BMC Psychiatry最新文献

Background: Ethiopian migrants to the Middle East and South Africa are exposed to dangerous traveling and working conditions and their experiences are mostly tragic. They are unwelcomed not only by the situation in the destination but also by the community at home which is an important indicator of stigma and discrimination. However, there is lack of evidence on how psychological distress is associated with migration experiences, stigma and coping strategies. Therefore, it was aimed to determine the mediating effect of psychological distress in the association between migration experiences and stigma and discrimination and coping strategies.

Methods: A total of 739 Ethiopian migrant returnees from the Middle East and South Africa were included in the study. A cross-sectional study was conducted in five migration hotspot areas in Ethiopia, namely Addis Ababa, Dessie, Shashemene, Hossana, and Gondar. Data related to socio-demographic, economic, migration experiences, psychological distress, coping strategies, and stigma and discrimination were collected. Psychological distress was measured using the 21- item version of the Depression, Anxiety and Stress Scale and coping strategies were measured with the Brief-COPE. Structural equation modeling was employed to estimate the relationship among variables.

Results: About 395 (57.33%) of the participants reported symptoms of depression, 428 (59.86%) anxiety symptoms, and 313 (45.21%) stress symptoms. The mediated association between physical violence and coping strategy through psychological distress was 0.29 (adjusted β = 0.29, 95%CI: 0.15, 0.44). Denial of salary had positive direct (adjusted β = 1.00, 95%CI: 0.50, 1.50) and mediated (adjusted β = 1.20, 95%CI: 0.71, 1.68) associations with stigma and discrimination through psychological distress. Restricted freedom had positive mediated (adjusted β = 0.39, 95%CI: 0.13, 0.65) and total (adjusted β = 0.94, 95%CI: 0.59, 1.29) associations with stigma and discrimination through psychological distress.

Conclusion: Depression, anxiety, and stress symptoms are common among migrant returnees. Religious practice is the most commonly used coping mechanism. Psychological distress has positive mediating association with the relationships between denial of salary by employers and stigma and discrimination, physical violence and coping strategy, and restricted freedom and stigma and discrimination. Psychological interventions to deal with the psychological distress and stigma and discrimination of migrant returnees and to encourage the practice of positive coping strategies are warranted.

Background: Auditory verbal hallucinations, which frequently involve negative emotions, are reliable symptoms of schizophrenia. Brain asymmetries have also been linked to the condition, but the relevance of asymmetries within the amygdala, which coordinates all emotional signals, to the content of and response to auditory verbal hallucinations has not been explored.

Methods: We evaluated the performance of two asymmetry biomarkers that were recently introduced in literature: the distance index, which captures global asymmetries, and a revised version of the laterality index, which captures left-right local asymmetries. We deployed random forest regression models over values computed with the distance index and with the laterality index over amygdala nuclei volumes (lateral, basal, accessory-basal, anterior amygdaloid area, central, medial, cortical, cortico-amygdaloid area, and paralaminar) for 71 patients and 71 age-matched controls.

Results: Both biomarkers made successful predictions for the 35 items of the revised version of the Belief About Voices Questionnaire, such that hallucination severity increased with increasing local asymmetries and with decreasing global asymmetries of the amygdala.

Conclusions: Our findings highlight a global reorganization of the amygdala, where left and right nuclei volumes differ pairwise but become proportionally more similar as hallucinations increase in severity. Identifying asymmetries in particular brain structures relevant to specific symptoms could help monitor the evolution and outcome of psychopathological conditions.

Background: The present study is an intervention-based qualitative study that explores the factors causing depression among antenatal women and analyses coping strategies based on the modified version of the Thinking Healthy Programme (THP) intervention in the urban setting of Lahore, Pakistan.

Methods: An exploratory qualitative evaluation approach was used in the present study. The study comprises four phases, i.e., the screening phase, exploratory phase, intervention phase, and evaluation phase. During the first phase, pregnant women aged 18-45 years were screened for anxiety and depression by using the Urdu-translated Patient Health Care Questionnaire-9. In the second phase, identified women were interviewed to explore the factors responsible for depression. In the third phase, the intervention was administered via the THP intervention. In the last phase, the same women were reinterviewed to analyse the outcomes of the intervention. Thematic analysis was performed for the analysis of the interviews.

