Global Mental Health最新文献

Empathy plays a crucial role in psychosocial and psychological interventions, greatly impacting rapport building, patient adherence, and satisfaction with treatment. Empathetic interactions enhance patient's self-reflection and the delivery of more personalized therapeutic interventions tailored to the unique needs of each patient, thereby improving the overall quality of care. Despite empathy being central to psychosocial interventions, there are currently no valid and reliable patient-centered tools that assess the lay-therapist empathy that they show and/or exhibit toward their patients. In this study, the patient-rated Empathy Scale for Lay Therapists was developed to assess empathy in community health workers delivering psychosocial interventions. Psychometric validation was based on a cross-sectional study embedded in a non-inferiority cluster randomized trial of the Thinking Healthy Programme for perinatal depression in Pakistan. Community testing with perinatal women confirmed the scale's understandability and logical structure, highlighting its face validity. Among the 980 trial participants, a high level of agreement with the Empathy Scale for Lay Therapists (mean score 2.616) was observed, indicating effective communication and empathy from health workers. The scale demonstrated excellent internal consistency (Cronbach's alpha 0.96). Exploratory Factor Analysis revealed a unidimensional structure, capturing 87.81% of the total variance, with strong factor loadings.

Increasing mental health issues in India demands for a strong intervention to curb the rise. According to the World Health Organization, roughly around 21 Indians out of 100,000 die by suicide every year. The burden on mental health domain increases due to the existing system as most of the existing services follow a traditional approach and are most sought after but lack reachability and ease of access. This study recognises the need for programmes that help in reachability and ease of access while simultaneously maintaining anonymity, therefore, analyses the impact of chat-based therapy provided online through the platform. The paper analyses the difference in subjective unit of well-being (SUW) pre and post chat-based sessions among 2624 college students and 805 corporate employees. The Wilcoxon signed rank test between pre and post intervention indicates significant results with the p < 0.001 (Z = -44.100a) suggesting and increase in SUW scores post intervention. Further, the Kruskal-Wallis test revealed that the gender of the clients has an association with the SUW scores (p < 0.05). It was also found that the duration of the sessions had a positive relation with the impact scores (p < 0.001).

As part of the formative work of the SUCCEED Africa consortium, we followed a participatory process to identify existing gaps and resources needed for the development and implementation of a rights-based intervention for people with lived experience of psychosis in Malawi, Nigeria, Sierra Leone and Zimbabwe. In 2021, we conducted a desk review of published and grey literature on psychosis in the four SUCCEED countries. Using an adapted version of the PRIME situation analysis template, data were extracted across the five domains of the WHO Community-Based Rehabilitation (CBR) Matrix: health, education, livelihoods, social and empowerment. This was supplemented with insights from personal communications with key stakeholders and the lived and professional experiences of team members. Findings indicate that people with lived experience of psychosis have limited access to services and opportunities across the five CBR domains. Participation in social, religious, empowerment and political activities is restricted due to stigma and a lack of advocacy. People with lived experience of psychosis in SUCCEED countries are not generally able to access support in line with essential components of CBR. There is a need for their greater inclusion in policy and advocacy activities.

A history of psychologically traumatic experiences can impact health outcomes for pregnant people and their infants. The perception and prevalence of traumatic experiences during pregnancy may differ by geographical region. To better understand trends in how and what kinds of psychological trauma are assessed globally, we conducted a secondary analysis on a larger systematic review examining psychological trauma measurement in pregnancy. Through a systematic literature review conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, completed between July 2021 and September 2023 using Ovid MEDLINE, Ovid EMBASE, Scopus, Web of Science, PsycInfo and Cochrane, we identified 576 research studies assessing psychological trauma during pregnancy that were conducted across nine geopolitical regions. Most of these studies took place in North America, followed by sub-Saharan Africa, Europe, Asia, the Middle East or Northern Africa, Oceania, South America, and Central America. The fewest number of studies was conducted across multiple regions. We found that most studies measuring psychological trauma in pregnancy across the nine geopolitical regions assessed interpersonal trauma, and the fewest number of studies assessed healthcare trauma. Moreover, for each type of psychological trauma assessed, the greatest number of studies was conducted in North America. We also found that Central America, Oceania, sub-Saharan Africa, Asia, Middle East or Northern Africa, Europe, and studies conducted across multiple regions had one-third or more studies that only used in-house assessments, rather than previously validated assessments of psychological trauma. The results of this review emphasize the need for regionally specific and culturally appropriate measures of psychological trauma for pregnant people, which prioritize the types of psychological trauma that are most common in a given region. Newly developed measures can be used for screening and treatment of patients using trauma-informed obstetric care.

Background: While early intervention in psychosis (EIP) programs have been increasingly implemented across the globe, many initiatives from Africa, Asia and Latin America are not widely known. The aims of the current review are (a) to describe population-based and small-scale, single-site EIP programs in Africa, Asia and Latin America, (b) to examine the variability between programs located in low-and-middle income (LMIC) and high-income countries in similar regions and (c) to outline some of the challenges and provide recommendations to overcome existing obstacles.

Methods: EIP programs in Africa, Asia and Latin America were identified through experts from the different target regions. We performed a systematic search in Medline, Embase, APA PsycInfo, Web of Science and Scopus up to February 6, 2024.

Results: Most EIP programs in these continents are small-scale, single-site programs that serve a limited section of the population. Population-based programs with widespread coverage and programs integrated into primary health care are rare. In Africa, EIP programs are virtually absent. Mainland China is one of the only LMICs that has begun to take steps toward developing a population-based EIP program. High-income Asian countries (e.g. Hong Kong and Singapore) have well-developed, comprehensive programs for individuals with early psychosis, while others with similar economies (e.g. South Korea and Japan) do not. In Latin America, Chile is the only country in the process of providing population-based EIP care.

