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Kassa MA, Anbesaw T, Nakie G, Melkam M, Azmeraw M, Semagn EG, Abate BB. Investigating war trauma, its effects, and associated risk factors on anxiety among high school students in Woldia town, northeast Ethiopia, 2022. Front Psychiatry 2024; 15:1368285. [PMID: 39056017 PMCID: PMC11270624 DOI: 10.3389/fpsyt.2024.1368285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 06/13/2024] [Indexed: 07/28/2024] Open
Abstract
Background Anxiety symptoms are the most frequent mental health problems in the world, and it is a serious public health concern, especially among adolescents, because if left untreated, adolescent anxiety can have a number of detrimental effects, including lower academic performance, strained relationships with friends and family, substance addiction, thoughts of suicide and homicide, and trouble finding work. While this vulnerability is concerning in all situations, it is particularly critical in armed conflict areas. Ethiopia is one of the most recent war-affected countries, but to the best of our knowledge, limited studies focused on adolescents in this context. Therefore, this study assessed the experience of war trauma and its effects on anxiety symptoms among high school students in Woldia town, Ethiopia. Objective We assessed the experience of war trauma and its effects on anxiety among high school students, as well as associated risk factors, in war-affected areas in Woldia town, northeast Ethiopia. Methods A cross-sectional study design was conducted from May 23 to June 08 2022. Data were collected from high school students in Woldia town. Bivariable and multivariable logistic regression analyses were used to identify independent factors associated with anxiety. Results A total of 624 out of 660 students participated in the study (94.5% response rate). The prevalence of anxiety among high school students in Woldia town was 39.7%. In the multivariable analysis, having depression (AOR = 9.24, 95% CI: 6.27, 13.64), witnessing the murder of family/friends (AOR = 1.93, 95% CI: 1.05, 3.57), being of female sex (AOR=1.59, 95% CI: 1.08, 2.36), and having a family history of mental illness (AOR=1.69, 95% CI: 1.00, 2.85) were factors significantly associated with anxiety. Conclusions and recommendations The prevalence of anxiety in this study was approximately two in five high school students. Therefore, we recommend that the Ministry of Education collaborate with the Ministry of Health to expand and implement mental health services in high schools to promote the wellbeing of students for the prevention of anxiety.
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Affiliation(s)
- Mulat Awoke Kassa
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tamrat Anbesaw
- Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Girum Nakie
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Molla Azmeraw
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Elsabet Gezmu Semagn
- Department of Veterinary Parasitology, College of Veterinary Medicine, Wollo University, Dessie, Ethiopia
| | - Biruk Beletew Abate
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
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Salari N, Heidarian P, Hassanabadi M, Babajani F, Abdoli N, Aminian M, Mohammadi M. Global Prevalence of Social Anxiety Disorder in Children, Adolescents and Youth: A Systematic Review and Meta-analysis. JOURNAL OF PREVENTION (2022) 2024:10.1007/s10935-024-00789-9. [PMID: 38852119 DOI: 10.1007/s10935-024-00789-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/01/2024] [Indexed: 06/10/2024]
Abstract
Social anxiety disorder is a prevalent mental health condition that significantly impairs social interactions, academic performance, and professional functioning in children, adolescents, and youth. This study aimed to investigate the global prevalence of social anxiety disorder across these developmental stages. Six electronic databases (PubMed, Scopus, Web of Science, Embase, ScienceDirect and Google Scholar) were systematically searched for studies related to the prevalence of social anxiety disorder in children, adolescents and youth. Random-effects models were employed for data analysis and Comprehensive Meta-Analysis Version 2.0. Heterogeneity was assessed using the I2 index. A total of 38 studies were included in the final analysis. The global prevalence of social anxiety disorder was estimated to be 4.7% in children, 8.3% in adolescents, and 17% in youth. These findings suggest a progressive increase in the prevalence of SAD across these developmental stages. Considering the prevalence of social anxiety disorder in this study, policymakers can use the findings of this study to inform and develop effective prevention strategies for individuals and communities most susceptible to this disorder.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Pegah Heidarian
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Hassanabadi
- Department of Strategy and Operations Management, College of Business and Law, University of the West of England, Bristol, UK
| | - Fateme Babajani
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nasrin Abdoli
- Department of Psychiatry, Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maliheh Aminian
- Research Center for Non-Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Masoud Mohammadi
- Research Center for Non-Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran.
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Nalugya JS, Engebretsen IMS, Nakasujja N, Ndeezi G, Babirye JN, Bakken V, Skar AMS, Tumwine JK, Skokauskas N. Improving alcohol and substance use screening in school-age children: translation, adaptation and psychometric evaluation of the CRAFFT tool for Lumasaaba, Uganda. Addict Sci Clin Pract 2024; 19:38. [PMID: 38745244 PMCID: PMC11095024 DOI: 10.1186/s13722-024-00465-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 04/22/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Children at risk of substance use disorders (SUD) should be detected using brief structured tools for early intervention. This study sought to translate and adapt the Car, Relax, Alone, Forget, Family/Friends, Trouble (CRAFFT) tool to determine its diagnostic accuracy, and the optimum cut-point to identify substance use disorders (SUD) risk in Ugandan children aged 6 to 13 years. METHODS This was a sequential mixed-methods study conducted in two phases. In the first qualitative phase, in Kampala and Mbale, the clinician-administered CRAFFT tool version 2.1 was translated into the local Lumasaaba dialect and culturally adapted through focus group discussions (FGDs) and in-depth interviews, in collaboration with the tool's authors. Expert reviews and translations by bilingual experts provided insights on linguistic comprehensibility and cultural appropriateness, while pilot testing with the target population evaluated the tool's preliminary effectiveness. In the second phase, the CRAFFT tool, adapted to Lumasaaba, was quantitatively validated against the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) for diagnosing SUD in Mbale district, through a survey. Participants, chosen randomly from schools stratified according to ownership, location, and school size, were assessed for the tool's reliability and validity, including comparisons to the MINI KID as the Gold Standard for diagnosing SUD. Data were analyzed using STATA-15. Receiver-operating-characteristic analysis was performed to determine the sensitivity, specificity, and criterion validity of the CRAFFT with the MINI-KID. RESULTS Of the 470 children enrolled, 2.1% (n = 10) had missing data on key variables, leaving 460 for analysis. The median age and interquartile range (IQR) was 11 (9-12) years and 56.6% were girls. A total of 116 (25.2%) children had consumed alcohol in the last twelve-month period and 7 (1.5%) had used other substances. The mean CRAFFT score for all the children (n = 460) was 0.32 (SD 0.95). The prevalence of any alcohol use disorder (2 or more positive answers on the MINI KID) in the last 12 months was 7.2% (n = 32). The Lumasaaba version of the CRAFFT tool demonstrated good internal consistency (Cronbach's α = 0.86) and inter-item correlation (Spearman correlation coefficient of 0.84 (p < 0.001). At a cut-off score of 1.00, the CRAFFT had optimal sensitivity (91%) and specificity (92%) (Area Under the Curve (AUC) 0.91; 95% CI 0.86-0.97) to screen for SUD. A total of 62 (13.5%) had CRAFFT scores of > 1. CONCLUSION The Lumasaaba version of the CRAFFT tool has sufficient sensitivity and specificity to identify school-age children at risk of SUD.
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Affiliation(s)
- Joyce Sserunjogi Nalugya
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
- Department of Psychiatry, Mulago National Referral and Teaching Hospital, Ministry of Health, Kampala, Uganda.
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.
| | - Ingunn Marie Stadskleiv Engebretsen
- Centre for International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Noeline Nakasujja
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Grace Ndeezi
- Department of Pediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Juliet N Babirye
- School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Victoria Bakken
- Centre for Child and Adolescent Mental Health and Child Protection, Institute of Psychiatry, Faculty of Medicine, NTNU, Trondheim, Norway
| | - Ane-Marthe Solheim Skar
- Global Health Cluster, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - James K Tumwine
- Department of Pediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Pediatrics and Child Health, School of Medicine, Kabale University, Kabale, Uganda
| | - Norbert Skokauskas
- Centre for Child and Adolescent Mental Health and Child Protection, Institute of Psychiatry, Faculty of Medicine, NTNU, Trondheim, Norway
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Al-Shekaili M, Al-Huseini S, Al-Kalbani Y, Mirza H, Chan MF, Hassan W, Al-Sulimani F, Al-Ghafri GS, Al-Sumri HS, Amer AB, Ganesh A, Al-Saadoon M, Al-Adawi S. Factors associated with anxiety-related symptoms in children and adolescents during COVID-19 in Oman: a cross-sectional study. Sci Rep 2024; 14:9812. [PMID: 38684717 PMCID: PMC11058269 DOI: 10.1038/s41598-024-59769-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/15/2024] [Indexed: 05/02/2024] Open
Abstract
Reports from different parts of the world suggest that the COVID-19 pandemic and the resultant lockdown and social distancing measures have heralded unprecedented mental health challenges among children and adolescents. To date, there is a dearth of studies emerging from the Arabian Gulf, where the majority of its population are children and adolescents. The study aims to examine the prevalence of anxiety-related symptoms and their covariates among children and adolescents in an Arabian Gulf country, Oman. This is a cross-sectional analytic study carried out over two weeks (1st to 15th of August 2020) during the COVID-19 pandemic across Oman. Parents were asked to complete the online survey, which consisted of the parent version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) instrument and questions regarding basic socio-demographic information. Logistic regression was used to identify the contributing variables associated with anxiety-related symptoms. A total of 790 valid responses were received. Among the 790 children, 33.3% (n = 263) were diagnosed with anxiety-related symptoms by the SCARED instrument. Logistic regression analysis suggested that anxiety-related symptoms in children and adolescents were significantly associated with three demographic variables. The model shows that children with divorced or separated parents were 1.9 times more likely to have anxiety-related symptoms than children of married couples (OR = 1.93, p = 0.035). Children living in families with an income below USD 1000/month, were 1.8 times more likely to have anxiety-related symptoms than a family with an income of USD 4000/month (OR = 1.833, p = 0.018). Children in grades 3-6 were 1.8 times more likely to have anxiety-related symptoms than those in grades 1-2 (OR = 1.79, p = 0.024). Anxiety-related symptoms are common among Omani children and adolescents. They are more likely to be reported in middle scholastic grade levels and children from families with marital discord and low socioeconomic status. It is not clear whether the presently observed rates of anxiety exceed the prevalence that would have been observed prior to the COVID-19 pandemic. More studies are therefore warranted using children and adolescents' self-reported scales.
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Affiliation(s)
| | | | | | - Hassan Mirza
- Department of Behavioural Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat 123, Oman
| | - Moon Fai Chan
- Department of Family Medicine and Public Health, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat 123, Oman
| | - Walid Hassan
- Al Massarah Hospital, Ministry of Health, Muscat, Oman
- The Okasha Institute of Psychiatry, Ain Shams University, El-Demerdash, El Abbassia, Cairo, 11657, Egypt
| | | | - Ghaniya Saif Al-Ghafri
- Directorate General of Health Services, Al Dhahira Governorate, Ibri Regional Hospital, Ministry of Health, Ibri, Oman
| | | | - Ahmed Bait Amer
- Department of Family Medicine and Public Health, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat 123, Oman
| | - Aishwarya Ganesh
- Department of Behavioural Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat 123, Oman
| | - Muna Al-Saadoon
- Department of Child Health, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat 123, Oman
| | - Samir Al-Adawi
- Department of Behavioural Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat 123, Oman.
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DadeMatthews A, Nzeakah C, Onofa L, DadeMatthews O, Ogundare T. Teenage Blues: Predictors of depression among adolescents in Nigeria. PLoS One 2024; 19:e0293995. [PMID: 38630744 PMCID: PMC11023510 DOI: 10.1371/journal.pone.0293995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 01/08/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Depressive disorders, with a prevalence of 15-21%, are among the most common disorders in children and adolescents, and increases the risk of suicide, the second leading cause of death in children aged 10 to 19. AIM To determine the prevalence and correlates of depressive disorders among senior students attending secondary schools in Abeokuta. METHOD The study was conducted in five schools randomly selected from a representative sample and was carried out in 2 phases. In the first phase, students were selected via systematic random sampling and given consent forms and GHQ-12 to administer to the parents. In the second phase, students who returned a signed informed consent form and filled out GHQ-12 were interviewed using MINI-KID, Rosenberg's Self-Esteem Scale, Family-APGAR, and sociodemographic questionnaire. Multivariate regression analyses were conducted with p-value <0.05 as level of significance. RESULTS The mean age was 15.3 years (SD = 1.27); 48.8% were male. The twelve-month prevalence of major depression was 11.3% and dysthymia was 1.4%. In the final regression analysis, female gender [OR = 4.3, p = 0.046], the experience of bullying [OR = 7.96, p = 0.004], difficulty getting along with friends, [OR = 7.5, p = 0.004], history of sexual abuse [OR = 8.1, p = 0.01], and perceived family dysfunction [OR = 4.9, p = 0,023] were found to be independent predictors of depressive disorders. CONCLUSION Depressive syndromes are a significant health burden in adolescents. Being female, being bullied, having a history of sexual abuse, and family dysfunctionality are risk factors associated with depression among these population.
