge-arle apmerrke areye alakenhe anerlte-aneme. Itne itelaretyakenhe nthakenhe-arle arne ingkirreke urrperle-areye-kenhe-le apmerrke areye atnerre ilirtnemere. Researchers itne akaltye-irreke artwe apmerrke Central Australia-arenye-arle akwele health akurne anthurre-ulkere, Australia arenye-arrpenhe areye-nge. Arrpenheme apeke clinic-werne alheme, kenhe itne akenhe itelaretyakenhe iwenhe-arle alhentere ngangkere-le itneke ileme, health itnekenhe-akerte, medications-akerte-arlke. Artwe atningke apeke itelaretyakenhe iwenhenge-arle itne ilkelhetyakenhe uthene akangketyakenhe uthene. The kwenhe PhD project mpwarerle-aneme apmerrke anwerneke-akerte. Anwerne ahentye aneme apmerrke areye atyenpe-irrirtnetyeke, atnerre anemele. Project nhenhe arne atyeperre anwerne-kenhe areye-akerte, angkentye, anpernirrentye, nthakenhe angkentye anwernekenhe intelhetyeke, anyenhenge, apmere-kenhe arritnye ingkirreke, thipe-kenhe arritnye, arne-kenhe arritnye, atnunthe apmere-altye-arlke. Apmerrke areye kwenhe akaltye-irretyeke nthakenhe English angketyeke, read-eme-iletyeke, intelhetyeke-arlke. Apmerrke areye apeke akaltye-irretyeke Akngerrepate arrwekelenye areye-ke, arne mwerre areye itne-arle mpware-warretyarte, kele itne anteme itnenhe ingkentetyeke. Artwe akaperte altywere-areye role models anwernekenhe aneme. 1930's-nge-ntyele governments-le laws mpwareke arritnye Assimilation Policy. Yanhe-iperre, atningke areye uye-akaltye-irreke urrperle-kenhe arne areye-kenhe-ke. Alhentere areye-le anamelhe-ileke arrpenheme apmere itnekenhe-nge-ntyele bungalow-atheke, ayerrere-werne atheke, antekerre-arlke. Assimilation Policys-nge ularre, tyerrtye atningke angkentye-ke uye akaltye-irreke, apmere-akerte, apmere-ke-artweye-ke, kwertengwerle-ke, laws anwernekenhe-arlke. Lhentere arrpenheme ahentye-aneke akaltye-irretyeke Tywerrenge-ke. Arne arrpenheme-ke itne-arle akaltye-irreke artwe-kenhe-ante, kenhe arrpenhe akenhe ingkirreke-ke. Arne nhenhe areye museums-uthene-le organisations arrpenhe areye uthene-le akwete atnyeneme. Alhentere areye-le itnenhe akeme "archives." Itnekenge-ntyele anwerne apmerrke areye akaltye-le-anthetyeke, nthakenhe arrwekelenye anwernekenhe anirntyeke-arteke. Kele, the pipe nhenhe intelhe-ileke apmerrke itnenhe alpeme-iletyeke rlterrke-irrirtnetyeke.
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Affiliation(s)
- Joel Liddle
- Orygen, Parkville, Victoria, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Parkville, Australia
- Strehlow Research Centre, Alice Springs, Northern Territory, Australia
- Charles Darwin University, Darwin, Northern Territory, Australia
| | - Marcia Langton
- Indigenous Studies Unit, Centre for Health Equity, The University of Melbourne, Parkville, Victoria, Australia
| | - James Rose
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Parkville, Australia
| | - Simon Rice
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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6
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Fusar-Poli P, Estradé A, Stanghellini G, Esposito CM, Rosfort R, Mancini M, Norman P, Cullen J, Adesina M, Jimenez GB, da Cunha Lewin C, Drah EA, Julien M, Lamba M, Mutura EM, Prawira B, Sugianto A, Teressa J, White LA, Damiani S, Vasconcelos C, Bonoldi I, Politi P, Vieta E, Radden J, Fuchs T, Ratcliffe M, Maj M. The lived experience of depression: a bottom-up review co-written by experts by experience and academics. World Psychiatry 2023; 22:352-365. [PMID: 37713566 PMCID: PMC10503922 DOI: 10.1002/wps.21111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/17/2023] Open
Abstract
We provide here the first bottom-up review of the lived experience of depression, co-written by experts by experience and academics. First-person accounts within and outside the medical field were screened and discussed in collaborative workshops involving numerous individuals with lived experience of depression, family members and carers, representing a global network of organizations. The material was enriched by phenomenologically informed perspectives and shared with all collaborators in a cloud-based system. The subjective world of depression was characterized by an altered experience of emotions and body (feeling overwhelmed by negative emotions, unable to experience positive emotions, stuck in a heavy aching body drained of energy, detached from the mind, the body and the world); an altered experience of the self (losing sense of purpose and existential hope, mismatch between the past and the depressed self, feeling painfully incarcerated, losing control over one's thoughts, losing the capacity to act on the world; feeling numb, empty, non-existent, dead, and dreaming of death as a possible escape route); and an altered experience of time (experiencing an alteration of vital biorhythms, an overwhelming past, a stagnation of the present, and the impossibility of the future). The experience of depression in the social and cultural context was characterized by altered interpersonal experiences (struggling with communication, feeling loneliness and estrangement, perceiving stigma and stereotypes), and varied across different cultures, ethnic or racial minorities, and genders. The subjective perception of recovery varied (feeling contrasting attitudes towards recovery, recognizing recovery as a journey, recognizing one's vulnerability and the need for professional help), as did the experience of receiving pharmacotherapy, psychotherapy, and social as well as physical health interventions. These findings can inform clinical practice, research and education. This journey in the lived experience of depression can also help us to understand the nature of our own emotions and feelings, what is to believe in something, what is to hope, and what is to be a living human being.
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Affiliation(s)
- Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- OASIS service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley, London, UK
| | - Andrés Estradé
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Giovanni Stanghellini
- Department of Health Sciences, University of Florence, Florence, Italy
- Diego Portales University, Santiago, Chile
| | - Cecilia Maria Esposito
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - René Rosfort
- S. Kierkegaard Research Centre, University of Copenhagen, Copenhagen, Denmark
| | - Milena Mancini
- Department of Psychological Sciences, Health and Territory, University of Chieti and Pescara "G. d'Annunzio", Chieti, Italy
| | - Peter Norman
- Recovery College, South London and Maudsley NHS Foundation Trust, London, UK
- Mosaic Clubhouse Brixton, London, UK
| | | | - Miracle Adesina
- Global Mental Health Peer Network, Ibadan, Nigeria
- Slum and Rural Health Initiative, Ibadan, Nigeria
| | - Gema Benavides Jimenez
- Global Mental Health Peer Network, Madrid, Spain
- Utrecht University, Utrecht, The Netherlands
- Instituto Superior de Estudios Psicológicos, Madrid, Spain
| | - Caroline da Cunha Lewin
- Global Mental Health Peer Network, London, UK
- Patient and Public Involvement Team, NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | | | - Marc Julien
- Global Mental Health Peer Network, Douala, Cameroon
| | | | - Edwin M Mutura
- Global Mental Health Peer Network, Nairobi, Kenya
- Mentally Unsilenced, Nairobi, Kenya
- Psychiatric Disability Organization of Kenya, Nakuru, Kenya
| | - Benny Prawira
- Global Mental Health Peer Network, Jakarta, Indonesia
- Into The Light Indonesia, Jakarta, Indonesia
| | - Agus Sugianto
- Global Mental Health Peer Network, Jakarta, Indonesia
- Indonesian Community Care for Schizophrenia, Jakarta, Indonesia
- University of Manchester, Manchester, UK
| | - Jaleta Teressa
- Global Mental Health Peer Network, Nekemte, Ethiopia
- Nekemte Specialized Hospital, Nekemte, Ethiopia
| | - Lawrence A White
- Global Mental Health Peer Network, Yellowknife, Canada
- Centre for Learning & Teaching Innovation, Aurora College, Yellowknife, Canada
- Advanced Graduate Student, Unicaf University, Lusaka, Zambia
| | - Stefano Damiani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Candida Vasconcelos
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ilaria Bonoldi
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Jennifer Radden
- Philosophy Department, University of Massachusetts, Boston, MA, USA
| | - Thomas Fuchs
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | | | - Mario Maj
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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Meldrum K, Andersson E, Webb T, Quigley R, Strivens E, Russell S. Screening depression and anxiety in Indigenous peoples: A global scoping review. Transcult Psychiatry 2023:13634615231187257. [PMID: 37490720 DOI: 10.1177/13634615231187257] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Indigenous peoples' worldviews are intricately interconnected and interrelated with their communities and the environments in which they live. Their worldviews also manifest in a holistic view of health and well-being, which contrasts with those of the dominant western biomedical model. However, screening depression and/or anxiety in Indigenous peoples often occurs using standard western tools. Understandably, the cultural appropriateness of these tools has been questioned. The purpose of this scoping review was to map the literature that used any type of tool to screen depression or anxiety in Indigenous adults globally. A systematic scoping review method was used to search databases including, but not limited to, CINAHL, PubMed, Scopus and Google. Database-specific search terms associated with Indigenous peoples, depression and anxiety, and screening tools were used to identify literature. In addition, citation searches of related systematic reviews and relevant websites were conducted. The data set was limited to English language publications since database inception. Fifty-four publications met the review's inclusion criteria. Most studies were completed in community settings using standard western depression and anxiety screening tools. Thirty-three different tools were identified, with the Patient Health Questionnaire-9 being the most frequently used. The review's findings are concerning given repeated calls for culturally appropriate screening tools to be used with Indigenous peoples. Although there has been some work to cross-culturally adapt depression screening tools for specific Indigenous populations, clearly more clinicians and researchers need to be aware of, and use, culturally appropriate approaches to screening.