Results: Data was analyzed using thematic analysis following an deductive and indictive approach in both pre- and post-intervention phase. Three main themes emerged in the pre-intervention phase: (1) the impact of adverse life events on the mental health of pregnant women, (2) the adverse effects of marital relationship issues on pregnant women, and (3) depression-causing factors due to the joint family system. Furthermore, four themes emerged in the post-intervention stage: (1) development of positivity in thinking and attitude, (2) learning about stress management through the provision of compassion and sharing avenues, (3) gaining self-esteem to address matters positively, and (4) improving relationships with the unborn child and family. Numerous pregnant women praised the THP project and recommended that hospitals adopt it to assist pregnant patients in the Pakistani health system.

Conclusion: The study concludes that THP can be a valuable tool for helping many pregnant women who are experiencing prenatal depression recover, however, there is a further need for exploring its benefits in varying social and cultural contexts.

Trial registration: The study has been registered at https://clinicaltrials.gov/ (NCT04663243).

Background: We were interested in developing a methodology for diagnosing the depression status of a focused population group, such as the Korean university student group, with higher accuracy. To this end, we proposed a method of fusing the data collected from multiple depression self-questionnaires aided by a psychiatrist's diagnosis. In particular, we found that the standard diagnostic cut-offs and factor analysis prepared for a general population by depression self-questionnaires are inadequate for a focused population with its unique cultural background. In this study, a novel approach to optimizing diagnostic cut-offs and generalizing factor analysis for the Korean university student group is presented in the fusion space of multiple self-questionnaires.

Methods: We collected the data from 30 randomly selected Korean university students, over 21 weeks, with the psychiatric evaluation as a reference, then established the optimal cut-off regions in the fused CESD - PHQ9 score space based on the statistical correlation between CES - D and PHQ - 9 and the reference diagnostics. We also re-extracted the factors in the fused CESD - PHQ9 space to expose the key factors that are behind the depression characteristics of the group.

Results: We verified the existence of a clear correlation between CES - D and PHQ - 9 scores. However, the standard cut-offs of CES - D and PHQ - 9 are found inconsistent with the correlation. The new cut-off regions we obtained in the fused CESD - PHQ9 score space are consistent with the correlation and optimal for the psychiatrist's diagnosis with the sensitivity and specificity of 80.95% and 89.74%, respectively. Also, we identified that "socio-psychological" and "interpersonal relationship" factors are the major factors for the depression characteristics of the group.

Limitations: Although the new cut-off regions we presented were based on the incorporation of clinical diagnosis into the fused CESD - PHQ9 score space, further verification with a larger scale of clinical data is helpful.

Conclusion: We identified optimal cut-off regions and generalized factor analysis in the fusion space, which can provide more reliable and trustworthy diagnoses. These can serve as a self-diagnostic tool for reliably identifying the depression characteristics of a focused population as well as effectively linking individuals and psychiatrists as an intermediary.

Background: Perinatal depression is a significant public health issue affecting one in four women globally. It occurs at a critical time of a woman's life; affecting her relationships with family, and child's emotional, behavioral, and cognitive development. Considering the burden of the problem to the whole family, this systematic review and meta-analysis was conducted to estimate the pooled prevalence of perinatal depression and its determinants in Ethiopia to provide up-to-date evidence at a national level.

Methods: All observational studies conducted on perinatal depression in Ethiopia were included based on the selection criteria. Data was extracted using Microsoft Excel and then exported to STATA version-11 for analysis. The random-effects model was employed to estimate the pooled effect size of perinatal depression and its determinants with 95% confidence intervals. Funnel plots analysis and Egger regression tests were conducted to check the publication bias. Sub-group and sensitivity analyses were also performed.