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Affiliation(s)
- Adefunke DadeMatthews
- College of Human Sciences, Human Development and Family Studies, Auburn University, Auburn, Alabama, United States of America
- Department of Clinical Services, Neuropsychiatric Hospital, Aro, Abeokuta, Nigeria
| | - Chukwuemeka Nzeakah
- Department of Clinical Services, Neuropsychiatric Hospital, Aro, Abeokuta, Nigeria
- Kent & Medway All Age Eating Disorder Service, North East London NHS Foundation Trust, Maidstone, Kent, United Kingdom
| | - Lucky Onofa
- Department of Clinical Services, Neuropsychiatric Hospital, Aro, Abeokuta, Nigeria
| | - Oluwagbemiga DadeMatthews
- School of Kinesiology, College of Human Sciences and Education, Louisiana State University, Baton Rouge, Louisiana, United States of America
| | - Temitope Ogundare
- Department of Psychiatry, Boston Medical Center, Boston, Massachusetts, United States of America
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Victor Mbanuzuru A, Uwakwe R, Sochukwu Anyaoku C, Okwudili Ojimba A, Chinyere Mbanuzuru M, Ezenyeaku CA, Chukwudinma Obi D, Nkiru Okafor C, Prosper Okonkwo U. Generalized anxiety disorder screening using gad-7 among in-school adolescents of anambra state, nigeria: a comparative study between urban and rural areas. Child Adolesc Psychiatry Ment Health 2023; 17:91. [PMID: 37468988 DOI: 10.1186/s13034-023-00637-4] [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] [Received: 03/11/2023] [Accepted: 06/28/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Previous studies have reported that general anxiety disorder manifestations differ in diverse settings. OBJECTIVE To determine and compare the prevalence of probable anxiety disorders among in-school adolescents in urban and rural areas of Anambra State. METHODS A total of 1187 in-school adolescents were recruited using a multi-stage sampling technique. The study instrument was an interviewer-administered pretested questionnaire adopted from General Anxiety Disorder (GAD-7). Data were analyzed with the IBM Statistical Package for the Social Sciences (SPSS) version 22. RESULT One hundred and twenty of the participants out of the 1187 (10.1%) were found to have probable generalized anxiety disorders using GAD-7 as screening tool. The prevalence of symptoms of anxiety disorder revealed that urban participants had a higher prevalence compared to their rural counterparts (11% vs. 8.8%), while females had a higher prevalence compared to the males in the ratio of 3:2 (or 12% vs. 8%). The prevalence of symptoms of anxiety disorders among females was higher than that of males even when compared based on a rural and urban settings. When all other variables are held constant, urban participants were found to have a 50% higher chance of being identified with anxiety disorders compared to their rural participants (OR = 1.500, C.I.:1.002-2.246, p = 0.049). CONCLUSION The prevalence of probable anxiety disorders was found in 10% of the participants. The females have a higher propensity to exhibit symptoms of anxiety disorders than the males. Anxiety status affects how adolescents view their general health. The study started from the date of approval by the West African College of Physicians on the 21 February 2017, but Ethical Clearance from NAUTHEC was given on the 19th December 2016.
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Affiliation(s)
- Ahoma Victor Mbanuzuru
- Department of Community Medicine & Primary Health Care, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Rechard Uwakwe
- Department of Psychiatry, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Chinekwu Sochukwu Anyaoku
- Department of Family Medicine, Nnamdi Azikiwe University Teaching Hospital, Awka, Anambra State, Nigeria
| | - Anastacia Okwudili Ojimba
- Center for Communicable Disease Control and Research, Federal Medical Centre Asaba, Asaba, Delta State, Nigeria
| | | | | | - Darlington Chukwudinma Obi
- Department of Community Medicine and Primary Health Care, Faculty of Medicine, College of Health Sciences, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Christiana Nkiru Okafor
- Department of Nursing, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Uchenna Prosper Okonkwo
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.
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Armandpishe S, Pakzad R, Jandaghian-Bidgoli M, Abdi F, Sardashti M, Soltaniha K. Investigating factors affecting the prevalence of stress, anxiety and depression among citizens of Karaj city: A population-based cross-sectional study. Heliyon 2023; 9:e16901. [PMID: 37346360 PMCID: PMC10279824 DOI: 10.1016/j.heliyon.2023.e16901] [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: 12/14/2022] [Revised: 05/24/2023] [Accepted: 05/31/2023] [Indexed: 06/23/2023] Open
Abstract
Background & aim Stress, anxiety, and depression are among the major public health problems worldwide. These problems, which may lead to more challenges, continue to grow. Therefore, the aim of this study was to investigate the main factors affecting the prevalence of stress, anxiety, and depression among citizens of Karaj. Materials & methods A total of 920 people participated in the study. The Depression, Anxiety, and Stress Scale (DASS), consisting of 21 items, was used for the assessment of the studied problems. Single and multiple regressions were used for the data analysis. In addition, all statistical analysis was done by Stata version 12 at the 0.05significance level. Results We found that the prevalence rate of depression, anxiety, and stress was 4.79%, 13.28%, and 15.13%, respectively. Education level was significantly associated with stress (b: 1.21; p < 0.001), anxiety (b: 2.03; p < 0.001), and depression (b: 0.48; p: 0.039). The association of the female gender with stress (b: 2.05; p < 0.001) and anxiety (b: 1.01; p: 0.002) was also confirmed. The association of being divorced or widowed with stress (b: 1.84; p: 0.005), anxiety (b: 1.21; p: 0.001), and depression (b: 1.85; p: 0.003) was approved. There was also a significant association between family size and stress (b: 0.39; p: 0.041). Gender and economic status were known as the most effective factors in the incidence of the studied problems. Conclusion The prevalence rate of depression, stress, and anxiety in Karaj should be taken into consideration. Therefore, the preventive and therapeutic measures need to be considered for reducing the effects of the risk factors.
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Affiliation(s)
- Sara Armandpishe
- Student Research Committee, Nursing and Midwifery Faculty, Alborz University of Medical Sciences, Karaj, Iran
| | - Reza Pakzad
- Student Research Committee, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | | | - Fatemeh Abdi
- Assistant Professor, Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Maryam Sardashti
- Student Research Committee, Nursing and Midwifery Faculty, Alborz University of Medical Sciences, Karaj, Iran
| | - Kimia Soltaniha
- Student Research Committee, Nursing and Midwifery Faculty, Alborz University of Medical Sciences, Karaj, Iran
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Friedberg R, Baiocchi M, Rosenman E, Amuyunzu-Nyamongo M, Nyairo G, Sarnquist C. Mental health and gender-based violence: An exploration of depression, PTSD, and anxiety among adolescents in Kenyan informal settlements participating in an empowerment intervention. PLoS One 2023; 18:e0281800. [PMID: 36989329 PMCID: PMC10057741 DOI: 10.1371/journal.pone.0281800] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/30/2023] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVE This study examines the prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD) among adolescents attending schools in several informal settlements of Nairobi, Kenya. Primary aims were estimating prevalence of these mental health conditions, understanding their relationship to gender-based violence (GBV), and assessing changes in response to an empowerment intervention. METHODS Mental health measures were added to the final data collection point of a two-year randomized controlled trial (RCT) evaluating an empowerment self-defense intervention. Statistical models evaluated how past sexual violence, access to money to pay for a needed hospital visit, alcohol use, and self-efficacy affect both mental health outcomes as well as how the intervention affected female students' mental health. FINDINGS Population prevalence of mental health conditions for combined male and female adolescents was estimated as: PTSD 12.2% (95% confidence interval 10.5-15.4), depression 9.2% (95% confidence interval 6.6-10.1) and anxiety 17.6% (95% confidence interval 11.2% - 18.7%). Female students who reported rape before and during the study-period reported significantly higher incidence of all mental health outcomes than the study population. No significant differences in outcomes were found between female students in the intervention and standard-of-care (SOC) groups. Prior rape and low ability to pay for a needed hospital visit were associated with higher prevalence of mental health conditions. The female students whose log-PTSD scores were most lowered by the intervention (effects between -0.23 and -0.07) were characterized by high ability to pay for a hospital visit, low agreement with gender normative statements, larger homes, and lower academic self-efficacy. CONCLUSION These data illustrate a need for research and interventions related to (1) mental health conditions among the young urban poor in low-income settings, and (2) sexual violence as a driver of poor mental health, leading to a myriad of negative long-term outcomes.
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Affiliation(s)
- Rina Friedberg
- LinkedIn, Data Science and Applied Research (all work completed while at Department of Statistics, Stanford University), Stanford, CA, United States of America
| | - Michael Baiocchi
- Stanford Prevention Research Center, Stanford, CA, United States of America
- Department of Statistics, Stanford University, Stanford, CA, United States of America
| | - Evan Rosenman
- Harvard Data Science Initiative, Cambridge, MA, United States of America
| | | | - Gavin Nyairo
- African Institute for Health and Development, Nairobi, Kenya
| | - Clea Sarnquist
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America
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Draper CE, Cook CJ, Howard SJ, Makaula H, Merkley R, Mshudulu M, Tshetu N, Scerif G. Caregiver perspectives of risk and protective factors influencing early childhood development in low‐income, urban settings: A social ecological perspective. INFANT AND CHILD DEVELOPMENT 2023. [DOI: 10.1002/icd.2417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2023]
Affiliation(s)
- Catherine E. Draper
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Caylee J. Cook
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Steven J. Howard
- Early Start and School of Education University of Wollongong Wollongong New South Wales Australia
| | - Hleliwe Makaula
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Rebecca Merkley
- Department of Cognitive Science Carleton University Ottawa Canada
| | - Mbulelo Mshudulu
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Nosibusiso Tshetu
- SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Gaia Scerif
- Department of Experimental Psychology University of Oxford Oxford UK
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Runcan R, Nadolu D, David G. Predictors of Anxiety in Romanian Generation Z Teenagers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4857. [PMID: 36981765 PMCID: PMC10049436 DOI: 10.3390/ijerph20064857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
Adolescence is a very complex period of life, full of challenges, and explorations that young people have to face on the path to becoming adults. In adolescence, specific deviations from the everyday lifestyle, as well as emotional failures or imbalances, may also occur. When things tend to become more and more unclear, adolescents come to directly face some form of anxiety. The present study concerns the relationship of Romanian adolescents with their fathers from the perspective of anxiety issues. For this, an anonymous questionnaire was applied using a sample of availability of 558 teenagers and a complementary second questionnaire was intended for their fathers (N2 = 114 subjects). The questionnaire addressed to Generation Z Romanian adolescents included items regarding the self-assessment of one's own behaviour and relationship with one's father, as well as the Generalized Anxiety Disorder Scale-7 (GAD-7). The questionnaire addressed to the fathers included mirror questions regarding the relationship with their children. The main results showed that the relationship between adolescents and their fathers has an ambivalent impact on anxiety: if it is a strong relationship, the risk to develop anxiety decreases, while if it is a weak relationship, it increases the risk of anxiety.
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Affiliation(s)
- Remus Runcan
- Faculty of Educational Science, Psychology and Social Work, “Aurel Vlaicu” University of Arad, 310032 Arad, Romania
| | - Delia Nadolu
- The Department of Sociology, West University of Timisoara, 300223 Timisoara, Romania
| | - Gheorghe David
- Department of Agricultural Technologies, Faculty of Agriculture, University of Life Sciences “King Mihai I” from Timisoara, 300645 Timisoara, Romania
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Ssewamala FM, Brathwaite R, Neilands TB. Economic Empowerment, HIV Risk Behavior, and Mental Health Among School-Going Adolescent Girls in Uganda: Longitudinal Cluster-Randomized Controlled Trial, 2017‒2022. Am J Public Health 2023; 113:306-315. [PMID: 36603167 PMCID: PMC9932384 DOI: 10.2105/ajph.2022.307169] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 01/07/2023]
Abstract
Objectives. To investigate the long-term (12- and 24-month) impact of an economic empowerment intervention on HIV risk behaviors and mental health among school-going adolescent girls in Uganda. Methods. A total of 1260 girls aged 14 to 17 years were randomized at the school level to (1) standard health and sex education (controls; n = 408 students; n = 16 schools), (2) 1-to-1 matched savings youth development account (YDA; n = 471 students; n = 16 schools), or (3) combination intervention (YDA and multiple family group [YDA+MFG]; n = 15 schools; n = 381 students). Mixed-effects models were fitted. Results. YDA and YDA+MFG girls had significantly lower depressive symptoms and better self-concept than controls at 24 months. Only YDA+MFG girls had significantly lower hopelessness levels than controls. There were no significant study group differences at 12 and 24 months for sexual risk-taking behavior and attitudes. There was no significant difference between YDA and YDA+MFG groups for all outcomes. Conclusions. Providing YDA and MFG can positively improve adolescent girls' mental health, but our analyses showed no significant differences across groups on sexual risk-taking behaviors. Future studies may consider replicating these interventions and analyses in older populations, including those transitioning into young adults. Trial Registration. ClinicalTrials.gov Identifier: NCT03307226. (Am J Public Health. 2023;113(3):306-315. https://doi.org/10.2105/10.2105/AJPH.2022.307169).
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Affiliation(s)
- Fred M Ssewamala
- Fred M. Ssewamala and Rachel Brathwaite are with the International Center for Child Health and Development, Brown School, Washington University in St Louis, MO. Torsten B. Neilands is with the Division of Prevention Science, University of California, San Francisco
| | - Rachel Brathwaite
- Fred M. Ssewamala and Rachel Brathwaite are with the International Center for Child Health and Development, Brown School, Washington University in St Louis, MO. Torsten B. Neilands is with the Division of Prevention Science, University of California, San Francisco
| | - Torsten B Neilands
- Fred M. Ssewamala and Rachel Brathwaite are with the International Center for Child Health and Development, Brown School, Washington University in St Louis, MO. Torsten B. Neilands is with the Division of Prevention Science, University of California, San Francisco
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Askenazy F, Bodeau N, Nachon O, Gittard M, Battista M, Fernandez A, Gindt M. Analysis of Psychiatric Disorders by Age Among Children Following a Mass Terrorist Attack in Nice, France, on Bastille Day, 2016. JAMA Netw Open 2023; 6:e2255472. [PMID: 36735258 PMCID: PMC9898818 DOI: 10.1001/jamanetworkopen.2022.55472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
This cross-sectional study examines psychiatric disorders among children after a mass terrorist attack in Nice, France, in 2016.
