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Strategies to improve access to mental health and psychosocial support among displaced populations in Ethiopia 改善埃塞俄比亚流离失所人口获得心理健康和社会心理支持的战略
IF 0.4 Q4 PSYCHIATRY Pub Date : 2023-06-19 DOI: 10.2174/2666082219666230619143922
M. Greene, T. Firew, Mara Getz, Eleanor Streicker, P. Thind, Eri Tayama, Kinfu Manzura Lafto, Noah Wubishet Ayele, Tinsae Abera Worku, Ryan Carson, Cécile Fanton d'Andon, T. Yilma, M. Wainberg, Yaregal Fufa
In 2021, more than 23 million people were in need of humanitarian assistance in Ethiopia, including four million internally displaced persons and returnees. Displaced populations face an elevated risk of mental health and psychosocial problems, yet they often have limited access to mental health and psychosocial support.This study aimed to assess: 1) the mental health and psychosocial needs and resources among displaced persons in Ethiopia; and 2) examine barriers, and facilitators, and identify strategies to improve access to culturally appropriate mental health and psychosocial support in this population and context.We conducted a sequential mixed-methods assessment of mental health and psychosocial needs and resources. First, we conducted 16 key informant interviews with those who had experience and knowledge regarding the mental health situation of displaced persons in Ethiopia, including mental health providers and humanitarian practitioners. Second, we conducted an assessment of available mental health services in 15 internally displaced persons (IDP) sites in Ethiopia along with 28 key informant interviews in this context to explore some of the challenges and strategies to improving access to mental health and psychosocial support.Access to mental health services was limited in IDP sites. Participants identified numerous barriers to accessing services that ranged from limited supply and fragmentation of existing mental health services to an incongruence between formal mental health services and explanatory models of mental illness. Strategies to address these barriers included engagement of community members and key stakeholders (e.g., traditional and religious healers), improving mental health literacy, strengthening referral systems and mental health capacity, and improving coordination and integration of mental health within the national health system.This study highlights several challenges and opportunities for improving access to mental health and psychosocial support among displaced persons in Ethiopia. Efforts to bridge gaps in access to mental health and psychosocial support must consider both systems-level factors that influence availability as well as community factors influencing perceptions and acceptability of services within this context.
2021年,埃塞俄比亚有2300多万人需要人道主义援助,其中包括400万国内流离失所者和返回者。流离失所者面临心理健康和社会心理问题的高风险,但他们获得心理健康和社会心理支持的机会往往有限。本研究旨在评估:1)埃塞俄比亚流离失所者的心理健康和社会心理需求和资源;2)检查障碍和促进因素,并确定战略,以改善在这一人群和环境中获得文化上适当的精神卫生和社会心理支持的机会。我们对心理健康和社会心理需求及资源进行了连续的混合方法评估。首先,我们与那些对埃塞俄比亚境内流离失所者的心理健康状况有经验和知识的人(包括心理健康提供者和人道主义从业人员)进行了16次关键举报人访谈。其次,我们对埃塞俄比亚15个境内流离失所者营地的现有心理健康服务进行了评估,并在此背景下对28个关键信息提供者进行了访谈,以探讨改善获得心理健康和社会心理支持的一些挑战和战略。国内流离失所者营地获得精神卫生服务的机会有限。与会者确定了获得服务的许多障碍,从现有精神卫生服务的供应有限和分散,到正式精神卫生服务与精神疾病解释模式之间的不一致。解决这些障碍的战略包括社区成员和主要利益攸关方(例如传统和宗教治疗师)的参与,提高精神卫生素养,加强转诊系统和精神卫生能力,以及改善国家卫生系统内精神卫生的协调和整合。这项研究强调了在改善埃塞俄比亚流离失所者获得心理健康和社会心理支持方面的若干挑战和机遇。在获得精神卫生和社会心理支持方面弥合差距的努力必须考虑影响可获得性的系统级因素以及影响在这方面对服务的看法和可接受性的社区因素。
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引用次数: 0
Heart failure and depression: A revisited review 心力衰竭和抑郁:重新回顾
IF 0.4 Q4 PSYCHIATRY Pub Date : 2023-06-09 DOI: 10.2174/2666082219666230609143447
A. Almaghraby, N. Leelaviwat, Ehab Ismael Dosouky, Mohamed Elsayed, Shadi Ahmed, M. Abdelnabi
In this revisited review, the authors aimed to discuss the general prevalence and burden of depression in patients diagnosed with heart failure. The postulated mechanisms of depression in patients with heart failure, the diagnostic approaches, methods as well as treatment options were all discussed. The safety of depression medications in heart failure patients was also discussed. Through the review of the updated literature and current guidelines, the authors concluded that a team approach is the best way to manage those types of patients.