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Affiliation(s)
| | | | | | | | - Edward Strivens
- James Cook University
- Queensland Health, Cairns and Hinterland Hospital and Health Service
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Basit T, Anderson M, Lindstrom A, Santomauro DF, Whiteford HA, Ferrari AJ. Diagnostic accuracy of the Composite International Diagnostic Interview (CIDI 3.0) in an urban Indigenous Australian sample. Aust N Z J Psychiatry 2023; 57:283-290. [PMID: 36688275 DOI: 10.1177/00048674221150361] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The Composite International Diagnostic Interview 3.0 is a standardised diagnostic interview commonly used in population-based mental health surveys, but has not been used in community-residing Indigenous Australians. This paper seeks to determine whether the Composite International Diagnostic Interview 3.0 can produce valid diagnostic information when compared with a diagnostic interview in an urban Indigenous Australian sample. METHOD This research was conducted over 10 weeks with adult Indigenous clients of two participating Aboriginal Medical Services in South-East Queensland. Using a cross-sectional, repeated-measures design, participants were administered the Composite International Diagnostic Interview 3.0 by an Indigenous interviewer and within 2 weeks attended a second appointment with an Indigenous clinical psychologist, who produced a diagnostic summary. The Composite International Diagnostic Interview 3.0 diagnoses were compared with the diagnostic summaries and clinical concordance between the two measures was calculated. RESULTS The diagnostic accuracy of the Composite International Diagnostic Interview 3.0 differed by module. The Post-traumatic Stress Disorder and Major Depression modules had good utility in diagnosing post-traumatic stress disorder and major depressive episodes, respectively; however, the Mania module that provides diagnoses of bipolar disorder was found to be unsuitable for this population. Although there were no identified contraindications for the use of the Generalised Anxiety and Alcohol Use Disorder modules, further research on the diagnostic accuracy of these modules is warranted. CONCLUSIONS The Composite International Diagnostic Interview 3.0 can accurately diagnose some common mental disorders in an Indigenous Australian population, but was found to be unsuitable for others. Given these findings, care should be taken when using the Composite International Diagnostic Interview 3.0 in epidemiological prevalence studies with Indigenous Australian populations.
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Affiliation(s)
- Tabinda Basit
- Queensland Centre for Mental Health Research, The Park - Centre for Mental Health, Archerfield, QLD, Australia.,School of Public Health, The University of Queensland, Herston, QLD, Australia.,Institute for Urban Indigenous Health, Windsor, QLD, Australia
| | - Mathew Anderson
- Institute for Urban Indigenous Health, Windsor, QLD, Australia
| | - Akiaja Lindstrom
- Queensland Centre for Mental Health Research, The Park - Centre for Mental Health, Archerfield, QLD, Australia.,School of Public Health, The University of Queensland, Herston, QLD, Australia.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Damian F Santomauro
- Queensland Centre for Mental Health Research, The Park - Centre for Mental Health, Archerfield, QLD, Australia.,School of Public Health, The University of Queensland, Herston, QLD, Australia.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Harvey A Whiteford
- Queensland Centre for Mental Health Research, The Park - Centre for Mental Health, Archerfield, QLD, Australia.,School of Public Health, The University of Queensland, Herston, QLD, Australia.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Alize J Ferrari
- Queensland Centre for Mental Health Research, The Park - Centre for Mental Health, Archerfield, QLD, Australia.,School of Public Health, The University of Queensland, Herston, QLD, Australia.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
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9
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Meldrum K, Andersson E, Sagigi B, Webb T, Wapau C, Quigley R, Strivens E, Russell S. How Australian First Nations peoples living in the Torres Strait and Northern Peninsula Area of Australia describe and discuss social and emotional well-being: a qualitative study protocol. BMJ Open 2022; 12:e067052. [PMID: 36600438 PMCID: PMC9772669 DOI: 10.1136/bmjopen-2022-067052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Colonisation has, and continues to, negatively impact the mental well-being of Australia's First Nations peoples. However, the true magnitude of the impact is not known, partially because clinicians have low levels of confidence in using many existing screening tools with First Nations clients. In addition, many authors have critiqued the use of tools designed for Western populations with First Nations peoples, because their worldview of health and well-being is different. Therefore, the aim of the overarching study is to develop an appropriate mental well-being screening tool(s) for older adults (aged 45 and over) living in the Torres Strait that can be used across primary health and geriatric settings. This protocol describes the first phase designed to achieve the overarching aim-yarning about social and emotional well-being (inclusive of mental well-being) in First Nations peoples living in the Torres Strait and Northern Peninsula Area of Australia. METHOD AND ANALYSIS The study will be guided by decolonising and participatory action research methodologies. Yarning is an Australian First Nations relational method that relies on storytelling as a way of sharing knowledge. Yarning circles will be conducted with community members and health and aged care workers living on six different island communities of the Torres Strait. Participants will be recruited using purposive sampling. Thematic analysis of the data will be led by Torres Strait Islander members of the research team. ETHICS AND DISSEMINATION The Far North Queensland, Human Research Ethics Committee (HREC) (HREC/2021/QCH/73 638-1518) and James Cook University HREC (H8606) have approved this study. Dissemination of study findings will be led by Torres Strait members of the research team through conferences and peer-reviewed publications.
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Affiliation(s)
- Kathryn Meldrum
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Ellaina Andersson
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Betty Sagigi
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Torres and Cape Hospital and Health Service, Queensland Health, Thursday Island, Queensland, Australia
| | - Torres Webb
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Chenoa Wapau
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Torres and Cape Hospital and Health Service, Queensland Health, Thursday Island, Queensland, Australia
| | - Rachel Quigley
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Edward Strivens
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Cairns and Hinterland Hospital and Health Service, Queensland Health, Cairns, Queensland, Australia
| | - Sarah Russell
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
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2021 PIF essay competition explores the role of cultural intelligence in improving health outcomes for Indigenous peoples. Australas Psychiatry 2022; 30:418-420. [PMID: 35674325 DOI: 10.1177/10398562221100100d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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11
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Liddle J, Langton M, Rose JWW, Rice S. New thinking about old ways: Cultural continuity for improved mental health of young Central Australian Aboriginal men. Early Interv Psychiatry 2022; 16:461-465. [PMID: 34169649 DOI: 10.1111/eip.13184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 05/17/2021] [Accepted: 06/06/2021] [Indexed: 11/29/2022]
Abstract
Decades of reports and policy have drawn attention to the significant social and occupational impairment of many young Aboriginal men in Central Australia. However, the role of mental ill-health as a contributing factor to this impairment, and culturally appropriate intervention targets have received insufficient attention in the psychiatry literature. Despite having the worst health outcomes of any population in Australia, Aboriginal men chronically underuse primary health care services. It's proposed that interventions ensuring cultural continuity through Identity-strengthening with a particular focus on positive Aboriginal masculinities will address a critical mental health gap for young men. In Central Australian and broader Indigenous populations, tangible and measurable kinship, language, religious and economic (KLRE) activities are catalytic vehicles for restoring traditional knowledge that suffer ongoing pressures as a result of colonization and assimilationist Government policy. By transforming KLRE knowledge content from ethnographic archives, these culturally rich repositories may be utilized to create education and engagement materials that will support young Aboriginal men's efforts to obtain and maintain positive mental health. This proposal focuses on building resilience through the acquisition of KLRE knowledge which young Aboriginal men can utilize as resources for enhancing positive identity and mental health outcomes.
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Affiliation(s)
- Joel Liddle
- Orygen, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Marcia Langton
- Indigenous Studies Unit, Centre for Health Equity, The University of Melbourne, Parkville, Victoria, Australia
| | - James W W Rose
- Indigenous Studies Unit, Centre for Health Equity, The University of Melbourne, Parkville, Victoria, Australia
| | - Simon Rice
- Orygen, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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12
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Herrman H, Patel V, Kieling C, Berk M, Buchweitz C, Cuijpers P, Furukawa TA, Kessler RC, Kohrt BA, Maj M, McGorry P, Reynolds CF, Weissman MM, Chibanda D, Dowrick C, Howard LM, Hoven CW, Knapp M, Mayberg HS, Penninx BWJH, Xiao S, Trivedi M, Uher R, Vijayakumar L, Wolpert M. Time for united action on depression: a Lancet-World Psychiatric Association Commission. Lancet 2022; 399:957-1022. [PMID: 35180424 DOI: 10.1016/s0140-6736(21)02141-3] [Citation(s) in RCA: 301] [Impact Index Per Article: 150.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 09/15/2021] [Accepted: 09/21/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Helen Herrman
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Sangath, Goa, India; Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Christian Kieling
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Child & Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Michael Berk
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
| | - Claudia Buchweitz
- Graduate Program in Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Brandon A Kohrt
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA
| | - Mario Maj
- Department of Psychiatry, University of Campania L Vanvitelli, Naples, Italy
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Myrna M Weissman
- Columbia University Mailman School of Public Health, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Dixon Chibanda
- Department of Psychiatry, University of Zimbabwe, Harare, Zimbabwe; Centre for Global Mental Health, The London School of Hygiene and Tropical Medicine, London, UK
| | - Christopher Dowrick
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Louise M Howard
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christina W Hoven
- Columbia University Mailman School of Public Health, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Helen S Mayberg
- Departments of Neurology, Neurosurgery, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Shuiyuan Xiao
- Central South University Xiangya School of Public Health, Changsha, China
| | - Madhukar Trivedi
- Peter O'Donnell Jr Brain Institute and the Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Lakshmi Vijayakumar
- Sneha, Suicide Prevention Centre and Voluntary Health Services, Chennai, India
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13
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Faruk MO, Hasan MT. Mental health of indigenous people: is Bangladesh paying enough attention? BJPsych Int 2022. [DOI: 10.1192/bji.2022.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Indigenous people face numerous challenges to their mental health across the world. We consider the situation in Bangladesh, where those living in the remote hill tracts areas of Eastern Bangladesh experience widespread difficulties. Few seek attention for their problems from professional services, in part because of stigma or a lack of awareness that help could be made available, but also because in these remote areas few resources are available. We make recommendations to improve this situation, which could be implemented with the assistance of primary healthcare services and traditional healers.
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14
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Carlin E, Cox Z, Orazi K, Derry KL, Dudgeon P. Exploring Mental Health Presentations in Remote Aboriginal Community Controlled Health Services in the Kimberley Region of Western Australia Using an Audit and File Reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1743. [PMID: 35162765 PMCID: PMC8835535 DOI: 10.3390/ijerph19031743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/25/2022] [Accepted: 01/29/2022] [Indexed: 02/04/2023]
Abstract
The study aims to explore the role of mental health care in remote Aboriginal health services in the Kimberley region of Western Australia and provide a more nuanced understanding of the patients presenting for care, their needs, and the clinical response. Little is currently known about primary health care presentations for mental health, suicide, and self-harm for remote dwelling Aboriginal residents of the Kimberley region, despite high rates of psychological distress, self-harm, and suicide across the area. This study was progressed through a retrospective, cross-sectional audit of the electronic medical records system used by three remote clinics to explore the interactions recorded by the clinics about a patient's mental health. In addition, an in-depth file review was conducted on a stratified purposive sample of 30 patients identified through the audit. Mental ill-health and psychological distress were found to be prominent within clinical presentations. Psychosocial factors were frequently identified in relation to a patient's mental health presentation. Optimizing patients' recovery and wellness through service improvements, including an enhanced mental health model of care, is an important next step.