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Affiliation(s)
- Florence Askenazy
- Service Universitaire de psychiatrie de l’enfant et de l’adolescent, Hôpitaux pédiatriques de Nice, Centre Hospitalier Universitaire-Lenval, Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, Nice, France
| | - Nicolas Bodeau
- Service Universitaire de psychiatrie de l’enfant et de l’adolescent, Hôpitaux pédiatriques de Nice, Centre Hospitalier Universitaire-Lenval, Nice, France
| | - Ophélie Nachon
- Service Universitaire de psychiatrie de l’enfant et de l’adolescent, Hôpitaux pédiatriques de Nice, Centre Hospitalier Universitaire-Lenval, Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, Nice, France
| | - Mélanie Gittard
- Paris School of Economics, Centre International de Recherche sur l’Environnement et le Developpement and Ecole Nationale des Ponts et Chaussées, Paris, France
| | - Michèle Battista
- Service Universitaire de psychiatrie de l’enfant et de l’adolescent, Hôpitaux pédiatriques de Nice, Centre Hospitalier Universitaire-Lenval, Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, Nice, France
| | - Arnaud Fernandez
- Service Universitaire de psychiatrie de l’enfant et de l’adolescent, Hôpitaux pédiatriques de Nice, Centre Hospitalier Universitaire-Lenval, Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, Nice, France
| | - Morgane Gindt
- Service Universitaire de psychiatrie de l’enfant et de l’adolescent, Hôpitaux pédiatriques de Nice, Centre Hospitalier Universitaire-Lenval, Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, Nice, France
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Anyanwu MU. Psychological distress in adolescents: prevalence and its relation to high-risk behaviors among secondary school students in Mbarara Municipality, Uganda. BMC Psychol 2023; 11:5. [PMID: 36624544 PMCID: PMC9830719 DOI: 10.1186/s40359-023-01039-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Psychological distress among adolescents negatively affects their academic performance, relationships with family and friends, and ability to participate fully in the community. Stressful life events in low-income countries and risk-taking behavior of adolescents have raised concerns regarding the impact of psychological distress among adolescents. Therefore, the present study estimated the prevalence of psychological distress and examined the high-risk behaviors associated with psychological distress among Ugandan adolescents. METHODS A community based cross-sectional study was conducted among secondary school students in Mbarara Municipality, Uganda. Multistage cluster sampling was used to recruit 921 adolescents from 12 schools. Psychological distress was assessed using the 10-item Kessler Psychological Distress Scale (K10). Logistic regression was used with p-value estimating regression coefficient and 95% confidence interval for odds ratio and adjusted odds ratio (AOR). RESULTS The prevalence of psychological distress using the K10 was 57%. Logistic regression analyses showed that risky sexual behavior [AOR = 1.52; 95% confidence interval (CI) 1.02-2.28], substance use (AOR = 2.06; 95% CI 1.49-2.84) were associated with psychological distress. Students in mixed schools (comprising both sexes) (AOR = 1.94; 95% CI 1.19-3.15) and adolescents with chronic illness (AOR = 1.68; 95% CI 1.18-2.38) were more likely to report psychological distress. CONCLUSION The prevalence of psychological distress among school-going adolescents is high. Risky sexual behavior, substance use as well as chronic illness were associated with psychological distress. In addition, the type of school was significantly associated with psychological distress. The findings suggest the need for policy makers and stakeholders in health and education sectors to institute measures that will address mental health issues among adolescents.
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Affiliation(s)
- Michael U Anyanwu
- Department of Community Health, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda.
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Nampijja M, Sembajjwe W, Mpairwe H, Mpango R, Kinyanda E. Prevalence and correlates of neurocognitive impairment and psychiatric disorders among schoolchildren in Wakiso District, Uganda: a cross-sectional study. Wellcome Open Res 2022; 6:217. [PMID: 36873715 PMCID: PMC9975401 DOI: 10.12688/wellcomeopenres.17005.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
Background: There is limited data on the burden of mental disorders among children in the general population in Africa. We examined the prevalence and correlates of neurocognitive and psychiatric disorders among schoolchildren in Uganda. Methods: This cross-sectional study enrolled 322 schoolchildren aged 5-17years in Wakiso, Uganda. We assessed for neurocognitive impairment using the Kaufmann-Assessment-Battery, and psychiatric disorders (major-depressive-disorder (MDD), attention-deficit-hyperactivity-disorder (ADHD), generalised-anxiety-disorder (GAD), and substance-use-disorder (SUD)) using the parent version of the Child and Adolescent Symptom Inventory-5, and Youth Inventory-4R Self Report. Prevalence and risk factors were determined using respectively descriptive statistics, and univariable and multivariable logistic regression. Results: Twenty-five participants (8%) had neurocognitive impairment. Nineteen (5.9%) participants had MDD, nine (2.8%) had ADHD, seven (2.2%) had GAD, 14 (8.6%) had SUD; and 30 (9.3%) had any psychiatric disorder. Among the exposure variables examined in this study, including asthma, age, sex, grade of schooling, type of school and maternal and father's education and family socio-economic status, only asthma was associated with the disorders (MDD). Conclusions: The relatively high burden of mental disorders in this general population of children warrants targeted screening of those at risk, and treatment of those affected. Further, future studies should extensively investigate the factors that underlie the identified psychiatric disorders in this and similar general populations.
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Affiliation(s)
- Margaret Nampijja
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
| | | | - Harriet Mpairwe
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene and Tropical Medicine, Keppel Street, Bloomsbury, London, London, WC1E 7HT, UK., UK
| | - Richard Mpango
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Mental Health, School of Health Sciences, Soroti University, Soroti, Uganda
| | - Eugene Kinyanda
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala,, Kampala, P.O. Box 7072, Kampala, Uganda
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Intolerance of uncertainty as a transdiagnostic vulnerability to anxiety disorders in youth. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03645-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Nampijja M, Sembajjwe W, Mpairwe H, Mpango R, Kinyanda E. Prevalence and correlates of neurocognitive impairment and psychiatric disorders among schoolchildren in Wakiso District, Uganda: a cross-sectional study. Wellcome Open Res 2022; 6:217. [PMID: 36873715 PMCID: PMC9975401 DOI: 10.12688/wellcomeopenres.17005.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2022] [Indexed: 11/20/2022] Open
Abstract
Background: There is limited data on the burden of mental disorders among children in the general population in Africa. We examined the prevalence and correlates of neurocognitive and psychiatric disorders among schoolchildren in Uganda. Methods: This cross-sectional study enrolled 322 schoolchildren aged 5-17years in Wakiso, Uganda. We assessed for neurocognitive impairment using the Kaufmann-Assessment-Battery, and psychiatric disorders (major-depressive-disorder (MDD), attention-deficit-hyperactivity-disorder (ADHD), generalised-anxiety-disorder (GAD), and substance-use-disorder (SUD)) using the parent version of the Child and Adolescent Symptom Inventory-5, and Youth Inventory-4R Self Report. Prevalence and risk factors were determined using respectively descriptive statistics, and univariable and multivariable logistic regression. Results: Twenty-five participants (8%) had neurocognitive impairment. Nineteen (5.9%) participants had MDD, nine (2.8%) had ADHD, seven (2.2%) had GAD, 14 (8.6%) had SUD; and 30 (9.3%) had any psychiatric disorder. Among the exposure variables examined in this study, including asthma, age, sex, grade of schooling, type of school and maternal and father's education and family socio-economic status, only asthma was associated with the disorders (MDD). Conclusions: The relatively high burden of mental disorders in this general population of children warrants targeted screening of those at risk, and treatment of those affected. Further, future studies should extensively investigate the factors that underlie the identified psychiatric disorders in this and similar general populations.
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Affiliation(s)
- Margaret Nampijja
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
| | | | - Harriet Mpairwe
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene and Tropical Medicine, Keppel Street, Bloomsbury, London, London, WC1E 7HT, UK., UK
| | - Richard Mpango
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Mental Health, School of Health Sciences, Soroti University, Soroti, Uganda
| | - Eugene Kinyanda
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala,, Kampala, P.O. Box 7072, Kampala, Uganda
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17
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Zemestani M, Hosseini M, Petersen JM, Twohig MP. A pilot randomized controlled trial of culturally-adapted, telehealth group acceptance and commitment therapy for iranian adolescent females reporting symptoms of anxiety. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mustaffa MS, Bafghi ZR, Ahmadi A, Haghdoost A, Mansor MS. Potential Sociodemographic Predictors of Childhood Anxiety Disorders: A Cross-Sectional Study. JOURNAL OF INDIAN ASSOCIATION FOR CHILD AND ADOLESCENT MENTAL HEALTH 2022. [DOI: 10.1177/09731342221142047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background: Previous studies have shown that the prevalence of anxiety among primary school students in rural areas is relatively high. Also, this stage is a critical developmental stage of academic life. Childhood anxiety disorders lead to significant disruption and interference with other aspects of life, including behavioral, emotional, cognitive, and academic achievement. Aims: This study aimed to find the frequency of 6 subtypes of anxiety disorders and to determine the potential sociodemographic factors of anxiety disorders among primary school students in a rural area of Malaysia. Methods: This was a cross-sectional study in which 411 students answered the Spence Children’s Anxiety Scale-Child version (SCAS-C). Descriptive analyses elucidated at-risk students, and multivariate analysis of variance and multiple linear regression presented potential predictors of anxiety disorders. Results: The most common abnormal level was for social phobia (SP) (n = 109/18.6%), and the least common were panic/agoraphobia (n = 85/14.1%) and physical injury fears (PIF) (n = 82/13.6%). Multivariate analysis of variance revealed that age ( P < .05), gender ( P < .05), father’s employment ( P < .05), and mother’s educational level (EL) P < .05) were predictors of overall anxiety. A Tukey post-hoc test revealed that older children are more likely to suffer from overall anxiety, separation anxiety (SA), SP, and obsessive-compulsive problems. Children of low-income families were less likely to suffer from SA than those of middle-income families. Children of stay-at-home mothers were less likely to suffer from overall anxiety, SA, and SP than mothers who worked more than 8 h per day. Multiple linear regression could predict 6 models of anxiety based on sociodemographic factors. Conclusion: According to our findings in this study, promoting mental health by providing preventive strategies and screening programs is more recommended for students with sociodemographic risk factors for anxiety disorders.
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Affiliation(s)
- Mohamed Sharif Mustaffa
- Department of Counselling, Faculty of Cognitive Sciences and Human Development, University Malaysia Sarawak, Sarawak, Malaysia
| | - Zahra Ramazanian Bafghi
- Student Research Committee, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Atefeh Ahmadi
- Nursing Research Center, Department of Counselling in Midwifery, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - AliAkbar Haghdoost
- Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Depression and anxiety symptoms amongst kenyan adolescents: Psychometric Properties, Prevalence Rates and Associations with Psychosocial Wellbeing and Sociodemographic factors. Res Child Adolesc Psychopathol 2022; 50:1471-1485. [PMID: 35675002 DOI: 10.1007/s10802-022-00940-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 01/09/2023]
Abstract
This study assessed the psychometric properties of standard Western-derived instruments, the prevalence of depression and anxiety symptoms, and their associations with sociodemographic and wellbeing variables in a large sample of Kenyan adolescents. Self-report measures of depression (PHQ-8) and anxiety (GAD-7) symptoms, social support, gratitude, happiness, optimism, and perceived control were administered to 2,192 Kenyan youths (57.57% female) aged 12-19. Both the PHQ-8 (α = 0.78) and GAD-7 (α = 0.82) showed adequate internal consistency. EFA with a sub-sample (N = 1096) yielded a 1-factor structure for both PHQ-8 and GAD-7, a subsequent CFA conducted on the basis of a 1-factor model on another sub-sample (N = 1096) yielded good and moderate goodness of fit, respectively, for the PHQ-8 (χ2 = 76.73; p < 0.001; RMSEA = 0.05; CFI = 0.96; TLI = 0.95) and the GAD-7 (χ2 = 88.19; p < 0.001; RMSEA = 0.07; CFI = 0.97; TLI = 0.95). Some 28.06% and 30.38% of participants met the clinical cut-off for depressive and anxiety symptoms, respectively. Social support, gratitude, happiness, and perceived control were negatively associated with both depression and anxiety symptoms. Older adolescents reported higher symptoms while adolescents with more siblings reported lower symptoms. The western-derived PHQ and GAD met conventional psychometric standards with adolescents in Kenya; depression and anxiety symptoms showed relatively high prevalence and significant associations with important psychosocial and sociodemographic factors.
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Abstract
The current study examines the prevalence of depression, anxiety, suicide risk, and PTSD in Ugandan youth (13-25 years) attending vocational training programs. Youth from five urban (n=224 females, 81 males) and four rural (n=153 females only) vocational training centers operated by a non-governmental organization completed demographic and mental health questionnaires. Nearly half of the youth reported moderate or severe depression and/or anxiety. More than half reported anxiety and depression-related impairment. Nearly a quarter of youth had considered or attempted suicide. More than half screened positive on the PC-PTSD screen. Rural female youth reported the most food insecurity (56.9%), trafficking (37.9%), severe depression (35.9%), depression-related impairment (56.9%), severe anxiety (26.1%), and anxiety-related impairment (55.6%). Results from this study suggest that Ugandan youth have exceedingly high rates of depression, anxiety, suicide risk, and probable PTSD. Rural female youth may be especially at risk. Relevant treatment interventions are needed that can be adapted to youth in vocational training centers.
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Cherenack EM, Sikkema KJ. Puberty- and Menstruation-Related Stressors Are Associated with Depression, Anxiety, and Reproductive Tract Infection Symptoms Among Adolescent Girls in Tanzania. Int J Behav Med 2022; 29:160-174. [PMID: 34195917 DOI: 10.1007/s12529-021-10005-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Puberty and menstruation are significant stressors for adolescent girls and young women in low-resource settings in sub-Saharan Africa. However, little is known about the impact of these stressors on girls' mental health and reproductive health. METHODS In 2018, a cross-sectional self-report survey was conducted with 581 adolescent girls and young women between 13 to 21 years old who had reached menarche and were attending secondary school in Moshi, Tanzania. Structural equation modeling was used to examine the relationships of puberty-related stressors and menstruation-related stressors (menstrual deficits, movement/activity difficulties, and menstrual symptoms) to depression, anxiety, and the likelihood of reporting reproductive tract infection (RTI) symptoms. RESULTS Puberty-specific stressors, menstrual symptoms, and menstrual deficits were associated with depression and anxiety. Movement/activity difficulties were associated with anxiety. Increases in menstrual symptoms, menstrual deficits, puberty stressors, and depression were associated with an increased likelihood of reporting a lifetime RTI. However, the relationship of puberty stressors and depression with RTIs was no longer significant in two of three models after correcting for Type I error. CONCLUSIONS Overall, puberty- and menstruation-related stressors were associated with mental health and symptoms of reproductive tract infections. This suggests there is an important relationship between stressors specific to adolescent girls and young women during puberty, mental health, and reproductive health. There is a need for adolescent-tailored interventions to reduce the negative impact of stressors among girls transitioning through puberty in sub-Saharan Africa.