在这篇回顾性综述中,作者旨在讨论被诊断为心力衰竭患者的抑郁症的普遍患病率和负担。对心力衰竭患者抑郁的假定机制、诊断方法、方法以及治疗方案进行了讨论。还讨论了心力衰竭患者服用抑郁症药物的安全性。通过对最新文献和当前指南的回顾,作者得出结论,团队方法是管理这些类型患者的最佳方式。
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引用次数: 0
The Winding Path of Depression in Argentina from Awareness to Functional Recovery 阿根廷抑郁症从意识到功能恢复的曲折之路
Q4 PSYCHIATRY Pub Date : 2023-05-19 DOI: 10.2174/2666082219666230519102418
Sergio Rojtenbrg, Daniel Mosca, Maria Fernanda Verdaguer, Monica Martinez, Paola M. Elorza
Background: Despite the huge global socioeconomic burden of depressive disorders, depression is often underreported and undertreated due to a lower level of awareness from both healthcare providers and payers in many countries. The lack of an evidence-based approach to care delivery has resulted in the inequitable allocation of health resources, causing resource scarcity issues in Argentina. Objective: The aim of this paper is to identify the gaps in evidence related to patients’ journeys and barriers in the existing care ecosystem contributing to poor access to quality care for depression in an Argentine context. Methods: A semi-systematic review of the literature was performed from 2012 to 2021 using Medline, Embase and Biosis and other unstructured sources (Google Scholar, the World Health Organization (WHO) website, Argentina Ministry of Health website, and Incidence and Prevalence Database (IPD) on awareness, screening, diagnosis, treatment, adherence and/or control of depression amongst adults (≥18 years). Any identified data gaps were supplemented with anecdotal data from local experts. Results: Low percentages of adult patients with depression awareness (<25%), screening (<10%), diagnosis (37.5%), received treatment (41.9%), adherence to treatment (37.5%), and control (37.5%) were observed. Conclusion: Ensuring a care continuum while considering full clinical remission with functional recovery as a therapeutic goal and advocacy for patient-centric adjustments in existing mental health policies would be key drivers for improving the depression care scenario.
背景:尽管抑郁症带来了巨大的全球社会经济负担,但由于许多国家的医疗保健提供者和支付者对抑郁症的认识水平较低,抑郁症往往被低估和治疗不足。由于缺乏以证据为基础的护理方法,导致卫生资源分配不公平,在阿根廷造成资源短缺问题。目的:本文的目的是确定在阿根廷的背景下,现有护理生态系统中与患者的旅程和障碍相关的证据差距,导致难以获得高质量的抑郁症护理。方法:使用Medline、Embase和Biosis以及其他非结构化来源(Google Scholar、世界卫生组织(WHO)网站、阿根廷卫生部网站和发病率和患病率数据库(IPD)对2012年至2021年的文献进行半系统综述,内容涉及成人(≥18岁)抑郁症的认知、筛查、诊断、治疗、依从性和/或控制。任何确定的数据缺口都用当地专家的轶事数据加以补充。结果:成年患者抑郁知知率(25%)、筛查率(10%)、诊断率(37.5%)、接受治疗率(41.9%)、坚持治疗率(37.5%)和对照组(37.5%)均较低。结论:在将临床完全缓解和功能恢复作为治疗目标的同时,确保护理的连续性,并在现有的心理健康政策中倡导以患者为中心的调整,将是改善抑郁症护理方案的关键驱动因素。
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引用次数: 0
Depression and Its Impact on Various Aspects of Life – A Narrative Review 抑郁症及其对生活各方面的影响——叙述性回顾
IF 0.4 Q4 PSYCHIATRY Pub Date : 2023-05-18 DOI: 10.2174/2666082219666230518105004
R. Balatif, Alshafiera Azayyana Mawadhani Sukma
Depression is a mental disorder that affects 279 million people. Patients with depression will not only have an impact on themselves but can also have an impact on others.Provide an overview of the impact of depression on health workers, workers, students and patients, as well as the prevention of depression.Data on the impact of depression and its prevention using the Google Scholar and Pubmed search engine.Depression in healthcare workers can affect the occurrence of misdiagnosis of a patient's disease, reduce the quality of service, and