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Affiliation(s)
- Emma Carlin
- Kimberley Aboriginal Medical Services, Broome, WA 6725, Australia;
- The Rural Clinical School of Western Australia, The University of Western Australia, Broome, WA 6725, Australia;
| | - Zaccariah Cox
- Kimberley Aboriginal Medical Services, Broome, WA 6725, Australia;
| | - Kristen Orazi
- The Rural Clinical School of Western Australia, The University of Western Australia, Broome, WA 6725, Australia;
| | - Kate L. Derry
- School of Indigenous Studies, University of Western Australia, Perth, WA 6009, Australia; (K.L.D.); (P.D.)
| | - Pat Dudgeon
- School of Indigenous Studies, University of Western Australia, Perth, WA 6009, Australia; (K.L.D.); (P.D.)
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15
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Atkinson-Briggs S, Jenkins A, Ryan C, Brazionis L. Health-risk behaviours among Indigenous Australians with diabetes: A study in the integrated Diabetes Education and Eye Screening (iDEES) project. J Adv Nurs 2022; 78:1305-1316. [PMID: 35037286 DOI: 10.1111/jan.15141] [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: 02/26/2021] [Revised: 11/09/2021] [Accepted: 12/09/2021] [Indexed: 11/27/2022]
Abstract
AIM To assess the prevalence of modifiable health-risk behaviours among Indigenous Australian adults with diabetes attending a regional Victorian Indigenous primary-care clinic. DESIGN A cross-sectional observational single-site study. METHODS As part of a multi-study project we administered the Smoking, Nutrition, Alcohol consumption, Physical activity and Emotional wellbeing (SNAPE) survey tool during the study baseline visit to methodically capture health-related behavioural data in the nurse-led integrated Diabetes Education and Eye Screening (iDEES) project in a regional Indigenous primary healthcare setting between January 2018 and March 2020. This descriptive SNAPE study helps address the lack of health behaviour data for Indigenous people with diabetes. RESULTS Of 172 eligible adults, 135 (79%) were recruited to the iDEES study, 50 (37%) male. All participated in at least one survey. Median (range) age was 56 (46-67) years; 130 (96%) had Type 2 diabetes of median [IQR] duration 6 (2-12) years. All 135 provided smoking data; 88 (65%) completed all surveys. Forty-nine (36%) and 29 (22%) were current or former smokers, respectively; 5 (6%) met vegetable intake guidelines, 22 (25%) met fruit intake guidelines; 38 [43%] drank alcohol in the past year. On average, participants walked for ≥10 min at a time 4 days/week and sat for an average of 8 h on weekdays; 35 (40%) had minimal-mild, and 30 (34%) had moderate-severe depressive symptoms. CONCLUSION Suboptimal modifiable health-risk behaviours and depressive symptoms are common in Indigenous Australian adults with diabetes. IMPACT Orderly assessment and reporting of health-risk behaviours using a single multi-component survey instrument (SNAPE tool) during a nurse-led diabetes education clinical visit is feasible and efficient. Such data may facilitate personalised interventions and improve diabetes management at both individual and health service levels.
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Affiliation(s)
| | - Alicia Jenkins
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Christopher Ryan
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Laima Brazionis
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
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16
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McInerney-Leo AM, West J, Meiser B, West M, Toombs MR, Brown MA, Duncan EL. The impact of Marfan syndrome on an Aboriginal Australian family: 'I don't like it as much as I don't like cancer'. J Genet Couns 2021; 31:620-630. [PMID: 34713948 DOI: 10.1002/jgc4.1529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 09/09/2021] [Accepted: 10/17/2021] [Indexed: 01/01/2023]
Abstract
Marfan syndrome (MFS) is an autosomal dominantly inherited connective tissue disorder. Aortic dilatation/dissection and ectopia lentis are the most severe features, which affect physical functioning and psychological well-being. In Aboriginal Australians, there is little psychosocial research on genetic conditions. This study explored the physical, psychological, and practical impacts of MFS on Aboriginal Australians. Eighteen (8 affected and 10 unaffected) members of a large Aboriginal Australian family with MFS participated in an ethically approved study. Semi-structured qualitative interviews were conducted, transcribed verbatim, and analyzed thematically. All individuals reported challenges from MFS, negatively affecting day-to-day living. Severe vision impairment was perceived as the greatest challenge, contributing to feelings of stigma and exclusion. With aging, concerns shifted toward cardiac complications. The unpredictability of lens dislocation and aortic dissection was reported to be psychologically challenging. Participants described MFS-related barriers to obtaining and retaining employment, especially following cardiac surgery; with consequential psychological and financial hardships. Participants articulated that their cultural drive to support the ill and respectfully mourn the deceased, regardless of distance, resulted in a significant financial burden. Additionally, when hospitalization and/or funerals occurred, financially solvent individuals were expected to share resources, without any expectation of repayment or reciprocity (i.e., 'demand sharing', common in Aboriginal Australian culture). This study documents the nature and pervasiveness of uncertainty for both affected and unaffected members of an MFS family. Many reported challenges are consistent with other MFS cohorts (including stigma, social exclusion, and unemployment). However, our findings suggest that cultural values may exacerbate the financial costs of MFS for Aboriginal Australians.
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Affiliation(s)
- Aideen M McInerney-Leo
- The University of Queensland Diamantina Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Queensland, Australia
| | - Jennifer West
- Prince Charles Hospital Clinical Unit, School of Clinical Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Bettina Meiser
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Malcolm West
- Prince Charles Hospital Clinical Unit, School of Clinical Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Maree R Toombs
- Faculty of Medicine, Rural Clinical School, The University of Queensland, Toowoomba, Queensland, Australia
| | - Matthew A Brown
- NHS Foundation Trust and King's College London NIHR Biomedical Research Centre, London, UK
| | - Emma L Duncan
- Department of Twin Research & Genetic Epidemiology, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,Department of Endocrinology, NHS Foundation Trust, London, UK
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17
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Faruk MO, Nijhum RP, Khatun MN, Powell GE. Anxiety and depression in two indigenous communities in Bangladesh. Glob Ment Health (Camb) 2021; 8:e34. [PMID: 34527262 PMCID: PMC8411373 DOI: 10.1017/gmh.2021.33] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/19/2021] [Accepted: 08/03/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The mental health status of indigenous people in Bangladesh has attracted little or no attention. The objective of the present study is to determine the extent of symptoms of anxiety and depression in the two largest indigenous communities in Bangladesh. METHODS In total, 240 participants were recruited, 120 from each of the Marma and Chakma communities with an overall mean age of 44.09 years (s.d. 15.73). Marma people were older (mean ages 48.92 v. 39.25, p < 0.001). Participants completed the Anxiety Scale (AS) and Depression Scale (DS) that have been developed and standardised in Bangladesh in the Bangla (Bengali) language. RESULTS Results indicated that anxiety and depression scores were elevated in both communities, 59.2% of the participants scoring above the cut-off for clinical significance on AS and 58.8% of the participants scoring above the cut-off for clinical significance on DS. Marma people compared to Chakma people were more anxious (M = 59.49 v. 43.00, p < 0.001) and more depressed (M = 106.78 v. 82.30, p < 0.001). The demographic variables of age, sex and socioeconomic status were weakly or inconsistently related to scores. In the Marma people, females scored higher on both AS and DS, but in the Chakma community, males scored higher on AS and the same on DS. CONCLUSION The finding of significant anxiety and depression in communities with such limited mental health services is a matter of concern and emphasises the need to formulate and implement appropriate mental health policies for indigenous people in Bangladesh and other parts of the world.
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Affiliation(s)
- Md. Omar Faruk
- Department of Clinical Psychology, University of Dhaka, Bangladesh
| | | | | | - Graham E. Powell
- Department of Clinical Psychology, University of Dhaka, Bangladesh
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18
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Faruk MO, Ching U, Chowdhury KUA. Mental health and well-being of indigenous people during the COVID-19 pandemic in Bangladesh. Heliyon 2021; 7:e07582. [PMID: 34345744 PMCID: PMC8319571 DOI: 10.1016/j.heliyon.2021.e07582] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/18/2021] [Accepted: 07/12/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The ongoing pandemic caused by the novel coronavirus and the subsequent containment strategies has taken a heavy toll on the mental health of people irrespective of age, gender, race, ethnicity, and geographical location. Studies have documented the mental health status of non-indigenous Bangladeshi people, but little attention has been paid during the pandemic to the investigation of the mental health status of indigenous people living in remote hilly areas. To address this gap the present study aimed at investigating the prevalence and accompanying risk factors of depression, anxiety, stress, and compromised well-being among indigenous people during the pandemic. METHODS A cross-sectional survey was conducted on 422 indigenous people aged between 16 and 90 using the 21-item Bangla Depression Anxiety Stress Scale (BDASS-21) and the Bangla version of the WHO-5 Well-being Index from January 30 to April 10, 2021. Data were collected by trained research assistants from three remote hilly areas namely Bandarban, Rangamati, and Khagracchari in the Chattogram Hill Tracts (CHT). Chi-squares, logistic regression, and ANOVA were performed to examine the association of variables. RESULTS The prevalence of moderate to extremely severe depression, anxiety, stress, and low well-being among the indigenous population during the pandemic was found to be 49.3%, 47.2%, 36.7%, and 50.9%, respectively. Risk predictors for depression, anxiety, and stress included age, ethnicity, geographical locations, educational attainment, occupation, and marital status. CONCLUSIONS The results suggest that the ongoing pandemic has led to the rise of common mental health problems among indigenous people during the pandemic. The results can contribute to the formation of mental health policy for indigenous people and the development of suitable mental health intervention strategies especially during and after the COVID-19 pandemic.
