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Fatemeh MT, Maryam N, Leila M. The story of staying out of normal routine life in adolescent mothers in marginal areas in Urmia through the Lenz of conventional content analysis approach. Midwifery 2024; 137:104108. [PMID: 39068701 DOI: 10.1016/j.midw.2024.104108] [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: 10/18/2023] [Revised: 05/09/2024] [Accepted: 07/08/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Adolescent pregnancy is a main health concern in relation to adolescent mothers and their neonates especially in deprived areas. AIM This study aimed to explore the experiences of adolescent mothers who live in deprived marginal areas in Urmia in Iran. METHODS This qualitative study was conducted in 2022-2023 using the conventional content analysis approach. Participants were eighteen adolescent mothers purposefully selected from healthcare centers in marginal areas in Urmia. Data were gathered via semi-structured interviews and were analyzed by the conventional content analysis method proposed by Graneheim and Lundman. FINDINGS ''Staying out of the life normal routine' was the main theme consisted of four categories 'forced early marriage', 'experience of abuse', 'learned helplessness', and 'impulses of hope under the shadow of motherhood' and five sub-categories role conflict, lifelong regret, attachment, reviving the lost self-value and the delight of family establishment. CONCLUSION Based on the results of the study health care providers, especially midwives, will be oriented to deal with adolescent mothers to help them to have successful transition to motherhood.
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Affiliation(s)
| | - Najjarzadeh Maryam
- School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Mokhtari Leila
- Nursing Department, Khoy University of Medical Sciences, Valiaasr Ave, Education, Research and Student Deputy, Khoy, West Azerbaijan 5816753464, Iran.
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Miafo JD, Nzebou D, Stoll B, Yimga Ngambia JC, von Overbeck Ottino S, Moayedoddin A. Perinatal mental disorders and suicidal risk among adolescent mothers living in urban areas of Cameroon. Front Psychiatry 2024; 15:1306440. [PMID: 38919637 PMCID: PMC11196771 DOI: 10.3389/fpsyt.2024.1306440] [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: 10/03/2023] [Accepted: 05/22/2024] [Indexed: 06/27/2024] Open
Abstract
Background In sub-Saharan Africa the birth rate among teenage mothers is the highest in the world. In 2021, there would be 6,114,000 births for 15-19-year-olds in this part of the world. In Cameroon, the fertility rate among adolescents aged 15-19 is 24%. However, there is a significant lack of data on the mental health of teenage mothers. Given the biopsychosocial conditions of the perinatal period and adolescence, we hypothesise that the prevalence of mental disorders and the risk of suicide is very high in Cameroon. The aim is therefore to determine the prevalence of perinatal mental disorders and suicide risk among adolescent mothers in urban areas of Cameroon. Methods Following ethical approval of the submitted protocol, we recruited adolescent mothers and data were collected using diagnostic interviews based on the DSM-5, PDM-2 and MINI guidelines. The types of sampling used were typical and incidental. Data were tabulated with Epidata 3.1 and processed with SPSS 25. Results 66.4% of adolescent mothers were diagnosed with a mental disorder and 27.4% with suicidal risk. It was found that there was a link between mental disorders and suicidal risk (p<0.001), with mothers at suicidal risk having an 8.4 times greater risk of having a mental disorder (OR=8.423). Linear regression confirmed the statistically significant relationship between perinatal mental disorders and suicidal risk. 31.1% of the total variance in suicidal risk was explained by mental disorders. The regression coefficients for mental disorders with a p<0.05 value is: perinatal depression (-0.279), post-partum psychosis (-0.133), trauma disorder (-0.034), generalised anxiety disorder (-0.008) and conduct disorder (-0.020). Conclusions Our hypothesis is confirmed, because the prevalence of 66.4% of mental disorders and 27.4% of suicidal risk are significantly high in Cameroon. In some way, the disorders predict suicidal risk, because the less an adolescent mother has one of these pathologies during the perinatal period, the less she will be at risk of suicide. More research of this kind is needed to contribute in providing more data, including solutions to address the morbidity and mortality problems associated with the mental health of teenage mothers.
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Affiliation(s)
| | - Daniel Nzebou
- Research Department, Uni-Psy et Bien-Être (UNIPSY), Yaoundé, Cameroon
| | - Beat Stoll
- Actions en Santé Publique (ASP), Geneva, Switzerland
- Institut de Santé Globale, Université de Genève, Geneva, Switzerland
| | | | - Saskia von Overbeck Ottino
- Service de psychiatrie de l’enfant et de l’adolescent, Hôpitaux Universitaires de Genève (HUG), Geneva, Switzerland
| | - Amir Moayedoddin
- Actions en Santé Publique (ASP), Geneva, Switzerland
- Service de psychiatrie de l’enfant et de l’adolescent, Hôpitaux Universitaires de Genève (HUG), Geneva, Switzerland
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Rahman Khan A, Shimul SMAK. Men's Suicide in Bangladesh: Impressions From the Socio-Ecological System Theory. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241257135. [PMID: 38776182 DOI: 10.1177/00302228241257135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
Suicide is a multilayered social behaviour containing overlapping components from individual to social spheres. This article discusses the findings of the context of male suicide in Bangladesh based on Bronfenbrenner's socio-ecological theory. The socio-ecological perspective allows to determine the risk factors of suicide at multiple levels. Fifteen male suicide cases were purposively selected from several rural areas of the Jhenaidah district which is known for high rates of suicide. Qualitative in-depth interviews (three for each case) with persons who are significant others to the deceased delineate the interactive context of suicide. While the analysis deductively hinges on four major themes (e.g., individual/micro, interpersonal/meso, community/exo, and societal/macro factors) in consonance with socio-ecological theory, ten sub-themes were inductively identified from the intriguing meanings of the interviews. Considering the integrative nature of suicide, the study underscores the necessity to introduce a multi-sectoral approach to effectively prevent suicide in Bangladesh.
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Adjimi Nyemgah C, Ranganathan M, Stöckl H. Intimate partner violence during pregnancy against adolescents in sub-Saharan Africa: a systematic review. Inj Prev 2024; 30:177-182. [PMID: 38195654 PMCID: PMC11137446 DOI: 10.1136/ip-2023-044985] [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: 05/26/2023] [Accepted: 12/03/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Adolescent pregnancy and intimate partner violence (IPV) are major public health issues that are linked to poor health outcomes particularly during pregnancy. In sub-Saharan Africa (SSA), previous studies on IPV during pregnancy have primarily focused on adults. This review examines the available evidence on adolescents' experience of IPV during pregnancy in SSA. DESIGN Systematic review. METHODS We searched multiple databases for articles that met our inclusion criteria. Included studies investigated IPV during pregnancy, including prevalence, risk factors and health outcomes among ever-pregnant adolescents aged 10-19 years old or younger in SSA. Studies were peer-reviewed studies from SSA, quantitative and/or qualitative; and published in English regardless of the year of publication. RESULTS Nine studies out of 570 abstracts screened, published between 2007 and 2020, met the inclusion criteria. The prevalence of IPV during pregnancy among adolescents in SSA ranged from 8.3% to 41%. Mental health symptoms, particularly depression, and anxiety, were associated with adolescent IPV during pregnancy and qualitatively linked to poor coping strategies when dealing with IPV. CONCLUSION This review found evidence of a linkage between pregnancy and IPV during pregnancy among adolescents. Given the long-term negative effects of IPV during pregnancy on adolescents and children, this conclusion points to the critical need for developing interventions to improve IPV detection during pregnancy in SSA among adolescents to interrupt its continuation into adulthood.
