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Shrestha R, Sapkota D, Sarraf RR, Mehra D, Ekström AM, Deuba K. Perceptions on violence against women and its impacts on mental health and response mechanisms among community-based stakeholders: a qualitative study from Nepal. BMC Womens Health 2024; 24:258. [PMID: 38658963 PMCID: PMC11040903 DOI: 10.1186/s12905-024-03064-5] [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: 12/28/2021] [Accepted: 03/29/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Violence against women (VAW) is a significant public health problem. With the emergence of the COVID-19 pandemic, the frequency and severity of VAW has escalated globally. Approximately one in four women in Nepal have been exposed to either physical, psychological, and/or sexual violence in their lifetime, with husbands or male partners being the perpetrators in most cases. VAW prevention has been under-researched in low- and middle-income countries, including Nepal. This study aims to explore the perspectives of local stakeholders, including healthcare providers and survivors of violence in Madhesh Province. The overarching goal is to provide insights for designing prevention and support programs that are acceptable to communities and cater to the needs of survivors. METHODS An explorative qualitative study was conducted in Madhesh Province, southern Nepal. A total of 21 interviews, including 15 in-depth interviews (IDIs) with health care providers, three IDIs with women seeking general or maternal and child health services at health care centres, three key informant interviews with the local stakeholders working in the field of VAW, and one focus group discussion with violence survivors, were conducted in Nepali by trained field interviewers. Interviews were recorded, transcribed, translated into English, and analysed using content analysis. RESULTS VAW, particularly physical violence, was a common experience in the study area. Sociocultural traditions such as dowry, child marriages and son preference were identifiable triggers for VAW, causing significant physical injuries and mental health problems, including suicide. Health care providers reported that violence survivors often hide their experiences of violence and do not seek any kind of help. Women feared that violence would increase in frequency and intensity if their perpetrators found out that they had disclosed their experiences of violence to health care providers. Local stakeholders emphasized the importance of engaging community leaders and garnering support from both women and men in interventions designed to reduce VAW and its impacts on mental health. CONCLUSIONS Participants reported that verbal and physical violence is often perceived as a normal part of women's lives. Women should be made aware of available support services and empowered and supported to increase access and uptake of these services. Additionally, more individual-based counselling sessions that encourage women to escape violence and its mental health consequences while maintaining privacy and confidentiality are recommended.
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Affiliation(s)
- Rachana Shrestha
- Public Health and Environment Research Centre (PERC), Lalitpur, Nepal
- Knowledge to Action (K2A), Lalitpur, Nepal
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Diksha Sapkota
- Public Health and Environment Research Centre (PERC), Lalitpur, Nepal
- Griffith Criminology Institute, Queensland, Australia
| | | | - Devika Mehra
- MAMTA Health Institute for Mother and Child, New Delhi, India
- Public Health Consultant, Medeon Science Park, Malmö, Sweden
| | - Anna Mia Ekström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, South General Hospital, Stockholm, Sweden
| | - Keshab Deuba
- Public Health and Environment Research Centre (PERC), Lalitpur, Nepal.
- Knowledge to Action (K2A), Lalitpur, Nepal.
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
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Koly KN, Tasnim Z, Ahmed S, Saba J, Mahmood R, Farin FT, Choudhury S, Ashraf MN, Hasan MT, Oloniniyi I, Modasser RB, Reidpath DD. Mental healthcare-seeking behavior of women in Bangladesh: content analysis of a social media platform. BMC Psychiatry 2022; 22:797. [PMID: 36529761 PMCID: PMC9760542 DOI: 10.1186/s12888-022-04414-z] [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: 07/16/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Mental health remains a highly stigmatized area of healthcare, and people often conceal their concerns rather than seek assistance or treatment. The Women Support Initiative Forum (WSIF) is a social media platform established in 2018 to provide expert and peer-led psychosocial support services to women of all ages in Bangladesh. The anonymous nature of the forum means that mental health concerns can be aired without fear of identification. METHOD A content analysis was conducted on the anonymous posts retrieved from the WSIF platform between 8th March 2020 and 7th July 2022. Around 1457 posts were initially selected for analysis which was reduced to 1006 after removing duplicates and non-relevant posts, such as queries about the addresses of the doctors and other non-mental health-related issues. A thematic analysis of the data was conducted using an inductive approach. RESULT The 1006 posts generated four themes and nine sub-themes. All the women mentioned mental health symptoms (n = 1006; 100%). Most also mentioned reasons for seeking mental healthcare (n = 818; 81.31%), healthcare-seeking behavior (n = 667; 66.30%), and barriers to seeking mental healthcare (n = 552; 54.87%). The majority of women described symptoms of stress, depression, and anxiety-like symptoms, which were aggregated under common mental health conditions. Mental health symptoms were ascribed to various external influences, including marital relationship, intrafamilial abuse, and insecurities related to the COVID-19 pandemic. A large proportion of posts were related to women seeking information about mental healthcare services and service providers (psychologists or psychiatrists). The analysis found that most women did not obtain mental healthcare services despite their externalized mental health symptoms. The posts identified clear barriers to women accessing mental health services, including low mental health literacy, the stigma associated with mental healthcare-seeking behavior, and the poor availability of mental health care services. CONCLUSION The study revealed that raising mass awareness and designing culturally acceptable evidence-based interventions with multisectoral collaborations are crucial to ensuring better mental healthcare coverage for women in Bangladesh.