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Affiliation(s)
- Md. Omar Faruk
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
| | - Umay Ching
- Department of Psychology, University of Dhaka, Dhaka, Bangladesh
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Togni SJ. The Uti Kulintjaku Project: The Path to Clear Thinking. An Evaluation of an Innovative, Aboriginal‐Led Approach to Developing Bi‐Cultural Understanding of Mental Health and Wellbeing. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12243] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Black EB, Toombs MR, Kisely S. The Cultural Validity of Diagnostic Psychiatric Measures for Indigenous Australians. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12335] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Emma B. Black
- School of Medicine, Rural Clinical School, The University of Queensland,
| | - Maree R. Toombs
- School of Medicine, Rural Clinical School, The University of Queensland,
| | - Steve Kisely
- School of Medicine, Rural Clinical School, The University of Queensland,
- School of Medicine, Southern Clinical School, The University of Queensland,
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'Having a Quiet Word': Yarning with Aboriginal Women in the Pilbara Region of Western Australia about Mental Health and Mental Health Screening during the Perinatal Period. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214253. [PMID: 31683908 PMCID: PMC6862568 DOI: 10.3390/ijerph16214253] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/28/2019] [Accepted: 10/31/2019] [Indexed: 11/26/2022]
Abstract
Despite high rates of perinatal depression and anxiety, little is known about how Aboriginal women in Australia experience these disorders and the acceptability of current clinical screening tools. In a 2014 study, the Kimberley Mum’s Mood Scale (KMMS) was validated as an acceptable perinatal depression and anxiety screening tool for Aboriginal women in the Kimberley region of Western Australia. In the current study, we explored if it was appropriate to trial and validate the KMMS with Aboriginal women in the Pilbara. Yarning as a methodology was used to guide interviews with 15 Aboriginal women in the Pilbara who had received maternal and child health care within the last three years. Data were analysed thematically, the results revealing that this cohort of participants shared similar experiences of stress and hardship during the perinatal period. Participants valued the KMMS for its narrative-based approach to screening that explored the individual’s risk and protective factors. While support for the KMMS was apparent, particular qualities of the administering health care professional were viewed as critical to the tool being well received and culturally safe. Building on these findings, we will work with our partner health services in the Pilbara to validate the KMMS with Pilbara Aboriginal women.
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Farnbach S, Gee G, Eades AM, Evans JR, Fernando J, Hammond B, Simms M, DeMasi K, Glozier N, Brown A, Hackett ML. Process evaluation of the Getting it Right study and acceptability and feasibility of screening for depression with the aPHQ-9. BMC Public Health 2019; 19:1270. [PMID: 31533670 PMCID: PMC6749631 DOI: 10.1186/s12889-019-7569-4] [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: 04/26/2019] [Accepted: 08/29/2019] [Indexed: 11/30/2022] Open
Abstract
Background The Getting it Right study determined the validity, sensitivity, specificity and acceptability of the culturally adapted 9-item Patient Health Questionnaire (aPHQ-9) as a screening tool for depression in Aboriginal and Torres Strait Islander (hereafter referred to as Indigenous) people. In this process evaluation we aimed to explore staff perceptions about whether Getting it Right was conducted per protocol, and if the aPHQ-9 was considered an acceptable and feasible screening tool for depression in primary healthcare. This process evaluation will provide information for clinicians and policy makers about the experiences of staff and patients with Getting it Right and what they thought about using the aPHQ-9. Methods Process evaluation using grounded theory approaches. Semi-structured interviews with primary healthcare staff from services participating in Getting it Right were triangulated with feedback (free-text and elicited) from participants collected during the validation study and field notes. Data were thematically analysed according to the Getting it Right study protocol to identify the acceptability and feasibility of the aPHQ-9. Results Primary healthcare staff (n = 36) and community members (n = 4) from nine of the ten participating Getting it Right services and Indigenous participants (n = 500) from the ten services that took part. Most staff reported that the research was conducted according to the study protocol. Staff from two services reported sometimes recruiting opportunistically (rather than recruiting consecutive patients attending the service as outlined in the main study protocol), when they spoke to patients who they knew from previous interactions, because they perceived their previous relationship may increase the likelihood of patients participating. All Getting it Right participants responded to at least six of the seven feedback questions and 20% provided free-text feedback. Most staff said they would use the aPHQ-9 and most participants said that the questions were easy to understand (87%), the response categories made sense (89%) and that they felt comfortable answering the questions (91%). Conclusion Getting it Right was predominantly conducted according to the study protocol. The aPHQ-9, the first culturally adapted, nationally validated, freely available depression screening tool for use by Indigenous people, appears to be acceptable and feasible to use. Trial registration Australian New Zealand Clinical Trial Registry ANZCTR12614000705684, 03/07/2014.
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Affiliation(s)
- Sara Farnbach
- The George Institute for Global Health, The University of New South Wales, PO Box M201, Missenden Road, Sydney, New South Wales, 2050, Australia. .,University of New South Wales, Sydney, New South Wales, 2052, Australia. .,University of Sydney, Sydney, New South Wales, 2006, Australia.
| | - Graham Gee
- Victorian Aboriginal Health Service, Melbourne, Victoria, 3065, Australia.,University of Melbourne, Melbourne, Victoria, 3000, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, 3052, Australia
| | - Anne-Marie Eades
- The George Institute for Global Health, The University of New South Wales, PO Box M201, Missenden Road, Sydney, New South Wales, 2050, Australia.,University of New South Wales, Sydney, New South Wales, 2052, Australia.,University of Sydney, Sydney, New South Wales, 2006, Australia
| | - John Robert Evans
- The University of Technology, Sydney, New South Wales, 2006, Australia.,The University of Sydney, Sydney, New South Wales, 2006, Australia
| | - Jamie Fernando
- The Glen Centre (Ngampie), Chittaway Point, New South Wales, 2261, Australia.,The University of Newcastle, Newcastle, New South Wales, 2308, Australia
| | - Belinda Hammond
- Nunkuwarrin Yunti of South Australia, Adelaide, South Australia, 5000, Australia
| | - Matty Simms
- The University of Sydney, Sydney, New South Wales, 2006, Australia
| | - Karrina DeMasi
- Aboriginal Medical Services Alliance Northern Territory, Darwin, 0801, Australia
| | - Nick Glozier
- Brain and Mind Centre and Central Clinical School University of Sydney, Sydney, New South Wales, 2052, Australia
| | - Alex Brown
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - Maree L Hackett
- The George Institute for Global Health, The University of New South Wales, PO Box M201, Missenden Road, Sydney, New South Wales, 2050, Australia.,University of New South Wales, Sydney, New South Wales, 2052, Australia.,University of Sydney, Sydney, New South Wales, 2006, Australia.,The University of Central Lancashire, Preston, PR1 2HE, UK
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Canuto K, Harfield S, Wittert G, Brown A. Listen, understand, collaborate: developing innovative strategies to improve health service utilisation by Aboriginal and Torres Strait Islander men. Aust N Z J Public Health 2019; 43:307-309. [PMID: 31287939 DOI: 10.1111/1753-6405.12922] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Kootsy Canuto
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, South Australia.,Freemasons Foundation Centre for Men's Health, University of Adelaide, South Australia.,Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE), University of Adelaide, South Australia
| | - Stephen Harfield
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, South Australia.,Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE), University of Adelaide, South Australia
| | - Gary Wittert
- Freemasons Foundation Centre for Men's Health, University of Adelaide, South Australia
| | - Alex Brown
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, South Australia.,Freemasons Foundation Centre for Men's Health, University of Adelaide, South Australia.,Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE), University of Adelaide, South Australia.,Sansom Institute for Health Research, University of South Australia
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Canuto K, Brown A, Wittert G, Harfield S. Understanding the utilization of primary health care services by Indigenous men: a systematic review. BMC Public Health 2018; 18:1198. [PMID: 30352579 PMCID: PMC6199732 DOI: 10.1186/s12889-018-6093-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 10/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aboriginal and Torres Strait Islander men experience worse health outcomes and are the most marginalized and disadvantaged population group in Australia. Primary health care services are critical to providing both clinical and social and emotional support, however, remain underutilized by Aboriginal and Torres Strait Islander men. This review aims to better understand the utilization of primary health care services by Indigenous men and assess the effectiveness of strategies implemented to improve utilization. METHODS A four-step search strategy was employed across four databases to find peer-reviewed publications and grey literature from Australia, New Zealand, Canada and America. The search began in March 2015 and included the following databases PubMed, CINAHL, Informit (Indigenous collection) and Embase. Additional databases and websites were also searched for grey literature, reference lists of included publications were searched for additional studies and relevant experts were consulted. RESULTS The literature search found seven articles that met the inclusion criteria; four describing three research projects, plus three expert opinion pieces. The search was unable to find published research on strategies implemented to improve primary health care utilization by Indigenous men. There is limited published research focused on the utilization of primary health care by Indigenous men. From the identified papers Indigenous men described factors impacting utilization which were categorized into three primary organizing themes; those related to health services, the attitudes of Indigenous men and knowledge. It is evident from the identified papers that improvements in Indigenous health can only occur if future programs are developed in collaboration with health services and Indigenous men to address differing requirements. CONCLUSIONS Currently, health systems in Australia are limited in their ability to improve the health and wellbeing of Aboriginal and Torres Strait Islander males without such strategies. Future research should focus on evaluating the implementation of men specific utilization strategies. It is through evidence-based research that subsequent policies and programs can be made and implemented to improve Indigenous men's health.
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Affiliation(s)
- Kootsy Canuto
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, Australia. .,Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, Australia. .,Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE), University of Adelaide, Adelaide, Australia.
| | - Alex Brown
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, Australia.,Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE), University of Adelaide, Adelaide, Australia.,Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | - Gary Wittert
- Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, Australia
| | - Stephen Harfield
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, Australia.,Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE), University of Adelaide, Adelaide, Australia
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McPherson S, Rost F, Town J, Abbass A. Epistemological flaws in NICE review methodology and its impact on recommendations for psychodynamic psychotherapies for complex and persistent depression. PSYCHOANALYTIC PSYCHOTHERAPY 2018. [DOI: 10.1080/02668734.2018.1458331] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Susan McPherson
- School of Health and Social Care, University of Essex, Colchester, UK
| | - Felicitas Rost
- Portman Clinic, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Joel Town
- Faculty of Medicine, Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Allan Abbass
- Faculty of Medicine, Centre for Emotions and Health, Dalhousie University, Halifax, Canada
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Kilian A, Williamson A. What is known about pathways to mental health care for Australian Aboriginal young people?: a narrative review. Int J Equity Health 2018; 17:12. [PMID: 29374482 PMCID: PMC5787237 DOI: 10.1186/s12939-018-0727-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Accepted: 01/16/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To (1) gain an understanding of current trajectories of Aboriginal young people through the mental health care system in Australia; (2) summarize what mental health care pathways have been developed or evaluated to guide mental health care delivery for Aboriginal young people; and (3) identify barriers and facilitators to the adoption of effective mental health care pathways for Aboriginal young people. METHODS Databases, including, AMED, Embase, Global Health, Health and Psychosocial Instruments, Healthstar, MEDLINE, PsychINFO via Ovid, CINAHL via EBSCO, The Cochrane Library, Indigenous Collections, Informit and Health Systems Evidence, were searched to identify evidence concerning mental health service delivery for Aboriginal young people in a primary care setting. RESULTS We did not identify any reports or publications explicitly describing the current trajectories of Aboriginal young people through the mental health care system in Australia. Furthermore, we were unable to locate any mental health-related treatment pathways which had been explicitly developed or modified to meet the needs of Aboriginal young people. The use of appropriate assessment tools, engagement of family and community, flexibility, and central coordination have been identified in the literature as potential facilitators of culturally appropriate mental health service delivery for Aboriginal children and adolescents. CONCLUSIONS Aboriginal children and adolescents may face additional difficulties navigating the mental health care system in Australia due to complex socio-cultural factors and the dearth of culturally appropriate and effective mental-health related treatment pathways. Additional research regarding (1) practice trends in Aboriginal settings and (2) how Aboriginal child and adolescent mental health can be improved is urgently needed to inform clinical practice and improve mental health service access and outcomes for Aboriginal young people in Australia.