increase the risk of suicide. Depression in other workers can result in lost productivity and income, absenteeism, presenteeism, and accidents in the workplace. Depression in students causes decreased student achievement, difficulties concentrating and social interactions, and absenteeism. In patients with physical illness, depression can increase the risk of mortality, re-hospitalization, higher costs, poor treatment adherence, and lost follow-up. Depression prevention can help lower the risk of depression by up to 21%. This prevention must be done as early as possible and starts from the scope of prevention at the family level. Then this prevention can be done individually, especially for those with a high risk of experiencing depression. The last prevention is universal prevention (population) which can be started by educating the communityDepression can happen to anyone and will have a detrimental impact on themselves and others. Prevention of depression should be done as early as possible to prevent the impacts of depression.
抑郁症是一种精神障碍,影响着2.79亿人。抑郁症患者不仅会对自己产生影响,也会对他人产生影响。概述抑郁症对卫生工作者、工人、学生和病人的影响,以及抑郁症的预防。使用b谷歌Scholar和Pubmed搜索引擎的抑郁症影响和预防数据。医护人员的抑郁症会影响患者疾病的误诊,降低服务质量,并增加自杀的风险。其他员工的抑郁症可能导致生产力和收入下降、缺勤、出勤和工作场所事故。学生抑郁会导致学生成绩下降、注意力不集中、社会交往困难以及缺勤。对于有身体疾病的患者,抑郁症会增加死亡率、再次住院、更高的费用、治疗依从性差和失去随访的风险。预防抑郁症可以将患抑郁症的风险降低21%。这种预防必须尽早进行,并从家庭一级的预防范围开始。然后,这种预防可以单独进行,特别是对于那些患抑郁症的高风险人群。最后一种预防是普遍预防(人群),可以从教育社区开始。抑郁症可能发生在任何人身上,并将对自己和他人产生有害影响。预防抑郁症应尽早做好,防止抑郁症的影响。
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引用次数: 0
Internalized Stigma and Quality of Life in Patients With Alcohol Use Disorder: A Cross-Sectional Study From Gujarat, India 酒精使用障碍患者的内化耻辱和生活质量:来自印度古吉拉特邦的横断面研究
IF 0.4 Q4 PSYCHIATRY Pub Date : 2023-05-17 DOI: 10.2174/2666082219666230517141308
Saumitra Nemlekar, Urvika Parekh, Rakesh Gandhi, Dhruv Bardolia
Substance use disorders (SUDs) contribute to one-fifth of all disability-adjusted life years caused by psychiatric illnesses. They have a high treatment gap. Stigma affects the lives of people with SUDs and is shown to impede the pursuit of valued life goals and recovery from addiction. We studied stigma and QOL in patients with Alcohol Use disorders (AUD).Participants between 18 and 65 years with a clinical diagnosis of AUD were included (inpatients and outpatients). Demographic and clinical data were recorded using a semi-structured questionnaire. ISMIS & WHOQOL-Bref questionnaires were used to assess internalized stigma and quality of life.Of the 141 participants, 89(63.10%) patients had severe self-stigma, 31(22.10%) patients had moderate self-stigma, and 21(14.90) patients had mild self-stigma. In ISMIS, stigma due to alienation (3.22) was higher than social withdrawal, discrimination, stereotype, and stigma resistance. In the WHOQOL-Bref questionnaire, the mean score of social domain (9.45) was the lowest compared to the other domains of the quality of life scale. A significant association was found between the education and the duration of substance use with ISMI grades with people with up to 10th standard education (p-value - 0.002*), living in urban areas (p-value - 0.022*), and ten or more years of substance use (p-value - 0.00002).The various domains of quality of life generally negatively correlated with the internalized stigma score, suggesting that a greater degree of self-stigma is associated with poorer quality of life.