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Affiliation(s)
- Kamrun Nahar Koly
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
| | - Zarin Tasnim
- grid.52681.380000 0001 0746 8691BRAC James P Grant School of Public Health, BRAC University, Dhaka, 1213 Bangladesh
| | - Sharmin Ahmed
- Department of Epidemiology, National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, 1212 Bangladesh
| | - Jobaida Saba
- grid.414142.60000 0004 0600 7174Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh ,grid.411808.40000 0001 0664 5967Department of Public Health and Informatics, Jahangirnagar University, Dhaka, 1342 Bangladesh
| | - Rudbar Mahmood
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - Faria Tasnim Farin
- grid.254444.70000 0001 1456 7807Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, Detroit, MI USA
| | - Sabrina Choudhury
- Department of Epidemiology, National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, 1212 Bangladesh
| | - Mir Nabila Ashraf
- grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
| | - M. Tasdik Hasan
- grid.1002.30000 0004 1936 7857Action Lab, Department of Human Centred Computing, Faculty of Information Technology, Monash University, Melbourne, Australia ,grid.443034.40000 0000 8877 8140Department of Public Health, State University of Bangladesh, Dhaka, Bangladesh ,grid.10025.360000 0004 1936 8470Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
| | - Ibidunni Oloniniyi
- grid.10824.3f0000 0001 2183 9444Departmental of Mental Health, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria ,grid.459853.60000 0000 9364 4761Mental Health Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun Nigeria
| | - Rifath Binta Modasser
- grid.443005.60000 0004 0443 2564School of Public Health, Independent University Bangladesh (IUB), Bashundhara, Dhaka, 1229 Bangladesh
| | - Daniel D. Reidpath
- grid.440425.30000 0004 1798 0746Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Subang Jaya, Malaysia
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Kamalikhah T, Mehri A, Gharibi F, Rouhani-Tonekaboni N, Japelaghi M, Dadgar E. Prevalence and related factors of intimate partner violence among married women in Garmsar, Iran. J Inj Violence Res 2022; 14:1693. [PMID: 35780333 PMCID: PMC9805666 DOI: 10.5249/jivr.v14i3.1693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 06/25/2022] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is the most common type of domestic violence often used by men against their wives. Due to the destructive and widespread social and health consequences of IPV, the present study aimed to investigate the prevalence and related factors of IPV among married women in Garmsar, Iran. METHODS Using multi-stage clusters sampling method, this cross-sectional study included 400 married women in Garmsar, Iran. The data collection process was conducted during October and December 2019 using a researcher-made questionnaire. The content validity of the questionnaire was confirmed using content validity ratio (CVR) and content validity index (CVI) indicators (0.85 and 0.88, respectively). Also, the reliability was confirmed by examining the internal consistency and obtaining a score of 0.93 for Cronbach's alpha. Descriptive and analytical statistics were performed using t-test, analysis of variance (ANOVA), and Tukey's post-hoc test. RESULTS Most participants were in the age range of 20-40 years (mean age: 34.9 years). The overall exposure of women to IPV was 56.11%. In addition, the most prevalent types of IPV included legal (24%), social (24%), financial (22%), verbal (16%), physical (13%), emotional (12%), and sexual (11%). The effective factors on the prevalence of IPV included number of children, education level, occupation, and age (P less than 0.05). CONCLUSIONS We witnessed that women living in Garmsar faced different types of IPV and their overall exposure to this phenomenon was higher than the national and global average. To resolve the problem, the following measurements are recommended: a careful investigation of the reasons for the spread of IPV, implementing interventions based on reliable evidence, and serious cooperation of the experts and relevant governmental and non-governmental institutions, particularly citizens.