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Affiliation(s)
- Emily M Cherenack
- Department of Psychology and Neuroscience, Duke Global Health Institute, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA.
| | - Kathleen J Sikkema
- Department of Psychology and Neuroscience, Duke Global Health Institute, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA
- Department of Sociomedical Sciences, Columbia University, 722 W 168th Street, New York, NY, 10032, USA
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Opio JN, Munn Z, Aromataris E. Prevalence of Mental Disorders in Uganda: a Systematic Review and Meta-Analysis. Psychiatr Q 2022; 93:199-226. [PMID: 34427855 DOI: 10.1007/s11126-021-09941-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 11/26/2022]
Abstract
This systematic review was conducted to determine the prevalence of mental disorders among children and adults in Uganda. A comprehensive systematic search for relevant studies reporting prevalence of mental disorders in children or adults in Uganda was conducted in PubMed, Embase, PsycINFO, Scopus, Web of Science databases and grey literature sources. Study was eligible if, validated instrument based on the International Classification of Diseases or Diagnostic and Statistical Manual of Mental Disorders criteria to assess a mental disorder was used. Eligible studies were critically appraised, prevalence data extracted and pooled using the random-effects model. Certainty in the pooled prevalence estimates was evaluated using the Grading of Recommendation, Assessment, Development and Evaluation approach. A total of 632 records were obtained, of which 26 articles from 24 studies conducted in Uganda were included in the review. Overall and with moderate level of certainty, the prevalence of any mental disorder in Uganda was 22.9% (95% C.I 11.0% - 34.9%) in children and 24.2% (95% C.I 19.8% - 28.6%) in adults. Prevalence of anxiety disorders was 14.4% (95% C.I 4.9% - 24.0%) in children and 20.2% (95% C.I 14.5% - 25.9%) in adults. The prevalence of current depressive disorders was 22.2% (95% C.I 9.2% - 35.2%) in children and 21.2% (95% C.I 16.8% - 25.6%) in adults. Eating disorder and psychotic syndrome disorder were also reported. Our findings suggest that depression and anxiety disorders are common mental disorders in Uganda, affecting approximately one in four persons. The findings provide essential insights for health service planning, clinical practice, and future epidemiological research in Uganda.
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Affiliation(s)
- John Nelson Opio
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia.
| | - Zachary Munn
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Edoardo Aromataris
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
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Anxiety among urban, semi-urban and rural school adolescents in Dhaka, Bangladesh: Investigating prevalence and associated factors. PLoS One 2022; 17:e0262716. [PMID: 35061810 PMCID: PMC8782381 DOI: 10.1371/journal.pone.0262716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 12/31/2021] [Indexed: 11/19/2022] Open
Abstract
Background
Anxiety disorder is one of the emerging public health problems in many low- and middle-income countries (LMICs). Likewise, in Bangladesh, a growing number of adolescents are experiencing such symptoms though we have very limited research evidence available. The purpose of this study was to investigate the prevalence of anxiety and the factors associated with this condition among urban, semi-urban, and rural school adolescents in Bangladesh.
Methods
This cross-sectional study used a two-stage cluster sampling procedure. A self-administered questionnaire was conveyed to 2355 adolescents from nine secondary schools of Dhaka, Bangladesh. Of the respondents, 2313 completed the seven-item Generalized Anxiety Disorder (GAD-7). Besides, sociodemographic information, self-reported body image as well as modification of Leisure Time Exercise Questionnaire (LTEQ) and WHO Global PA Questionnaire (GPAQ) were used to determine the sociodemographic and lifestyle factors associated with anxiety among adolescents.
Results
A total of 20.1% of adolescents were experiencing moderate to severe anxiety; of them, a significantly higher proportion (49.9%) of female adolescents were suffering more than males (40.1%). Furthermore, age, student’s grade, father’s educational level, number of family members, and residential setting were found to be significantly associated with anxiety among adolescents. In terms of lifestyle factors, irregular physical activity (AOR: 1.31; 95% CI: 1.05–1.63), high screen time (AOR: 1.51; 95% CI:1.21–1.88), sleep dissatisfaction (AOR: 3.79; 95% CI: 3.02–4.76), and underweight body image (AOR: 2.37; 95% CI:1.70–3.28) were found to be significantly associated with anxiety among school adolescents of urban, semi-urban, and rural residential settings.
Conclusions
Anxiety is prevalent among urban, semi-urban, and rural school adolescents in Dhaka, Bangladesh. To lessen this prevalence of anxiety among Bangladeshi adolescents, evidence-based health programs- healthy school trials—and policies should therefore be taken based on the findings of this study.
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Karki A, Thapa B, Pradhan PMS, Basel P. Depression, anxiety and stress among high school students: A cross-sectional study in an urban municipality of Kathmandu, Nepal. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000516. [PMID: 36962418 PMCID: PMC10022099 DOI: 10.1371/journal.pgph.0000516] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/02/2022] [Indexed: 11/18/2022]
Abstract
Depression and anxiety are the most widely recognized mental issues affecting youths. It is extremely important to investigate the burden and associated risk factors of these common mental disorders to combat them. Therefore, this study was undertaken with the aim to estimate the prevalence and identify factors associated with depression, anxiety, and stress among high school students in an urban municipality of Kathmandu, Nepal. A cross-sectional study was conducted among 453 students of five randomly selected high schools in Tokha Municipality of Kathmandu. Previously validated Nepali version of depression, anxiety, and stress scale (DASS-21) was used to assess the level of symptoms of depression, anxiety and stress (DAS). Multivariable logistic regression was carried out to decide statistically significant variables of symptoms of DAS at p-value<0.05. The overall prevalence of DAS was found to be 56.5% (95% CI: 51.8%, 61.1%), 55.6% (95%CI: 50.9%, 60.2%) and 32.9% (95%CI: 28.6%, 37.4%) respectively. In the multivariable model, nuclear family type, students from science or humanities faculty, presence of perceived academic stress, and being electronically bullied were found to be significantly associated with depression. Female sex, having mother with no formal education, students from science or humanities faculty and presence of perceived academic stress were significantly associated with anxiety. Likewise, female sex, currently living without parents, and presence of perceived academic stress were significantly associated with stress. Prevention and control activities such as school-based counseling services focusing to reduce and manage academic stress and electronic bullying are recommended in considering the findings of this research.
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Affiliation(s)
- Anita Karki
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Bipin Thapa
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| | - Pranil Man Singh Pradhan
- Department of Community Medicine, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Prem Basel
- Department of Community Medicine, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
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Nampijja M, Sembajjwe W, Mpairwe H, Mpango R, Kinyanda E. Prevalence and correlates of neurocognitive impairment and psychiatric disorders among schoolchildren in Wakiso District, Uganda: a cross-sectional study. Wellcome Open Res 2021; 6:217. [PMID: 36873715 PMCID: PMC9975401 DOI: 10.12688/wellcomeopenres.17005.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 11/20/2022] Open
Abstract
Background: There is limited data on the burden of mental disorders among 'healthy' children in Africa. We examined the prevalence and correlates of neurocognitive and psychiatric disorders among schoolchildren in Uganda. Methods: This cross-sectional study enrolled 322 schoolchildren aged 5-17years in Wakiso, Uganda. We assessed for neurocognitive impairment using the Kaufmann-Assessment-Battery, and psychiatric disorders (major-depressive-disorder (MDD), attention-deficit-hyperactivity-disorder (ADHD), generalised-anxiety-disorder (GAD), and substance-use-disorder (SUD)) using the parent version of the Child and Adolescent Symptom Inventory-5, and Youth Inventory-4R Self Report. Prevalence and risk factors were determined using percentages and logistic regression. Results: Twenty-five participants (8%) had neurocognitive impairment. Nineteen (5.9%) participants had MDD, nine (2.8%) had ADHD, seven (2.2%) had GAD, 14 (8.6%) had SUD; and 30 (9.3%) had any psychiatric disorder. None of the factors examined were associated with the disorders. Conclusions: The unexpectedly high burden of mental disorders in this general population of children warrants targeted screening of those at risk, and treatment of those affected. Further, future studies should extensively investigate the factors that underlie the identified psychiatric disorders in this and similar general populations.
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Affiliation(s)
- Margaret Nampijja
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
| | | | - Harriet Mpairwe
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene and Tropical Medicine, Keppel Street, Bloomsbury, London, London, WC1E 7HT, UK., UK
| | - Richard Mpango
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Mental Health, School of Health Sciences, Soroti University, Soroti, Uganda
| | - Eugene Kinyanda
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala,, Kampala, P.O. Box 7072, Kampala, Uganda
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Mutapi F, Pfavayi L, Osakunor D, Lim R, Kasambala M, Mutemeri A, Rusakaniko S, Chibanda D, Mduluza T. Assessing early child development and its association with stunting and schistosome infections in rural Zimbabwean children using the Griffiths Scales of Child Development. PLoS Negl Trop Dis 2021; 15:e0009660. [PMID: 34379618 PMCID: PMC8357151 DOI: 10.1371/journal.pntd.0009660] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/18/2021] [Indexed: 11/19/2022] Open
Abstract
There is a paucity of reference early childhood development (ECD) data at community level in rural Africa. Our objective was to conduct a comprehensive assessment of ECD in rural Zimbabwe and determine the impact of stunting and schistosome infections on ECD. Using the Griffiths Scales of Child Development, we conducted a cross sectional assessment of Eye and Hand Coordination (EHC), Personal-Social-Emotional (PSE), Language and Communication (LC), Foundations of Learning (FL) and Gross Motor (GM) domains and the summary General Development (GD) in 166 children aged 6-72 months. The effects of stunting, malnutrition and Schistosoma haematobium infection on ECD was determined. The impact of praziquantel curative treatment of schistosome infection on the developmental scores was determined through a longitudinal follow up at 6 and 12 months. From an initial 166 children, 11 were found to have developmental deficits warranting further investigation. Of the remaining 155, 58.7% recorded a good (≥ average) score for the overall General Development (GD). Proportions of children scoring above the cut-off (≥ average) for each domain were GM (84.5%), PSE (80.6%), EHC (61.9%), FL (43.9%) and LC (44.5%). The prevalence of stunting was 26.8% (95% CI = 20.1%-34.8%) Scores for stunted children were significantly lower for EHC (p = 0.0042), GM (p = 0.0099), and GD (p = 0.0014) with the fraction of lower scores attributable to stunting being GM = 63.4%, GD = 46.6%, EHC = 45%, and LC = 21%. S. haematobium infection prevalence was 39.7% and mean infection intensity was 5.4 eggs/10 ml urine. Infected children had poorer cognitive performance scores for the FL (p = 0.0005) with 30.8% of poor FL attributable to the infection. Performance in all domains improved to the expected normal or above reference levels at 6 and 12 months post curative treatment of schistosome infections. Our study documented reference values for ECD in rural Zimbabwean children. The study detected deficiencies in the FL domain, which were more pronounced in children, infected with schistosomes, highlighting the need for provision of cognitive stimulation tools and access to early childhood foundation education. There is also need for improved child nutrition and treatment of schistosome infections to improve child development outcomes.
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Affiliation(s)
- Francisca Mutapi
- Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA), University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
| | - Lorraine Pfavayi
- Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA), University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Derick Osakunor
- Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA), University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
| | - Rivka Lim
- Institute of Immunology & Infection Research, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA), University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom
| | - Maritha Kasambala
- School of Life Sciences, University of KwaZulu-Natal; Westville, South Africa
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA) Zimbabwe, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe of Zimbabwe
| | - Arnold Mutemeri
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Parirenyatwa Hospital, Harare, Zimbabwe
| | - Simbarashe Rusakaniko
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA) Zimbabwe, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe of Zimbabwe
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Parirenyatwa Hospital, Harare, Zimbabwe
| | - Dixon Chibanda
- Department of Psychiatry, College of Health Sciences, University of Zimbabwe, Parirenyatwa Hospital, Harare, Zimbabwe
| | - Takafira Mduluza
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA) Zimbabwe, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe of Zimbabwe
- Department of Biochemistry, University of Zimbabwe, Harare, Zimbabwe
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Deng N, Bi H, Zhao J. Maternal Psychological Control and Rural Left-Behind Children's Anxiety: The Moderating Role of Externalizing Problem Behavior and Teacher Support. Front Psychol 2021; 12:624372. [PMID: 34290639 PMCID: PMC8288028 DOI: 10.3389/fpsyg.2021.624372] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 02/26/2021] [Indexed: 11/13/2022] Open
Abstract
Based on the risk and protective factor framework and context-dependent theory, the present study investigated the association between maternal psychological control and anxiety among left-behind children in rural China as well as the moderating roles of externalizing problem behavior and teacher support in this association. A total of 149 children with two migrant parents, 306 children with only a migrant father, and 287 accompanied children aged 11–16 years (M = 13.85 years, SD = 0.50) in the rural areas of Shandong Province, Eastern China, participated in the study. Children reported their perceived levels of maternal psychological control, teacher support, externalizing problem behavior, and anxiety. The results provided evidence that a higher level of psychological control was associated with more anxiety symptoms in all three groups of children, and this association was stronger in children with two migrant parents than in accompanied children. Hierarchical regression analysis supported our hypotheses that the moderating effects of externalizing problem behavior and teacher support varied as a function of parents' migrant status, with externalizing problem behavior exacerbating the impact of psychological control on anxiety in accompanied children, and teacher support buffering the impact of psychological control on anxiety in children with a migrant father. These findings broaden our understanding of the factors and processes that contribute to anxiety problems in left-behind children in rural China.