物质使用障碍(SUDs)占精神疾病引起的所有残疾调整生命年的五分之一。他们的待遇差距很大。耻辱感影响了sud患者的生活,并阻碍了对有价值的生活目标的追求和从成瘾中恢复。我们研究了酒精使用障碍(AUD)患者的耻辱感和生活质量。参与者年龄在18 - 65岁之间,临床诊断为AUD(住院患者和门诊患者)。使用半结构化问卷记录人口统计和临床数据。使用ISMIS和whoqol - brief问卷评估内化污名和生活质量。141例患者中,重度自我耻感89例(63.10%),中度自我耻感31例(22.10%),轻度自我耻感21例(14.90)。在ISMIS中,因疏离而产生的耻辱感(3.22)高于社会退缩、歧视、刻板印象和耻辱感抵抗。在whoqol - brief问卷中,社会领域的平均得分(9.45分)是生活质量量表其他领域中最低的。受教育程度和物质使用持续时间与ISMI等级之间存在显著关联,与受教育程度高达10级的人(p值- 0.002*)、居住在城市地区的人(p值- 0.022*)和10年或更长时间的物质使用(p值- 0.00002)有关。生活质量的各个领域通常与内化污名得分呈负相关,这表明更大程度的自我污名与更差的生活质量有关。
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引用次数: 0
Assessment of Patients' Referral Patterns with Complains of Self-harm and Aggression in the COVID-19 Era 新冠肺炎时代自残、攻击患者转诊模式评估
IF 0.4 Q4 PSYCHIATRY Pub Date : 2023-05-16 DOI: 10.2174/2666082219666230516155749
M. Bahreini, Amirmasoud Kazemzadeh Houjaghan, Pantea Arya, Sepide Aarabi, H. Ashraf
Due to the high transmission rate of COVID-19, the high prevalence of the disease, the high mortality rate, and its effects on mental health, we aimed to assess the current status of psychiatric symptoms.In this observational study, we have assessed various psychiatric presentations and disorders before and after the COVID-19 pandemic within the same time limit. Data have been obtained from the psychiatric interview performed by an attending physician in psychiatry.The following features have been observed after the pandemic: increased depressed mood, irritability, crime trend, physical violations, personality disorders along with improved family support, and decreased suicidal ideation. No significant difference has been observed in the rate of response to psychotherapy and psychiatric medications before and after the time of the pandemic.Increased physical threat and aggression, substance use, and symptoms of psychosis were more frequently observed in the time of the pandemic. The physical threat was mainly committed by younger patients with psychiatric illnesses.
鉴于COVID-19的高传播率、高患病率、高死亡率及其对心理健康的影响,我们旨在评估精神症状的现状。在这项观察性研究中,我们在同一时间限制内评估了COVID-19大流行前后的各种精神症状和疾病。数据是从精神病学主治医师进行的精神病学访谈中获得的。大流行后观察到以下特点:情绪低落、易怒、犯罪倾向、身体侵犯、人格障碍增加,同时家庭支持得到改善,自杀意念减少。在大流行前后,对心理治疗和精神病药物的反应率没有观察到显著差异。在大流行期间,更经常观察到身体威胁和攻击、药物使用和精神病症状的增加。身体威胁主要由年轻的精神疾病患者实施。
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引用次数: 0
A few methodological points in candidate gene associations studies in psychiatry with a case study 精神病学候选基因关联研究的几个方法学要点与案例研究
IF 0.4 Q4 PSYCHIATRY Pub Date : 2023-04-18 DOI: 10.2174/2666082219666230418112434
V. Trkulja
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引用次数: 0
Auto-aggressive Behavior as a Medical and Social Problem of OurTime: Definitions, Concepts, and Retrospective of Research byRussian Authors, Narrative Review 自攻击行为作为我们时代的医学和社会问题:定义、概念和俄罗斯作者研究回顾,叙事评论
IF 0.4 Q4 PSYCHIATRY Pub Date : 2023-04-18 DOI: 10.2174/2666082219666230418090309
E. Darin
