Global Mental Health最新文献

People with tuberculosis (TB) and TB survivors are at increased risk for mental health (MH) conditions. Better management of conditions like depression can improve adherence to TB treatment, and integrating MH care into TB treatment may reduce the MH treatment gap and improve outcomes. This qualitative study explored design characteristics for integrated MH-TB care in Pune, India. Data collection involved in-depth interviews (n = 25) with TB survivors with lived experience of MH conditions, their family members, and TB and MH providers. Data collection and analysis were guided by the Consolidated Framework for Implementation Research, and journey maps illustrated patient experiences. Participants shared suggestions for integrated care models, advantages and barriers to integration, intervention delivery agents, and local perceptions of MH conditions. Barriers included limited awareness about MH and perspectives about MH treatment, which were limited to consuming medication. Suggestions for integrated interventions included raising awareness about MH conditions and existing MH services among TB providers, regular MH screening and counseling for people with TB, and engaging TB survivors to share their experiences with patients in group settings. These insights highlight the importance of working with people with lived experience and understanding patient journeys to inform intervention implementation and sustainability.

Background: The thinking healthy program (THP) is an evidence-based psychological intervention for perinatal depression designed for delivery by nonspecialist health workers. To ensure its relevance in Nepal, we adapted THP using the mental health Cultural Adaptation and Contextualization for Implementation (mhCACI) framework. Methods: Using mhCACI's 10-step process, we applied a participatory approach involving a multidisciplinary team to adapt both content and implementation strategies. A qualitative study nested within a pilot trial was conducted to assess feasibility and acceptability of adapted THP through in-depth interviews with perinatal women (n = 20), family members (n = 11) and focus group discussions with Female Community Health Volunteers (FCHVs) (n = 16). Results: FCHVs were selected as delivery agents. Implementation adaptations included reducing the number of THP sessions from 16 to 8, integration of additional 2.5-day Foundational Helping Skills training and skill-based training methods. Manual revisions included simplified language, cultural idioms, visual aids and locally relevant examples. Referral pathways for gender-based violence, suicide and severe mental illness were included. The adapted THP was well received by providers and recipients. Conclusion: The adaptation demonstrates how global interventions can be contextually tailored for low-resource settings while preserving therapeutic integrity, offering a scalable model for community-based mental health care.

This systematic review and meta-analysis was a study that enquired into the prevalence and epidemiology of depression in university students in Pakistan, between 2000 and 2025. Depression is a significant global mental illness with high prevalence in young adulthood. University students are the most susceptible to this risk because of the factors related to it, i.e., academic stress, financial hardships, social pressure, and cultural stigma of mental illness. Although the concerns have been on the increase, the prevalence rates of depression have been widely varied among Pakistani students, with some studies reporting as low as 2.5% to as high as 85%, primarily because of the sampling techniques, assessment instruments, and geographical settings. The present review is based on the findings of 35 studies involving over 11,000 students and suggests that the prevalence rate is approximately 51% in a pooled form, meaning that about 50% of university students in Pakistan are subjected to depressive symptoms. The high level of heterogeneity of the selected studies highlights the acute necessity of the formulation of a standard-based diagnostic criteria and culturally competent mental health assessment instruments. Moreover, systemic challenges, such as the shortage of trained mental health professionals and the general unawareness of the disorder, are continuing to affect the diagnosis and treatment of the disorder at an early stage. According to the results, the necessity of a multi-faceted approach toward mental health, including the establishment of counseling facilities in universities, the development of stress management training, and the federal stigma-reduction campaign, is pressing. The most significant elements of enhancing the well-being of students and the mental health landscape of Pakistan as a whole are early intervention and empowering mental health infrastructure.

The aim of the present study was to develop short and very short forms of the Children's Test Anxiety Scale (CTAS) using the ant colony optimization (ACO) algorithm. The item selection algorithm for the short form was applied to Sample 1 (N = 570), and the best-fitting short form was identified based on validity and reliability evidence. These analyses were then replicated with Sample 2 (N = 825) to confirm the findings. Children's Perceived Academic Self-Efficacy Scale used for convergent validity. Also measurement invariance tested by gender. Additionally, a very short form of the scale (CTAS-VS) was developed using a subset of the same sample. Across all three studies, consistent results were found in terms of model fit, factor structure and validity. Overall, findings suggest that both the 14-item short form (CTAS-S) and the 3-item very short form (CTAS-VS), developed via the ACO algorithm, possess strong psychometric properties.