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Affiliation(s)
- Na Deng
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Hongyan Bi
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jinxia Zhao
- College of Education, Linyi University, Linyi, China
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Campbell S, Osborn TL. Adolescent psychopathology and psychological wellbeing: a network analysis approach. BMC Psychiatry 2021; 21:333. [PMID: 34217254 PMCID: PMC8254923 DOI: 10.1186/s12888-021-03331-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/18/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The extent to which psychological wellbeing may play a preventive and therapeutic role in the development and maintenance of adolescent emotional disorders depends, in part, on the nature of the overlap between these two constructs. We estimated network analysis to examine the relationship between adolescent psychopathology (measured by depression and anxiety symptoms) and psychological wellbeing (measured by happiness, optimism, social support, perceived control, and gratitude). METHODS This was a cross-sectional study with a large community sample of Kenyan adolescents (N = 2192, aged 13-18). Network analyses were conducted to examine the topology, stability, centrality, and bridge nodes of a network of psychopathology and psychological wellbeing measures. RESULTS Two distinct community clusters emerged, one for psychopathology nodes and another for wellbeing nodes, suggesting that these are two distinct but connected concepts. Central and bridge nodes of the wellbeing and psychopathology network were identified. The most central nodes in the network were family provides emotional help and support and self-blame; the strongest negative edges between psychopathology and psychological wellbeing were depressed mood-I love life and irritability-I am a joyful person; the main bridge nodes were family helps me and I can talk to family about problems. CONCLUSIONS Our findings expand understanding of the relationship between psychopathology and wellbeing in an understudied population and are suggestive of how psychological wellbeing can inform psychopathological treatment and preventive efforts in low-income regions such as those in Sub Saharan Africa.
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Ahinkorah BO, Aboagye RG, Arthur-Holmes F, Hagan JE, Okyere J, Budu E, Dowou RK, Adu C, Seidu AA. A Multi-Country Analysis of Prevalence of Anxiety-Induced Sleep Disturbance and Its Associated Factors among In-School Adolescents in Sub-Saharan Africa Using the Global School-Based Health Survey. Healthcare (Basel) 2021; 9:healthcare9020234. [PMID: 33671775 PMCID: PMC7926929 DOI: 10.3390/healthcare9020234] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/12/2021] [Accepted: 02/14/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Among the health problems affecting adolescents, anxiety disorders are considered among the health-compromising or debilitating outcomes that affect adolescents' mental health. We examined the prevalence and factors associated with anxiety-induced sleep disturbance among in-school adolescents in sub-Saharan Africa (SSA). (2) Methods: This study involved a cross-sectional analysis of data from the Global School-Based Health Survey (GSHS). We analyzed data on 25,454 in-school adolescents from eleven (11) countries in SSA with a dataset between 2010 and 2017. Two multivariable logistic regression models were built to determine the strength of the association between anxiety-induced sleep disturbance and the explanatory variables. The results of the regression analyses were presented using adjusted odds ratios (aOR) and their respective 95% confidence intervals (CIs). Statistical significance was set at p-value < 0.05. (3) Results: The overall prevalence of anxiety-induced sleep disturbance among in-school adolescents in SSA was 12.2%. The prevalence ranged from 5.1% in Tanzania to 20.5% in Benin. The odds of anxiety-induced sleep disturbance was higher among adolescents aged 15 and above [aOR = 1.26, 95% CI = 1.15, 1.39] compared to those aged 14 or younger. Additionally, the odds of anxiety-induced sleep disturbance was higher among adolescents who were bullied [aOR = 1.54, 95% CI = 1.42, 1.67], those that felt lonely [aOR = 3.85, 95% CI = 3.52, 4.22], those who had suicidal ideations [aOR = 1.70, 95% CI = 1.52, 1.90], those who had suicidal plan [aOR = 1.26, 95% CI = 1.13, 1.41], those who have had suicidal attempt [aOR = 1.21, 95% CI = 1.08, 1.35], those who used marijuana [aOR = 1.27, 95% CI = 1.06, 1.52], and those who were truant at school [aOR = 1.33, 95% CI = 1.22, 1.46]. However, male adolescents had lower odds of anxiety-induced sleep disturbance [aOR = 0.88, 95% CI = 0.81, 0.95], compared to their female counterparts. (4) Conclusions: We found a relatively high prevalence of anxiety-induced sleep disturbance among in-school adolescents in SSA. Higher age, being female, being bullied, loneliness, having suicidal ideations/plan/attempt, use of marijuana and truancy were risk factors for anxiety-induced sleep disturbance. The findings, therefore, highlight the urgency for policies (e.g., early school-based screening) and interventions (e.g., Rational Emotive Behavioral Education (REBE), Social Emotional Learning (SEL) that target in-school adolescents within the most at-risk populations of anxiety-induced sleep disturbance in SSA.
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Affiliation(s)
- Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW 2007, Australia;
| | - Richard Gyan Aboagye
- School of Public Health, University of Health and Allied Sciences, Ho PMB 31, Ghana; (R.G.A.); (R.K.D.)
| | - Francis Arthur-Holmes
- Department of Sociology and Social Policy, Lingnan University, 8 Castle Peak Road, Tuen Mun, Hong Kong, China;
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast PMB, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Postfach 10 01 31, 33501 Bielefeld, Germany
- Correspondence:
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast PMB TF0494, Ghana; (J.O.); (E.B.); (A.-A.S.)
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast PMB TF0494, Ghana; (J.O.); (E.B.); (A.-A.S.)
| | - Robert Kokou Dowou
- School of Public Health, University of Health and Allied Sciences, Ho PMB 31, Ghana; (R.G.A.); (R.K.D.)
| | - Collins Adu
- Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi PMB AK, Ghana;
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast PMB TF0494, Ghana; (J.O.); (E.B.); (A.-A.S.)
- College of Public Health, Medical and Veterinary Services, James Cook University, Townsville, QLD 4811, Australia
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Ahinkorah BO, Aboagye RG, Arthur-Holmes F, Seidu AA, Frimpong JB, Budu E, Amoako BM, Hagan JE. Predictors of Anxiety-Induced Sleep Disturbance among in-School Adolescents in Ghana: Evidence from the 2012 Global School-Based Health Survey. Behav Sci (Basel) 2021; 11:bs11020020. [PMID: 33535435 PMCID: PMC7912318 DOI: 10.3390/bs11020020] [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: 12/21/2020] [Revised: 01/08/2021] [Accepted: 01/22/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Psychological problems of adolescents have become a global health and safety concern. Empirical evidence has shown that adolescents experience diverse mental health conditions (e.g., anxiety, depression, and emotional disorders). However, research on anxiety-induced sleep disturbance among in-school adolescents has received less attention, particularly in low- and middle-income countries. This study's central focus was to examine factors associated with t anxiety-induced sleep disturbance among in-school adolescents in Ghana. (2) Methods: Analysis was performed using the 2012 Global School-based Health Survey (GSHS). A sample of 1342 in-school adolescents was included in the analysis. The outcome variable was anxiety-induced sleep disturbance reported during the past 12 months. Frequencies, percentages, chi-square, and multivariable logistic regression analyses were conducted. Results from the multivariable logistic regression analysis were presented as crude and adjusted odds ratios at 95% confidence intervals (CIs) and with a statistical significance declared at p < 0.05. (3) Results: Adolescents who went hungry were more likely to report anxiety-induced sleep disturbance compared to their counterparts who did not report hunger (aOR = 1.68, CI = 1.10, 2.57). The odds of anxiety-induced sleep disturbance were higher among adolescents who felt lonely compared to those that never felt lonely (aOR = 2.82, CI = 1.98, 4.01). Adolescents who had sustained injury were more likely to have anxiety-induced sleep disturbance (aOR = 1.49, CI = 1.03, 2.14) compared to those who had no injury. Compared to adolescents who never had suicidal ideations, those who reported experiencing suicidal ideations had higher odds of anxiety-induced sleep disturbance (aOR = 1.68, CI = 1.05, 2.71). (4) Conclusions: Anxiety-induced sleep disturbance among in-school adolescents were significantly influenced by the psychosocial determinants such as hunger, loneliness, injury, and suicidal ideation in this study. The findings can help design appropriate interventions through effective strategies (e.g., early school-based screening, cognitive-behavioral therapy, face-face counseling services) to reduce psychosocial problems among in-school adolescents in Ghana.
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Affiliation(s)
- Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW 2007, Australia;
| | - Richard Gyan Aboagye
- School of Public Health, University of Health and Allied Sciences, Ho PMB 31, Ghana;
| | - Francis Arthur-Holmes
- Department of Sociology and Social Policy, Lingnan University, 8 Castle Peak Road, Tuen Mun, Hong Kong;
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast PMB TF0494, Ghana; (A.-A.S.); (E.B.)
- College of Public Health, Medical and Veterinary Services, James Cook University, Townsville, QLD 4811, Australia
| | - James Boadu Frimpong
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast PMB TF0494, Ghana;
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast PMB TF0494, Ghana; (A.-A.S.); (E.B.)
| | - Bernard Mensah Amoako
- Department of Counselling Psychology, University of Education, Winneba, Winneba PMB 25, Ghana;
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast PMB TF0494, Ghana;
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Postfach 10 01 31, 33501 Bielefeld, Germany
- Correspondence:
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Nabunya P, Damulira C, Byansi W, Muwanga J, Bahar OS, Namuwonge F, Ighofose E, Brathwaite R, Tumwesige W, Ssewamala FM. Prevalence and correlates of depressive symptoms among high school adolescent girls in southern Uganda. BMC Public Health 2020; 20:1792. [PMID: 33238965 PMCID: PMC7689972 DOI: 10.1186/s12889-020-09937-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 11/19/2020] [Indexed: 12/12/2022] Open
Abstract
Background In sub-Saharan Africa (SSA), adolescent girls and young women are three times more likely than boys to have depressive disorders. Understanding adolescents’ unique and common vulnerabilities and protective factors is essential for the development of appropriate interventions and programming focused on child and adolescent mental health. This paper examines the prevalence and predictors of depressive symptoms among high school adolescent girls in southern Uganda. Methods Baseline data from a longitudinal cluster randomized study involving 1260 adolescent girls (14–17 years), recruited from 47 secondary schools were utilized. Depressive symptoms were estimated using the 21-item Beck’s Depression Inventory. Hierarchical linear regression modelling was utilized to estimate key predictors of depressive symptoms among adolescent girls. Results Of the total sample, 16.35% (n = 206) reported severe depressive symptoms and almost one in every three adolescent girls interviewed (29.68%, n = 374) reported moderate symptoms. These symptoms were more prevalent among older adolescents (16 years and above). In addition, family relationships, social support, as well as measures of psychological wellbeing (self-concept and self-esteem) were all associated with lower levels of depressive symptoms. Hopelessness was associated with higher levels of depressive symptoms among adolescent girls. Conclusion Findings from this study indicate a high prevalence of depressive symptoms, especially among older adolescent girls. In addition, family support factors and adolescents’ psychological wellbeing were associated with low levels of depressive symptoms –pointing to the need to strengthen family functioning and adolescent’s psychological wellbeing to mitigate risks. Taken together, findings support increasing calls for early screening and detection of depressive symptoms to facilitate timely referral to care and treatment. Findings may also inform the development and incorporation of gender-specific mental health components in programming targeting adolescent girls, in low-resource communities in SSA. Trial registration This trial was prospectively registered with ClinicalTrials.gov (registration number: NCT03307226) on 11 October 2017.
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Affiliation(s)
- Proscovia Nabunya
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA.
| | - Christopher Damulira
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
| | - William Byansi
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
| | - Joelynn Muwanga
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
| | - Ozge Sensoy Bahar
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
| | - Flavia Namuwonge
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
| | - Eloho Ighofose
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
| | - Rachel Brathwaite
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
| | - Wilberforce Tumwesige
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
| | - Fred M Ssewamala
- Washington University in St. Louis, Brown School of Social Work, International Center for Child Health and Development (ICHAD), One Brookings Drive, St. Louis, MO, 63130, USA
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Kirabira J, Lam A, Ssuna B, Rukundo GZ. Psychiatric disorders among children and adolescents with active epilepsy in southwestern Uganda. PAMJ ONE HEALTH 2020; 3:9. [PMID: 34604861 PMCID: PMC8486297 DOI: 10.11604/pamj-oh.2020.3.9.25146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
INTRODUCTION the study aimed to determine the prevalence of emotional, behavioral, developmental and psychosis related disorders among children and adolescents with active epilepsy aged 5 to 18 years in southwestern Uganda. METHODS we conducted a cross sectional study at one big urban hospital, two rural health centers and one rural special needs school. The disorders were assessed using an adapted parent version of the Child and Adolescent Symptom Inventory-5 (CASI-5). RESULTS one hundred and sixty-one participants were assessed, and 93 (57.8%) had at least one psychiatric disorder. Developmental disorders were the most prevalent at 39.8% (95%CI 32.11 - 47.39), followed by emotional disorders, 30.4% (95%CI 23.25-37.62), behavioral disorders, 7.5% (95%CI 3.35-11.55) and psychosis related disorders, 6.2% (95%CI 2.44 - 9.98). Thirty-nine participants (24.2%) had at least two psychiatric disorders. Developmental disorders were associated with younger age (aOR=0.86, p=0.001) and having epilepsy-related physical injuries and deformities (aOR=2.36, p=0.036). Emotional disorders (aOR=1.13, p=0.007) and psychosis related disorders (aOR=1.44, p=0.007) were associated with increasing age, whereas a family history of epilepsy was protective (aOR=0.22, p=0.042). CONCLUSION psychiatric disorders were highly prevalent among children and adolescents with epilepsy in southwestern Uganda; highlighting the need to integrate screening and management of these disorders into routine epilepsy care.
