Global Mental Health最新文献

Global migration is reshaping mental healthcare, creating challenges and opportunities that demand intercultural dialogue. In 2021 the World Psychiatry Exchange Program was launched under the auspices of the World Psychiatric Association to promote global collaboration and mutual learning. Its third call for applications, opened in October 2023, received 162 applications from 68 individuals, more than double the number from the second edition. Applicants represented a diverse geographical distribution (Asia 58.8%, Africa 22.1%, Europe 10.3%, South America 5.9% and North America 2.9%), with ages ranging from 25 to 52 years (mean 34 years). Just over half (53%) were early career psychiatrists within 7 years of specialising, while 47% were psychiatry trainees. Following a competitive selection process, 15 psychiatrists undertook exchanges in 2024 across Europe, Africa and Asia, with placements in Croatia, India, Iran, Malaysia, Tunisia, Spain and the United Kingdom. Evaluation data showed consistently positive feedback: 82% strongly endorsed the clarity and ease of the application process, and all participants reported feeling well supported by local coordinators.As psychiatry responds to global demographic change, investment in intercultural competencies and flexible training pathways is essential. The psychiatrist of the future is a global psychiatrist, equipped to deliver care, education, and leadership globally.

Healthcare professionals in Iraq are exposed to war-related stressors that may undermine psychological well-being. This study examined post-traumatic stress disorder (PTSD) and depression and their association with peace of mind (PoM). In a cross-sectional survey, 174 physicians, nurses, pharmacists and allied health workers from multiple Iraqi regions completed an online questionnaire including demographics and validated Arabic measures of PTSD, depression (BDI) and PoM. Reliability was checked using Cronbach's alpha, and analyses used descriptive statistics, t-tests, Spearman correlations and stepwise regression. Mild-to-moderate PTSD symptoms were reported by 66.1% of participants, and 39.1% reported at least mild depressive symptoms; 54.0% showed moderate PoM. In regression models, higher PTSD and depression scores significantly predicted lower PoM, whereas years of professional experience predicted higher PoM. These findings indicate a substantial burden of trauma- and depression-related symptoms among Iraqi healthcare workers and suggest that workplace-focused mental health supports and organizational policies are needed to protect well-being in conflict-affected settings.

Gender, as a sociostructural factor, may shape child development through social norms that influence family dynamics. We examined whether more egalitarian parental relationships are associated with better developmental outcomes. Using data from the Pelotas 1993 birth cohort (Brazil), we adapted a population-level gender inequality metric to characterise parental relationships. The Couple's Gender Inequality Index (CGII) was derived from maternal health, parental education and income. Associations between CGII and educational attainment, quality of life, and depression at age 18 were assessed using linear regression models adjusted for family income, gestational age, birth weight, parental cohabitation and race. The sample comprised 2,852 participants (1,446 women). Higher CGII scores, indicating greater equality within couples, were associated with significantly higher educational attainment in both females and males. Higher quality of life at age 18 was observed in the second and fourth CGII quartiles compared with the most unequal. Greater equality was associated with lower risk of depression at age 18, although this association was not robust to adjustment. Among girls, a similar pattern was observed for emotional symptoms at age 15. Overall, greater couple-level gender inequality was associated with poorer developmental outcomes in offspring.

Online synchronous chat, or 'Live Chat', is distinguished by its real-time, anonymous, and text-based nature. There is limited understanding of the characteristics of those who choose Live Chat services compared to Blended Services. This study examined the demographic, psychosocial, and service engagement profiles of young people using the Irish Live Chat service, Jigsaw Live Chat, compared with those attending Jigsaw's Blended (in-person and/or video) support Service. Routine service-based data were analysed from 1,313 Live Chat and 3,604 Blended Service users. Reasons for attendance among Live Chat users seeking mental health support were analysed using content analysis. Live Chat users were more likely to be gender-diverse, older, and to report higher psychological distress than Blended Service users. Anxiety and low mood were common presenting issues. Attendance reasons varied, with over one-third citing multiple issues and many experiencing persistent distress. A minority attended for information or while waiting for other support. Overall, users reported high satisfaction. Live Chat users waited an average of 2.5 minutes, compared with typical waits of 1-2 months for the Blended Service. These findings highlight Live Chat as a distinct and essential access point for highly distressed and underserved youth, particularly those with minority gender and sexual identities.