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Affiliation(s)
| | - Meghna Ranganathan
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Heidi Stöckl
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Institute for Medical Information Processing, Biometry and Epidemiology, Faculty of Medicine, Ludwig-Maximilians-Universität München, München, Bayern, Germany
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Abdul Rahim K, Egglestone NJ, Tsagareli IG, Usmani W, Meherali S, Lassi ZS. Mental health outcomes beyond the post-partum period among adolescent mothers: a systematic review and meta-analysis. Health Psychol Behav Med 2024; 12:2305741. [PMID: 38313449 PMCID: PMC10836488 DOI: 10.1080/21642850.2024.2305741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/08/2024] [Indexed: 02/06/2024] Open
Abstract
Background Adolescence is the most crucial part of life. The vulnerability of adolescent mothers is even more pronounced and can affect various health aspects. While they suffer from social and emotional stresses shortly after giving birth, the long-term effect after the post-partum period of adolescent pregnancy on the mental outcomes holds prime importance. Thus, this systematic review aims to ascertain the association between adolescent pregnancy on mental health outcomes. Methods The search strategy was run in June 2023 on databases including PubMed, CINAHL, Scopus, Psych Info, and Embase . Quality assessment of the studies was done using the National Institute of Health (NIH)'s National Heart, Lung and Blood Institute (NHLBI) tool for observational studies. For studies that measured similar outcomes, a meta-analysis was conducted. Findings The search strategy yielded 21 results from all databases and cross-referencing. Of these, all except for one (case-control) were cross-sectional and cohort studies. The pooled analysis found a significant association between adolescent pregnancy and depression (RR 1.34; 95% CI 1.05, 1.72, 6 studies, heterogeneity: Chi2 P 0.01; I2 = 60%); however, no association was found in anxiety (RR 1.05; 95% CI 0.26, 4.14, 2 studies; heterogeneity: Chi² P = 0.0003; I2 = 93%) and suicidal ideation (RR 3.21; 95% CI 0.17, 59.33; 3 studies; heterogeneity: Chi2 P < 0.00001; I2 = 98%). Implication These findings suggest that the mental health needs of adolescent mothers must be addressed and innovative and effective interventions that support and address the mental health needs of adolescent mothers are needed to improve their mental health.
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Affiliation(s)
- Komal Abdul Rahim
- Internal Medicine, Aga Khan University Hospital, Karachi, Pakistan
- Dean’s Office, Medical College, Aga Khan University, Karachi, Pakistan
- Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | | | | | - Wania Usmani
- Public Health Information Development Unit, Torrens University Australia, Adelaide, Australia
| | | | - Zohra S. Lassi
- Adelaide Medical School, Robinsons Research Institute University of Adelaide, Adelaide, Australia
- Faculty of Health and Medical Sciences, School of Public Health, University of Adelaide, Adelaide, Australia
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Kathono J, Nyongesa V, Mwaniga S, Obonyo G, Yator O, Wambugu M, Banerjee J, Breuer E, Duffy M, Lai J, Levy M, Njuguna S, Kumar M. Adolescent perspectives on peripartum mental health prevention and promotion from Kenya: Findings from a design thinking approach. PLoS One 2024; 19:e0290868. [PMID: 38165879 PMCID: PMC10760697 DOI: 10.1371/journal.pone.0290868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/17/2023] [Indexed: 01/04/2024] Open
Abstract
In Kenya, approximately one in five girls aged 15-19 years old are pregnant or already a mother. Adolescent girls and young women experience significant mental health vulnerabilities during the pregnancy and postpartum periods, leading to poor antenatal and postnatal care attendance and inferior infant and maternal health outcomes. Pregnant adolescents often experience stigma and disenfranchisement due to their pregnancy status and at the same time lack access to mental health support within health settings, schools, religious institutions, and communities. This paper presents the results of qualitative interviews embedded within the human-centered design (HCD) process used to adapt the Helping Adolescents Thrive (HAT) program for Kenyan peripartum adolescents including young fathers. This qualitative study used two phases. First, a HAT advisory group participated in a series of four workshops to help identify and articulate mental health promotion needs and deepened the team's understanding of youth-centered thinking. Second, qualitative interviews were conducted with 39 pregnant and parenting adolescents to understand their perspectives on mental health prevention and promotion. Pregnant and parenting adolescents articulated different needs including poor support, stigma, and psychological disturbances. Parenting adolescents reported disturbed relationships, managing motherhood, poor health, and social empowerment. Participants highlighted sources of stress including economic challenges, fear of delivery, strained relationships, rejection, and stigma. Participants described psychological disturbances such as feeling stressed, worthless, withdrawn, and suicidal. Coping mechanisms reported by participants included engaging in domestic activities, hobbies, and social networking. Peers, family and spirituality were identified as important sources of support, as well as school integration, livelihoods, support groups and mentorships. Findings from this study can be used to strengthen and adapt HAT program, policy and practice for mental health prevention and promotion for pregnant and parenting adolescents.