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Affiliation(s)
- Alexandra Kilian
- McMaster Health Forum, 1280 Main Street West, MML-417, Hamilton, ON L8S 4L6 Canada
| | - Anna Williamson
- Centre for Informing Policy in Health with Evidence Research, Sax Institute, Level 13, Building 10, 235 Jones St, Ultimo, NSW 2007 Australia
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Davy C, Kite E, Sivak L, Brown A, Ahmat T, Brahim G, Dowling A, Jacobson S, Kelly T, Kemp K, Mitchell F, Newman T, O'Brien M, Pitt J, Roesch K, Saddler C, Stewart M, Thomas T. Towards the development of a wellbeing model for aboriginal and Torres Strait islander peoples living with chronic disease. BMC Health Serv Res 2017; 17:659. [PMID: 28915842 PMCID: PMC5602951 DOI: 10.1186/s12913-017-2584-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 08/30/2017] [Indexed: 11/22/2022] Open
Abstract
Background Re-defining the way in which care is delivered, to reflect Aboriginal and Torres Strait Islander peoples’ needs and values, is essential for improving the accessibility of primary healthcare. This study focused on developing a Framework to support the quality of care and quality of life of, as well as treatment for, Aboriginal and Torres Strait Islander peoples living with chronic disease. Methods A team of researchers, including thirteen experienced Aboriginal healthcare professionals, came together to undertake this important work. Using a Participatory Action Approach, this study actively engaged people with local knowledge to ensure that the Framework was developed by and for Aboriginal people. Results The final Wellbeing Framework consists of two core values and four elements, each supported by four principles. Importantly, the Framework also includes practical examples of how the principles could be applied. National Reference Group members, including community representatives, policy makers and healthcare providers, reviewed and approved the final Framework. Conclusion The outcome of this collaborative effort is a Framework to guide primary healthcare services to develop locally relevant, flexible approaches to care which can respond to communities’ and individuals’ varied understandings of wellbeing.
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Affiliation(s)
- Carol Davy
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia.
| | - Elaine Kite
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia
| | - Leda Sivak
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia
| | - Alex Brown
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia
| | - Timena Ahmat
- Wuchopperen Health Service, 22C Evans St, Atherton, QLD, 4883, Australia
| | - Gary Brahim
- Wirraka Maya Health Service Aboriginal Corporation, 17 Hamilton Road, South Hedland, WA, 6722, Australia
| | - Anna Dowling
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia
| | - Shaun Jacobson
- Nunkuwarrin Yunti Inc, 182-190 Wakefield Street, Adelaide, South Australia, 5000, Australia
| | - Tania Kelly
- Wirraka Maya Health Service Aboriginal Corporation, 17 Hamilton Road, South Hedland, WA, 6722, Australia
| | - Kaylene Kemp
- Maari Ma Health Aboriginal Corporation, 428 Argent St, Broken Hill, NSW, 2880, Australia
| | - Fiona Mitchell
- Maari Ma Health Aboriginal Corporation, 428 Argent St, Broken Hill, NSW, 2880, Australia
| | - Tina Newman
- Tharawal Aboriginal Corporation, 187 Riverside Dr, Airds, NSW, 2560, Australia
| | - Margaret O'Brien
- Danila Dilba Health Service, 1/26 Knuckey St, Darwin, Northern Territory, 0800, Australia
| | - Jason Pitt
- Tharawal Aboriginal Corporation, 187 Riverside Dr, Airds, NSW, 2560, Australia
| | - Kesha Roesch
- Nunkuwarrin Yunti Inc, 182-190 Wakefield Street, Adelaide, South Australia, 5000, Australia
| | - Christine Saddler
- Winnunga Nimmityjah Aboriginal Health Service, 63 Boolimba Cres, Narrabundah, ACT, 2604, Australia
| | - Maida Stewart
- Danila Dilba Health Service, 1/26 Knuckey St, Darwin, Northern Territory, 0800, Australia
| | - Tiana Thomas
- Wuchopperen Health Service, 22C Evans St, Atherton, QLD, 4883, Australia
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Black E, Kisely S, Alichniewicz K, Toombs M. Mood and anxiety disorders in Australia and New Zealand's indigenous populations: A systematic review and meta-analysis. Psychiatry Res 2017; 255:128-138. [PMID: 28544944 DOI: 10.1016/j.psychres.2017.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 02/01/2017] [Accepted: 05/09/2017] [Indexed: 12/31/2022]
Abstract
The Indigenous populations of Australia and New Zealand are considered at higher risk of mood and anxiety disorders but many studies do not include direct comparisons with similar non-Indigenous controls. We conducted a systematic search of relevant electronic databases, as well as snowballing and targeted searches of the grey literature. Studies were included for meta-analysis if they compared rates of mood and anxiety disorders between Indigenous and non-Indigenous Australians or Maori. Seven Australian and 10 NZ studies were included. Overall, Indigenous people in both countries did not have significantly higher rates of disorder. However, in terms of specific disorders, there were differences in risk by gender, country (Australia or NZ), disorder type, and prevalence (current, 12-month or lifetime). For instance, Indigenous Australians and Maori both had significantly lower rates of simple phobias (current prevalence) and Maori participants had significantly lower rates of both lifetime simple phobia and generalised anxiety disorders. By contrast, Indigenous Australians had significantly higher rates of bipolar affective disorder and social phobia (current prevalence). Generalisations regarding the risk of psychiatric disorders in Indigenous people cannot therefore be made as this varies by several factors. These include disorder type, sociodemographic factors, Indigenous origin and study method.
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Affiliation(s)
- Emma Black
- Rural Clinical School, School of Medicine, The University of Queensland, Australia
| | - Steve Kisely
- University of Queensland, School of Medicine, Woolloongabba, Australia.
| | | | - Maree Toombs
- Rural Clinical School, School of Medicine, The University of Queensland, Australia
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Social and emotional wellbeing assessment instruments for use with Indigenous Australians: A critical review. Soc Sci Med 2017; 187:164-173. [PMID: 28689090 DOI: 10.1016/j.socscimed.2017.06.046] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 06/21/2017] [Accepted: 06/30/2017] [Indexed: 01/15/2023]
Abstract
RATIONALE There is growing recognition that in addition to universally recognised domains and indicators of wellbeing (such as population health and life expectancy), additional frameworks are required to fully explain and measure Indigenous wellbeing. In particular, Indigenous Australian wellbeing is largely determined by colonisation, historical trauma, grief, loss, and ongoing social marginalisation. Dominant mainstream indicators of wellbeing based on the biomedical model may therefore be inadequate and not entirely relevant in the Indigenous context. It is possible that "standard" wellbeing instruments fail to adequately assess indicators of health and wellbeing within societies that have a more holistic view of health. OBJECTIVE The aim of this critical review was to identify, document, and evaluate the use of social and emotional wellbeing measures within the Australian Indigenous community. METHOD The instruments were systematically described regarding their intrinsic properties (e.g., generic v. disease-specific, domains assessed, extent of cross-cultural adaptation and psychometric characteristics) and their purpose of utilisation in studies (e.g., study setting, intervention, clinical purpose or survey). We included 33 studies, in which 22 distinct instruments were used. RESULTS Three major categories of social and emotional wellbeing instruments were identified: unmodified standard instruments (10), cross-culturally adapted standard instruments (6), and Indigenous developed measures (6). Recommendations are made for researchers and practitioners who assess social and emotional wellbeing in Indigenous Australians, which may also be applicable to other minority groups where a more holistic framework of wellbeing is applied. CONCLUSION It is advised that standard instruments only be used if they have been subject to a formal cross-cultural adaptation process, and Indigenous developed measures continue to be developed, refined, and validated within a diverse range of research and clinical settings.
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Self-reported health-related quality-of-life issues for Aboriginal and Torres Strait Islander patients with experience of cancer in Australia: a review of literature. INT J EVID-BASED HEA 2016; 13:233-53. [PMID: 26126000 DOI: 10.1097/xeb.0000000000000051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Aboriginal peoples and Torres Strait Islander peoples (who comprise the indigenous people or the original inhabitants of Australia before colonization) are more likely to experience cancers with poorer prognoses, are more likely to be diagnosed with cancer at a later stage of disease progression, are less likely to receive adequate cancer treatment and are more likely to pass away due to cancer, compared with other Australians. Cancer and biomedical therapies for cancer often have significant, ongoing effects on patient health-related quality of life (HRQL). Therefore, consideration of HRQL for Aboriginal and Torres Strait Islander peoples with experience of cancer in Australia is imperative. This article examines the literature for HRQL issues self-reported by Aboriginal and/or Torres Strait Islander people with experience of cancer in Australia. METHODS A search of peer-reviewed journal articles, government reports, and other literature was undertaken using electronic databases and citation snowballing. Self-reports from Aboriginal and/or Torres Strait Islander people with experience of cancer were examined. HRQL issues were determined utilizing the Australian Psycho-Oncology Co-operative Research Group's definition of HRQL. RESULTS Fifty-two documents were found with original data from Aboriginal and/or Torres Strait Islander people who self-reported their experiences of cancer. No published reports were found that specifically examined self-reports from Aboriginal and/or Torres Strait Islander people on the impact of cancer and biomedical treatment on their HRQL. CONCLUSION Previous literature suggests that there is urgency for improved communication and cultural competency in cancer care for Aboriginal and Torres Strait Islander patients in Australia, with a stronger focus on meeting patient needs and improving HRQL. This review has provided insight into HRQL issues for Aboriginal and Torres Strait Islander patients with cancer in Australia. Further work using patient-reported outcomes measures would provide greater insight into the impact of cancer and biomedical treatments on Aboriginal and Torres Strait Islander patients' HRQL.