Refugees in Germany often do not receive the necessary mental healthcare. Understanding refugees' healthcare needs, that is factors that support or hinder their health, can foster the development of effective, culturally appropriate and accessible health services. The present exploratory study investigated these needs using cognitive-affective maps (CAM), a recently developed mind map-like measurement technique enabling participants to visualise their thoughts and emotions as networks. Thirty refugees from diverse regions of origin (West Africa, Middle East and Ukraine) were asked to indicate factors supporting and hindering their health by drawing a CAM using a digital tool. We analysed the drawn CAM concepts qualitatively according to a five-step procedure, including deductive and inductive category formation. Drawn CAM concepts concerning supporting factors were grouped along the categories 'resources' and 'possibilities for explicit treatments of healthcare needs', suggesting an openness to promote well-being among refugees. Yet, various concepts were grouped along the categories 'psychological challenges', 'specific living conditions in Germany' and 'access to healthcare', focusing on factors hindering well-being. Frequency analyses of these categories suggested differences between the subsamples, which should be further investigated in future studies in order to integrate a possible heterogeneity within refugee populations in offered healthcare.

Mental health symptoms pose a significant vulnerability to stressful life events among currently married women, adversely impacting their overall well-being and quality of life. This study explores the spatial patterns and factors associated with anxiety, depressive symptoms and the co-occurrence of both symptoms among currently married women of reproductive age in Bangladesh. This study utilised data from 13,372 (weighted) currently married women aged 15-49 years in the Bangladesh Demographic and Health Survey (BDHS) 2022, which used a cross-sectional design. Multivariable logistic regression models determined the associated factors. Additionally, spatial distribution and hotspot analysis were conducted using ArcGIS version 10.8. The weighted prevalence of moderate to severe anxiety, depressive symptoms and co-occurrence of anxiety and depressive (CAD) symptoms among currently married women of reproductive age was 4.1% (95% confidence interval [CI]: 3.8%, 4.5%), 4.8% (95% CI: 4.7%, 5.4%) and 2.2% (95% CI: 2.1%, 2.6%), respectively. Clustering of anxiety symptoms (Moran's I = 0.063, p < 0.001), depressive symptoms (I = 0.091, p < 0.001) and CAD symptoms (I = 0.082, p < 0.001) were observed, with hotspots in Rangpur, Sylhet and Chittagong regions. Logistics regression analysis shows that currently married women who were living in the Barishal, Khulna, Rangpur and Sylhet regions, who belong to households with a higher wealth index, who experienced high levels of intimate partner violence (IPV), have completed high school, who are sexually inactive and whose husbands are unemployed, were more likely to experience CAD symptoms. Additionally, currently married women of reproductive age, whose age was 25-34 years, who are labourers, whose pregnancies are terminated and who have ≥5 children ever born, are at a higher risk of having anxiety symptoms. Besides, currently married women aged 25-34 years and 35-44 years, who are underweight, were more likely to have depressive symptoms. The findings highlight a significant regional disparity in the burden of anxiety, depressive and CAD symptoms among currently married women of reproductive age in Bangladesh. These findings can help design site-specific programmes and actions for women in the hot spot areas of Rangpur, Sylhet and Chittagong.

Anxiety and depressive disorders are global health challenges, placing a significant burden on adults and healthcare systems in low- and middle-income countries (LMICs), such as Ghana. Social determinants of mental health, including poor healthcare access and poverty, may be associated with their prevalence. However, a paucity of prevalence data poses challenges for intervention planning and resource allocation. This review aimed to (1) examine the prevalence of anxiety and depressive disorders and symptoms among adults in Ghana, and (2) explore social determinants of mental health potentially associated with anxiety and depressive disorders and symptoms. We searched electronic databases and secondary sources from inception until September 30, 2024. Meta-analyses were performed to estimate the pooled prevalence. Narrative synthesis explored social determinants potentially associated with anxiety and depressive disorders and symptoms. We included 38 studies (22,587 adults). Pooled point prevalence of anxiety and depressive disorders and symptoms was 40.3% (95% confidence interval [CI]: 31.8-49.4%) and 33.0% (95% CI: 27.7-38.8%), respectively. Most studies (37 studies) reported the prevalence of symptoms and not disorders. Social determinants of mental health, including educational attainment and urban environment, were associated with higher levels of anxiety symptoms, while ethnicity and traumatic experiences were associated with higher levels of depressive symptoms. There was a high degree of heterogeneity, and the majority of studies used self-report screening tools, which may have skewed prevalence estimates. More than a third of adults in Ghana were found to experience anxiety and depressive symptoms, and social determinants of mental health may be associated with prevalence. High-quality research and contextually appropriate interventions targeting the identified social determinants of mental health associated with anxiety and depressive symptoms are needed to reduce disparities and improve the mental well-being of adults in Ghana.