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Affiliation(s)
| | | | | | | | - Obadia Yator
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | | | | | - Erica Breuer
- University of Newcastle, Newcastle, New South Wales, Australia
| | - Malia Duffy
- St Ambrose University, Davenport, Iowa, United States of America
- Health Across Humanity, LLC, Boston, Massachusetts, United States of America
| | - Joanna Lai
- UNICEF Headquarters, New York, NY, United States of America
| | - Marcy Levy
- UNICEF Headquarters, New York, NY, United States of America
| | - Simon Njuguna
- Division of Mental Health, Ministry of Health, Nairobi, Kenya
| | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- Institute for Excellence in Health Equity, New York University Grossman School of Medicine, New York, NY, United States of America
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Ajayi AI, Athero S, Muga W, Kabiru CW. Lived experiences of pregnant and parenting adolescents in Africa: A scoping review. Reprod Health 2023; 20:113. [PMID: 37537592 PMCID: PMC10401816 DOI: 10.1186/s12978-023-01654-4] [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: 05/25/2022] [Accepted: 07/26/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Previous studies have not synthesized existing literature on the lived experiences of pregnant and parenting adolescents (aged 10-19) in Africa. Such evidence synthesis is needed to inform policies, programs, and future research to improve the well-being of the millions of pregnant or parenting adolescents in the region. Our study fills this gap by reviewing the literature on pregnant and parenting adolescents in Africa. We mapped existing research in terms of their substantive focus, and geographical distribution. We synthesized these studies based on thematic focus and identified gaps for future research. METHODS We used a three-step search strategy to find articles, theses, and technical reports reporting primary research published in English between January 2000 and June 2021 in PubMed, Jstor, AJOL, EBSCO Host, and Google Scholar. Three researchers screened all articles, including titles, abstracts, and full text, for eligibility. Relevant data were extracted using a template designed for the study. Overall, 116 studies met the inclusion criteria and were included in the study. Data were analyzed using descriptive and thematic analyses. RESULTS Research on pregnant and parenting adolescents is limited in volume and skewed to a few countries, with two-fifths of papers focusing on South Africa (41.4%). Most of the studies were African-led (81.9%), received no funding (60.3%), adopted qualitative designs (58.6%), and were published between 2016 and 2021 (48.3%). The studies highlighted how pregnancy initiates a cycle of social exclusion of girls with grave implications for their physical and mental health and social and economic well-being. Only 4.3% of the studies described an intervention. None of these studies employed a robust research design (e.g., randomized controlled trial) to assess the intervention's effectiveness. Adolescent mothers' experiences (26.7%) and their education (36.2%) were the most studied topics, while repeat pregnancy received the least research attention. CONCLUSION Research on issues affecting pregnant and parenting adolescents is still limited in scope and skewed geographically despite the large burden of adolescent childbearing in many African countries. While studies have documented how early pregnancy could result in girls' social and educational exclusion, few interventions to support pregnant and parenting adolescents exist. Further research to address these gaps is warranted.
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Affiliation(s)
- Anthony Idowu Ajayi
- Sexual, Reproductive, Maternal, New-Born, Child, and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Nairobi, Kenya.
| | - Sherine Athero
- Sexual, Reproductive, Maternal, New-Born, Child, and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Winstoun Muga
- Sexual, Reproductive, Maternal, New-Born, Child, and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Caroline W Kabiru
- Sexual, Reproductive, Maternal, New-Born, Child, and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Nairobi, Kenya
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Ongeri L, Nyawira M, Kariuki SM, Bitta M, Schubart C, Penninx BWJH, Newton CRJC, Tijdink JK. Perspectives on reasons for suicidal behaviour and recommendations for suicide prevention in Kenya: qualitative study. BJPsych Open 2023; 9:e38. [PMID: 36797822 PMCID: PMC9970164 DOI: 10.1192/bjo.2023.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Little is known about the reasons for suicidal behaviour in Africa, and communities' perception of suicide prevention. A contextualised understanding of these reasons is important in guiding the implementation of potential suicide prevention interventions in specific settings. AIMS To understand ideas, experiences and opinions on reasons contributing to suicidal behaviour in the Coast region of Kenya, and provide recommendations for suicide prevention. METHOD We conducted a qualitative study with various groups of key informants residing in the Coast region of Kenya, using in-depth interviews. Audio-recorded interviews were transcribed and translated from the local language before thematic inductive content analysis. RESULTS From the 25 in-depth interviews, we identified four key themes as reasons given for suicidal behaviour: interpersonal and relationship problems, financial and economic difficulties, mental health conditions and religious and cultural influences. These reasons were observed to be interrelated with each other and well-aligned to the suggested recommendations for suicide prevention. We found six key recommendations from our thematic content analysis: (a) increasing access to counselling and social support, (b) improving mental health awareness and skills training, (c) restriction of suicide means, (d) decriminalisation of suicide, (e) economic and education empowerment and (f) encouraging religion and spirituality. CONCLUSIONS The reasons for suicidal behaviour are comparable with high-income countries, but suggested prevention strategies are more contextualised to our setting. A multifaceted approach in preventing suicide in (coastal) Kenya is warranted based on the varied reasons suggested. Community-based interventions will likely improve and increase access to suicide prevention in this study area.
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Affiliation(s)
- Linnet Ongeri
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Miriam Nyawira
- Neuroscience Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Symon M Kariuki
- Neuroscience Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya; and Department of Public Health, Pwani University, Nairobi, Kenya
| | - Mary Bitta
- Neuroscience Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya; and Department of Psychiatry, University of Oxford, UK
| | - Chris Schubart
- Division of Mental Health, Tergooi Medical Centre, Hilversum, The Netherlands
| | | | - Charles R J C Newton
- Neuroscience Unit, Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya; and Department of Psychiatry, University of Oxford, UK
| | - Joeri K Tijdink
- Department of Ethics, Law and Humanities, Amsterdam UMC, Vrije Universiteit, The Netherlands; and Department of Philosophy, Faculty of Humanities, VU Universiteit, The Netherlands
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Hajure M, Roba G, Gezimu W, Nigatu D, Mohammedhussein M, Ebrahim J, Mamo A, Dule A, Jemal K. Perinatal suicidal behavior in sub-Saharan Africa: A study protocol for a systematic review with meta-analysis. PLoS One 2023; 18:e0285406. [PMID: 37155620 PMCID: PMC10166536 DOI: 10.1371/journal.pone.0285406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 04/20/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Perinatal mental illnesses are predominant during gestation and continue for a year after delivery. According to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), suicide is classified as a direct cause of death among the maternal population. The occurrence of suicidal behavior among perinatal women was considered the main contributor to the burden of the disorder. Hence, the current study will develop a protocol for a systematic review as well as a meta-analysis on estimating the prevalence and determinants of perinatal suicidal behavior in Sub-Saharan African countries. METHODS PubMed/MEDLINE, Scopus, EMBASE, PsycINFO, and the Web of Science electronic databases will be searched for studies reporting primary data. The second search strategy will be done with Google Scholar, using a combination of the medical subject headings and keywords as the search terms. The studies will be classified into included, excluded, and undecided categories. The studies will be judged based on the eligibility criteria. Heterogeneity will be checked by using the I2 test (Cochran Q test) at a p-value of 0.05 and assuming that the I2 value is > 50%. Publication bias will be checked using a funnel plot, Beg's rank, and Eggers linear statistical tests. A subgroup analysis and sensitivity test will be carried out. The risk of bias will be assessed using the Joanna Briggs Institute (JBI), and the quantitative analysis will determine whether or not to proceed based on the results. DISCUSSION This protocol's comprehensive review is expected to generate sufficient evidence on the prevalence of suicidal behavior and its determinants among women during the perinatal period in Sub-Saharan African countries over the last two decades. Hence, this protocol will be imperative to collect and combine empirical data on suicidal behavior during the perinatal period, and doing so will help to provide essential implications or better evidence to plan different kinds of interventions considering determinants expected to impact the burden of suicidal behavior during the perinatal period. SYSTEMATIC REVIEW REGISTRATION PROSPERO (CRD42022331544).