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Affiliation(s)
- Tahereh Kamalikhah
- Student Research Committee, School of Nutrition and Food Sciences, Semnan University of Medical Science, Semnan, Iran
| | - Ali Mehri
- Health Education and Promotion Department, Sabzevar University of Medical Science, Sabzevar, Iran
| | - Farid Gharibi
- Social Determinants of Health Research Center, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
| | - Nooshin Rouhani-Tonekaboni
- Health Education and Promotion Department, Research Center of Health and Environment, School of Health, Gilan University of Medical Science, Gilan, Iran
| | - Masoume Japelaghi
- Student Research Committee, School of Nutrition and Food Sciences, Semnan University of Medical Science, Semnan, Iran
| | - Elham Dadgar
- Department of Nursing, Aligoudarz School of Nursing, Lorestan University of Medical Sciences, Aligoudarz, Iran
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Koly KN, Abdullah R, Shammi FA, Akter T, Hasan MT, Eaton J, Ryan GK. Mental Health and Community-Based Rehabilitation: A Qualitative Description of the Experiences and Perspectives of Service Users and Carers in Bangladesh. Community Ment Health J 2022; 58:52-66. [PMID: 33683536 DOI: 10.1007/s10597-021-00790-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 01/31/2021] [Indexed: 11/28/2022]
Abstract
Since 2016, Promotion of Human Rights of Persons with Disabilities in Bangladesh (PHRPB) has been working to include people with psychosocial disabilities in their community-based inclusive development work, and to increase access to formal mental health care. Field visits were carried out to PHRPBD catchment areas in Dhaka and Chittagong for a case study on the integration of mental health into community-based rehabilitation (CBR). This paper synthesizes the results of twenty-five semi-structured interviews carried out as part of the case study. Participants included people with psychosocial disabilities, intellectual disabilities, epilepsy or other cognitive impairments and their carers as needed. Interviews were audio-recorded, transcribed and translated from Bangla to English, then hand-coded for content analysis. Results were organized into five overarching categories: (1) explanatory models, (2) help-seeking behaviors, (3) impact of services, (4) challenges and barriers to improving mental health, (5) recommendations of users and carers. Respondents either had no explanation for why service users had become unwell or attributed it to physically and/or emotionally traumatic events or supernatural causes. Before attending PHRPBD's mental health services, most had visited formal or informal health care providers, often with disappointing results. Despite positive feedback on PHRPBD's services, participants identified ongoing challenges. Stigma, discrimination and human rights abuses persist and are compounded by issues of gender inequality. Participants also identified barriers and made recommendations specific to the program itself, mainly regarding accessibility (e.g., cost, distance, frequency). This study adds to the limited body of qualitative research on mental health in Bangladesh, reinforcing previous findings on explanatory models and health-seeking behaviors while providing new insights into the impact of a CBR program in this context. Feedback of service users and carers suggests that CBR may indeed be a useful approach to increase access to services in Bangladesh for people with psychosocial or intellectual disabilities, epilepsy or other cognitive impairments. However, this program is not without its limitations, some of which are the product of broader issues within the mental health system and others of the social and cultural context. More research is needed to formally evaluate this and other CBR programs in the Global South.
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Affiliation(s)
- Kamrun Nahar Koly
- Health System and Population Studies Division, ICDDR, B, Dhaka, Bangladesh.
| | - Rehnuma Abdullah
- Department of Public Health, North South University, Dhaka, Bangladesh
| | | | - Taslima Akter
- Centre for Disability in Development, Dhaka, Bangladesh
| | - M Tasdik Hasan
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Julian Eaton
- CBM Global, Laudenbach, Germany.,Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Grace K Ryan
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
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Life loaded with threat and vulnerability: a qualitative inquiry into the experiences of HIV negative married women in serodiscordant heterosexual relationships. BMC Womens Health 2021; 21:402. [PMID: 34876115 PMCID: PMC8650320 DOI: 10.1186/s12905-021-01546-4] [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: 02/13/2021] [Accepted: 11/19/2021] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Violence against women is a major, complex, multidimensional and widespread public health concern worldwide. The current qualitative study was conducted to understand the experience of violence among HIV negative married women in heterosexual serodiscordant relationships.
Methods
A qualitative description (QD) was conducted from October 2018 to January 2020 in Mashhad, Iran. The participants were 15 HIV negative women, who married and lived with HIV positive men, through purposive sampling method. The data were collected using semi-structured interviews. Data analyzed using conventional content analysis adopted by Graneheim and Lundman.
Results
The main overarching theme emerged entitled: life loaded with threat and vulnerability. This theme consisted of four categories of self-directed violence, intimate partner violence, cultural violence and structural violence. The violence began soon after awareness of husband's infection with acts such as suicide attempts and a sense of abhorrence for living with an infected person, and continued with confrontation with various types of violence in the family and society, which put women in constant threat and vulnerability.
Conclusions
This study provided an insight into different aspects of violence in Iranian women in HIV serodiscordant relationships. Considering the role of men in the occurrence of violence, policymakers must create and execute family-centered interventions to address attitudes and behaviors that lead to marital conflicts and spousal abuse in order to prevent violence. Health care professionals should also be trained to screen women for violence and refer those who require care to specialists to reduce vulnerability.