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Affiliation(s)
- Joseph Kirabira
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, PO Box 1410, Mbarara, Uganda
- Department of Mental Health, Gulu University, PO Box 166, Gulu, Uganda
- Department of Mental Health and Psychiatry, Kampala International University, Western Campus, PO Box 71, Bushenyi, Uganda
| | - Alice Lam
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Bashir Ssuna
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, PO Box 1410, Mbarara, Uganda
| | - Godfrey Zari Rukundo
- Department of Epidemiology and Biostatistics, Makerere College of Health Sciences (MakCHS), Kampala, Uganda
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Prevalence, comorbidity and predictors of anxiety disorders among children and adolescents. Asian J Psychiatr 2020; 53:102059. [PMID: 32512529 DOI: 10.1016/j.ajp.2020.102059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 03/28/2020] [Accepted: 03/29/2020] [Indexed: 11/22/2022]
Abstract
Childhood anxiety may lead to serious health consequences in later life. The present study provides the prevalence, comorbidity, and predictors of anxiety disorders among children and adolescents. This was a cross-sectional national project that was implemented on 28,698 children and adolescents in Iran. Participants entered the study by multistage cluster sampling with an equal number of each gender and three age groups (6-9, 10-14, and 15-18 years) within each cluster. The tools used in this research were the demographic questionnaire and K-SADS-PL. To analyze the data logistic regression and chi-square tests were used in SPSS (ver. 16). The prevalence of anxiety disorder in children and adolescents was 13.2 in boys and 15.1 in girls. Furthermore, gender, age, place of residence and history of psychiatric hospitalization of parents could predict anxiety disorders. Anxiety disorders had comorbidity with behavioral disorders, neurodevelopmental disorders, mood disorders, psychotic disorders, substance abuse disorders, and elimination disorders. According to our findings in this study, anxiety disorders affect the performance, health and life of children and adolescents, identifying the childhood anxiety, as well as finding diseases that are associated with anxiety disorders, can help in the prevention of the disorder.
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Al-Yateem N, Bani Issa W, Rossiter RC, Al-Shujairi A, Radwan H, Awad M, Fakhry R, Mahmoud I. Anxiety related disorders in adolescents in the United Arab Emirates: a population based cross-sectional study. BMC Pediatr 2020; 20:245. [PMID: 32450837 PMCID: PMC7249318 DOI: 10.1186/s12887-020-02155-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 05/20/2020] [Indexed: 01/04/2023] Open
Abstract
Background Anxiety disorders are common among children and adolescents. However, there is a paucity of up-to-date data on the prevalence and correlates of anxiety-related disorders among children and adolescents in the United Arab Emirates (UAE). Methods We conducted a cross sectional study to determine the prevalence of specific anxiety-related disorders (e.g., generalized anxiety disorder, panic disorder, separation anxiety, social anxiety) in the UAE, and identify correlations between these disorders and adolescents’ demographic variables. Participants were 968 adolescents aged 13–18 years attending secondary schools across the UAE. Convenience sampling was used to recruit participants. We collected demographic information and data about participants’ anxiety levels. Anxiety was assessed using the Arabic and English versions of the Screen for Child Anxiety Related Disorders scale. Univariate analyses (independent sample t-tests and analysis of variance) were performed to evaluate factors affecting participants’ anxiety scores. Chi-square tests were used to compare factors associated with anxiety disorders. Results Participants’ mean age was 16 ± 1.8 years, and 65.8% were female. The overall prevalence of anxiety disorders was 28%, with this being significantly higher in girls (33.6%) than boys (17.2%) (p < 0.0001). Participants aged < 16 years had higher generalized anxiety, separation anxiety, and social anxiety scores compared with those aged ≥16 years (p ≤ 0.05). Those from households with a maid had significantly higher generalized anxiety, panic disorder, separation anxiety, and significant school avoidance scores than those without a maid (p ≤ 0.05). In addition, participants from middle and low economic backgrounds had higher separation anxiety scores compared with children from high economic backgrounds (p ≤ 0.05). The multivariate analysis showed the main associated factors with anxiety were gender (being female, p < 0.001) and caregiver (other than mother and father together, p < 0.001). Conclusions We found a high incidence of anxiety-related disorders among school-aged adolescents in the UAE, with girls being more affected than boys. This suggests that age-appropriate initiatives are urgently needed to reduce the high rate of anxiety-related disorders. It may also be necessary to further investigate the two main associated factors with anxiety identified in this study (being female and non-parental caregivers).
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Affiliation(s)
- Nabeel Al-Yateem
- University of Sharjah, Sharjah, UAE. .,School of Nursing, Midwifery & Indigenous Health, Faculty of Science, Charles Sturt University, Leeds Parade, Orange, New South Wales, Australia. .,Research Institute of Medical and Health Sciences, Sharjah, UAE.
| | - Wegdan Bani Issa
- University of Sharjah, Sharjah, UAE.,Research Institute of Medical and Health Sciences, Sharjah, UAE
| | - Rachel C Rossiter
- School of Nursing, Midwifery & Indigenous Health, Faculty of Science, Charles Sturt University, Leeds Parade, Orange, New South Wales, Australia
| | | | - Hadia Radwan
- University of Sharjah, Sharjah, UAE.,Research Institute of Medical and Health Sciences, Sharjah, UAE
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Social anxiety disorder among children and adolescents: A nationwide survey of prevalence, socio-demographic characteristics, risk factors and co-morbidities. J Affect Disord 2020; 263:450-457. [PMID: 31969277 DOI: 10.1016/j.jad.2019.12.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/06/2019] [Accepted: 12/08/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Social anxiety disorder is a frequent psychiatric disorder. We aimed to estimate the life-time prevalence, socio-demographic characteristics, risk factors and co-morbidities of this condition among children and adolescents. METHODS This was a cross sectional national survey conducted in Iranian individuals aged 6 to 18 years. Face-to-face household interviews were performed by trained clinical psychologists. The Farsi version of the kiddie schedule for affective disorders and schizophrenia for school-age children/present and lifetime version (K-SADS-PL) was administered to estimate the SAD prevalence. Parental personality traits and their psychopathologies were also obtained using Millon clinical multiaxial inventory, third edition (MCMI-III) to find the possible risk factors. RESULTS From 29,878 participants, 585 individuals were diagnosed with SAD and weighted lifetime prevalence of 1.8% was observed. The odds of this condition was significantly higher among older adolescents (odds ratio (OR):1.47; 95% confidence interval(CI): 1.11-1.95) and individuals with paternal history of psychiatric hospitalization (OR: 2.96; 95%CI: 1.29-6.79). Higher means of persistent depression disorder (OR: 1.009; 95%CI: 1.000-1.018) and melancholic personality trait (OR: 1.007; 95%CI: 1.001-1.014) in mothers as well as schizophrenia spectrum (OR: 1.014; 95%CI: 1.001-1.027) and anxiety (OR: 1.010; 95%CI: 1.010-1.021) in fathers were statistically associated with higher odds of SAD in their children. Other anxiety disorders and behavioral disorders were the most prevalent co-morbidities. LIMITATIONS The cross-sectional analysis does not enable analyses of possible causal associations. Lacking control group and follow-up periods were other major limitations that should be resolved in future studies. CONCLUSION Clinicians and researchers need to continue studying this condition at all levels and in all developmental periods.
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Orellana JDY, Ribeiro MRC, Barbieri MA, Saraiva MDC, Cardoso VC, Bettiol H, Silva AAMD, Barros FC, Gonçalves H, Wehrmeister FC, Menezes AMB, Del-Ben CM, Horta BL. Mental disorders in adolescents, youth, and adults in the RPS Birth Cohort Consortium (Ribeirão Preto, Pelotas and São Luís), Brazil. CAD SAUDE PUBLICA 2020; 36:e00154319. [PMID: 32022176 DOI: 10.1590/0102-311x00154319] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 10/21/2019] [Indexed: 01/14/2023] Open
Abstract
Although depression and anxiety are known to result in disabilities and workplace and health system losses, population-based studies on this problem are rare in Brazil. The current study assessed the prevalence of mental disorders in adolescents, youth, and adults and the relationship to sociodemographic characteristics in five birth cohorts (RPS) in Ribeirão Preto (São Paulo State), Pelotas (Rio Grande do Sul State), and São Luís (Maranhão State), Brazil. Major depressive episode, suicide risk, social phobia, and generalized anxiety disorder were assessed with the Mini International Neuropsychiatric Interview. Bootstrap confidence intervals were estimated and prevalence rates were stratified by sex and socioeconomic status in the R program. The study included 12,350 participants from the cohorts. Current major depressive episode was more prevalent in adolescents in São Luís (15.8%; 95%CI: 14.8-16.8) and adults in Ribeirão Preto (12.9%; 95%CI: 12.0-13.9). The highest prevalence rates for suicide risk were in adults in Ribeirão Preto (13.7%; 95%CI: 12.7-14.7), and the highest rates for social phobia and generalized anxiety were in youth in Pelotas, with 7% (95%CI: 6.3-7.7) and 16.5% (95%CI: 15.4-17.5), respectively. The lowest prevalence rates of suicide risk were in youth in Pelotas (8.8%; 95%CI: 8.0-9.6), social phobia in youth in Ribeirão Preto (1.8%; 95%CI: 1.5-2.2), and generalized anxiety in adolescents in São Luís (3.5%; 95%CI: 3.0-4.0). Mental disorders in general were more prevalent in women and in individuals with lower socioeconomic status, independently of the city and age, emphasizing the need for more investment in mental health in Brazil, including gender and socioeconomic determinants.
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Affiliation(s)
| | | | - Marco Antonio Barbieri
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | | | - Viviane Cunha Cardoso
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | - Heloísa Bettiol
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
| | | | - Fernando C Barros
- Faculdade de Medicina, Universidade Católica de Pelotas, Pelotas, Brasil
| | - Helen Gonçalves
- Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Brasil
| | | | | | - Cristina Marta Del-Ben
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
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Ahulu LD, Gyasi-Gyamerah AA, Anum A. Predicting risk and protective factors of generalized anxiety disorder: a comparative study among adolescents in Ghana. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2019. [DOI: 10.1080/02673843.2019.1698440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Lynda Dede Ahulu
- Clinical Psychology Unit, Accra Psychiatric Hospital , Accra, Ghana
| | | | - Adote Anum
- Department of Psychology, University of Ghana , Legon, Ghana
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Kyohangirwe L, Okello E, Namuli JD, Ndeezi G, Kinyanda E. Prevalence and factors associated with major depressive disorder among adolescents attending a primary care facility in Kampala, Uganda. Trop Doct 2019; 50:30-36. [PMID: 31594531 DOI: 10.1177/0049475519879586] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Information on major depressive disorder (MDD) in primary care settings in sub-Saharan Africa is limited, yet this is required to improve service development. We explored prevalence and factors associated with MDD among adolescents attending a primary care facility in urban Uganda. At Naguru Teenage Information and Health Centre, 281 adolescents were assessed for MDD using the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-Kid). Prevalence and risk factors were determined using frequencies and regressions, respectively. The prevalence of adolescent MDD was 18.2 %. Vulnerability factors were orphanhood, childhood trauma (particularly emotional abuse and physical neglect) while social support was protective. Considerable burden of clinically significant depression exists in primary care settings in Uganda; this may well contribute to a poor quality of life.
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Affiliation(s)
- Leticia Kyohangirwe
- Psychiatrist, Department of Psychiatry, Makerere University, College of Health Sciences, Kampala, Uganda.,Scientist and study coordinator, Mental Health Section, MRC/UVRI and LSHTM Uganda Research Unit, Kampala, Uganda
| | - Elialilia Okello
- Associate Professor, Department of Psychiatry, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Justine D Namuli
- Lecturer, Department of Psychiatry, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Grace Ndeezi
- Professor, Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Eugene Kinyanda
- Professor, Department of Psychiatry, Makerere University, College of Health Sciences, Kampala, Uganda.,Head of the Mental Health Section, Mental Health Section, MRC/UVRI and LSHTM Uganda Research Unit/Senior Wellcome Trust Fellowship, Kampala, Uganda
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Madasu S, Malhotra S, Kant S, Sagar R, Mishra AK, Misra P, Ahamed F. Prevalence and determinants of anxiety disorders among adolescents in a rural community from northern India. Asian J Psychiatr 2019; 43:137-142. [PMID: 31146170 DOI: 10.1016/j.ajp.2019.05.009] [Citation(s) in RCA: 8] [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: 09/22/2018] [Revised: 04/07/2019] [Accepted: 05/02/2019] [Indexed: 01/04/2023]
Abstract
INTRODUCTION There is scarce data available on community based prevalence of Anxiety Disorders (ADs) amongst adolescents in north Indian settings. OBJECTIVE To determine the prevalence of anxiety disorders, and associated factors amongst adolescents in a rural community of Ballabgarh block, district Faridabad, Haryana. METHODS Participants (10-19 years) were enrolled through simple random sequence from a sampling frame of adolescents residing in 28 villages of Ballabgarh block using household survey technique. They were screened using Screen for Childhood Anxiety Related Emotional Disorders (SCARED) tool and then subjected to confirmatory diagnosis using Mini-International Neuropsychiatric Interview for Children/Adolescent (MINI KID). All adolescents with ADs were assessed for co-psychiatric morbidities using MINI-KID and functional impairment using Children Global Assessment Scale (CGAS). Prevalence and 95% Confidence intervals are reported. Additionally, socio-demographic factors were elicited using a semi-structured interview schedule and associations were determined using multivariable logistic regression analysis. RESULTS A total of 678 adolescents participated in this study with mean age (SD) as 14.2 (2.5) years. The age adjusted prevalence of anxiety disorders was found to be 16.6% (95% CI: 16.0-17.2). The most prevalent anxiety disorder among participants was social anxiety disorders followed by specific phobias. Female sex and low socio-economic status were associated with anxiety disorders. Two third of adolescents with ADs had no functional impairment and almost one third were found to have one or more co-existing psychiatric co-morbidity. CONCLUSION We found a high prevalence of ADs in rural north Indian community settings warranting adequate health system response at primary care level.