The study of autoaggression is one of the main areas of research workin psychiatry, suicidology, and psychology. Suicidal behavior remains one of the most dangerous forms of autoaggressive behavior. In recent years, both in Russia, and around the world,there has been an increased interest in the problem of non-suicidal injuries.This review aims to analyze, summarize, and present definitions of autoaggression,suicidal behavior, and self-harm that are relevant among Russian authors, as well as presentlong-term results of dissertation research by Russian authors on this topic.A non-systematic narrative review is presented. In the first section, a search wasmade for Russian-language, and English-language sources in the databases: ELibrary.ru, PubMed, and the “google scholar” search system. Articles were searched by keywords: SelfInjurious Behavior Suicide Suicidal Ideation Suicide, Attempted, autoaggression, self-harm,and adolescents. In the second section, a search and analysis of dissertation research by Russian authors from 2000 to 2020 are carried out using the database of the Russian State Library.On this topic, a total of 86 papers were found, of which 66 theses directly study these issues, 8theses have information on this topic in the results and conclusions, and 12 theses were excluded from the results as not relevant. The story is arranged in chronological order from oldest tonewest. Abstracts of dissertations are used for citation.The behavior of an autoaggressive nature, self-injurious behavior, and non-suicidalself-harm is currently a phenomenon that is widespread among adolescents. Currently, NSSI isan urgent problem of mental health among adolescents.
对自体攻击的研究是精神病学、自杀学和心理学的主要研究领域之一。自杀行为仍然是最危险的自我攻击行为之一。近年来,无论是在俄罗斯,还是在世界各地,人们对非自杀性伤害的问题越来越感兴趣。这篇综述的目的是分析、总结和介绍与俄罗斯作者有关的自我攻击、自杀行为和自我伤害的定义,以及俄罗斯作者在这一主题上的论文研究的长期结果。本文提出了一种非系统的叙述回顾。在第一部分中,对数据库中的俄语和英语资源进行了搜索:ELibrary.ru、PubMed和“谷歌scholar”搜索系统。文章按关键词搜索:自残行为自杀自杀意念自杀未遂自我攻击自我伤害青少年。第二部分利用俄罗斯国家图书馆数据库对2000年至2020年俄罗斯作者的论文研究进行了检索和分析。关于这个课题,共发现86篇论文,其中66篇论文直接研究了这些问题,8篇论文在结果和结论中有关于这个课题的信息,12篇论文因不相关而被排除在结果之外。这个故事是按时间顺序排列的,从最古老的到最新的。论文摘要用于引证。自我攻击行为、自残行为和非自杀性自残行为是目前青少年中普遍存在的一种现象。目前,自伤是青少年心理健康的一个亟待解决的问题。
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引用次数: 0
Havana Syndrome: A Mysterious Illness or a New Domain of Warfare 哈瓦那综合症:一种神秘的疾病还是一个新的战争领域
IF 0.4 Q4 PSYCHIATRY Pub Date : 2023-03-20 DOI: 10.2174/2666082219666230320153841
Soumitra Nath
Havana syndrome cases increased in Cuba at the end of 2016 and early 2017, and the consequences ranged from minor to severe health concerns. In almost all affected individuals, symptoms like difficulty-concentrating, visual issues, brain-fog, memory problems, tinnitus, and sleep-related complaints were reported. Some initial studies pointed the causative possibility towards energy weapons, ultrasound, microwaves, microbes and chemicals. However, to date, no study has provided a comprehensive explanation of this sudden mysterious syndrome, and the root cause remains unexplained.