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Atinga RA, Yarney L, Saa-Touh Mort K, Gariba JA, Salifu Yendork J. Measures and narratives of the nature, causes and consequences of violent assaults and risk perception of psychiatric hospitals in Ghana: Mental Health workers' perspectives. Int J Ment Health Nurs 2021; 30 Suppl 1:1342-1353. [PMID: 33998754 DOI: 10.1111/inm.12878] [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: 01/28/2021] [Revised: 04/13/2021] [Accepted: 04/19/2021] [Indexed: 11/27/2022]
Abstract
Literature shows that mental healthcare workers in Ghana face incessant fear of patient violence that compromise safe care delivery. However, the nature, scale, perceived causes, and consequences of these assaults and how they shape risk perceptions have received limited empirical attention, hence the need for this study. The study employed sequential explanatory mixed methods where questionnaire administration preceded and informed the design of an interview guide used for in-depth interviews with health workers in referral psychiatric hospitals. Descriptive statistics and multivariate logistic regressions were used to analyze the quantitative data. Qualitative data were transcribed and analyzed thematically. Findings showed that physical and non-physical violent assaults and risk perceptions of the hospitals were statistically and significantly associated with females (P < 0.01), nurses (P < 0.01), other clinical cadre (P < 0.01), and those with low job tenure (P < 0.05). About 57% and 71% of the sample reported experiencing physical and non-physical assaults, respectively. Major and minor injuries and psychosocial problems were frequent sequelae following physical violent assaults. As a result, 80% of the participants perceived the hospitals environment to be unsafe to provide care. Violent assaults compromises safety and care delivery efforts suggesting the need for systematic interventions to minimize mental healthcare workers exposure to patient violence.
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Affiliation(s)
- Roger A Atinga
- Department of Public Administration and Health Services Management, University of Ghana Business School, Accra, Ghana
| | - Lily Yarney
- Department of Public Administration and Health Services Management, University of Ghana Business School, Accra, Ghana
| | | | - Joshua A Gariba
- Department of Sociology, School of Social Sciences, University of Ghana, Accra, Ghana
| | - Joana Salifu Yendork
- Department of Psychology, School of Social Sciences, University of Ghana, Accra, Ghana
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Poreddi V, Sai Nikhil Reddy S, Gandhi S, Marimuthu P, BadaMath S. 'Unheard voices': Perceptions of women with mental illness on nurses screening routinely for domestic violence: A qualitative analysis. INVESTIGACION Y EDUCACION EN ENFERMERIA 2021; 39:e03. [PMID: 34822230 PMCID: PMC8912164 DOI: 10.17533/udea.iee.v39n3e03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 09/03/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To explore women's experiences of violence and their opinion on routine screening for domestic violence by nursing professionals in mental health care settings. METHODS This qualitative narrative research design was carried out among 20 asymptomatic women with mental illness at a tertiary care centre in Bangalore, India. RESULTS Narrative content analysis was performed, and five dominant themes have emerged: 1. Understanding the nature and signs of violence (subtheme: Meaning of violence), 2. Abusive experiences of women with mental illness (subthemes: Physical violence, psychological violence, social violence, sexual violence and financial violence), 3. Experiences on disclosure of violence (subthemes: Identification of violence by nursing professionals, Experiences of disclosure of violence), 4. Barriers for disclosure of abuse(subthemes: Fear of consequences, the hectic schedule of nursing staff, helplessness and hopelessness, perceived poor family support). 5.Routine screening for violence by nursing professionals (subthemes: reasons for routine inquiry of violence, nature of inquiry by the nursing professionals). CONCLUSIONS Women with mental illness were undergoing more than one form of violence, and most of the participants supported routine screening by nursing professionals. Nurses play an essential role in identifying and supporting abused women in mental health care settings.
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Affiliation(s)
| | | | - Sailaxmi Gandhi
- Department of Nursing, National Institute of Mental Health and Neuro Sciences, India,
| | - P Marimuthu
- Department of Bio-statistics, National Institute of Mental Health and Neuro Sciences, India,
| | - Suresh BadaMath
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, India,
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Rashid Soron T, Ashiq MAR, Al-Hakeem M, Chowdhury ZF, Uddin Ahmed H, Afrooz Chowdhury C. Domestic Violence and Mental Health During the COVID-19 Pandemic in Bangladesh. JMIR Form Res 2021; 5:e24624. [PMID: 34346893 PMCID: PMC8439177 DOI: 10.2196/24624] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 04/16/2021] [Accepted: 04/22/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The COVID-19 lockdown, the advent of working from home, and other unprecedent events have resulted in multilayer and multidimensional impacts on our personal, social, and occupational lives. Mental health conditions are deteriorating, financial crises are increasing in prevalence, and the need to stay at home has resulted in the increased prevalence of domestic violence. In Bangladesh, where domestic violence is already prevalent, the lockdown period and stay-at-home orders could result in more opportunities and increased scope for perpetrators of domestic violence. OBJECTIVE In this study, we aimed to determine the prevalence and pattern of domestic violence during the initial COVID-19 lockdown period in Bangladesh and the perceptions of domestic violence survivors with regard to mental health care. METHODS We conducted this cross-sectional web-based study among the Bangladeshi population and used a semistructured self-reported questionnaire to understand the patterns of domestic violence and perceptions on mental health care from August to September 2020. The questionnaire was disseminated on different organizational websites and social media pages (ie, those of organizations that provide mental health and domestic violence services). Data were analyzed by using IBM SPSS (version 22.0; IBM Corporation). RESULTS We found that 36.8% (50/136) of respondents had faced domestic violence at some point in their lives; psychological abuse was the most common type of violence. However, the prevalence of the economical abuse domestic violence type increased after the COVID-19 lockdown was enforced. Although 96.3% (102/136) of the participants believed that domestic violence survivors need mental health support, only 25% (34/136) of the respondents had an idea about the mental health services that are available for domestic violence survivors in Bangladesh and how and where they could avail mental health services. CONCLUSIONS Domestic violence is one of the most well-known stressors that have direct impacts on physical and mental health. However, the burden of domestic violence is often underreported, and its impact on mental health is neglected in Bangladesh. The burden of this problem has increased during the COVID-19 crisis, and the cry for mental health support is obvious in the country. However, it is necessary to provide information about available support services; telepsychiatry can be good option for providing immediate mental health support in a convenient and cost-effective manner.
