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Puno A, Kim J, Bhatia A, Jeong J, Kim R. Violence Against Children, Self-Harm, and Suicidal Behaviors: A Pooled and Country-Specific Analysis of Eight Low- and Middle-Income Countries. J Adolesc Health 2024; 75:60-68. [PMID: 38739049 DOI: 10.1016/j.jadohealth.2024.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 02/14/2024] [Accepted: 02/28/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE This study assessed associations between experiences of physical or sexual violence in childhood and self-harm, suicidal ideation, and suicide attempts among young people in low- and middle-income countries (LMICs) and whether these associations varied by sex and perpetrator identity. METHODS We used nationally representative data from the Violence Against Children and Youth Surveys in eight LMICs (2017-2019). The analytic sample included 33,381 young men and women (ages 13-24 years). Multivariable logistic regressions with country-fixed effects were used to estimate the associations between childhood physical and sexual violence and the three outcomes. Stratified analyses were performed by country, participant's sex, and type of perpetrator (parent/caregiver, other adults, peers, and intimate partner). RESULTS About 40% of the participants reported physical childhood violence, and 10% experienced childhood sexual violence. Childhood violence was associated with increased odds of self-harm (physical violence: adjusted odds ratio [aOR]: 2.2, 95% confidence interval [CI]: 2.0-2.4; sexual violence: aOR: 2.7, 95%, CI: 2.3-3.0), suicidal ideation (physical: aOR: 3.0, 95% CI: 2.7-3.3; sexual: aOR: 4.0, 95%, CI: 3.6-4.5), and suicide attempts (physical: aOR: 3.6, 95% CI: 3.2-4.1; sexual: aOR: 4.9, 95%, CI: 4.3-5.7). Consistent findings were observed in country-specific analyses. The odds of all outcomes were highest among those who experienced childhood physical violence by intimate partners and childhood sexual violence by parents or caregivers. Young women who experienced childhood sexual violence had higher odds for all outcomes than young men. DISCUSSION Violence prevention and mental health programs for young people in LMICs should consider the types of violence experienced, the perpetrator, and the sex of the survivor.
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Affiliation(s)
- Abigail Puno
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea; Division of Biological Sciences, University of the Philippines Visayas, Iloilo, Philippines
| | - Jinseo Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Amiya Bhatia
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Joshua Jeong
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Rockli Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea; Division of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea.
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Alliende LM, Strauss GP, Yang LH, Mittal VA. Perceptions of stigma in youth at clinical high risk for psychosis and depressive symptomatology. Schizophr Res 2024; 269:79-85. [PMID: 38754312 PMCID: PMC11249038 DOI: 10.1016/j.schres.2024.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 04/16/2024] [Accepted: 04/27/2024] [Indexed: 05/18/2024]
Abstract
It is unclear what types of stigma youth at clinical high risk for psychosis (CHR) experience, and the relationship between them and symptomatology. 94 CHR youth, and a control group of 45 youth with no psychosis spectrum symptoms (NP) were rated for perceived devaluation (i.e. negative views from others) and internalized mental health stigma (i.e. the extent to which they would agree with said views) as well as positive and mood symptomatology. CHR youth reported stigma more frequently than the NP group (χ2(1) = 53.55, p < .001) and at higher levels (perceived devaluation: t (137) = 8.54, p < .001; internalized stigma: t (137) = 7.48, p < .001). Surprisingly, in the CHR group, positive symptoms held no significant relationship to stigma measures. However, ratings of perceived devaluation stigma were associated with depressive symptomatology (β = 0.27, t = 2.68, p = .0087) and depression scores were conversely associated with perceived devaluation stigma (β = 0.30, t = 2.05, p = .043). These findings speak to the relationship between depressive symptomatology and perceived devaluation stigma in CHR youth. Perceived devaluation stigma showed greater clinical significance and could have different mechanisms than internalized stigma in CHR youth. It is also noteworthy that while positive symptoms play a central role in defining the CHR syndrome, they seem less relevant to the experience of stigma than mood symptoms. These findings highlight the importance of interventions aimed at ameliorating youth's exposure to negative views about mental health as those managing depressive symptomatology.