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Affiliation(s)
- Mohammedamin Hajure
- Department of Nursing, College of Health Sciences, Madda Walabu University, Shashemene, Ethiopia
| | - Gebiso Roba
- Department of Public health, College of Health Sciences, Mattu University, Mattu, Ethiopia
| | - Wubishet Gezimu
- Department of Nursing, College of Health Sciences, Mattu University, Mattu, Ethiopia
| | - Desalegn Nigatu
- Department of Nursing, College of Health Sciences, Mattu University, Mattu, Ethiopia
| | - Mustefa Mohammedhussein
- Department of psychiatry, College of Health Sciences, Madda Walabu University, Bale, Ethiopia
| | - Jemal Ebrahim
- Department of psychiatry, College of Health Sciences, Madda Walabu University, Bale, Ethiopia
| | - Aman Mamo
- Department of Nursing, College of Health Sciences, Madda Walabu University, Shashemene, Ethiopia
| | - Aman Dule
- Department of Nursing, College of Health Sciences, Madda Walabu University, Shashemene, Ethiopia
| | - Kiyar Jemal
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Irangani L, Prasanna IR, Gunarathne SP, Shanthapriya SH, Wickramasinghe ND, Agampodi SB, Agampodi TC. Social determinants of health pave the path to maternal deaths in rural Sri Lanka: reflections from social autopsies. Reprod Health 2022; 19:221. [PMID: 36471339 PMCID: PMC9724344 DOI: 10.1186/s12978-022-01527-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Ending preventable maternal deaths remains a challenge in low- and middle-income countries (LMICs). Society perceived causes and real-life observations can reveal the intangible causes of maternal deaths irrespective of formal maternal death investigations. This study reports complex patterns in which social determinants act towards paving the path to maternal deaths in a rural Sri Lankan setting. METHODS We conducted social autopsies for 15/18 maternal deaths (in two consecutive years during the past decade) in district A (pseudonymized). In-depth interviews of 43 respondents and observations were recorded in the same field sites. During thematic analysis, identified themes were further classified according to the World Health Organization framework for social determinants of health (SDH). The patterns between themes and clustering of social determinants based on the type of maternal deaths were analyzed using mixed methods. RESULTS Discernable social causes underpinned 12 out of 15 maternal deaths. Extreme poverty, low educational level, gender inequity, and elementary or below-level occupations of the husband were the characteristic structural determinants of most deceased families. Social isolation was the commonest leading cause manifesting as a reason for many other social factors and resulted in poor social support paving the path to most maternal deaths. A core set of poverty, social isolation, and poor social support acted together with alcohol usage, and violence leading to suicides. These core determinants mediating through neglected self-health care led to delay in health-seeking. Deficits in quality of care and neglect were noted at health institutions and the field. CONCLUSION Social autopsies of maternal deaths revealed complex social issues and social determinants of health leading to maternal deaths in Sri Lanka, indicating the need for a socially sensitive health system.
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Affiliation(s)
- Lasandha Irangani
- grid.430357.60000 0004 0433 2651Department of Humanities, Faculty of Social Sciences and Humanities, Rajarata University of Sri Lanka, Mihintale, 50300 Sri Lanka
| | - Indika Ruwan Prasanna
- grid.430357.60000 0004 0433 2651Department of Economics, Faculty of Social Sciences and Humanities, Rajarata University of Sri Lanka, Mihintale, 50300 Sri Lanka
| | - Sajaan Praveena Gunarathne
- grid.430357.60000 0004 0433 2651Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008 Sri Lanka
| | - Sandaru Hasaranga Shanthapriya
- grid.430357.60000 0004 0433 2651Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008 Sri Lanka
| | - Nuwan Darshana Wickramasinghe
- grid.430357.60000 0004 0433 2651Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008 Sri Lanka
| | - Suneth Buddhika Agampodi
- grid.430357.60000 0004 0433 2651Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008 Sri Lanka
| | - Thilini Chanchala Agampodi
- grid.430357.60000 0004 0433 2651Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008 Sri Lanka
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Ntshayintshayi PN, Sehularo LA, Mokgaola IO, Sepeng NV. Exploring the psychosocial challenges faced by pregnant teenagers in Ditsobotla subdistrict. Health SA 2022; 27:1880. [PMID: 36483505 PMCID: PMC9724101 DOI: 10.4102/hsag.v27i0.1880] [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: 12/10/2021] [Accepted: 06/01/2022] [Indexed: 11/06/2022] Open
Abstract
Background Pregnant teenagers usually experience psychosocial challenges such as a great amount of stress when they have to deal with an unwanted pregnancy, unpreparedness for parenthood and a lack of income as well as labour and birth complications. These are further complicated by the stigma from their families, friends and community. Unaddressed psychosocial challenges during teenage pregnancy can adversely affect the health outcomes of both mother and the child. Aim This study explores and describes the psychosocial challenges faced by pregnant teenagers in the Ditsobotla subdistrict. Setting The study was conducted in three health centres in the Ditsobotla subdistrict. Methods A qualitative-exploratory-descriptive and contextual research design was used. Non-probability purposive and convenience sampling techniques were used to select the participants. Semistructured individual interviews through WhatsApp video calls were used to collect data, which were analysed using conventional content analysis. Results Three themes emerged from the findings of the study, namely psychological challenges, social challenges and suggestions to address psychosocial challenges faced by pregnant teenagers. Conclusion The findings established that pregnant teenagers in the Ditsobotla subdistrict are faced with psychosocial challenges which negatively impact their psychological health and social life. Suggestions made in this study have the potential to improve the psychosocial well-being of pregnant teenagers in the Ditsobotla subdistrict if implemented. Contributions The findings of this study provide important information that may be used to improve the psychosocial well-being of pregnant teenagers in the Ditsobotla subdistrict.