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Ha DH, Xiangqun J, Cecilia MG, Jason A, Do LG, Jamieson LM. Social inequality in dental caries and changes over time among Indigenous and non-Indigenous Australian children. Aust N Z J Public Health 2016; 40:542-547. [DOI: 10.1111/1753-6405.12566] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 03/01/2015] [Accepted: 04/01/2015] [Indexed: 11/29/2022] Open
Affiliation(s)
- Diep Hong Ha
- Australian Research Centre for Population Oral Health (ARCPOH), School of Dentistry; The University of Adelaide; South Australia
| | - Ju Xiangqun
- Australian Research Centre for Population Oral Health (ARCPOH), School of Dentistry; The University of Adelaide; South Australia
| | - Mejia Gloria Cecilia
- Australian Research Centre for Population Oral Health (ARCPOH), School of Dentistry; The University of Adelaide; South Australia
- School of Dental Medicine; East Carolina University; USA
| | - Armfield Jason
- Australian Research Centre for Population Oral Health (ARCPOH), School of Dentistry; The University of Adelaide; South Australia
| | - Loc G. Do
- Australian Research Centre for Population Oral Health (ARCPOH), School of Dentistry; The University of Adelaide; South Australia
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health (ARCPOH), School of Dentistry; The University of Adelaide; South Australia
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Campbell D. Economies through Application of Nonmedical Primary-Preventative Health: Lessons from the Healthy Country Healthy People Experience of Australia's Aboriginal People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:400. [PMID: 27482574 PMCID: PMC4847062 DOI: 10.3390/ijerph13040400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 03/24/2016] [Indexed: 12/02/2022]
Abstract
The World Health Organization reports noncommunicable disease as a global pandemic. While national and international health research/policy bodies, such as the World Health Organization and the Australian Institute of Health and Welfare, emphasize the importance of preventative health, there is a continuing distortion in the allocation of resources to curative health as a result of government failure. Government failure is, in part, the result of a political response to individual preference for certainty in receiving treatment for specific health conditions, rather than the uncertainty of population-based preventative intervention. This has led to a failure to engage with those primary causative factors affecting chronic disease, namely the psychosocial stressors, in which the socioeconomic determinants are an important component. Such causal factors are open to manipulation through government policies and joint government-government, government-private cooperation through application of nonmedical primary-preventative health policies. The health benefits of Aboriginal people in traditional land management, or caring-for-country, in remote to very remote Australia, is used to exemplify the social benefits of nonmedical primary-preventative health intervention. Such practices form part of the "healthy country, health people" concept that is traditionally relied upon by Indigenous peoples. Possible health and wider private good and public good social benefits are shown to occur across multiple disciplines and jurisdictions with the possibility of substantial economies. General principles in the application of nonmedical primary-preventative health activities are developed through consideration of the experience of Afboriginal people participation in traditional caring-for-country.
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Zhang A, Hughes JT, Brown A, Lawton PD, Cass A, Hoy W, O'Dea K, Maple-Brown LJ. Resting heart rate, physiological stress and disadvantage in Aboriginal and Torres Strait Islander Australians: analysis from a cross-sectional study. BMC Cardiovasc Disord 2016; 16:36. [PMID: 26868922 PMCID: PMC4751751 DOI: 10.1186/s12872-016-0211-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 02/04/2016] [Indexed: 02/22/2023] Open
Abstract
Background Lower socioeconomic status has been linked to long-term stress, which can manifest in individuals as physiological stress. The aim was to explore the relationship between low socioeconomic status and physiological stress in Aboriginal and Torres Strait Islander Australians. Methods Using data from the eGFR Study (a cross-sectional study of 634 Indigenous Australians in urban and remote areas of northern and central Australia), we examined associations between resting heart rate and demographic, socioeconomic, and biomedical factors. An elevated resting heart rate has been proposed as a measure of sustained stress activation and was used as a marker of physiological stress. Relationships were assessed between heart rate and the above variables using univariate and multiple regression analyses. Results We reported a mean resting heart rate of 74 beats/min in the cohort (mean age 45 years). On multiple regression analysis, higher heart rate was found to be independently associated with Aboriginal ethnicity, being a current smoker, having only primary level schooling, higher HbA1c and higher diastolic blood pressure (model R2 0.25). Conclusions Elevated resting heart rate was associated with lower socioeconomic status and poorer health profile in Aboriginal and Torres Strait Islander Australians. Higher resting heart rate may be an indicator of stress and disadvantage in this population at high risk of chronic diseases. Electronic supplementary material The online version of this article (doi:10.1186/s12872-016-0211-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alice Zhang
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia.,School of Medicine, University of Maryland, Baltimore, USA
| | - Jaquelyne T Hughes
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia.,Division of Medicine, Royal Darwin Hospital, Darwin, Australia
| | - Alex Brown
- South Australian Health and Medical Research Institute, Adelaide, Australia.,School of Population Health, University of South Australia, Adelaide, Australia
| | - Paul D Lawton
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Alan Cass
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Wendy Hoy
- Centre for Chronic Disease, The University of Queensland, Brisbane, Australia
| | - Kerin O'Dea
- School of Population Health, University of South Australia, Adelaide, Australia
| | - Louise J Maple-Brown
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia. .,Division of Medicine, Royal Darwin Hospital, Darwin, Australia.
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Sarnyai Z, Berger M, Jawan I. Allostatic load mediates the impact of stress and trauma on physical and mental health in Indigenous Australians. Australas Psychiatry 2016; 24:72-5. [PMID: 26646603 DOI: 10.1177/1039856215620025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES A considerable gap exists in health and social emotional well-being between Indigenous people and non-Indigenous Australians. Recent research in stress neurobiology highlights biological pathways that link early adversity and traumas as well as life stresses to ill health. We argue that the neurobiological stress response and its maladaptive changes, termed allostatic load, provide a useful framework to understand how adversity leads to physical and mental illness in Indigenous people. In this paper we review the biology of allostatic load and make links between stress-induced systemic hormonal, metabolic and immunological changes and physical and mental illnesses. CONCLUSIONS Exposure to chronic stress throughout life results in an increased allostatic load that may contribute to a number of metabolic, cardiovascular and mental disorders that shorten life expectancy in Indigenous Australians.
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Affiliation(s)
- Zoltán Sarnyai
- Associate Professor of Pharmacology, College of Public Health, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
| | - Maximus Berger
- Graduate Student, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Isabella Jawan
- Medical Student, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
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Hatala AR, Waldram JB. The role of sensorial processes in Q'eqchi' Maya healing: A case study of depression and bereavement. Transcult Psychiatry 2016; 53:60-80. [PMID: 26337478 DOI: 10.1177/1363461515599328] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Theory and research on the healing practices of Indigenous communities around the globe have often been influenced by models of "symbolic healing" that privilege the way patients consciously interpret or derive meaning from a healing encounter. In our work with a group of Q'eqchi' Maya healers in southern Belize, these aspects of "symbolic healing" are not always present. Such empirical observations force us to reach beyond models of symbolic healing to understand how healing might prove effective. Through the extended analysis of a single case study of rahil ch'ool or "depression," we propose to advance understanding of forms of healing which are not dependent on a shared "mythic" or "assumptive world" between patient and healer or where therapeutic efficacy does not rely on the patient's ability to "believe" in or consciously "know" what is occurring during treatment. In this we demonstrate how the body, as a site of experience, transformation, and communication, becomes the therapeutic locus in healing encounters of this kind and argue that embodied mediums of sensorial experience be considered central in attempts to understand healing efficacy.
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Malhi GS, Bassett D, Boyce P, Bryant R, Fitzgerald PB, Fritz K, Hopwood M, Lyndon B, Mulder R, Murray G, Porter R, Singh AB. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Aust N Z J Psychiatry 2015; 49:1087-206. [PMID: 26643054 DOI: 10.1177/0004867415617657] [Citation(s) in RCA: 511] [Impact Index Per Article: 56.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To provide guidance for the management of mood disorders, based on scientific evidence supplemented by expert clinical consensus and formulate recommendations to maximise clinical salience and utility. METHODS Articles and information sourced from search engines including PubMed and EMBASE, MEDLINE, PsycINFO and Google Scholar were supplemented by literature known to the mood disorders committee (MDC) (e.g., books, book chapters and government reports) and from published depression and bipolar disorder guidelines. Information was reviewed and discussed by members of the MDC and findings were then formulated into consensus-based recommendations and clinical guidance. The guidelines were subjected to rigorous successive consultation and external review involving: expert and clinical advisors, the public, key stakeholders, professional bodies and specialist groups with interest in mood disorders. RESULTS The Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders (Mood Disorders CPG) provide up-to-date guidance and advice regarding the management of mood disorders that is informed by evidence and clinical experience. The Mood Disorders CPG is intended for clinical use by psychiatrists, psychologists, physicians and others with an interest in mental health care. CONCLUSIONS The Mood Disorder CPG is the first Clinical Practice Guideline to address both depressive and bipolar disorders. It provides up-to-date recommendations and guidance within an evidence-based framework, supplemented by expert clinical consensus. MOOD DISORDERS COMMITTEE Professor Gin Malhi (Chair), Professor Darryl Bassett, Professor Philip Boyce, Professor Richard Bryant, Professor Paul Fitzgerald, Dr Kristina Fritz, Professor Malcolm Hopwood, Dr Bill Lyndon, Professor Roger Mulder, Professor Greg Murray, Professor Richard Porter and Associate Professor Ajeet Singh. INTERNATIONAL EXPERT ADVISORS Professor Carlo Altamura, Dr Francesco Colom, Professor Mark George, Professor Guy Goodwin, Professor Roger McIntyre, Dr Roger Ng, Professor John O'Brien, Professor Harold Sackeim, Professor Jan Scott, Dr Nobuhiro Sugiyama, Professor Eduard Vieta, Professor Lakshmi Yatham. AUSTRALIAN AND NEW ZEALAND EXPERT ADVISORS Professor Marie-Paule Austin, Professor Michael Berk, Dr Yulisha Byrow, Professor Helen Christensen, Dr Nick De Felice, A/Professor Seetal Dodd, A/Professor Megan Galbally, Dr Josh Geffen, Professor Philip Hazell, A/Professor David Horgan, A/Professor Felice Jacka, Professor Gordon Johnson, Professor Anthony Jorm, Dr Jon-Paul Khoo, Professor Jayashri Kulkarni, Dr Cameron Lacey, Dr Noeline Latt, Professor Florence Levy, A/Professor Andrew Lewis, Professor Colleen Loo, Dr Thomas Mayze, Dr Linton Meagher, Professor Philip Mitchell, Professor Daniel O'Connor, Dr Nick O'Connor, Dr Tim Outhred, Dr Mark Rowe, Dr Narelle Shadbolt, Dr Martien Snellen, Professor John Tiller, Dr Bill Watkins, Dr Raymond Wu.