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Affiliation(s)
| | | | - Marzia Al-Hakeem
- Telepsychiatry Research and Innovation Network Ltd, Dhaka, Bangladesh
| | | | - Helal Uddin Ahmed
- Department of Child, Adolescent, and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh
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Bukuluki P, Kisaakye P, Etti B, Ocircan M, Bev RR. Tolerance of Violence against Women and the Risk of Psychosocial Distress in Humanitarian Settings in Northern Uganda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8103. [PMID: 34360397 PMCID: PMC8345785 DOI: 10.3390/ijerph18158103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/05/2021] [Accepted: 07/19/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND Violence against women (VAW) remains a public health concern, which can sometimes lead to mental or psychological stress among other negative consequences. DATA AND METHODS we fitted a binary logistic regression model on 657 respondents from host and refugee settings in three humanitarian districts (Adjumani, Obongi, and Lamwo) to examine the determinants of psychosocial stress. RESULTS experience of psychosocial distress is higher among refugees than host populations. Results indicate a higher proportion of respondents who ever experienced psychosocial stress in the 6 months preceding the survey among those who believed that a woman should tolerate violence (59% vs. 53%). Respondents who believed that a woman should tolerate violence had higher odds of experiencing psychosocial stress than their counterparts who believed a woman should not tolerate violence (OR = 6.86; 95%CI = 1.23-38.22). The likelihood to experience psychosocial stress was higher among females (OR = 6.94; 95%CI = 1.76-27.32), those with primary education (OR = 4.73; 95%CI = 1.24-18.00), and respondents with less than USD 2.7 as personal income one month before the survey (OR = 3.37; 95%CI = 1.32-8.62). Respondents who said that women should engage in income generation activities had higher odds to experience psychosocial stress (OR = 0.39; 95%CI = 0.17-0.89). CONCLUSION results suggest that income and positive attitudes toward female-led income generating activities act as protective measures against psychosocial distress. Given the associations between VAW and psychosocial distress, efforts aimed at prevention and response to VAW in humanitarian settings should integrate mental health and psychosocial support interventions.
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Affiliation(s)
- Paul Bukuluki
- School of Social Sciences, Makerere University, Kampala 7062, Uganda
| | - Peter Kisaakye
- School of Statistics and Planning, Makerere University, Kampala 7062, Uganda;
| | - Bonny Etti
- Save the Children, Kampala 12018, Uganda; (B.E.); (M.O.); (R.-R.B.)
| | - Micheal Ocircan
- Save the Children, Kampala 12018, Uganda; (B.E.); (M.O.); (R.-R.B.)
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Habib Z, Soomro KA. Underprivileged Women Impacted by Ethnic Violence: Deconstructing Lives. GENDER ISSUES 2021; 38:305-323. [PMID: 33758494 PMCID: PMC7970734 DOI: 10.1007/s12147-021-09277-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
Though the city of Karachi in Pakistan is a nucleus of ethnic violence, only a limited number of studies have been conducted on the predicament of underprivileged women during ongoing conflicts. There has been negligible focus on how the women are coping in the post violence milieu. Voices of disadvantaged women remain unheard in patriarchal societies, particularly in developing and underdeveloped countries. The objective of this qualitative study is to provide voice to underprivileged women impacted by ethnic violence and to comprehend post violence conditions under which they are surviving. This research accentuates the relevance of studying gender dimension of violence (GDV) from women's perspectives. Findings from five focus group interviews with 24 participants highlight the harrowing tales of poverty, despair, physical and psychological distress with which the women are coping. Individual, semi structured interviews were conducted with two female workers from local Non-Governmental Organizations (NGOs) to examine measures for rehabilitation of the women. Data from NGO workers underscores the inertia of government in this respect and recommendations include endeavors of governmental and non-governmental organizations to provide healthcare, education and vocational training to the impacted women.