2016年底和2017年初,古巴的哈瓦那综合征病例有所增加,其后果从轻微到严重不等。几乎所有受影响的人都报告了注意力难以集中、视觉问题、脑雾、记忆问题、耳鸣和睡眠相关主诉等症状。一些初步研究指出了能源武器、超声波、微波、微生物和化学品的致病可能性。然而,到目前为止,还没有任何研究对这种突然出现的神秘综合征提供全面的解释,其根本原因仍然无法解释。
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引用次数: 0
CRISPR/Cas9 Technology for Non-Coding Gene Editing in Schizophrenia Therapeutics: The Recent Progress And Challenges CRISPR/Cas9非编码基因编辑技术在精神分裂症治疗中的应用:最新进展和挑战
IF 0.4 Q4 PSYCHIATRY Pub Date : 2023-03-20 DOI: 10.2174/2666082219666230320151355
Chakresh Kumar Jain, Khushi R. Mittal, Nandini Jain, Swati Mittal
Within a decade the Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR/Cas9 system), an advanced gene-editing technology became one of the celebrated approaches in modern disease therapeutics and was reported to have a potential role in the alteration of non-coding RNAs segment which are the pivotal causes behind the several mental disorder such as Schizophrenia. In general, Schizophrenia is referred as a neurodevelopmental disorder and symptomatically exhibited by social deficit, cognitive dysfunction, apathy, delusions, hallucinations, etc. At a genomics level large number of loci are susceptible for genetic alteration in schizophrenia and are mostly located in the genome’s non-coding region. With the growing variants and mutations in ncRNA genes (miRNA and lncRNA) strongly associated with schizophrenia, the need to develop a genetic tool to help with the treatment and study of schizophrenia increases. Recently the use of CRISPR/cas9 technology in the productive alteration of non-coding RNAs genes such as miRNA; miR-291, miR-141, and miR-21, lncRNA, lncRNA-21A, AK023948, and LncRNA Rian has been reported. The Cas9 protein and guide RNA (gRNA) together form the CRISPR/Cas9 system is known to be highly specific and efficient for manipulating the impact of gene mutations linked to genomic DNA like ncRNA besides other inheritable genetic diseases. Copy number variations are also found to be linked with schizophrenia. The generation of reciprocal CNVs of 15q13.3 and 16p11.2 in human-induced pluripotent stem cells (iPSCs) with the CRISPR/Cas 9 system has opened new possibilities. Still, there are some limitations and challenges yet to be defeated, like the blood-brain barrier poses an obstacle to treating mental disorders and ethical issues like genomic DNA manipulation of eggs and embryos. This review brings schizophrenia-associated ncRNAs and CRISPR gene-editing technology for the non-coding parts of the genomic DNA together and recent challenges.
在十年内,聚集性规则间隔短回文重复序列(CRISPR/Cas9系统),一种先进的基因编辑技术,成为现代疾病治疗中著名的方法之一,据报道,它在非编码RNA片段的改变中具有潜在作用,而非编码RNA是精神分裂症等几种精神障碍背后的关键原因。一般来说,精神分裂症是一种神经发育障碍,其症状表现为社交缺陷、认知功能障碍、冷漠、妄想、幻觉等。在基因组学水平上,大量基因座易受精神分裂症基因改变的影响,并且大多位于基因组的非编码区。随着与精神分裂症密切相关的ncRNA基因(miRNA和lncRNA)的变异和突变不断增加,开发一种基因工具来帮助精神分裂症的治疗和研究的必要性增加。最近,CRISPR/cas9技术在非编码RNA基因如miRNA的生产性改变中的应用;已经报道了miR-291、miR-141和miR-21、lncRNA、lncRNA-21A、AK023948和lncRNA-Rian。众所周知,Cas9蛋白和引导RNA(gRNA)一起形成CRISPR/Cas9系统具有高度特异性,能够有效地控制与ncRNA等基因组DNA相关的基因突变以及其他可遗传遗传疾病的影响。拷贝数变异也被发现与精神分裂症有关。利用CRISPR/Cas 9系统在人类诱导多能干细胞(iPSC)中产生15q13.3和16p11.2的相互CNV开辟了新的可能性。尽管如此,仍有一些局限性和挑战有待克服,比如血脑屏障对治疗精神障碍和伦理问题构成了障碍,比如卵子和胚胎的基因组DNA操作。这篇综述将精神分裂症相关的ncRNA和用于基因组DNA非编码部分的CRISPR基因编辑技术结合在一起,以及最近的挑战。
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引用次数: 0
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Current Psychiatry Research and Reviews
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