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Affiliation(s)
- Gin S Malhi
- Discipline of Psychiatry, Kolling Institute, Sydney Medical School, University of Sydney, Sydney, NSW, Australia CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Darryl Bassett
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia School of Medicine, University of Notre Dame, Perth, WA, Australia
| | - Philip Boyce
- Discipline of Psychiatry, Sydney Medical School, Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre (MAPrc), Monash University Central Clinical School and The Alfred, Melbourne, VIC, Australia
| | - Kristina Fritz
- CADE Clinic, Discipline of Psychiatry, Sydney Medical School - Northern, University of Sydney, Sydney, NSW, Australia
| | - Malcolm Hopwood
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Bill Lyndon
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia Mood Disorders Unit, Northside Clinic, Greenwich, NSW, Australia ECT Services Northside Group Hospitals, Greenwich, NSW, Australia
| | - Roger Mulder
- Department of Psychological Medicine, University of Otago-Christchurch, Christchurch, New Zealand
| | - Greg Murray
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Richard Porter
- Department of Psychological Medicine, University of Otago-Christchurch, Christchurch, New Zealand
| | - Ajeet B Singh
- School of Medicine, Deakin University, Geelong, VIC, Australia
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Kaiser BN, Haroz EE, Kohrt BA, Bolton PA, Bass JK, Hinton DE. "Thinking too much": A systematic review of a common idiom of distress. Soc Sci Med 2015; 147:170-83. [PMID: 26584235 PMCID: PMC4689615 DOI: 10.1016/j.socscimed.2015.10.044] [Citation(s) in RCA: 141] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 10/14/2015] [Accepted: 10/19/2015] [Indexed: 12/16/2022]
Abstract
Idioms of distress communicate suffering via reference to shared ethnopsychologies, and better understanding of idioms of distress can contribute to effective clinical and public health communication. This systematic review is a qualitative synthesis of "thinking too much" idioms globally, to determine their applicability and variability across cultures. We searched eight databases and retained publications if they included empirical quantitative, qualitative, or mixed-methods research regarding a "thinking too much" idiom and were in English. In total, 138 publications from 1979 to 2014 met inclusion criteria. We examined the descriptive epidemiology, phenomenology, etiology, and course of "thinking too much" idioms and compared them to psychiatric constructs. "Thinking too much" idioms typically reference ruminative, intrusive, and anxious thoughts and result in a range of perceived complications, physical and mental illnesses, or even death. These idioms appear to have variable overlap with common psychiatric constructs, including depression, anxiety, and PTSD. However, "thinking too much" idioms reflect aspects of experience, distress, and social positioning not captured by psychiatric diagnoses and often show wide within-cultural variation, in addition to between-cultural differences. Taken together, these findings suggest that "thinking too much" should not be interpreted as a gloss for psychiatric disorder nor assumed to be a unitary symptom or syndrome within a culture. We suggest five key ways in which engagement with "thinking too much" idioms can improve global mental health research and interventions: it (1) incorporates a key idiom of distress into measurement and screening to improve validity of efforts at identifying those in need of services and tracking treatment outcomes; (2) facilitates exploration of ethnopsychology in order to bolster cultural appropriateness of interventions; (3) strengthens public health communication to encourage engagement in treatment; (4) reduces stigma by enhancing understanding, promoting treatment-seeking, and avoiding unintentionally contributing to stigmatization; and (5) identifies a key locally salient treatment target.
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Affiliation(s)
- Bonnie N Kaiser
- Department of Anthropology and Department of Epidemiology, Emory University, 1557 Dickey Drive, Atlanta, GA 30322, USA; Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC 27701, USA.
| | - Emily E Haroz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Brandon A Kohrt
- Department of Psychiatry & Behavioral Sciences, Duke Global Health Institute, and Department of Cultural Anthropology, Duke University, 310 Trent Drive, Durham, NC 27710, USA
| | - Paul A Bolton
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Broadway, Baltimore, MD 21205, USA
| | - Judith K Bass
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Devon E Hinton
- Department of Psychiatry, Massachusetts General Hospital, 15 Parkman Street, WACC 812, Boston, MA 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
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Amarasena N, Kapellas K, Skilton MR, Maple-Brown LJ, Brown A, O'Dea K, Celermajer DS, Jamieson LM. Associations with dental caries experience among a convenience sample of Aboriginal Australian adults. Aust Dent J 2015; 60:471-8. [DOI: 10.1111/adj.12256] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2014] [Indexed: 11/29/2022]
Affiliation(s)
- N Amarasena
- Australian Research Centre for Population Oral Health; School of Dentistry; The University of Adelaide; South Australia
| | - K Kapellas
- Australian Research Centre for Population Oral Health; School of Dentistry; The University of Adelaide; South Australia
- Menzies School of Health Research; Charles Darwin University; Darwin Northern Territory
| | - MR Skilton
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders; The University of Sydney; New South Wales
| | - LJ Maple-Brown
- Menzies School of Health Research; Charles Darwin University; Darwin Northern Territory
- Division of Medicine; Royal Darwin Hospital; Darwin Northern Territory
| | - A Brown
- South Australian Health and Medical Research Institute; Adelaide South Australia
| | - K O'Dea
- School of Population Health; The University of South Australia
| | - DS Celermajer
- Sydney Medical School; The University of Sydney; New South Wales
| | - LM Jamieson
- Australian Research Centre for Population Oral Health; School of Dentistry; The University of Adelaide; South Australia
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Abstract
Several Indigenous communities around the globe maintain unique conceptions of mental illness and disorder. The Q'eqchi' Maya of southern Belize represent one Indigenous community that has maintained, due to highly "traditional" ways of life and the strong presence of many active localized healers or bush doctors, distinct conceptions of mental disorders as compared to Western psychiatric nosology. The purpose of this ethnographic study was to understand and interpret Q'eqchi' nosological systems of mental disorders involving the factors--spiritual, cultural, social, historical, cosmological, or otherwise--implicated in their articulation and construction. Over a period of 9 months, and with the help of cultural advisors from several Q'eqchi' communities, 94 interviews with five different traditional Q'eqchi' healers were conducted. This paper demonstrates that the mental illnesses recognized by the Q'eqchi' healers involved narrative structures with recognizable variations unfolding over time. What we present in this paper are 17 recognizable illnesses of the mind grouped within one of four broad "narrative genres." Each genre involves a discernible plot structure, casts of characters, themes, motifs, and a recognizable teleology or "directedness." In narrative terms, the healer's diagnostic and therapeutic work can be understood as an ability to discern plot, to understand and interpret a specific case within the board, empirically based structure of Q'eqchi' medical epistemology.
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Davis TME, Hunt K, Bruce DG, Starkstein S, Skinner T, McAullay D, Davis WA. Prevalence of depression and its associations with cardio-metabolic control in Aboriginal and Anglo-Celt patients with type 2 diabetes: the Fremantle Diabetes Study Phase II. Diabetes Res Clin Pract 2015; 107:384-91. [PMID: 25656760 DOI: 10.1016/j.diabres.2014.12.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 10/14/2014] [Accepted: 12/26/2014] [Indexed: 01/23/2023]
Abstract
AIMS To determine the prevalence and associates of depression in Aboriginal and Anglo-Celt (AC) Australians with type 2 diabetes. METHODS Community-based patients were screened using the Patient Health Questionnaire (PHQ-9) as part of detailed assessment. The prevalence of any current depression, major depression and antidepressant use by racial group was compared after adjustment for age, sex, educational attainment and marital status. Multiple logistic regression was used to determine associates of current depression. RESULTS The 107 Aboriginal participants were younger (mean±SD 54.3±11.8 vs. 67.2±10.6 years), less often male (34.6% vs. 50.9%) and married (39.3% vs. 61.7%), and more likely to smoke (44.6% vs. 8.1%) than the 793 AC subjects (P≤0.002). Fifty-two Aboriginal (48.5%) and 772 AC participants (97.4%) completed the PHQ-9; these Aboriginals had similar socio-demographic, anthropometric and diabetes-related characteristics to those without PHQ-9 data. A quarter of the Aboriginals had current depression vs 10.6% of ACs (P=0.16), 15.4% vs. 4.1% had major depression (P=0.029), and 68.8% vs. 29.7% had untreated depression (P=0.032). Compared with non-depressed participants, patients with current depression were younger and more likely to smoke, to be overweight/obese and to have worse glycaemic control (P≤0.024). Significant independent associates of current depression were educational attainment (inversely), smoking status, body mass index and fasting plasma glucose in the AC group and alcohol use in the Aboriginal group. CONCLUSIONS Although prevalence of depression was not significantly increased in the Aboriginal patients, it was more likely to be major and untreated. Depression complicating type 2 diabetes is associated with adverse cardiovascular risk.
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Affiliation(s)
- Timothy M E Davis
- University of Western Australia, School of Medicine & Pharmacology, Fremantle Hospital, Fremantle, Western Australia, Australia.
| | - Kerry Hunt
- University of Western Australia, School of Medicine & Pharmacology, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - David G Bruce
- University of Western Australia, School of Medicine & Pharmacology, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - Sergio Starkstein
- University of Western Australia, School of Psychiatry and Clinical Neurosciences, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - Timothy Skinner
- Charles Darwin University, School of Psychological and Clinical Sciences, Casuarina, Northern Territory, Australia
| | - Daniel McAullay
- Edith Cowan University, Kurongkurl Katitjin Centre for Indigenous Australian Education and Research, Mt Lawley, Western Australia, Australia; Australian National University, Australian Primary Health Care Research Institute, Canberra, Australian Capital Territory, Australia
| | - Wendy A Davis
- University of Western Australia, School of Medicine & Pharmacology, Fremantle Hospital, Fremantle, Western Australia, Australia
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Amarasena N, Kapellas K, Brown A, Skilton MR, Maple-Brown LJ, Bartold MP, O'Dea K, Celermajer D, Slade GD, Jamieson L. Psychological distress and self-rated oral health among a convenience sample of Indigenous Australians. J Public Health Dent 2014; 75:126-33. [PMID: 25496507 DOI: 10.1111/jphd.12080] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 10/17/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study sought to: a) estimate the frequency of poor self-rated oral health as assessed by a summary measure; b) compare frequency according to sociodemographic, behavioral, and psychological distress factors; and (3) determine if psychological distress was associated with poor self-rated oral health after adjusting for confounding. METHODS Data were from a convenience sample of Indigenous Australian adults (n = 289) residing in Australia's Northern Territory. Poor self-rated oral health was defined as reported experience of toothache, poor dental appearance or food avoidance in the last 12 months. A logistic regression model was used to evaluate socio-demographic, behavioral, and psychological distress associations with poor self-rated oral health (SROH). Effects were quantified as odds ratios (OR). RESULTS The frequency of poor SROH was 73.7 percent. High psychological distress, measured by a Kessler-6 score ≥8, was experienced by 33.9 percent of participants. Poor SROH was associated with high levels of psychological distress, being older, being female, and usually visiting a dentist because of a problem. In the multivariable model, factors that were significantly associated with poor SROH after adjustment for other covariates included having a high level of psychological distress (OR 2.74, 95% CI 1.25-6.00), being female (OR 2.22, 95% CI 1.03-4.78), and usually visiting a dentist because of a problem (OR 3.57, 95% CI 1.89-6.76). CONCLUSIONS Poor self-rated oral health and high levels of psychological distress were both highly frequent among this vulnerable population. Psychological distress was significantly associated with poor self-rated oral health after adjustment for confounding.