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Affiliation(s)
- Peaceful N. Ntshayintshayi
- Quality in Nursing and Midwifery (NuMIQ) Research Focus Area, Faculty of Health Sciences, North-West University, Mmabatho, South Africa
| | - Leepile A. Sehularo
- Quality in Nursing and Midwifery (NuMIQ) Research Focus Area, Faculty of Health Sciences, North-West University, Mmabatho, South Africa
| | - Isaac O. Mokgaola
- Quality in Nursing and Midwifery (NuMIQ) Research Focus Area, Faculty of Health Sciences, North-West University, Mmabatho, South Africa
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Palfreyman A, Gazeley U. Adolescent perinatal mental health in South Asia and Sub-Saharan Africa: A systematic review of qualitative and quantitative evidence. Soc Sci Med 2022; 313:115413. [PMID: 36215926 DOI: 10.1016/j.socscimed.2022.115413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/14/2022] [Accepted: 09/27/2022] [Indexed: 01/26/2023]
Abstract
Despite the contribution of mental ill-health to perinatal morbidity and mortality, the experiences of adolescent girls and young women (AGYW) in low- and middle-income countries remain overlooked. This review explores potential intersecting vulnerabilities for perinatal mental health to identify the prevalence, risk factors, interventions, and implications for health services and future research. We searched mixed-methods English-language studies in four databases (MEDLINE, PsycInfo, Global Health, Embase) published between January 1, 2000 and April 30, 2022 reporting age-disaggregated data on the prevalence, risk factors, and interventions for AGYW's mental health during pregnancy through one year postpartum (quantitative) and/or the mental health experiences of AGYW in the perinatal period (qualitative). Our search yielded 3205 results, of which 48 met the inclusion criteria. Both regions observe a paucity of robust evidence and intervention evaluations, particularly South Asia. While meta-analysis was infeasible due to study heterogeneity, quantitative studies do identify individual-level risk factors for perinatal depression. Qualitative studies emphasise stigma's impact, among other societal-level social risk factors, on diverse perinatal mental health outcomes of importance to AGYW themselves. Rigorous evaluations of interventions are lacking bar two protocols with forthcoming results. Evidence gaps persist concerning prevalence of outcomes beyond depression and implications of AGYW's perinatal experiences including pregnancy/perinatal loss and obstetric and postpartum complications. High-quality research, including comparable prevalence and multi-method evidence identifying risk and protective factors and promising interventions is urgently needed to improve adolescent wellbeing in the perinatal period. A key strength of this review is our assessment of available evidence for both regions. In doing so, we address a critical blind spot of prior reviews that focused either on adult perinatal mental health in low- and middle-income countries, or on AGYW perinatal mental health in high-income settings but neglected the intersection of these potential vulnerabilities for these high-burden, low-resource contexts.
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Affiliation(s)
- Alexis Palfreyman
- Institute for Global Health, University College London, London, WC1N 1EH, UK.
| | - Ursula Gazeley
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
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Kreniske P, Morrison C, Spencer BH, Levine A, Liotta L, Fisher PW, Nguyen N, Robbins RN, Dolezal C, Kluisza L, Wiznia A, Abrams EJ, Mellins CA. HIV and suicide risk across adolescence and young adulthood: an examination of socio-demographic, contextual and psychosocial risk factors for attempted suicide in a longitudinal cohort of ageing adolescents affected by HIV living in the New York City Area. J Int AIDS Soc 2022; 25 Suppl 4:e25984. [PMID: 36176026 PMCID: PMC9522633 DOI: 10.1002/jia2.25984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 08/01/2022] [Indexed: 12/22/2022] Open
Abstract
Introduction As children become adolescents and young adults (AYA), their risk for attempting suicide increases dramatically, with chronic health conditions an important risk factor. This study examined correlates of suicidality across development in AYA living with perinatally acquired HIV (AYALPHIV) and those perinatally HIV‐exposed but uninfected (AYAPHEU). Methods Data come from an ongoing longitudinal New York City‐based study (N = 339) with AYALPHIV and AYAPHEU interviewed every 12–18 months from 2003 to 2019 (mean enrolment age = 12 years; current mean age = 27 years). The Diagnostic Interview Schedule for Children (adolescent or young adult version) assessed psychiatric disorders and first‐reported suicide attempt. Generalized estimating equations were used to examine associations between first‐reported suicide attempt and socio‐demographic, contextual and psychosocial correlates measured concurrently across six timepoints. Results At enrolment, 51% of participants were female, 72% heterosexual, 60% Black and 50% Latinx. Attempted suicide was significantly higher among AYALPHIV (27%, CI 21–33%) compared to AYAPHEU (16%, CI 10–22%), with an OR of 1.74 (CI 1.04–2.92) in a model adjusting for age. For AYALPHIV, anxiety (OR 2.66, CI 1.46–4.85), mood (OR 3.62, CI 1.49–8.81) and behaviour disorders (OR 5.05, CI 2.15–11.87) and past‐year arrest (OR 3.05, CI 1.26–7.4), negative life events (OR 1.27, CI 1.11–1.46), city stress (OR 2.28, CI 1.46–3.57), pregnancy (OR 2.28, CI 1.08–4.81) and HIV stigma (OR 2.46, CI 1.27–4.75) were associated with increased odds of attempted suicide, while identifying as heterosexual (OR 0.27, CI 0.14–0.52), higher personal (OR 0.45, CI 0.26–0.80) and family self‐concept (OR 0.36, CI 0.22–0.57) were protective. Interactions by HIV status and age were found: substance use was more strongly associated with attempted suicide among AYAPHEU than AYALPHIV, while negative life events and higher religiosity were more strongly associated with increased odds of attempted suicide among AYA ≥ 19 versus ≤ 18 years. Conclusions AYALPHIV compared to AYAPHEU faced unique risks for attempted suicide as they age into adulthood, with the highest risk among AYALPHIV experiencing HIV stigma or pregnancy and the highest risk among AYAPHEU with substance use. Assessing for suicide risk and correlates with attention to ageing can inform preventive interventions tailored to meet AYALPHIV and AYAPHEU needs.
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Affiliation(s)
- Philip Kreniske
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Corey Morrison
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Bailey Holmes Spencer
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Alina Levine
- Mental Health Data Science, Research Foundation for Mental Hygiene, New York City, New York, USA
| | - Lucy Liotta
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Prudence W Fisher
- Child and Adolescent Psychiatry, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Nadia Nguyen
- The Aaron Diamond AIDS Research Center, New York City, New York, USA
| | - Reuben N Robbins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Curtis Dolezal
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Luke Kluisza
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Andrew Wiznia
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Elaine J Abrams
- ICAP at Columbia University, Mailman School of Public Health and Vagelos College of Physicians & Surgeons, Columbia University, New York City, New York, USA
| | - Claude A Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
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Legazpi PCC, Rodríguez-Muñoz MF, Olivares-Crespo ME, Izquierdo-Méndez N. Review of suicidal ideation during pregnancy: risk factors, prevalence, assessment instruments and consequences. PSICOLOGIA-REFLEXAO E CRITICA 2022; 35:13. [PMID: 35606474 PMCID: PMC9127017 DOI: 10.1186/s41155-022-00220-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 05/12/2022] [Indexed: 01/20/2023] Open
Abstract
Background Pregnancy is a period when women are particularly vulnerable to suicidal ideation and a great opportunity for suicide risk prevention. Aims This study aimed to establish a comprehensive understanding of suicidal ideation prevalence, risk factors, screening tools, consequences and management during pregnancy. Method A literature search was performed in MEDLINE and PsycInfo databases from 2016 to 2021. A narrative synthesis of the literature and a critical overview of the current issues/questions to be addressed within the topic of suicidal ideation during pregnancy was performed. Results The prevalence of suicidal ideation during pregnancy was between 2.73 and 18% internationally. The risk factors identified were major depressive disorder, anxiety disorder, difficulties with sleep, previous suicide attempts, high rumination, low incomes, being black, being young, low educational level, partner violence, having poor support, food insecurity, history of child abuse, high obstetric risk, multiparity, previous induced abortion and exposure to tobacco or human immunodeficiency virus diagnosis. The screening tools used for suicidal ideation during pregnancy were item 10 of the Edinburgh Postpartum Depression Scale and item 9 of the Patient Health Questionnaire. Results showed that suicidal ideation during pregnancy is associated with poor cognitive development in children and low birth weight. No case management studies on suicidal ideation were found. Limitations The main limitation of the available studies was the lack of articles with a high degree of methodological rigour on this subject. Conclusions This narrative review is a state-of-the-art paper about suicidal ideation during pregnancy. Further research is needed, and researchers should carry out systematic reviews and meta-analyses, leading to Clinical Practice Guidelines in this area. This effort would improve our evidence-based practice in Perinatal Psychology and prevent associated suicidal behaviour.