Depression is underrecognized in primary care, which is a barrier to treatment. For the last decade, Zimbabwe has invested in increasing access to depression treatment within primary healthcare. This study describes depression recognition by nurses and referral to treatment in four primary care clinics in Zimbabwe. Research staff screened 200 patients after they attended a primary care visit at a study clinic. They assessed depression using the PHQ-9 and assessed depression and/or anxiety using the Shona Symptoms Questionnaire (SSQ-14). Medical records were examined for depression and/or anxiety diagnoses. Positive depression and anxiety screens were compared with nurse documentation. 69.5% of participants were women and 56.5% were living with HIV. 6.0% had a PHQ-9 score ≥11, indicative of depression, and 22.0% had an SSQ score ≥9, indicative of depression and/or anxiety. None of the patients who screened positive for probable depression and/or anxiety were recognized by nurses. Nurses who saw the patients in the sample were surveyed. Most had not received formal training on mental health in primary care (mhGAP) prior to patient data collection. Despite efforts to expand depression treatment in Zimbabwe, individuals with probable depression were unrecognized by nurses, though nurses offered some care for other mental health conditions.

Background: Anxiety and depression are common among patients with wounds, impairing healing and quality of life. This study estimated their prevalence and associated factors across community-and referral care facilities in Taabo, Côte d'Ivoire.

Method: An exploratory cross-sectional study included 157 patients aged ≥16 years with wounds, recruited consecutively between October and December 2023. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Demographic and wound characteristics were collected. Associations were examined using Chi-square or Fisher's exact tests, and multivariate logistic regression adjusted for age and gender identified independent factors.

Results: Anxiety and depression scores were lowest at household level (6.0 and 5.4) compared to health centre (7.4 and 6.9) and general hospital (9.1 and 9.8). Prevalence was 25.4% and 18.5% at the household level, 49.0% and 55.1% at health centre and 77.4% and 84.9% at the general hospital. Anxiety was independently associated with older age and female gender, while depression was associated to female gender, larger wound size (≥5 cm) and referral-level care.

Conclusion: Early household-based wound care by CHWs was associated with lower prevalence of anxiety and depression. Integrating psychosocial support into wound management, particularly at referral facilities, may reduce the mental health burden.

Mental health conditions among youths are increasing rapidly, taking into consideration their biological, psychological and social development in the time of technological advancement with its associated challenges. Therefore, this study examined the psychometric properties of eight mental health scales among Ghanaian youth. A total of 708 youths (62.1% females; 10-29 years) from junior high schools, senior high schools and a university were recruited to respond to measures on depression, anxiety, somatic symptoms, obsessive-compulsive symptoms, insomnia, smartphone application-based addiction, internet addiction, life satisfaction, stress and cognitive fatigue. Confirmatory factor analysis (CFA) and Pearson's r were used to analyse the data. The findings indicated acceptable CFA fit for all scales (comparative fit index [CFI] >0.9, Tucker-Lewis index [TLI] >0.9, root mean square error of approximation [RMSEA] <0.08 and standardized root mean square residual [SRMR] <0.08), and internal reliability was satisfactory (Cronbach's α = 0.774-0.868 and McDonald's ω = 0.775-0.870). Correlation analyses showed significant relationships between all the measures except for life satisfaction and internet addiction, and stress and life satisfaction. Both the CFA indices and correlation analyses indicate that all the mental health measures demonstrate acceptable initial evidence of reliability and construct validity.