Conclusions: Financial resources and integration in mental health care, as well as the availability of epidemiological data on psychosis, impact the implementation of EIP programs. Given the major treatment gap of early psychosis in Africa, Latin America and large parts of Asia, publicly funded, locally-led and accessible community-based EIP care provision is urgently needed.

Background: Low- and middle-income countries (LMICs) bear a disproportionate burden of mental illness, with limited access to biomedical care. This study examined pathways to care for psychosis in rural Uganda, exploring factors influencing treatment choices.

Methods: We conducted a mixed-methods study in Buyende District, Uganda, involving 67 in-depth interviews and 4 focus group discussions (data collection continued until thematic saturation was reached) with individuals with psychotic disorders, family members, and local leaders. Structured questionnaires were administered to 41 individuals with psychotic disorders.

Results: Three main themes emerged: (1) Positive attitudes towards biomedical providers, (2) Barriers to accessing biomedical care (3) Perceived etiologies of mental illness that influenced care-seeking behaviors. While 81% of participants eventually accessed biomedical care, the median time to first biomedical contact was 52 days, compared to 7 days for any care modality.

Conclusions: Despite a preference for biomedical care, structural barriers and diverse illness perceptions led many to seek pluralistic care pathways. Enhancing access to biomedical services and integrating traditional and faith healers could improve mental health outcomes in rural Uganda.

The European Union receives thousands of unaccompanied irregular migrant minors every year, but little is known about their life experiences during the migration process. The aim of this study is to describe their experiences as minors when they arrived in Spain in small boats, which will help to understand their psychosocial and health needs. A descriptive qualitative study was undertaken. In-depth interviews were conducted with 18 unaccompanied irregular migrants (15 men and 3 women) from different African countries with a mean age of 20.05 years (SD = 2.77). Thematic analysis was used to analyse the data. Three main themes emerged such as (1) unaccompanied irregular migrant minors: risking it all for a better life; (2) redefining your identity as a means of adaptation and (3) obtaining legal status to avoid deportation. Unaccompanied migrant minors risk their lives on the migration journey, but do not always find better conditions in the destination country. The unaccompanied irregular migrant minors are forced to rebuild their lives at a high cost; they experience rejection from the host society and their culture of origin, which has a negative impact on their physical and psychological health over time.

This study aimed to investigate the effects of physical multimorbidity on the trajectory of cognitive decline over 17 years and whether vary across wealth status. The study was conducted in 9035 respondents aged 50+ at baseline from nine waves (2002-2019) of the English Longitudinal Study of Aging. A latent class analysis was used to identify patterns of physical multimorbidity, and mixed multilevel models were performed to determine the association between physical multimorbidity and trajectories of cognitive decline. Joint analyses were conducted to further verify the influence of wealth status. Four patterns of physical multimorbidity were identified. Mixed multilevel models with quadratic terms of time and status/patterns indicated significant non-linear trajectories of multimorbidity on cognitive function. The magnitude of the association between complex multisystem patterns and cognitive decline increased the most as follow-up progressed. Individuals with high wealth and hypertension/diabetes patterns have significantly lower composite global cognitive z scores over time as compared with respiratory/osteoporosis patterns. Physical multimorbidity at baseline is associated with the trajectory of cognitive decline, and the magnitude of the association increased over time. The trend of cognitive decline differed in specific combinations of wealth status and physical multimorbidity.

Obesity is related to a wide variety of medical and psychological comorbidities which has short- and long-term effects on children's mental health. One of the most significant ones is depression. Thus, the current study utilized a descriptive methodology to explore the differences in depressive symptoms among overweight, obese, and normal-weight Palestinian children and adolescents. Data was collected from 270 Palestinian children and adolescents, aged (9-16) years: 85 with normal weight, 95 with over-weight and 90 obese. Findings showed that participants who are over-weight or obese exhibited more depressive symptoms than those with a normal weight. These findings showed that Palestinian children and adolescents who are over-weight or obese do experience depression and thus interventions should take this into account. In particular, it seems that over-weight boys or adolescents need more direct help in losing weight while obese children and adolescents who feel more helpless about their weight need serious psychological interventions. it is critical to offer psychological treatment as part of any weight loss intervention program for children and adolescents. Especially as these adolescents' families might encourage them to avoid seeking professional help and deal with the problem in the family.

Given the rate of advancement in predictive psychiatry, there is a threat that it outpaces public and professional willingness for use in clinical care and public health. Prediction tools in psychiatry estimate the risk of future development of mental health conditions. Prediction tools used with young populations have the potential to reduce the worldwide burden of depression. However, little is known globally about adolescents' and other stakeholders' attitudes toward use of depression prediction tools. To address this, key informant interviews and focus group discussions were conducted in Brazil, Nepal, Nigeria and the United Kingdom with 23 adolescents, 45 parents, 47 teachers, 48 health-care practitioners and 78 other stakeholders (total sample = 241) to assess attitudes toward using a depression prediction risk calculator based on the Identifying Depression Early in Adolescence Risk Score. Three attributes were identified for an acceptable depression prediction tool: it should be understandable, confidential and actionable. Understandability includes depression literacy and differentiating between having a condition versus risk of a condition. Confidentiality concerns are disclosing risk and impeding educational and occupational opportunities. Prediction results must also be actionable through prevention services for high-risk adolescents. Six recommendations are provided to guide research on attitudes and preparedness for implementing prediction tools.