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Affiliation(s)
| | - María F Rodríguez-Muñoz
- Department of Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain.
| | - María Eugenia Olivares-Crespo
- Deparment of Gynecology and Obstetrics, Hospital Clínico San Carlos & Faculty of Medicine Universidad Complutense de Madrid, Madrid, Spain
| | - Nuria Izquierdo-Méndez
- Deparment of Gynecology and Obstetrics, Hospital Clínico San Carlos & Faculty of Medicine Universidad Complutense de Madrid, Madrid, Spain
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15
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Mutahi J, Larsen A, Cuijpers P, Peterson SS, Unutzer J, McKay M, John-Stewart G, Jewell T, Kinuthia J, Gohar F, Lai J, Wamalwa D, Gachuno O, Kumar M. Mental health problems and service gaps experienced by pregnant adolescents and young women in Sub-Saharan Africa: A systematic review. EClinicalMedicine 2022; 44:101289. [PMID: 35198916 PMCID: PMC8851289 DOI: 10.1016/j.eclinm.2022.101289] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/11/2022] [Accepted: 01/18/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Pregnant adolescent girls and young women (AGYW, aged 12-24 years) are at high risk for mental health problems, particularly in the Sub-Saharan African (SSA) region. METHODS We performed a systematic review of mental health studies among pregnant AGYW in SSA published between January 1, 2007 and December 31, 2020 in PubMed, Embase, CINAHL, PsycInfo, and Global Index Medicus following PRISMA guidelines (PROSPERO: CRD42021230980). We used Bronfenbrenner's bioecological model to frame and synthesize results from included studies. FINDINGS Our search yielded 945 articles from which 18 studies were included (N = 8 quantitative, N = 9 qualitative, N = 1 case report). The most frequently studied mental health problem was depression (N = 9 studies); the most frequently utilized measurement tool was the Edinburgh Postnatal Depression Scale (N = 3). Studies reported life course factors, individual, microsystem, exosystem, macrosystem, and chronosystem-level factors associated with mental health problems. Gaps in mental health service delivery for pregnant AGYW included lack of confidentiality, judgmental healthcare worker attitudes, and lack of services tailored to their unique needs. INTERPRETATION Gaps remain in research and services for mental health among pregnant AGYW in SSA. Integration of mental health services within school, community, and healthcare settings that are tailored to pregnant AGYW could strengthen health systems within SSA. FUNDING Author contributions were supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (F31HD101149 to AL) and the Fogarty International Center (K43TW010716 to MK). The funding agencies had no role in the writing of the manuscript or the decision to submit it for publication. The project itself was not funded.
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Affiliation(s)
- Joan Mutahi
- Department of Psychiatry, College of Health Sciences, University of Nairobi, 00100 (19676), Nairobi, Kenya
| | - Anna Larsen
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, the Netherland
| | | | - Jurgen Unutzer
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Mary McKay
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, United States
| | - Grace John-Stewart
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Teresa Jewell
- University of Washington Libraries, Seattle, WA, United States
| | - John Kinuthia
- Research and Programs, Kenyatta National Hospital, Nairobi, Kenya
| | - Fatima Gohar
- United Nations Children's Fund (UNICEF), New York, NY, United States
| | - Joanna Lai
- United Nations Children's Fund (UNICEF), New York, NY, United States
| | - Dalton Wamalwa
- Department of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Onesmus Gachuno
- Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
| | - Manasi Kumar
- Department of Psychiatry, College of Health Sciences, University of Nairobi, 00100 (19676), Nairobi, Kenya
- Brain and Mind Institute, Aga Khan University, Kenya
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Abstract
PURPOSE OF REVIEW Suicide is a leading cause of death in the perinatal period (pregnancy and 1 year postpartum). We review recent findings on prevalence, risk factors, outcomes, and prevention and intervention for suicide during pregnancy and the first year postpartum. RECENT FINDINGS Standardization of definitions and ascertainment of maternal deaths have improved identification of perinatal deaths by suicide and risk factors for perinatal suicide. Reports of a protective effect of pregnancy and postpartum on suicide risk may be inflated. Clinicians must be vigilant for risk of suicide among their perinatal patients, especially those with mental health diagnoses or prior suicide attempts. Pregnancy and the year postpartum are a time of increased access to healthcare for many, offering many opportunities to identify and intervene for suicide risk. Universal screening for suicide as part of assessment of depression and anxiety along with improved access to mental health treatments can reduce risk of perinatal suicide.
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Affiliation(s)
- Kathleen Chin
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1959, NE Pacific Street, Box 356560, Seattle, WA 98195 USA
| | - Amelia Wendt
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1959, NE Pacific Street, Box 356560, Seattle, WA 98195 USA
| | - Ian M. Bennett
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1959, NE Pacific Street, Box 356560, Seattle, WA 98195 USA ,Department of Family Medicine, University of Washington, Seattle, WA USA ,Department of Global Health, University of Washington, Seattle, WA USA
| | - Amritha Bhat
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1959, NE Pacific Street, Box 356560, Seattle, WA, 98195, USA.