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Affiliation(s)
- Zehra Habib
- Manager Research Planning and Development Office of Research Innovation and Commercialization (ORIC), Institute of Business Management (IoBM), Karachi, Pakistan
| | - Kamal Ahmed Soomro
- Department of Education, Institute of Business Management (IoBM), Karachi, Pakistan
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Alam MM, Ahmed S, Dipti RK, Siddiquee REJ, Hawlader MDH. The prevalence and associated factors of depression during pre-, peri-, and post-menopausal period among the middle-aged women of Dhaka city. Asian J Psychiatr 2020; 54:102312. [PMID: 32795954 DOI: 10.1016/j.ajp.2020.102312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/21/2020] [Accepted: 07/10/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Depression is a serious mental health issue and a major concern among middle-aged women, especially during the menopause transition time. This study aimed to determine the prevalence and associated factors of depression among the middle-aged women of the menopause transition in Dhaka. METHODOLOGY A cross-sectional study was conducted among 41 to 60 years older women in Dhaka city using a multistage cluster sampling technique and face to face interview. RESULT In total 326 middle-aged women participated in the study, and among them, 30.4% had major depression. No statistically significant association was observed between menopause status and major depression. However, peri-(34.2%) and post-menopausal (33.3%) groups were more depressed compared to pre-menopausal (26.8%) groups. Our adjusted analysis indicates, marital status (p = 0.004), having salaried job (p < 0.001), number of offspring (p = 0.003), sedentary hours (p = 0.002), smoking habit (p = 0.012), hypertension (p = 0.012), chronic disease other than diabetes/hypertension (p = 0.006), vasomotor symptoms (p = 0.004) and sleep problem (p = 0.007) were significantly associated with depression status. CONCLUSION The study result indicates a high prevalence of major depression among middle-aged Bangladeshi women during the menopause transition. Therefore, depression should be routinely evaluated among middle-aged women for the monitoring and prevention of depression.
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Affiliation(s)
- Mohammad Morshad Alam
- Health, Nutrition and Population Global Practice, The World Bank, Agargaon, Dhaka, 1207, Bangladesh; Graduex Research Group, Dhaka, 1209, Bangladesh.
| | - Shakil Ahmed
- Department of Public Health, North South University, Dhaka-1229, Bangladesh.
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Poreddi V, Gandhi S, S SNR, Palaniappan M, BadaMath S. Violence against women with mental illness and routine screening: Nurses' knowledge, confidence, barriers and learning needs. Arch Psychiatr Nurs 2020; 34:398-404. [PMID: 33032765 DOI: 10.1016/j.apnu.2020.07.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/03/2020] [Indexed: 10/23/2022]
Abstract
Violence against women is a major public health issue and women with mental illness (WMI) are at a double disadvantage. While nurses play a key role in identifying and responding to abused women, research is limited on this issue from India. This qualitative study was aimed to explore nurses' knowledge, confidence, and learning needs in the identification and responding to disclosure of abuse in women with mental illness. The focus group discussions were conducted among nurses (N = 21) working in psychiatry units at a tertiary care center. An interview guide with semi-structured questions was used to collect the data. Five dominant themes and fifteen sub-themes have emerged from qualitative analysis. The dominant themes include; Awareness of abuse among women with mental illness (AWMI), Experiences of recognizing and responding to abuse, Barriers for routine screening for abuse, Educational preparedness, and learning needs, and Prevention of abuse in women with mental illness. The identified barriers include personal related (personal discomfort, lack of knowledge, etc.), job related (Time consuming, not a nurse's job, lack of time, etc.) and organizational (lack of policies and administrative support, etc.). Most of the participants expressed that they lack confidence in the routine screening of women for abuse due to inadequate training. Therefore, it is critical to include a topic on domestic violence in the nursing curriculum and provide ongoing learning opportunities to the nurses through CNE programs, workshops, and conferences.
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Affiliation(s)
- Vijayalakshmi Poreddi
- College of Nursing, National Institute of Mental Health and Neuro Sciences, (Institute of National Importance), Bangalore, India.
| | - Sailaxmi Gandhi
- Department of Nursing, National Institute of Mental Health and Neuro Sciences, (Institute of National Importance), Bangalore, India
| | | | - Marimuthu Palaniappan
- Department of Bio-statistics, National Institute of Mental Health and Neuro Sciences, (Institute of National Importance), Bangalore, India
| | - Suresh BadaMath
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, (Institute of National Importance), Bangalore, India
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13
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Kumari S, Kiran M, Chaudhury S. Severity of violence and quality of life of women with psychiatric disorders as compared to normal controls. Ind Psychiatry J 2020; 29:213-221. [PMID: 34158704 PMCID: PMC8188912 DOI: 10.4103/ipj.ipj_33_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 12/11/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Despite the fact that violence against women is a significant public health problem, there is a paucity of research into this area, and little is known about the extent to which women with psychiatric disorders are affected. AIM The aim of the study was to assess and compare the severity of violence and quality of life of women with psychiatric disorders and normal controls. MATERIALS AND METHODS Based on purposive sampling technique, a sample consisting of 120 participants was selected from in-patient (female section) and outpatient services of the Ranchi Institute of Neuro-Psychiatry and Allied Sciences and Kanke Area. Both groups were matched on sociodemographic details. Normal controls were screened using General Health Questionnaire-12. The severity of violence against women scale and the revised Conflict Tactics Scale were used to assess the severity of violence, and World Health Organization Quality of Life (WHOQOL)-BREF scale was used for the assessment of the quality of life. Scales were scored as per their test manuals. Results were tabulated and compared using appropriate statistical tests. RESULTS Women with psychiatric illness as well as normal controls faced various forms of symbolic violence equally. Women with psychiatric disorders faced significantly higher severity of physical assault, sexual coercion, and injury as compared to normal controls. Women with psychiatric disorders had significantly lower scores on WHOQOL BREF compared to normal participants. CONCLUSION Women with psychiatric disorders suffered significantly higher severity of both physical and sexual violence and had significantly worse quality of life compared to normal controls.