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Affiliation(s)
| | | | - Lawrence H Yang
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, USA
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Van Bortel T, Wickramasinghe ND, Treacy S, Khan N, Ouali U, Sumathipala A, Svab V, Nader D, Kadri N, Monteiro MF, Knifton L, Quinn N, Van Audenhove C, Lasalvia A, Bonetto C, Thornicroft G, van Weeghel J, Brouwers E. Anticipated and experienced stigma and discrimination in the workplace among individuals with major depressive disorder in 35 countries: qualitative framework analysis of a mixed-method cross-sectional study. BMJ Open 2024; 14:e077528. [PMID: 38904137 PMCID: PMC11191817 DOI: 10.1136/bmjopen-2023-077528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 06/05/2024] [Indexed: 06/22/2024] Open
Abstract
OBJECTIVES Workplace stigmatisation and discrimination are significant barriers to accessing employment opportunities, reintegration and promotion in the workforce for people with mental illnesses in comparison to other disabilities. This paper presents qualitative evidence of anticipated and experienced workplace stigma and discrimination among individuals with major depressive disorder (MDD) in 35 countries, and how these experiences differ across countries based on their Human Development Index (HDI) level. DESIGN Mixed-method cross-sectional survey. PARTICIPANTS, SETTING AND MEASURES The qualitative data were gathered as part of the combined European Union Anti-Stigma Programme European Network and global International Study of Discrimination and Stigma Outcomes for Depression studies examining stigma and discrimination among individuals with MDD across 35 countries. Anticipated and experienced stigma and discrimination were assessed using the Discrimination and Stigma Scale version 12 (DISC-12). This study used responses to the open-ended DISC-12 questions related to employment. Data were analysed using the framework analysis method. RESULTS The framework analysis of qualitative data of 141 participants identified 6 key 'frames' exploring (1) participants reported experiences of workplace stigma and discrimination; (2) impact of experienced workplace stigma and discrimination; (3) anticipated workplace stigma and discrimination; (4) ways of coping; (5) positive work experiences and (6) contextualisation of workplace stigma and discrimination. In general, participants from very high HDI countries reported higher levels of anticipated and experienced discrimination than other HDI groups (eg, less understanding and support, being more avoided/shunned, stopping themselves from looking for work because of expectation and fear of discrimination). Furthermore, participants from medium/low HDI countries were more likely to report positive workplace experiences. CONCLUSIONS This study makes a significant contribution towards workplace stigma and discrimination among individuals with MDD, still an under-researched mental health diagnosis. These findings illuminate important relationships that may exist between countries/contexts and stigma and discrimination, identifying that individuals from very high HDI countries were more likely to report anticipated and experienced workplace discrimination.
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Affiliation(s)
- Tine Van Bortel
- Leicester School of Allied Health Sciences, De Montfort University, Leicester, UK
- Cambridge Public Health, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Nuwan Darshana Wickramasinghe
- Department of Community Medicine, Rajarata University of Sri Lanka Faculty of Medicine and Allied Sciences, Saliyapura, Sri Lanka
| | | | - Nashi Khan
- Rashid Latif Khan University, Lahore, Pakistan
| | - Uta Ouali
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Athula Sumathipala
- Research Institute for Primary Care & Health Sciences, School of Medicine, Keele University, Keele, UK
- Institute for Global Health, Faculty of Health, Keele University, Staffordshire, UK
| | - Vesna Svab
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Doaa Nader
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nadia Kadri
- Psychiatric Center, Ibn Rushd University, Casablanca, Morocco
| | | | | | | | | | - Antonio Lasalvia
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Chiara Bonetto
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Graham Thornicroft
- Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jaap van Weeghel
- Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
- Phrenos Centre of Expertise, Utrecht, Netherlands
| | - Evelien Brouwers
- Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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Chen X, Wang S, Liao X, Li Y, Leung SF, Bressington DT. Interventions to decrease health students' stigma toward schizophrenia: A scoping review. Int J Nurs Stud 2024; 158:104837. [PMID: 38936243 DOI: 10.1016/j.ijnurstu.2024.104837] [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: 12/05/2023] [Revised: 05/27/2024] [Accepted: 05/30/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Schizophrenia is heavily stigmatized among health professionals. Given that health professional students are future members of the workforce and will provide care for people with schizophrenia, it is essential to implement interventions aimed at reducing stigma among this group. OBJECTIVE This scoping review aimed to identify and synthesize existing literature on interventions to decrease schizophrenia stigma among health professional students, and to determine the possible gaps in the literature. DESIGN Nine electronic databases and gray literature were searched, including PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature, PsycINFO, MEDLINE, Web of Science, Scopus, China National Knowledge Infrastructure, WanFang, and Google on 5 May 2023. Two researchers independently conducted data screening, data extraction, and assessed study risks. A most updated search was also done on 22 May 2024. The Cochrane risk of bias tool version 2 for randomized trials and Risk of Bias in Non-randomized Studies were used to assess the studies' risk of bias. Data synthesis and analysis were conducted by two reviewers using a narrative approach. Reporting adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. RESULTS This review included twenty-one studies with 2520 health professional students. The majority of included studies were non-randomized controlled trials (38 %) and pre-post studies (52 %). Most of the included studies were conducted in the United States (24 %). The participants in ten (48 %) studies were medical students. The number of intervention sessions ranged from one to 13, with an average of three. Seven (33 %) studies had an intervention duration of less than four weeks and 16 (76 %) studies had no follow-up. Various scales were used to assess the outcomes of schizophrenia stigma. Only two studies (10 %) indicated the intervention's ineffectiveness, with the majority of interventions led by psychiatry department faculty and individuals with schizophrenia. CONCLUSIONS Most studies (90 %) utilized various approaches, including face-to-face or online education, direct contact with individuals with schizophrenia, or a combination thereof, to diminish stigma among health professional students. However, none addressed cultural and empathy factors in their intervention designs, and the included studies lacked theoretical guidance. The review only comprised English quantitative studies with significant heterogeneity, with 17 studies (81 %) displaying serious or high risk of bias, limiting comprehensive discussions. These findings offer valuable insights for future systematic review. Tweetable abstract Studies on reducing health professional students' schizophrenia stigma need to address cultural and empathy factors.
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Affiliation(s)
- Xi Chen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Shanshan Wang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xiaoli Liao
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yan Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Sau Fong Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Daniel Thomas Bressington
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; Faculty of Health, Charles Darwin University, Casuarina, NT 0810, Australia
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Shokrgozar S, Abdollahi E, Abedrad M, Asadi P, Rouzbehan V, Nazari Z, Zare R. Investigating gender differences in quality of life and social support in patients with severe mental illnesses. Int J Soc Psychiatry 2024; 70:750-762. [PMID: 38439517 DOI: 10.1177/00207640241227366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
BACKGROUND Severe mental illnesses (SMIs), including schizophrenia and bipolar disorder affect patients significantly. Gender has been identified as a key factor influencing the experience of SMIs with notable disparities in prevalence, symptoms, and treatment outcomes. Additionally, the quality of life (QoL) and social support for patients with SMIs can vary based on gender. AIMS This study examined gender differences in QoL and social support of patients with SMIs. METHOD Participants include 170 outpatients with schizophrenia and bipolar disorder at Shafa Hospital (2021). QoL and social support were assessed using World Health Organization QoL (WHOQOL-BREF) questionnaire and Medical Outcomes Study Social Support Survey (MOS-SSS), respectively. Group differences were analyzed using t-test or Mann-Whitney U test, and two-way multivariate analyses of variance explored the effect of gender and disease type. RESULTS It was indicated that females with schizophrenia reported higher QoL than males, but the opposite was observed for bipolar disorder. Gender differences in social support were not significant among schizophrenia patients, nor between the two patient groups. However, women with bipolar disorder and multiple hospitalizations experienced lower social support and QoL compared to men. Additionally, more hospitalizations were associated with decreased QoL in both genders with schizophrenia. CONCLUSIONS Findings suggest the need for gender- specific interventions and support policies to enhance QoL and social support in patients with SMI.