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17
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Mokaya AG, Kikuvi GM, Mutai J, Khasakhala LI, Memiah P. Factors associated with the risk of suicidal behavior among adolescents transitioning to secondary school in Nairobi County, Kenya: a cross-sectional study. Pan Afr Med J 2022; 43:180. [PMID: 36879633 PMCID: PMC9984834 DOI: 10.11604/pamj.2022.43.180.35917] [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: 06/15/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction adolescence is a transitory stage in the lives of young people. The transition from primary to secondary school among adolescents is associated with suicidal behavior but is not well characterized in the Kenyan context. This study sought to elucidate factors associated with the risk of suicidal behavior among adolescents aged 11-18 years in transition to secondary school. Methods a cross-sectional design was employed in the study that was conducted among adolescents in 5 randomly selected secondary schools in Nairobi County. The study involved 539 students who had joined form 1 in January 2020. Data were collected using the suicide behavior questionnaire-revised (SBQ-R) in March 2020. Factors associated with suicidal behavior were assessed using a generalized linear model (GLM), using a poisson distribution with a log-link function to estimate adjusted prevalence ratios (aPR), and a significance level of p=.05. Results one-fifth (20.04%) of adolescents with a median age of 14 years were at risk of suicidal behavior. Depression (aPR=3.16, C.I {1.85, 5.41}, p=0.001) and lifetime alcohol use (aPR=1.87, C.I {1.17, 2.97}, p=0.009) were found to be significant factors for suicidal behavior. Conclusion depression and lifetime alcohol use are associated with the risk of suicidal behavior among adolescents transitioning from primary to secondary school. Interventions may need to be targeted at the pre-secondary or primary school level to prevent underage alcohol use and enhancement of social support to prevent depression in this demographic of the population.
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Affiliation(s)
- Aggrey Gisiora Mokaya
- Center for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya.,Department of Environmental Health and Disease Control, School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | - Gideon Mutie Kikuvi
- Department of Environmental Health and Disease Control, School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | - Joseph Mutai
- Center for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Peter Memiah
- Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland School of Medicine, Baltimore Maryland, USA
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18
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Kumar M, Chu W, Gellatly R, Wambua GN, Becker KD, Chorpita BF. Identified needs of peripartum adolescents in Sub-Saharan Africa from 2013 to 2021: a mapping of domains for strengthening psychosocial interventions. Curr Opin Psychol 2021; 45:101291. [PMID: 35016086 DOI: 10.1016/j.copsyc.2021.12.003] [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: 07/31/2021] [Revised: 12/01/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022]
Abstract
Adolescent pregnancy and early motherhood pose significant socioeconomic and health risks in Sub-Saharan Africa, leading to considerable morbidity and mortality. To learn more about the needs of this population, we reviewed 24 articles featuring 21 samples covering 12,490 adolescents from 14 countries. Our coding revealed that adolescent mothers were studied more (85.7% of samples) than pregnant adolescents (61.9%). We summarized needs as per six categories. Resource needs were most prevalent, reported by 100% of samples, followed by ecology (85.7%), mental health (76.2%), medical (61.9%), other (61.9%), and education (33.3%). The most frequently reported resource needs were low income and unemployment. Low social support, low family functioning, and exposure to negative cultural norms were ecological needs prevalent in most samples. Among mental health concerns, depression was the most commonly reported problem, whereas other problems, such as anxiety, substance use, and suicidality, were reported much less frequently. HIV-positive status was the most frequently reported medical concern. Intervention developers should consider the range of challenges when designing psychosocial services for this population.
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Affiliation(s)
- Manasi Kumar
- Department of Psychiatry, University of Nairobi, Kenya.
| | - Wendy Chu
- Department of Psychology, University of South Carolina, USA
| | - Resham Gellatly
- Department of Psychology, University of California, Los Angeles, USA
| | - Grace Nduku Wambua
- Faculty of Behavioural and Movement Sciences, Clinical Psychology, Vrije Universiteit, Netherlands
| | | | - Bruce F Chorpita
- Department of Psychology, University of California, Los Angeles, USA
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Suh WY, Lee J, Yun JY, Sim JA, Yun YH. A network analysis of suicidal ideation, depressive symptoms, and subjective well-being in a community population. J Psychiatr Res 2021; 142:263-271. [PMID: 34392053 DOI: 10.1016/j.jpsychires.2021.08.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 01/18/2023]
Abstract
Although the relationship between subjective well-being (SWB) and suicidal ideation (SI) has been illustrated in previous research, few studies have conceptualized SWB as a comprehensive measure of life satisfaction in multiple domains, nor have they considered possible mediators such as depressive symptoms. Therefore, the present study aimed to identify dimensions of SWB correlated with SI, and to analyze associations among SWB sub-domains, depressive symptoms, and SI in a community population. A total of 1200 community adults in South Korea, aged 20-86 years, completed self-report questionnaires on demographics, depressive mood (Patient Health Questionnaire-9 [PHQ-9]), SI (item 9 of the PHQ-9), and 14 SWB sub-domains (Subjective Well-Being Inventory). Factors associated with SI, and interactions among SI, depressive mood, and SWB, were identified by logistic regression and phenotype network analyses, respectively. The five main factors influencing the regularized partial correlation network were life satisfaction, self-blame, job, hopelessness, and fatigue. Pathways were observed from work-life balance and life satisfaction to hopelessness; from self-blame and fatigue to safety and health; and from sleep disturbance, concentration difficulties, self-blame, and hopelessness to SI. Making job activities more emotionally rewarding, the potential for career progression and regular work hours could address anhedonia, hopelessness and sleep disturbance, respectively, thus enhancing SWB and reducing SI in the community population.