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Affiliation(s)
- Najith Amarasena
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, South Australia, Australia
| | - Kostas Kapellas
- School of Dentistry, University of Adelaide, Adelaide, South Australia, Australia
| | - Alex Brown
- Indigenous Health Research, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Michael R Skilton
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, New South Wales, Australia
| | - Louise J Maple-Brown
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Mark P Bartold
- Colgate Australian Clinical Dental Research Centre, University of Adelaide, Adelaide, South Australia, Australia
| | - Kerin O'Dea
- Sansom Research Institute, University of South Australia, Adelaide, South Australia, Australia
| | - David Celermajer
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, New South Wales, Australia
| | - Gary Douglas Slade
- School of Dentistry, University of Adelaide, Adelaide, South Australia, Australia
| | - Lisa Jamieson
- School of Dentistry, University of Adelaide, Adelaide, South Australia, Australia
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McNamara BJ, Banks E, Gubhaju L, Williamson A, Joshy G, Raphael B, Eades SJ. Measuring psychological distress in older Aboriginal and Torres Strait Islanders Australians: a comparison of the K-10 and K-5. Aust N Z J Public Health 2014; 38:567-73. [PMID: 25307151 DOI: 10.1111/1753-6405.12271] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Revised: 02/01/2014] [Accepted: 06/01/2014] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To assess the cross-cultural validity of two Kessler psychological distress scales (K-10 and K-5) by examining their measurement properties among older Aboriginal and Torres Strait Islanders and comparing them to those in non-Aboriginal individuals from NSW Australia. METHODS Self-reported questionnaire data from the 45 and Up Study for 1,631 Aboriginal and 231,774 non-Aboriginal people were used to examine the factor structure, convergent validity, internal consistency and levels of missing data of K-10 and K-5. RESULTS We found excellent agreement in classification of distress of Aboriginal participants by K-10 and K-5 (weighted kappa=0.87), high internal consistency (Cronbach's alpha K-10: 0.93, K-5: 0.88), and factor structures consistent with those for the total Australian population. Convergent validity was evidenced by a strong graded relationship between the level of distress and the odds of: problems with daily activities due to emotional problems; current treatment for depression or anxiety; and poor quality of life. CONCLUSIONS AND IMPLICATIONS K-10 and K-5 scales are promising tools for measuring psychological distress among Aboriginal and Torres Strait Islanders aged 45 and over in research and clinical settings.
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Abstract
A rich Haitian ethnopsychology has been described, detailing concepts of personhood, explanatory models of illness, and links between mind and body. However, little research has engaged explicitly with mental illness, and that which does focuses on the Kreyòl term fou (madness), a term that psychiatrists associate with schizophrenia and other psychoses. More work is needed to characterize potential forms of mild-to-moderate mental illness. Idioms of distress provide a promising avenue for exploring common mental disorders. Working in Haiti's Central Plateau, we aimed to identify idioms of distress that represent cultural syndromes. We used ethnographic and epidemiologic methods to explore the idiom of distress reflechi twòp (thinking too much). This syndrome is characterized by troubled rumination at the intersection of sadness, severe mental disorder, suicide, and social and structural hardship. Persons with "thinking too much" have greater scores on the Beck Depression Inventory and Beck Anxiety Inventory. "Thinking too much" is associated with 8 times greater odds of suicidal ideation. Untreated "thinking too much" is sometimes perceived to lead to psychosis. Recognizing and understanding "thinking too much" may allow early clinical recognition and interventions to reduce long-term psychosocial suffering in Haiti's Central Plateau.
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Rosenstock A, Mukandi B, Zwi AB, Hill PS. Closing the Gaps: competing estimates of Indigenous Australian life expectancy in the scientific literature. Aust N Z J Public Health 2014; 37:356-64. [PMID: 23895479 PMCID: PMC3796865 DOI: 10.1111/1753-6405.12084] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective: Closing the gap in life expectancy between Indigenous and other Australians within a generation is central to national Indigenous reform policy (Closing the Gap). Over time, various methods of estimating Indigenous life expectancy and with that, the life expectancy gap, have been adopted with differing, albeit non-comparable results. We present data on the extent of the gap and elucidate the pattern of use and interpretations of the different estimates of the gap, between 2007 and 2012. Methods: An extensive search was conducted for all peer-reviewed health publications citing estimates of and/or discussing the life expectancy of Indigenous Australians, for the period 2007–2012. Results: Five predominant patterns of citation of the gap estimates were identified: 20 years, 17 years, 15–20 years, 13 years, and 11.5 years for males and 9.7 years for females. Some authors misinterpret the most recent estimates as reflecting improvement from the 17-year figure, rather than the result of different methods of estimation. Support for the direct methods used to calculate Indigenous life expectancy is indicated. Conclusions and Implications: A specific estimate of the life expectancy gap has not been established among stakeholders in Indigenous health. Agreement on the magnitude of the gap is arguably needed in order to evaluate strategies aimed at improving health outcomes for Indigenous Australians. Moreover, measuring progress towards ‘closing the gap’ depends on the availability of comparable estimates, using the same techniques of measurement to assess changes over time.
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Affiliation(s)
- Amanda Rosenstock
- Australian Centre for International and Tropical Health, School of Population Health, University of Queensland, Australia
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45
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Caqueo-Urízar A, Urzúa A, De Munter K. Mental health of indigenous school children in Northern Chile. BMC Psychiatry 2014; 14:11. [PMID: 24438210 PMCID: PMC3898225 DOI: 10.1186/1471-244x-14-11] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 01/15/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anxiety and depressive disorders occur in all stages of life and are the most common childhood disorders. However, only recently has attention been paid to mental health problems in indigenous children and studies of anxiety and depressive disorders in these children are still scarce. This study compares the prevalence of anxiety and depressive symptoms in Aymara and non-Aymara children. Among the Aymara children, the study examines the relations between these symptoms and the degree of involvement with Aymara culture. METHODS We recruited 748 children aged 9 to 15 years from nine schools serving low socioeconomic classes in the city of Arica, in northern Chile. The children were equally divided between boys and girls and 37% of the children were Aymara. To evaluate anxiety and depressive symptoms we used the Stress in Children (SiC) instrument and the Children Depression Inventory-Short version (CDI-S), and used an instrument we developed to assess level of involvement in the Aymara culture. RESULTS There was no significant difference between Aymara and non-Aymara children on any of the instrument scales. Dividing the Aymara children into high-involvement (n = 89) and low-involvement (n = 186) groups, the low-involvement group had significantly higher scores on the Hopelessness subscale of the CDI-S (p = 0.02) and scores of marginally higher significance in overall Anxiety on the SiC (p = 0.06). CONCLUSIONS Although Aymara children have migrated from the high Andean plateau to the city, this migration has not resulted in a greater presence of anxiety and depressive symptoms. Greater involvement with the Aymara culture may be a protective factor against anxiety and depressive symptoms in Aymara children. This point to an additional benefit of maintaining cultural traditions within this population.
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Affiliation(s)
- Alejandra Caqueo-Urízar
- Departamento de Filosofía y Psicología, Universidad de Tarapacá, Avenida 18 de Septiembre #2222, Arica, Chile
| | - Alfonso Urzúa
- Escuela de Psicología, Universidad Católica del Norte, Avenida Angamos, 0610 Antofagasta, Chile
| | - Koen De Munter
- Departamento de Antropología, Universidad Alberto Hurtado, Cienfuegos 41, Santiago, Chile
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Brown ADH, Mentha R, Rowley KG, Skinner T, Davy C, O’Dea K. Depression in Aboriginal men in central Australia: adaptation of the Patient Health Questionnaire 9. BMC Psychiatry 2013; 13:271. [PMID: 24139186 PMCID: PMC3816593 DOI: 10.1186/1471-244x-13-271] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 10/01/2013] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND While Indigenous Australians are believed to be at a high risk of psychological illness, few screening instruments have been designed to accurately measure this burden. Rather than simply transposing western labels of symptoms, this paper describes the process by which a screening tool for depression was specifically adapted for use across multiple Indigenous Australian communities. METHOD Potential depression screening instruments were identified and interrogated according to a set of pre-defined criteria. A structured process was then developed which relied on the expertise of five focus groups comprising of members from primary Indigenous language groups in central Australia. First, focus group participants were asked to review and select a screening measure for adaptation. Bi-lingual experts then translated and back translated the language within the selected measure. Focus group participants re-visited the difficult items, explored their meaning and identified potential ways to achieve equivalence of meaning. RESULTS All five focus groups independently selected the Primary Health Questionnaire 9, several key conceptual differences were exposed, largely related to the construction of hopelessness. Together with translated versions of each instrument for each of the five languages, a single, simplified English version for use across heterogeneous settings was negotiated. Importantly, the 'code' and specific conceptually equivalent words that could be used for other Indigenous language groups were also developed. CONCLUSIONS The extensive process of adaptation used in this study has demonstrated that within the context of Indigenous Australian communities, across multiple language groups, where English is often a third or fourth language, conceptual and linguistic equivalence of psychological constructs can be negotiated. A validation study is now required to assess the adapted instrument's potential for measuring the burden of disease across all Indigenous Australian populations.
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Affiliation(s)
- Alex DH Brown
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, PO Box 11060, 5001, Adelaide, South Australia, Australia,Baker IDI (Heart and Diabetes Institute), Alice Springs, PO Box 1294, Northern Territory, Australia
| | - Ricky Mentha
- Baker IDI (Heart and Diabetes Institute), Alice Springs, PO Box 1294, Northern Territory, Australia
| | - Kevin G Rowley
- (Onemda VicHealth Koori Health Unit) Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Timothy Skinner
- School of Psychological and Clinical Sciences, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Carol Davy
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, PO Box 11060, 5001, Adelaide, South Australia, Australia.
| | - Kerin O’Dea
- School of Population Health, University of South Australia, Adelaide, South Australia
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