Brief, low-intensity interventions may hold untapped promise for bolstering maternal health in low-resource contexts. The current study used propensity score matching (PSM) to evaluate uptake and differential effectiveness of two low-intensity digital perinatal health (PH) support programs in Lima, Peru. Pregnant women (N = 251) were assigned to one of two conditions (PH vs. trauma-focused PH [TF-PH]) and received weekly psychoeducational content via WhatsApp from a lay paraprofessional for 5 weeks. Conditions were not randomly assigned; PSM was used to improve causal inference of the condition. Women were interviewed before participation (T1), immediately following treatment (T2) and at 3 (T3) and 12 months postpartum (T4). Intimate partner violence had strong negative effects on women's mental health, multisystem resilience and parenting, and single mothers reported higher levels of depression and posttraumatic stress symptoms than did partnered women. Intervention uptake was high, with 77% of women participating in all sessions. There were no significant differences between treatment groups over time, but effect sizes indicated a slight advantage of the TF-PH condition in addressing depression symptoms (d _r = -0.29) and multisystem resilience (d _r = 0.39). Study findings suggest that brief interventions may be well-received and that trauma-focused supports may also confer additional benefits for addressing depression and resilience.

Afro-Colombian adolescents in Tumaco face high mental-health risks due to armed conflict and structural marginalization. We tested the short-term efficacy of the 3C program to strengthen resilience, compassion, and prosocial behavior and to reduce anxiety, depression, and PTSD. Mixed-methods cluster RCT with concurrent triangulation; multilevel mixed-effects models with multiple imputation; assessments at baseline, 6, and 9 months. Resilience increased by 13.14 points at 6 months (large effect, d = 0.89) and remained elevated at 9 months. Anxiety and PTSD screenings were lower in the intervention group across follow-ups. Compassion and prosocial behavior improved at 6 months but attenuated by 9 months. Depression screenings decreased at 6 months and rebounded at 9 months. Qualitative data aligned with these patterns (students reported sustained use of stress-management skills and peer support). 3C demonstrated short-term efficacy for resilience, anxiety, and PTSD but showed limited durability for compassion, prosociality, and depression without ongoing reinforcement. The pattern of effect attenuation-particularly the complete depression rebound-indicates that 3C provides a foundational component requiring integration with booster sessions to sustain socioemotional gains.

Mental illness-related stigma acts as a critical barrier to care by fostering shame, fear of judgment and discrimination, which deters individuals from seeking help, delays treatment and worsens outcomes. This study aimed to investigate the forms, drivers and consequences of mental health-related stigma on help-seeking behavior. A cross-sectional study was conducted from November 2020 to March 2021. Data were collected from 419 participants using structured questionnaires, guided by the Health Stigma and Discrimination Framework and the Attitudes Towards Seeking Professional Psychological Help Scale for validation. Data were analyzed using Statistical Package for the Social Sciences version 22, employing descriptive statistics, chi-square tests and multinomial logistic regression. The average age of participants was 34.5 years. Findings revealed alarmingly high stigma: economic (76.8-80.2%), social (77.1-81.2%) and psychological (71.9-82.8%). Key drivers included stereotypes of dangerousness (58.7%) and systemic healthcare discrimination (65.6%). Multinomial regression confirmed that all stigma forms significantly reduced help-seeking odds. Structural barriers (odds ratio [OR] = 0.48) and internalized shame (OR = 0.53) were the strongest deterrents, with a multiplicative effect for combined economic and psychological stigma (OR = 0.41). This complex, multilayered barrier, driven by socio-cultural beliefs and structural failures, necessitates urgent, multifaceted interventions targeting public education, policy and self-stigma to improve mental health equity in rural Ghana.