This study focuses on the national and subnational estimation of prevalence, incidence, disability-adjusted life years (DALYs) related to self-harm and suicide mortality in Iran. These indicators of disease burden were analyzed over the period from 1990 to 2021, with stratifications based on sex, age and geographic location. Additionally, the percentage change observed between 1990 and 2021 was documented. The age-standardized prevalence rate (per 100,000) of self-harm decreased from 173.92 (95% UI: 146.13-208.75) in 1990 to 131.2 (95% UI: 110.55-156.67) in 2021, reflecting a percentage change of -0.25% over the period. In terms of self-harm prevalence in 2021, males had a higher rate (137.62 per 100,000) compared to females (124.82 per 100,000). The findings of the current study revealed that, despite significant challenges such as demographic shifts, economic instability and the impacts of war, the trends in self-harm incidents and suicide mortality rates in Iran have generally been on the decline. Additionally, it was observed that suicide-related deaths were more prevalent among males when compared to females. However, when examining self-harm behaviors over previous decades, these acts appeared to be more frequent among females.

During the perinatal period, women in low- and middle-income countries experience high rates of common mental disorders (CMDs). We aimed to estimate CMD prevalence at 6 and 12 months postpartum in Rahim Yar Khan (RYK), Pakistan, and identify factors associated with postpartum mental health. We conducted secondary analysis of a longitudinal birth cohort study, which was nested within the control arm of a community-based, cluster-randomized trial that enrolled pregnant women in their third trimester (n = 2,122). Mental health was assessed using the Self-Reporting Questionnaire. Factors associated with postpartum mental health were explored using mixed-effects linear regression, and associations between preconception, antenatal and postpartum CMDs were assessed using robust Poisson regression. The prevalence of CMDs was 16% and 17% at 6 and 12 months postpartum, respectively. Women who reported that their husbands were unhappy had poorer postpartum mental health, whereas high social support was associated with improved postpartum mental health. History of antenatal CMDs was associated with increased risk of CMDs at 6 and 12 months postpartum (adjusted risk ratio = 2.60 and 1.90, 95% confidence interval: 1.69-4.01 and 1.40-2.58, respectively). Mothers with identified risk factors may benefit from targeted mental health support during the perinatal period.

Continuous traumatic stress (CTS) exposure describes extended and ongoing collective trauma exposure that is associated with potential future danger and threat to the community. CTS has generated debate in the context of current definitions of trauma and posttraumatic stress disorder (PTSD) in the DSM-5. Prevalence data on posttraumatic stress symptoms (PTSS) and PTSD in adolescents aged 10 to 24 years following CTS exposure in Sub-Saharan Africa are lacking. This systematic review and meta-analysis sought to address this gap. We also synthesized evidence on other trauma-related mental disorders and moderators such as mean age, sex, country income, education level, PTSS/PTSD assessment tool, and recruitment method. A systematic literature search covering four databases yielded 460 papers that were screened for eligibility, with 10 studies included. Data were extracted and coded, and a meta-analysis of the pooled prevalence of clinically significant PTSS/PTSD was conducted. Results indicated a pooled prevalence of PTSS/PTSD of 32.0% (95% CI: 20.7% to 46.0%). Country income (World Bank category) and type of assessment (clinician-administered vs. self-report) significantly moderated the prevalence of PTSS/PTSD. Further research is needed to not only measure CTS as an exposure but also as a response separate from PTSS/PTSD among adolescents in Sub-Saharan Africa. Additionally, research is needed to determine the validity, reliability, and cultural relevance of CTS response measures. Such studies will help in better understanding the psychosocial impact of CTS exposure on adolescents and inform the development of future interventions. Detailed data on the prevalence of PTSS/PTSD and moderators thereof following CTS exposure in Sub-Saharan Africa are sparse. Further studies are needed to characterize CTS-related comorbidities and related phenomena in adolescents living under conditions of CTS exposure and to optimize evidence-based interventions.