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Affiliation(s)
- Swapna Madasu
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sumit Malhotra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Ashwani K Mishra
- National Drug Dependence and Treatment Centre, Ghaziabad and Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Puneet Misra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Farhad Ahamed
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
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40
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Talepasand S, Mohammadi MR, Alavi SS, Khaleghi A, Sajedi Z, Akbari P, Lari M, Kasaeian R, Eskandaripour M, Rashti E, Khaneghahi FY, Rashidi F, Hosseini SJ. Psychiatric disorders in children and adolescents: Prevalence and sociodemographic correlates in Semnan Province in Iran. Asian J Psychiatr 2019; 40:9-14. [PMID: 30673624 DOI: 10.1016/j.ajp.2019.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 01/02/2019] [Accepted: 01/16/2019] [Indexed: 11/20/2022]
Abstract
AIM The aim of this study was to estimate the prevalence of psychiatric disorders and sociodemographic correlates in children and adolescents ages 6-18 years in semnan province. METHOD Participants were 1037 children and adolescents ages 6 to 18 years in Semnan. This study was a survey study and its data have been taken from the National survey of Iranian Children and Adolescents' Psychiatric Disorders in 2017. A sample of children and adolescents from Semnan was selected by multistage cluster sampling method. Participants completed the K- SADS- PL interview. RESULTS Findings showed the general prevalence of psychiatric disorders in Semnan was 24.8 (CI95%: 22.2-27.5) with a proportion of female to male 1.1:1. As the age increased, the prevalence rate of psychiatric disorders decreased. In mothers with undergraduate education, the rate of prevalence of psychiatric disorders in children and adolescents was significantly lower than that of illiterate mothers (OR adjust = 0.309, p = .01). Among anxiety disorders, the highest rate of prevalence was related to Separation Anxiety Disorder (6.4%; CI95%: 5.03-8.01). Oppositional Defiant Disorder (4%; CI95%: 2.9-5.3) and Attention Deficit Hyperactivity Disorder (3.4%; CI95%: 2.4-4.7) had the highest rate of prevalence among behavioral disorders. Sex, Locus of life, socioeconomic status had no effect on the prevalence rate. CONCLUSION The disorders prevalence was higher than the previous prevalence that reported in Iran. Anxiety disorders are the most common disorders. The results showed that psychiatric disorders of the children and adolescents were not different in terms of sociodemograhic factors in Semnan.
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Affiliation(s)
- Siavash Talepasand
- Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran.
| | - Mohammad Reza Mohammadi
- Psychiatry and Psychology Research Center, Roozbeh hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Seyed Salman Alavi
- Psychiatry and Psychology Research Center, Roozbeh hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ali Khaleghi
- Psychiatry and Psychology Research Center, Roozbeh hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Zahra Sajedi
- Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran.
| | - Parastoo Akbari
- Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran.
| | - Marjan Lari
- Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran.
| | - Reyhaneh Kasaeian
- Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran.
| | | | - Elahe Rashti
- Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran.
| | | | - Fahimeh Rashidi
- Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran.
| | - Seyed Javad Hosseini
- Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran.
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Canals J, Voltas N, Hernández-Martínez C, Cosi S, Arija V. Prevalence of DSM-5 anxiety disorders, comorbidity, and persistence of symptoms in Spanish early adolescents. Eur Child Adolesc Psychiatry 2019; 28:131-143. [PMID: 30056588 DOI: 10.1007/s00787-018-1207-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 07/24/2018] [Indexed: 01/04/2023]
Abstract
Anxiety Disorders (AD) are the most prevalent mental disorders in children and adolescents and a relevant public health problem. The study aimed to determine the prevalence of ADs, the comorbidity, the sociodemographic correlates, and the functional impairment in Spanish school children. The initial sample included 1514 subjects (720 boys; mean age = 10.2), who filled out the Screen for Children's Anxiety-Related Emotional Disorders (SCARED). In a second phase, 562 subjects at risk and not-at-risk of anxiety were assessed with the Mini-International Neuropsychiatric Interview for Children and Adolescents to obtain DSM-5 diagnoses. Two years later (third phase; mean age 13.5), the SCARED was re-administered. The weighted prevalence of any AD was 11.8%. The most prevalent subtypes were specific phobia (16.2%) and generalized anxiety disorder (GAD) (6.9%). Girls showed higher rates of social anxiety (5.5%) than boys. Apart from being female, low socioeconomic status was also a risk factor for AD. The heterotypic comorbidity of any AD was 40.7%, and the homotypic comorbidity was 35.6%. After controlling for age and other ADs, we found that subjects with GAD had the highest risk of having other depressive disorders and ADs. Only 33.3% of the subjects with any AD had sought professional help. 52.9% of the subjects diagnosed with any of the ADs still had anxiety symptoms after a 2-year follow-up. These findings highlight that in Spain, ADs in early adolescence are an important public health problem and that detection and access to treatment need to be improved.
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Affiliation(s)
- Josefa Canals
- Department of Psychology, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Crta/de Valls s/n, 43007, Tarragona, Spain. .,Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili, Reus, Tarragona, Spain.
| | - Núria Voltas
- Department of Psychology, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Crta/de Valls s/n, 43007, Tarragona, Spain.,Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili, Reus, Tarragona, Spain
| | - Carmen Hernández-Martínez
- Department of Psychology, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Crta/de Valls s/n, 43007, Tarragona, Spain.,Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili, Reus, Tarragona, Spain
| | - Sandra Cosi
- Department of Psychology, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Crta/de Valls s/n, 43007, Tarragona, Spain
| | - Victoria Arija
- Nutrition and Public Health Unit, Universitat Rovira i Virgili, Reus, Spain.,Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili, Reus, Tarragona, Spain
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Yatham S, Sivathasan S, Yoon R, da Silva TL, Ravindran AV. Depression, anxiety, and post-traumatic stress disorder among youth in low and middle income countries: A review of prevalence and treatment interventions. Asian J Psychiatr 2018; 38:78-91. [PMID: 29117922 DOI: 10.1016/j.ajp.2017.10.029] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 10/27/2017] [Accepted: 10/30/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Low and middle income countries (LMICs) not only have the majority of the world's population but also the largest proportion of youth. Poverty, civil conflict and environmental stressors tend to be endemic in these countries and contribute to significant psychiatric morbidity, including depression, anxiety and post-traumatic stress disorder (PTSD). However, mental health data from LMICs is scarce, particularly data on youth. Evaluation of such information is crucial for planning services and reducing the burden of disability. This paper reviews the published data on the prevalence and randomized trials of interventions for depression, anxiety and PTSD in youth in LMICs. METHODS PubMed and Google Scholar were searched for articles published in English up to January 2017, using the keywords: Low/middle income country, depression, anxiety, post-traumatic stress disorder, child, youth, adolescent, prevalence, treatment, intervention, and outcomes. RESULTS The few prevalence studies in LMICs reported rates of up to 28% for significant symptoms of depression or anxiety among youth, and up to 87% for symptoms of PTSD among youth exposed to traumatic experienences, though these rates varied widely depending on several factors, including the assessments tools used. Most rigorous interventions employed some form or variation of CBT, with mixed results. Studies using other forms of psychosocial interventions appear to be heterogeneous and less rigorous. CONCLUSIONS The mental health burden due to depression and anxiety disorders in youth is substantial in LMICs, with high needs but inadequate services. Youth specific services for early detection and cost-effective interventions are needed.
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Affiliation(s)
- Swetha Yatham
- University of British Columbia, Canada (Currently St. George's Medical School, University of London, United Kingdom)
| | | | - Rosalia Yoon
- University of Toronto and Centre for Addiction and Mental Health, Canada
| | - Tricia L da Silva
- University of Toronto and Centre for Addiction and Mental Health, Canada
| | - Arun V Ravindran
- University of Toronto and Centre for Addiction and Mental Health, Canada.
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Lee HA, Kim JS, Lee YJ, Heo NH, Shim SH, Kwon YJ. Differences in Psychopathology between Offspring of Parents with Bipolar I Disorder and Those with Bipolar II Disorder: A Cross-Sectional Study. Psychiatry Investig 2018; 15:1135-1143. [PMID: 30360028 PMCID: PMC6318491 DOI: 10.30773/pi.2018.10.22.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 10/22/2018] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate differences in psychopathology between offspring of parents with bipolar I disorder (BP-I) and those with bipolar II disorder (BP-II). METHODS The sample included 201 offspring between 6 and 17 years of age who had at least one parent with BP-I or BP-II. The offspring were diagnostically evaluated using the Korean Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. Psychopathology and Clinical characteristics were evaluated, including lifetime DSM-5 diagnoses, depression, and childhood trauma. Lifetime DSM-5 diagnoses were also compared between schoolchildren aged 6 to 11 years and adolescents aged 12 to 17 years. RESULTS In lifetime DSM-5 diagnoses, offspring of parents with BP-I had significantly increased risk of developing MDD and BP-I than those with BP-II. Regarding clinical characteristics, ADHD rating scale and childhood trauma scale were significantly higher in offspring of parents with BP-I than that in those with BP-II. CONCLUSION The present study supports that BP-I may be etiologically distinct from BP-II by a possible genetic liability. Our findings indicate that additional research related to bipolar offspring is needed to enhance understanding of differences between BP-I and BP-II.
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Affiliation(s)
- Hyeon-Ah Lee
- Department of Psychiatry, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
| | - Ji-Sun Kim
- Department of Psychiatry, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
| | - Yeon-Jung Lee
- Department of Psychiatry, Seoul Hospital, College of Medicine, Soonchunhyang University, Seoul, Republic of Korea
| | - Nam-Hun Heo
- Department of Psychiatry, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
| | - Young-Joon Kwon
- Department of Psychiatry, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
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Hoosen N, Davids EL, de Vries PJ, Shung-King M. The Strengths and Difficulties Questionnaire (SDQ) in Africa: a scoping review of its application and validation. Child Adolesc Psychiatry Ment Health 2018; 12:6. [PMID: 29344084 PMCID: PMC5765647 DOI: 10.1186/s13034-017-0212-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 12/23/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Child and adolescent mental health in Africa remains largely neglected. Quick and cost-effective ways for early detection may aid early intervention. The Strengths and Difficulties Questionnaire (SDQ) is globally used to screen for mental health problems, but little is known about its use in Africa. We set out to perform a scoping review to examine existing studies that have used the SDQ in Africa. METHODS A comprehensive scoping review methodology was used to identify all peer-reviewed studies ever published that have used the SDQ in Africa. Data were extracted and analysed to assess the countries, languages and SDQ versions used, the purpose of the SDQ studies, psychometric properties of the SDQ, and to consider knowledge gaps for future in-country and cross-country studies. RESULTS Fifty-four studies from 12 African countries were identified, most from South Africa. Many different languages were used, but authorized SDQs in those languages were not always available on the SDQinfo website. Authors frequently commented on challenges in the translation and backtranslation of mental health terminology in African languages. The SDQ was typically used to investigate internalisation/externalization disorders in different clinical populations, and was most frequently used in the evaluation of children and adolescents affected by HIV/AIDS. Sixteen studies (29.6%) administered the SDQ to participants outside the intended age range, only 4 (7.4%) used triangulation of all versions to generate assessments, and eight studies (14.8%) used only subscales of the SDQ. Only one study conducted thorough psychometric validation of the SDQ, including examination of internal consistency and factor analysis. Where 'caseness' was defined in studies, UK cut-off scores were used in all but one of the studies. CONCLUSIONS The SDQ may be a very useful tool in an African setting, but the scoping review suggested that, where it was used in Africa researchers did not always follow instrument guidelines, and highlighted that very little is known about the psychometric properties of the SDQ in Africa. We recommend comprehensive evaluation of the psychometric properties of the SDQ in various African languages, including internal consistency, factor structure, need for local cut-off values and ensuring cultural equivalence of the instrument.