Results: This systematic review and meta-analysis included thirty studies and the pooled prevalence of perinatal depression in Ethiopia was 24.29% (95% CI (21.98, 26.59)). According to the subgroup analysis, the pooled prevalence of antenatal depression and others (postnatal and perinatal depression) was 24.24% and 24.52% respectively. Regarding determinants of perinatal depression, having unplanned pregnancy [OR = 3.04 (2.2, 4.2)], intimate partner violence [OR = 3.09(2.14, 4.46)], poor social support [OR = 3.3(2.38, 4.57)], and a history of depression [OR = 3.68(2.45, 5.52)] were significantly associated with depression.

Conclusion and recommendation: This study showed that the pooled prevalence of perinatal depression in Ethiopia was found to be high. To ensure the mental health of both the mother and child, health professionals should routinely screen perinatal women for depression giving special focus for those with a history of depression and managing them accordingly.

Background: Caregiving for people with mental illness (PwMI) could be burdensome, especially for informal caregivers. However, there is a scarcity of research investigating caregiving burden among informal caregivers of PwMI in China at the national level. To fill this gap, this study examined the prevalence of caregiving burden, depression, and anxiety, as well as their associated factors, among a cross-sectional sample of informal caregivers of PwMI in China.

Methods: Data were collected via an online survey between June and November 2023. Caregiving burden, depression, and anxiety were measured by the Zarit Burden Interview, the Patient Health Questionnaire, and the Generalized Anxiety Disorder Scale. Information on caregivers' sociodemographic, care recipients' sociodemographic and disease-related, and caregiving-related characteristics was also collected. Hierarchical regression analyses were performed to identify associated factors of caregiving burden, depression, and anxiety.

Results: A total of 1,224 informal caregivers of PwMI in China were included in the final analysis. 72.1% of the participants had high caregiving burden, 53.5% had moderate to severe depression, and 43.1% had moderate to severe anxiety. Caregiving burden, depression, and anxiety were inter-correlated with each other but exhibited different profiles of associated factors. The most important factors associated with all the three outcomes were disease-related characteristics, particularly care recipients' symptom stability, medication compliance, and insight. Informal caregivers of males with mental illness had higher levels of caregiving burden, depression, and anxiety than those of females. There was a lack of differentiation in caregiving burden, depression, and anxiety based on care recipients' diagnosis. Formal or common-law marriage was a protective factor for caregiver depression and anxiety but not for caregiving burden.

Conclusion: Informal caregivers of PwMI in China experienced a high level of caregiving burden, depression, and anxiety. Urgent actions are needed to relieve caregiving burden, depression, and anxiety among informal caregivers of PwMI in China.

Objective: The concept of "Healing Architecture" addresses the relevance of design and architectural issues on the outcome of medical and therapeutic treatment in hospitals. The questionnaire ARCHI was developed to record data on the opinion of different groups of users on the architectural design of their therapeutic environment in departments of child and adolescent psychiatry.

Method: A Questionnaire-based cross-sectional study was conducted in two phases between 2020 and 2022 using ARCHI to gather the perspectives of senior physicians and architects on the significance of architectural design in German child and adolescent psychiatric facilities.

Results: In the survey of the senior physicians, 49 heads of child and adolescents psychiatric departments initiated the survey, and 73.5% (n = 36) of them completed the questionnaire in its entirety. During the survey for the architect-specific, 145 individuals commenced the survey, and 60.7% of them completed the questionnaire (n = 88). Significant differences between architects and senior physicians became visible for four of the 93 items, namely "environment of the hospital", "structure of building", "labelling of floors" and "visible cleanliness".

Conclusions: Although senior physicians and architects were characterized by the same opinions on the relevance of architectural design on therapeutic issues for the major part of issues, differences could be obtained for several aspects which are important for the architectural planning of new departments and hospitals. It remains open why both professional groups had different point of views on these four aspects of hospital design which should be clarified to improve the process of hospital development in the future.

Background: Aid workers with a refugee background are increasingly engaged in the humanitarian field. These individuals, known as peer refugee helpers (PRHs), contribute to providing psychosocial support for other refugees. However, few studies have focused on the mental health and wellbeing of PRHs.

Objectives: This study aims to investigate the experiences of PRHs of Afghan origin in the humanitarian field in Greece.