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Affiliation(s)
- Sapna Kumari
- Department of Psychiatric Social Work, Ranchi Institute of Neuropsychiatry and Allied Sciences, Ranchi, Jharkhand, India
| | - Manisha Kiran
- Department of Psychiatric Social Work, Ranchi Institute of Neuropsychiatry and Allied Sciences, Ranchi, Jharkhand, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr D Y Patil Medical College, Hospital and Research Center, Pune, Maharashtra, India
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14
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Mootz JJ, Muhanguzi F, Greenfield B, Gill M, Gonzalez MB, Panko P, Mangen PO, Wainberg ML, Khoshnood K. Armed Conflict, Intimate Partner Violence, and Mental Distress of Women in Northeastern Uganda: A Mixed Methods Study. PSYCHOLOGY OF WOMEN QUARTERLY 2019; 43:457-471. [PMID: 35662739 PMCID: PMC9165613 DOI: 10.1177/0361684319864366] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
As global mental health research and programming proliferate, research that prioritizes women's voices and examines marginalized women's mental health outcomes in relation to exposure to violence at community and relational levels of the socioecological model is needed. In a mixed methods, transnational study, we examined armed conflict exposure, intimate partner violence (IPV), and depressive symptoms among 605 women in Northeastern Uganda. We used analysis of variance to test between groups of women who had experienced no IPV or armed conflict, IPV only, armed conflict only, and both; and linear regression to predict depressive symptoms. We used rapid ethnographic methods with a subsample (n = 21) to identify problem prioritization; and, to characterize women's mental health experiences, we conducted follow up in-depth interviews (n = 15), which we analyzed with grounded theory methods. Thirty percent of the sample met the cut-off for probable major depressive disorder; women exposed to both IPV and armed conflict had significantly higher rates of depression than all other groups. While women attributed psychological symptoms primarily to IPV exposure, both past-year IPV and exposure to armed conflict were significantly associated with depressive symptoms. Women identified socioeconomic neglect as having the most impact and described three interrelated mental health experiences that contribute to thoughts of escape, including escape through suicide. Policy efforts should be interprofessional, and specialists should collaborate to advance multi-pronged interventions and gender-informed implementation strategies for women's wellbeing.
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Affiliation(s)
- Jennifer J. Mootz
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Florence Muhanguzi
- Department of Women and Gender Studies, Makerere University, Kampala, Uganda
| | - Brenna Greenfield
- Department of Psychiatry, University of Minnesota Duluth, Duluth, MN, USA
| | - Meghan Gill
- Behavioral Health Department, Kalispell Regional Medical Center, Kalispell, MT, USA
| | - Miigis B. Gonzalez
- Pharmacy Practice and Pharmaceutical Sciences, University of Minnesota Duluth, Duluth, MN, USA
| | - Pavel Panko
- Educational Psychology, Institute for Measurement, Methodology, Analysis & Policy, Texas Tech University, Lubbock, TX, USA
| | | | - Milton L. Wainberg
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Kaveh Khoshnood
- School of Public Health, Yale University, New Haven, CT, USA
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15
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Carneiro JB, Gomes NP, Campos LM, Silva AFD, Cunha KSD, Costa DMDSCD. Understanding marital violence: a study in grounded theory. Rev Lat Am Enfermagem 2019; 27:e3185. [PMID: 31596418 PMCID: PMC6781316 DOI: 10.1590/1518-8345.3116.3185] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 05/14/2019] [Indexed: 11/28/2022] Open
Abstract
Objective: to understand the phenomenon of marital violence based on the experience of women in judicial process and network professionals. Method: a qualitative study, with theoretical-methodological support in grounded theory. Data collection took place in two regional Courts for Peace in the Home in a municipality of the Brazilian Northeast. Interviews were conducted with 38 participants, who composed two sample groups: women in situations of violence and network professionals. Results: the understanding of marital violence emerged for the phenomenon “Experiencing marital violence as a progressive and cyclical process, with repercussions for health and implications for social relations”. Conclusion: in recognizing marital violence as a recurring problem in the life of women, with implications for their own health and that of their children, the study points to the relevance of coping strategies based on institutional and social support.