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Affiliation(s)
- Nikhat Hoosen
- Adolescent Health Research Unit, Division of Child & Adolescent Psychiatry, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700 South Africa
- Health Policy and Systems Division, University of Cape Town, Cape Town, South Africa
| | - Eugene Lee Davids
- Adolescent Health Research Unit, Division of Child & Adolescent Psychiatry, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700 South Africa
| | - Petrus J. de Vries
- Adolescent Health Research Unit, Division of Child & Adolescent Psychiatry, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700 South Africa
| | - Maylene Shung-King
- Adolescent Health Research Unit, Division of Child & Adolescent Psychiatry, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700 South Africa
- Health Policy and Systems Division, University of Cape Town, Cape Town, South Africa
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Akol A, Nalugya J, Nshemereirwe S, Babirye JN, Engebretsen IMS. Does child and adolescent mental health in-service training result in equivalent knowledge gain among cadres of non-specialist health workers in Uganda? A pre-test post-test study. Int J Ment Health Syst 2017; 11:50. [PMID: 28855962 PMCID: PMC5571627 DOI: 10.1186/s13033-017-0158-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 08/20/2017] [Indexed: 12/16/2022] Open
Abstract
Background Early identification and management of child and adolescent mental health (CAMH) disorders helps to avert mental illness in adulthood but a CAMH treatment gap exists in Uganda. CAMH integration into primary health care (PHC) through in-service training of non-specialist health workers (NSHW) using the World Health Organisation (WHO) Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) is a strategy to address this gap. However, results of such training are not supported by information on training development or delivery; and are undifferentiated by NSHW cadre. We aim to describe an in-service CAMH training for NSHW in Uganda and assess cadre-differentiated learning outcomes. Methods Thirty-six clinical officers, nurses and midwives from 18 randomly selected PHC clinics in eastern Uganda were trained for 5 days on CAMH screening and referral using a curriculum based on the mhGAP-IG version 1.0 and PowerPoint slides from the International Association of Child and Adolescent Psychiatry and Allied Professions (IACAPAP). The residential training was evaluated through pre- and post- training tests of CAMH knowledge and attitudes using the participants’ post-test scores; and the difference between pre-test and post-test scores. Two-tailed t-tests assessed differences in mean pre-test and post-test scores between the cadres; hierarchical linear regression tested the association between cadre and post test scores; and logistic regression evaluated the relationship between cadre and knowledge gain at three pre-determined cut off points. Results Thirty-three participants completed both pre-and post-tests. Improved mean scores from pre- to post-test were observed for both clinical officers (20% change) and nurse/midwives (18% change). Clinical officers had significantly higher mean test scores than nurses and midwives (p < 0.05) but cadre was not significantly associated with improvement in CAMH knowledge at the 10% (AOR 0.08; 95 CI [0.01, 1.19]; p = 0.066), 15% (AOR 0.16; 95% CI [0.01, 2.21]; p = 0.170), or 25% (AOR 0.13; 95% CI [0.01, 1.74]; p = 0.122) levels. Conclusion We aimed to examine CAMH learning outcomes by NSHW cadre. NSHW cadre does not influence knowledge gain from in-service CAMH training. Thus, an option for integrating CAMH into PHC in Uganda using the mhGAP-IG and IACAPAP PowerPoint slides is to proceed without cadre differentiation. Electronic supplementary material The online version of this article (doi:10.1186/s13033-017-0158-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Angela Akol
- The Global Mental Health Research Group, Center for International Health, University of Bergen, Postboks 7804, N-5009 Bergen, Norway.,Makerere University School of Public Health, Kampala, Uganda
| | - Joyce Nalugya
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
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Ahmadi A, Mustaffa MS, Haghdoost AA, Mansor SMS. Eclectic approach to anxiety disorders among rural children. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2017; 39:88-97. [PMID: 28700038 DOI: 10.1590/2237-6089-2016-0047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 01/03/2017] [Indexed: 11/22/2022]
Abstract
Introduction Anxiety disorders in primary school-aged children negatively affect their mental health and psychological development. Available non-medical treatments for these conditions are time-consuming and expensive. In this context, eclectic therapy is a therapeutic approach that incorporates some therapeutic techniques and philosophies to create the ideal treatment. In this study, eclectic therapy consisted of art therapy and cognitive-behavioral therapy designed for children suffering from high level of anxiety in their middle childhood years. The therapy also included group guidance sessions for their mothers. The effectiveness of this intervention was examined in the study. Methods 61 students aged 9-12 years with high levels of anxiety participated in the study. Intervention A (n = 20) consisted of 9-hour eclectic therapy for children with 3-hour group guidance sessions for their mothers. Intervention B (n = 20) consisted of 9-hour eclectic therapy for children. There was also a control group (n = 21). Results Teacher ratings of children's mental health difficulties and self-report ratings of anxiety disorders indicated a significant difference from pretest to posttest, revealing a large effect size between the two interventions. Higher levels of pretest scores significantly predicted higher posttest scores for all domains of anxiety and mental health difficulties. Furthermore, age, gender, mothers working a 15-hour day, mother's educational level, parental divorce rates, parental death, and family monthly income predicted therapy outcomes. Conclusion Results provide support for the effectiveness of eclectic art and CBT to improve children's mental health and reduce anxiety through changing thoughts, beliefs, emotions, and behaviors that may cause fear and anxiety.
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Affiliation(s)
- Atefeh Ahmadi
- Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.,Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohamed Sharif Mustaffa
- Department of Counseling, Faculty of Cognitive Sciences and Human Development, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia
| | - Ali Akbar Haghdoost
- Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Mental Health Status of Children After the Great East Japan Earthquake and Fukushima Daiichi Nuclear Power Plant Accident. Asia Pac J Public Health 2017; 29:131S-138S. [DOI: 10.1177/1010539516675702] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The disaster at the Fukushima Daiichi Nuclear Power Plant after the Great East Japan Earthquake on March 11, 2011, might have affected the mental health status of children. To assess the mental health status, we measured the Strengths and Difficulties Questionnaire (SDQ) in 15 274 children (aged 4-15 years). The proportions of those who scored above the cutoff (≥16) of SDQ, reflecting the clinical range of the mental health status, were 25.0% (aged 4-6 years), 22.0% (aged 7-12 years, and 16.3% (aged 13-15 years), which were higher than that in the usual state (9.5%). We also explored the possibility that the distribution on the Fukushima prefectural map of the proportions of those who scored above the cutoff (≥16) of SDQ might correspond with the environmental radiation levels, but there was no significant correlation.
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Chander P, Kvalsvig J, Mellins CA, Kauchali S, Arpadi SM, Taylor M, Knox JR, Davidson LL. Intimate Partner Violence and Child Behavioral Problems in South Africa. Pediatrics 2017; 139:peds.2016-1059. [PMID: 28242862 PMCID: PMC5330393 DOI: 10.1542/peds.2016-1059] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Research in high-income countries has repeatedly demonstrated that intimate partner violence (IPV) experienced by women negatively affects the health and behavior of children in their care. However, there is little research on the topic in lower- and middle-income countries. The population-based Asenze Study gathered data on children and their caregivers in KwaZulu-Natal, South Africa. This data analysis explores the association of caregiver IPV on child behavior outcomes in children <12 years old and is the first such study in Africa. METHODS This population-based study was set in 5 Zulu tribal areas characterized by poverty, food insecurity, unemployment, and a high HIV prevalence. The Asenze Study interviewed caregivers via validated measures of IPV, alcohol use, caregiver mental health difficulties, and child behavior disorders in their preschool children. RESULTS Among the 980 caregivers assessed, 37% had experienced IPV from their current partner. Experience of partner violence (any, physical, or sexual) remained strongly associated with overall child behavior problems (odds ratio range: 2.46-3.10) even after age, HIV status, cohabitation with the partner, alcohol use, and posttraumatic stress disorder were accounted for. CONCLUSIONS Childhood behavioral difficulties are associated with their caregiver's experience of IPV in this population, even after other expected causes of child behavior difficulties are adjusted for. There is a need to investigate the longer-term impact of caregiver partner violence, particularly sexual IPV, on the health and well-being of vulnerable children in lower- and middle-income countries. Studies should also investigate whether preventing IPV reduces the occurrence of childhood behavior difficulties.
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Affiliation(s)
- Pratibha Chander
- Department of Epidemiology, Mailman School of Public Health, and
| | | | - Claude A. Mellins
- Columbia University and New York State Psychiatric Institute, New York, New York
| | - Shuaib Kauchali
- Paediatrics, University of KwaZulu-Natal, Durban, South Africa; and
| | - Stephen M. Arpadi
- Department of Epidemiology, Mailman School of Public Health, and,Department of Pediatrics, Columbia University, New York, New York
| | | | - Justin R. Knox
- Department of Epidemiology, Mailman School of Public Health, and
| | - Leslie L. Davidson
- Department of Epidemiology, Mailman School of Public Health, and,Department of Pediatrics, Columbia University, New York, New York
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Nalugya-Sserunjogi J, Rukundo GZ, Ovuga E, Kiwuwa SM, Musisi S, Nakimuli-Mpungu E. Prevalence and factors associated with depression symptoms among school-going adolescents in Central Uganda. Child Adolesc Psychiatry Ment Health 2016; 10:39. [PMID: 27800012 PMCID: PMC5081935 DOI: 10.1186/s13034-016-0133-4] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 10/17/2016] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Depression in adolescents constitutes a global public health concern. However, data on its prevalence and associated factors are limited in low income countries like Uganda. METHODS Using a cross-sectional descriptive study design, 519 adolescent students in 4 secondary schools in Mukono district, Uganda, were randomly selected after meeting study criteria. The 4 school types were: boarding mixed (boys and girls) school; day mixed school; girls' only boarding school; and, boys' only boarding school. The 519 participants filled out standardized questionnaires regarding their socio-demographic characteristics and health history. They were then screened for depression using the Children Depression Inventory (CDI) and those with a cut-off of 19 were administered the Mini International Neuro-Psychiatric Interview for Children and Adolescents 2.0 (MINI-KID), to ascertain the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM IV) diagnostic types of depression and any co morbidity. Logistic regression analyses were used to assess factors associated with significant depression symptoms (a score of 19 or more on the CDI). RESULTS There were 301 (58 %) boys and 218 (42 %) girls with age range 14-16 years and a mean age of 16 years (SD 2.18). Of 519 participants screened with the CDI, 109 (21 %) had significant depression symptoms. Of the 109 participants with significant depression symptoms, only 74 were evaluated with the MINI-KID and of these, 8 (11 %) met criteria for major depression and 6 (8 %) met criteria for dysthymia. Therefore, among participants that were assessed with both the CDI and the MINI-KID (n = 484), the prevalence of depressive disorders was 2.9 %. In this sample, 15 (3.1 %) reported current suicidal ideation. In the logistic regression analyses, significant depression symptoms were associated with single-sex schools, loss of parents and alcohol consumption. LIMITATIONS This is a cross-sectional study therefore, causal relationships are difficult to establish. Limited resources and the lack of collateral information precluded the assessment of a number of potential factors that could be associated with adolescent depression. The MINI-KID was administered to only 74 out of 109 students who scored ≥19 on the CDI since 35 students could not be traced again due to limited resources at the time. CONCLUSIONS Significant depression symptoms are prevalent among school-going adolescents and may progress to full-blown depressive disorders. Culturally sensitive psychological interventions to prevent and treat depression among school-going adolescents are urgently needed.
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Affiliation(s)
- Joyce Nalugya-Sserunjogi
- Department of Psychiatry, Makerere University, College of Health Sciences, Kampala, Uganda ,Mulago National Referral and Teaching Hospital, Ministry of Health, Kampala, Uganda
| | - Godfrey Zari Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Emilio Ovuga
- Department of Psychiatry, Gulu University, Gulu, Uganda
| | - Steven M. Kiwuwa
- Department of Child Health and Development, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Seggane Musisi
- Department of Psychiatry, Makerere University, College of Health Sciences, Kampala, Uganda
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Idro R, Kakooza-Mwesige A, Asea B, Ssebyala K, Bangirana P, Opoka RO, Lubowa SK, Semrud-Clikeman M, John CC, Nalugya J. Cerebral malaria is associated with long-term mental health disorders: a cross sectional survey of a long-term cohort. Malar J 2016; 15:184. [PMID: 27030124 PMCID: PMC4815157 DOI: 10.1186/s12936-016-1233-6] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 03/15/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Cerebral malaria (CM) and severe malarial anaemia (SMA) are associated with neuro-developmental impairment in African children, but long-term mental health disorders in these children are not well defined. METHODS A cohort of children previously exposed to CM (n = 173) or SMA (n = 99) had neurologic assessments performed and screening for behaviour difficulties using the Strengths and Difficulties Questionnaire (SDQ) a median of 21 months after the disease episode. These findings were compared to concurrently recruited community children (CC, n = 108). Participants with SDQ total difficulties score ≥ 17 had a mental health interview with the child and adolescent version of the Mini-International Neuropsychiatric Interview (MINI-KID) and a sample had brain magnetic resonance imaging (MRI). RESULTS Fifty-five children had SDQ score ≥ 17. On the MINI-KID, these children were classified as having no difficulties (n = 18), behaviour difficulties only (n = 13) or a mental health disorder (n = 24). Behaviour difficulties were seen in similar frequencies in CM (3.5%), SMA (4.0%) and CC (2.8%). In contrast, mental health disorders were most frequent in CM (10.4%), followed by SMA (4.0%) and CC (1.8%). Externalizing disorders (conduct, oppositional defiance and attention deficit hyperactivity) were the most common mental health disorders. The median total coma duration was 72 (IQR 36.0-115.0) h in patients with mental health disorders compared to 48 (IQR 28.5-78.7) h in those without, p = 0.039. Independent risk factors for mental health disorder included neurologic deficit at discharge (OR 4.09 (95% CI 1.60, 10.5) and seizure recurrences during hospitalization, (OR 2.80, 95% CI 1.13, 6.97). Brain MRI findings consistent with small vessel ischaemic neural injury was seen in over half of these children. CONCLUSIONS Cerebral malaria may predispose children to mental health disorders, possibly as a consequence of ischaemic neural injury. There is urgent need for programmes of follow-up, diagnosis and interventions for these children.
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Affiliation(s)
- Richard Idro
- />Department of Paediatrics and Child Health, Mulago Hospital, Makerere University College of Health Sciences, P.O Box 7072, Kampala, Uganda
| | - Angelina Kakooza-Mwesige
- />Department of Paediatrics and Child Health, Mulago Hospital, Makerere University College of Health Sciences, P.O Box 7072, Kampala, Uganda
- />Neuropediatric Research Unit, Astrid Lindgren Children’s Hospital, Karolinska Institutet, Solna, Stockholm Sweden
| | - Benjamin Asea
- />Department of Paediatrics and Child Health, Mulago Hospital, Makerere University College of Health Sciences, P.O Box 7072, Kampala, Uganda
| | - Keron Ssebyala
- />Department of Paediatrics and Child Health, Mulago Hospital, Makerere University College of Health Sciences, P.O Box 7072, Kampala, Uganda
| | - Paul Bangirana
- />Department of Paediatrics and Child Health, Mulago Hospital, Makerere University College of Health Sciences, P.O Box 7072, Kampala, Uganda
| | - Robert O. Opoka
- />Department of Paediatrics and Child Health, Mulago Hospital, Makerere University College of Health Sciences, P.O Box 7072, Kampala, Uganda
| | - Samson K. Lubowa
- />Department of Paediatrics and Child Health, Mulago Hospital, Makerere University College of Health Sciences, P.O Box 7072, Kampala, Uganda
| | | | - Chandy C. John
- />Departments of Pediatrics, Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, USA
| | - Joyce Nalugya
- />Department of Paediatrics and Child Health, Mulago Hospital, Makerere University College of Health Sciences, P.O Box 7072, Kampala, Uganda
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