Methods: Seven focus group interviews took place in a hybrid format, online or in-person. PRHs of Afghan origin (N = 18), working for various Aid/Humanitarian Organizations (AOs), participated. Data was analyzed using template analysis.

Results: The analysis identified job resources reflected in the dimensions of sense of coherence (meaningfulness, manageability, comprehensibility) and job demands associated with role overload, role conflict, and role boundaries. Gender differences were noticeable. Specifically, female PRHs experienced empowerment, through accessing new opportunities often not available within Afghan communities. Female PRHs frequently reported going against traditional gender roles and faced negative reactions from their peers. Male PRHs reported feeling empowered through their engagement as a PRH, as it helped them fulfill their personal goals, such as becoming a good example within their families or communities.

Conclusions: Recommendations for policymakers and AOs based on the study results include: (1) Offer training, supervision, and psychosocial support for PRHs to enhance work engagement and prevent emotional exhaustion; (2) Address gender differences ensuring the protection and support of female PRHs; (3) Adopt scalable psychosocial interventions to promote agency and a concrete way of engaging with beneficiaries; (4) Formalize job roles outlining responsibilities and expectations for PRHs.

Introduction: Problematic gaming (PG) is a serious issue among adolescents worldwide, and there is evidence suggesting that school bullying behaviors may be associated with increased rates of PG. This study aimed to examine the associations between school bullying behaviors and PG among adolescents, with a focus on sex effects.

Methods: A total of 20,197 participants were recruited from the 2023 School-based Chinese Adolescents Health Survey. Information about school bullying behaviors and PG was measured. Sampling weights were utilized to estimate the prevalence, and weighted logistic regression models were executed. Stratified analyses by sex were performed.

Results: Among Chinese adolescents, the weighted prevalence of PG was 4.2%, 8.1% were identified as victims, 1.8% as bullies, and 3.4% as bully-victims. A higher frequency of school bullying behaviors corresponds to a higher prevalence of PG. After adjusting for covariates, victims (AOR = 1.34, 95% CI = 1.03-1.73), bullies (AOR = 2.08, 95% CI = 1.39-3.11), and bully-victims (AOR = 2.75, 95% CI = 2.09-3.61) were associated with PG. Moreover, the severity of PG tended to increase with the number of involved in school bullying behaviors. The interaction terms of bully-victims and sex were significant. Further stratified analyses by sex indicated that the association of school bullying behaviors with PG was stronger for females than males, especially those identified as bully-victims.

Conclusion: School bullying behaviors are associated with PG among adolescents, with a stronger association found in female adolescents, particularly those identified as bully-victims. These findings suggest that implementing prevention and control measures for school bullying could help reduce PG among adolescents.

Background: Observational studies have shown a link between autoimmune diseases and schizophrenia, with conflicting conclusions. Due to the existence of confounding factors, the causal link between autoimmune diseases and schizophrenia is still unknown.

Method: We conducted a comprehensive Mendelian randomization (MR) analysis of schizophrenia and ten common autoimmune diseases in individuals of European descent using genome-wide association studies (GWASs). To evaluate the relationships between autoimmune diseases and schizophrenia, inverse variance weighted, MR-RAPS, Bayesian weighted MR, constrained maximum likelihood, debiased IVW, MR-Egger, and weighted median were utilized. Several sensitivity analyses were performed to ensure the reliability of the study's results.

Results: Our findings reveal that genetically predicted ankylosing spondylitis is related to an increased risk of schizophrenia, whereas celiac disease, type 1 diabetes, and systemic lupus erythematosus are associated with a lower risk of schizophrenia. In the reverse MR analysis, our study indicated that genetically predicted schizophrenia is linked to higher risks of ankylosing spondylitis, Crohn's disease, ulcerative colitis, inflammatory bowel disease, and psoriasis. Neither multiple sclerosis nor rheumatoid arthritis have been linked to schizophrenia, and vice versa.

Conclusion: Despite contradicting some other observational reports, this study showed support for a causal link between autoimmune diseases and schizophrenia. To gain a better understanding of the mechanisms underlying the development of immune-mediated schizophrenia, additional research is required to identify potential mechanisms identified in observational studies.