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Affiliation(s)
- Jordana Brock Carneiro
- Universidade Federal da Bahia, Escola de Enfermagem, Salvador, BA, Brazil.,Scholarship holder at Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | | | - Luana Moura Campos
- Universidade Federal da Bahia, Escola de Enfermagem, Salvador, BA, Brazil.,Scholarship holder at Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Andrey Ferreira da Silva
- Universidade Federal da Bahia, Escola de Enfermagem, Salvador, BA, Brazil.,Scholarship holder at Fundação de Amparo à Pesquisa do Estado da Bahia (FAPESB), Brazil
| | - Kamylla Santos da Cunha
- Universidade Federal de Santa Catarina, Departamento de Enfermagem, Florianópolis, SC, Brazil.,Scholarship holder at Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
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Sambo P, Nicoletto C, Giro A, Pii Y, Valentinuzzi F, Mimmo T, Lugli P, Orzes G, Mazzetto F, Astolfi S, Terzano R, Cesco S. Hydroponic Solutions for Soilless Production Systems: Issues and Opportunities in a Smart Agriculture Perspective. FRONTIERS IN PLANT SCIENCE 2019; 10:923. [PMID: 31396245 PMCID: PMC6668597 DOI: 10.3389/fpls.2019.00923] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 07/01/2019] [Indexed: 05/19/2023]
Abstract
Soilless cultivation represent a valid opportunity for the agricultural production sector, especially in areas characterized by severe soil degradation and limited water availability. Furthermore, this agronomic practice embodies a favorable response toward an environment-friendly agriculture and a promising tool in the vision of a general challenge in terms of food security. This review aims therefore at unraveling limitations and opportunities of hydroponic solutions used in soilless cropping systems focusing on the plant mineral nutrition process. In particular, this review provides information (1) on the processes and mechanisms occurring in the hydroponic solutions that ensure an adequate nutrient concentration and thus an optimal nutrient acquisition without leading to nutritional disorders influencing ultimately also crop quality (e.g., solubilization/precipitation of nutrients/elements in the hydroponic solution, substrate specificity in the nutrient uptake process, nutrient competition/antagonism and interactions among nutrients); (2) on new emerging technologies that might improve the management of soilless cropping systems such as the use of nanoparticles and beneficial microorganism like plant growth-promoting rhizobacteria (PGPRs); (3) on tools (multi-element sensors and interpretation algorithms based on machine learning logics to analyze such data) that might be exploited in a smart agriculture approach to monitor the availability of nutrients/elements in the hydroponic solution and to modify its composition in realtime. These aspects are discussed considering what has been recently demonstrated at the scientific level and applied in the industrial context.
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Affiliation(s)
- Paolo Sambo
- Department of Agronomy, Food, Natural Resources, Animals and Environment (DAFNAE), University of Padova, Legnaro, Italy
| | - Carlo Nicoletto
- Department of Agronomy, Food, Natural Resources, Animals and Environment (DAFNAE), University of Padova, Legnaro, Italy
| | - Andrea Giro
- Department of Agronomy, Food, Natural Resources, Animals and Environment (DAFNAE), University of Padova, Legnaro, Italy
| | - Youry Pii
- Faculty of Science and Technology, Free University of Bozen-Bolzano, Bolzano, Italy
| | - Fabio Valentinuzzi
- Faculty of Science and Technology, Free University of Bozen-Bolzano, Bolzano, Italy
| | - Tanja Mimmo
- Faculty of Science and Technology, Free University of Bozen-Bolzano, Bolzano, Italy
| | - Paolo Lugli
- Faculty of Science and Technology, Free University of Bozen-Bolzano, Bolzano, Italy
| | - Guido Orzes
- Faculty of Science and Technology, Free University of Bozen-Bolzano, Bolzano, Italy
| | - Fabrizio Mazzetto
- Faculty of Science and Technology, Free University of Bozen-Bolzano, Bolzano, Italy
| | - Stefania Astolfi
- Department of Agricultural and Forestry Sciences (DAFNE), University of Tuscia, Viterbo, Italy
| | - Roberto Terzano
- Department of Soil, Plant and Food Sciences, University of Bari, Bari, Italy
| | - Stefano Cesco
- Faculty of Science and Technology, Free University of Bozen-Bolzano, Bolzano, Italy
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Bhavsar V, Bhugra D. Violence towards people with mental illness: Assessment, risk factors, and management. Psychiatry Clin Neurosci 2018; 72:811-820. [PMID: 30084514 DOI: 10.1111/pcn.12775] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 07/21/2018] [Accepted: 07/24/2018] [Indexed: 11/28/2022]
Abstract
AIM Violence is an important problem for clinicians, for public health, and for victims. Aside from greater risk of perpetrating violence, people with mental illness are also more commonly victimized than the general population. However, guidance on the assessment and management of violent victimization in clinical settings is limited. METHODS We carried out a review and consolidation of clinical and research literature on violent victimization in people with mental illness. RESULTS Assessment of mental state in someone who has been victimized should evaluate both historical factors (such as pattern, timing, perpetrator characteristics, and contextual factors) and clinical factors (including affective and cognitive changes). CONCLUSION Concerted clinical and policy attention to factors that might increase vulnerability, such as alcohol use, lack of support, and the social environment, could improve outcomes.
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Affiliation(s)
- Vishal Bhavsar
- Department of Health Services and Population Research, King's College London, and South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK
| | - Dinesh Bhugra
- Department of Affective Disorders, King's College London, London, UK
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