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Affiliation(s)
- Won Young Suh
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Jongjun Lee
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea; Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Jin-Ah Sim
- School of AI Convergence, Hallym University, Chuncheon, Republic of Korea
| | - Young Ho Yun
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Family Medicine, Seoul Nation University Hospital, Seoul, Republic of Korea
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20
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Roberts KJ, Smith C, Cluver L, Toska E, Sherr L. Understanding Mental Health in the Context of Adolescent Pregnancy and HIV in Sub-Saharan Africa: A Systematic Review Identifying a Critical Evidence Gap. AIDS Behav 2021; 25:2094-2107. [PMID: 33452658 PMCID: PMC7810185 DOI: 10.1007/s10461-020-03138-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2020] [Indexed: 11/28/2022]
Abstract
Adolescent (10-19 years) mental health remains an overlooked global health issue. Rates of adolescent pregnancy within sub-Saharan Africa are some of the highest in the world and occur at the epicentre of the global HIV epidemic. Both experiencing adolescent pregnancy and living with HIV have been found to be associated with adverse mental health outcomes, when investigated separately. Poor mental health may have implications for both parent and child. The literature regarding mental health within groups experiencing both HIV and adolescent pregnancy is yet to be summarised. This systematic review sought to identify (1) the prevalence/occurrence of common mental disorder amongst adolescents who are living with HIV and have experienced pregnancy, (inclusive of adolescent fathers) in sub-Saharan Africa (2) risk and protective factors for common mental disorder among this group, and (3) interventions (prevention/treatment) for common mental disorder among this group. A systematic search of electronic databases using pre-defined search terms, supplemented by hand-searching, was undertaken in September 2020. One author and an independent researcher completed a title and abstract screening of results from the search. A full-text search of all seemingly relevant manuscripts (both quantitative and qualitative) was undertaken and data extracted using pre-determined criteria. A narrative synthesis of included studies is provided. Quality and risk of bias within included studies was assessed using the Newcastle-Ottawa scale. A systematic keyword search of databases and follow-up hand searching identified 2287 unique records. Of these, thirty-eight full-text quantitative records and seven full-text qualitative records were assessed for eligibility. No qualitative records met the eligibility criteria for inclusion within the review. One quantitative record was identified for inclusion. This study reported on depressive symptomology amongst 14 pregnant adolescents living with HIV in Kenya, identifying a prevalence of 92.9%. This included study did not meet the high methodological quality of this review. No studies were identified reporting on risk and protective factors for common mental disorder, and no studies were found identifying any specific interventions for common mental disorder for this group, either for prevention or for treatment. The limited data identified within this review provides no good quality evidence relating to the prevalence of common mental disorder among adolescents living with HIV who have experienced pregnancy in sub-Saharan Africa. No data was available relating to risk and protective factors or interventions for psychological distress amongst this group. This systematic review identifies a need for rigorous evidence regarding the mental health of pregnant and parenting adolescents living with HIV, and calls for granular interrogation of existing data to further our understanding of the needs of this group. The absence of research on this topic (both quantitative and qualitative) is a critical evidence gap, limiting evidence-based policy and programming responses, as well as regional development opportunities.
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Affiliation(s)
| | - Colette Smith
- Institute for Global Health, University College London, London, UK
| | - Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Elona Toska
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
- Department of Sociology, University of Cape Town, Cape Town, South Africa
| | - Lorraine Sherr
- Institute for Global Health, University College London, London, UK
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21
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Olibamoyo O, Ola B, Coker O, Adewuya A, Onabola A. Trends and patterns of suicidal behaviour in Nigeria: Mixed-methods analysis of media reports from 2016 to 2019. S Afr J Psychiatr 2021; 27:1572. [PMID: 33824754 PMCID: PMC8008030 DOI: 10.4102/sajpsychiatry.v27i0.1572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 01/28/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Media coverage of suicides in Nigeria appears to be explicitly descriptive and deviates from the recommended best practice. Despite these shortcomings, verifiable information provided by these media outlets could arguably, at the minimum, mirror the reality of the trends and patterns of suicidal behaviour in Nigeria. AIM This study aimed to analyse the trends and patterns of suicidal behaviour in Nigeria using media reports from 2016 to 2019. We examined the effect of gender and age groups on these trends and patterns of suicidal behaviour. SETTING The study was carried out in Nigeria. METHODS Qualitative content analysis was used to assess the content of each verifiable suicide event. In total, 336 verified suicide-related events were selected from 4365 media reports. Quantitative data were collected on age, gender, type of suicidal behaviour, method, place and motivation for suicidal behaviour. Data were analysed using the Statistical Package for the Social Sciences software. Fisher's exact test was used to examine the association between gender, age groups and other variables. p-value was set at ≤ 0.05. RESULTS Completed suicide was the most common reported suicidal behaviour. Hanging was the dominant reported method, followed by poisoning. Significant gender differences were observed between age groups (p < 0.001) and methods of suicidal behaviour (p < 0.001). Also, significant age differences were observed between the methods of suicidal behaviour (p < 0.001), places (p < 0.001) and motivations for suicidal behaviour (p < 0.001). CONCLUSION The study confirms that there are gender and age differences in the trends and patterns of suicidal behaviour in Nigeria.
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Affiliation(s)
- Olushola Olibamoyo
- Department of Behavioural Medicine, Faculty of Clinical Sciences, Lagos State University College of Medicine, Lagos, Nigeria
| | - Bolanle Ola
- Department of Behavioural Medicine, Faculty of Clinical Sciences, Lagos State University College of Medicine, Lagos, Nigeria
| | - Olurotimi Coker
- Department of Behavioural Medicine, Faculty of Clinical Sciences, Lagos State University College of Medicine, Lagos, Nigeria
| | - Abiodun Adewuya
- Department of Behavioural Medicine, Faculty of Clinical Sciences, Lagos State University College of Medicine, Lagos, Nigeria
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Stonbraker S, Haight E, Soriano L, Guijosa L, Davison E, Bushley D, Messina L, Halpern M. Establishing content for a digital educational support group for new adolescent mothers in the Dominican Republic: a user-centered design approach. Int J Adolesc Med Health 2020; 34:219-232. [PMID: 32857722 DOI: 10.1515/ijamh-2020-0054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/24/2020] [Indexed: 11/15/2022]
Abstract
Background As digital interventions to improve health become widespread globally, it is critical to include target end-users in their design. This can help ensure interventions are maximally beneficial among intended populations. Objectives To generate the content of a digital educational support group, administered through WhatsApp, for new adolescent mothers and establish participants' cellular access and WhatsApp use. Participants Adolescent mothers with new babies. Methods We completed a two-phase user-centered design process. In phase I design sessions, participants discussed their postpartum experiences and completed an activity to elucidate their health and wellbeing information needs. In phase II sessions, participants individually identified which health information topics were important to them, then all topics were prioritized as a group. Phase II participants also completed a brief survey on cell phone access and WhatsApp use. Results Phase I included 24 participants, 21 of whom completed phase II. Priority health and wellbeing information topics in the postpartum period were identified as: child growth and development, understanding your baby, common childhood illnesses, breastfeeding, childhood nutrition, family planning, and self-care. Of phase II participants, 45% had cellular phone access and none had a data plan. Cellular service was inconsistently obtained with data packages or Wi-Fi. 30% of participants had no experience using WhatsApp. Conclusions Participants identified numerous health information needs, which will serve as the content for our planned digital support group and provides valuable insight for health care providers globally. Less than half of participants had consistent cellular phone access, and none had reliable access to cellular service.
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Affiliation(s)
- Samantha Stonbraker
- Columbia University School of Nursing, New York, NY, USA
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | - Elizabeth Haight
- Planned Parenthood of the Great Northwest and the Hawaiian Islands, Seattle, WA, USA
| | - Leidy Soriano
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | - Linda Guijosa
- Planned Parenthood of the Great Northwest and the Hawaiian Islands, Seattle, WA, USA
| | - Eliza Davison
- Planned Parenthood of the Great Northwest and the Hawaiian Islands, Seattle, WA, USA
| | - Diane Bushley
- Planned Parenthood of the Great Northwest and the Hawaiian Islands, Seattle, WA, USA
| | - Luz Messina
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | - Mina Halpern
- Clínica de Familia La Romana, La Romana, Dominican Republic
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