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Affiliation(s)
- Somayeh Shokrgozar
- Department of Psychiatry, Kavosh Behavioral, Cognitive and Addiction Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Elahe Abdollahi
- Department of Psychiatry, Kavosh Behavioral, Cognitive and Addiction Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Morvarid Abedrad
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Parham Asadi
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Vida Rouzbehan
- Department of Psychiatry, Kavosh Behavioral, Cognitive and Addiction Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Nazari
- Department of Psychology, Lahijan Branch, Islamic Azad University, Iran
| | - Roghayeh Zare
- Neuroscience Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Joseph AP, Babu A, Prakash LTO. The forgotten half: addressing the psychological challenges of wives of individuals with alcohol use disorder (AUD) in low- and middle-income countries. Front Psychiatry 2024; 15:1377394. [PMID: 38571999 PMCID: PMC10988612 DOI: 10.3389/fpsyt.2024.1377394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/05/2024] [Indexed: 04/05/2024] Open
Affiliation(s)
- Akhil P. Joseph
- Department of Sociology & Social Work, Christ (Deemed to be University), Bangalore, Karnataka, India
- School of Social Work, Marian College Kuttikkanam Autonomous, Kuttikkanam, Kerala, India
| | - Anithamol Babu
- School of Social Work, Marian College Kuttikkanam Autonomous, Kuttikkanam, Kerala, India
- School of Social Work, Tata Institute of Social Sciences Guwahati Off-Campus Jalukbari, Assam, India
| | - LT Om Prakash
- Department of Sociology & Social Work, Christ (Deemed to be University), Bangalore, Karnataka, India
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Al Shamari BK, O’Hara L. "I am not the same as before": a mixed-methods study on depression in people with spinal injury in Qatar. Front Psychiatry 2024; 15:1288772. [PMID: 38455515 PMCID: PMC10918847 DOI: 10.3389/fpsyt.2024.1288772] [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: 09/04/2023] [Accepted: 02/01/2024] [Indexed: 03/09/2024] Open
Abstract
Incidence of spinal injury is high in the Middle East and North African region (MENA) due to the high incidence of road traffic crashes. A spinal injury may trigger mental health issues. Compared to the general population, people with spinal injury are at higher risk for developing major depression, anxiety, post-traumatic stress disorders, substance abuse, and suicide. Objectives The objectives of the study were to determine depression prevalence; identify relationships between depression and cause and site of spinal injury, sociodemographic factors, and social support; and explore the lived experiences of depression in people with spinal injury in Qatar. Methods A sequential cross-sectional mixed methods study was conducted. In the quantitative component, the universal sample consisted of 106 consenting individuals presenting with spinal injury at Hamad General Hospital, Doha, Qatar between January and December 2020. The Patient Health Questionnaire-9 was used to assess levels of depression and the Medical Outcomes Study Social Support Survey was used to assess perceived social support. The cause and site of injury were obtained from patient records. In the qualitative component, semi-structured in-depth interviews were conducted with 12 purposively selected participants from the quantitative component. Results Spinal injury had a negative impact on participants physical, mental, social, and spiritual wellbeing. In total, 69% of participants had some level of depression: 28% mild, 25.5% minimal, and 15% moderate to severe. Depression was not associated with socio-demographic factors, or the cause or site of spinal injury. Higher levels of emotional/informational support and positive social interaction were associated with milder depression. Social support and religious faith were critical in assisting participants to cope with their new situation. Conclusions Depression is prevalent among people with spinal injury attending health services. Early detection, referral, and treatment of depression are recommended. Strategies to enhance emotional/informational support and positive social interaction should be developed and tested with people with spinal injury.
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Affiliation(s)
| | - Lily O’Hara
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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Thornicroft G, Sunkel C, Milenova M. How to stop stigma: implementing The Lancet Commission on ending stigma and discrimination in mental health. Lancet Psychiatry 2024; 11:88-89. [PMID: 38008101 DOI: 10.1016/s2215-0366(23)00374-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/03/2023] [Accepted: 11/03/2023] [Indexed: 11/28/2023]
Affiliation(s)
- Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
| | | | - Maria Milenova
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
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