Identification of plant flora affecting common psychiatric disorders based on ethnobotanical knowledge of Ilam, Iran

ABSTRACT
 ObjectivesRates of common mental disorders may be increasing among children and adolescents, though evidence of this is mixed. Symptom questionnaires in population surveys may overestimate clinical disease. Conversely, lower participation of individuals with mental disorders may lead to underestimates in surveys. Clinical databases may have greater population coverage and contain information of more obvious clinical validity; however, several factors, including the help-seeking behaviour of individuals and the recording practices of clinicians, may influence burden-of-disease estimates based on these databases. The aim of the current investigation was to compare case definitions of common mental disorders (CMD) using linked electronic primary care data to definitions derived from self-reported data obtained in an observational study.
 ApproachWe studied 1,562 adolescents who had completed the Revised Clinical Interview Schedule (CIS-R) in the Avon Longitudinal Study of Parents and Children (ALSPAC) at age 17-18 years and had linkage established to their electronic primary care records for at least 6 months after the time they completed the CIS-R. We used lists of Read codes corresponding to diagnoses, symptoms and treatment to create twelve definitions of CMD and also of depression alone. We calculated sensitivities and specificities of these, using CIS-R case definitions as the reference standard. All analyses were carried in Stata 13.0.
 ResultsSensitivities ranged from 5.2% to 24.3% for depression and from 3.8% to 19.2% for CMD. The specificities of all definitions were above 98% for depression and above 96% for CMD. For both depression and CMD, the definition that included current diagnosis, treatment or symptoms identified the highest proportion of cases.
 ConclusionsMost individuals meeting case definitions for CMD based on information in clinical records also met CMD case definitions based on symptoms reported in a contemporaneous survey. Conversely, many individuals identified as CMD cases based on reported symptoms had no evidence of CMD in their clinical records. A small number of individuals with CMD recorded in their clinical records had not reported symptoms of this in the survey. Overall, these data suggest that clinical databases are likely to yield underestimates of the burden of CMD in the population. Clinical records appear to yield highly valid diagnoses of common mental disorders which may be useful for studying risk factors and outcomes of these conditions. The greatest epidemiological value is likely to be obtained when the combination of information from both survey and clinical records is possible.

BackgroundVietnam has limited evidence about the burden of common and severe mental disorders among adults to inform policy. The aim of this paper was to estimate the prevalence of common and severe mental disorders among adults and factors associated with them in Vietnam.MethodsWe conducted a cross-sectional household survey among people aged at least 16 years in Thanh Hoa and Ben Tre provinces which are nationally representative of the North and the South of Vietnam. The World Health Organization Self-Reporting Questionnaire 24 was used to screen for clinically significant symptoms of common and severe mental disorders at the individual level. Household characteristics were obtained in face-to-face interviews with the household heads. A multilevel mixed-effects logistic regression model was used to identify associated factors of the common and severe mental disorders.ResultsAmong 611 households which included 1528 adults, the point prevalence of clinically significant symptoms was 14.4% for common mental disorders and 8.2% for severe mental disorders after weighting by age groups. Common mental disorders were associated with social factors including lived in a Northern rather than a Southern province, disadvantaged household economic status, in which a family member(s) misused alcohol, the family lacking links to social organisations able to provide instrumental support, and the individual not having completed primary school. Severe mental disorders had fewer associations with social factors compared to common mental disorders, but were associated with living in the Northern province, disadvantaged household economic status, family violence and being older than 50 years.ConclusionsThe prevalence of clinically significant symptoms of common and severe mental disorders among adults in Vietnam was higher than in high income countries and had a strong association with household characteristics. The result indicates that a community-based approach to reduce household risk factors and to provide instrumental support might be an effective strategy to alleviate the burden of mental health problems in Vietnam.

BackgroundRates of common mental disorders may be increasing among children and adolescents, though evidence of this is mixed. Symptom questionnaires in population surveys may overestimate clinical disease. Conversely, lower participation...

Common mental health disorders (CMD) during pregnancy are a public health concern because of the implications for the mother and infant's health during pregnancy and after birth. The prevalence and factors related to common mental disorders vary globally. Therefore, this study assessed the magnitude and factors associated with common mental disorder among pregnant women attending ANC follow-up in North Wollo Zone, Northeast Ethiopia. An institutional-based cross-sectional study was conducted in North Wollo, Amhara Region, Northeast Ethiopia. A multistage sampling technique was used to select 777 study participants. The common mental disorder was assessed by using SRQ-20. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 23. Logistic regression analysis was done to identify the independent variables associated with common mental disorders. Independent variables with a p value less than 0.05 were considered significantly associated with CMD. The magnitude of CMD was 18.1% (95% CI: 15.5, 21.0). Factors significantly associated with CMD were the educational level of participants (AOR = 0.17, 95% CI: 0.06, 0.48), husband's educational status (AOR = 11.13, 95%: 4.18, 29.66), unplanned pregnancy (AOR = 2.54, 95% CI: 1.26, 5.09), self-reported complication on the current pregnancy (AOR = 0.11, 95% CI: 0.05, 0.21), self-reported complication during the previous delivery (AOR = 3.38, 95% CI: 1.39, 8.18), undernutrition (AOR = 2.19, 95%: 1.26, 3.81), high psychosocial risk (AOR = 20.55, 95% CI: 9.69, 43.59), having a legal issue (AOR = 2.06, 95%: 1.12, 3.79), and relationship problem (AOR = 7.22, 95% CI: 3.59, 14.53). Conclusions and Recommendation. One in five pregnant women has common mental disorder. Educational status of the participants and their spouses, unplanned pregnancy, self-reported complication during current and previous pregnancy, psychosocial risk, and legal and relationship problems were the main determinants of common mental disorders. Therefore, screening pregnant women for mental disorders and provision of necessary mental health services are recommended to minimize the adverse health outcome of CMD during pregnancy.

ContextDespite the high prevalence of work disability due to common mental disorders (CMD), no information exists on the rates and predictors of recurrence in a United States population.ObjectiveTo estimate recurrent work disability statistics and evaluate factors associated with recurrence due to CMDs including adjustment, anxiety, bipolar, and depressive disorders.MethodsRecurrent work disability statistics were calculated using a nationwide database of disability claims. For the CMDs, univariate and multiple variable analyses were used to examine demographic factors and comorbidities associated with the time to recurrence.ResultsOf the CMDs, cases with bipolar (n = 3,017) and depressive disorders (n = 20,058) had the highest recurrence densities, 98.7 and 70.9 per 1000 person-years, respectively. These rates were more than three times higher than recurrence rates for other chronic disorders (e.g., diabetes, asthma; n = 105,558) and non-chronic disorders (e.g., injury, acute illnesses; n = 153,786). Individuals with CMD were also more likely to have a subsequent disability distinct from their mental health condition. Risk factors for recurrent CMD disability included being younger, being an hourly employee, living in a geographic area with more college graduates, having more previous psychiatric visits, having a previous work leave, and the type of work industry.ConclusionsResults indicate that CMD patients may benefit from additional care and disability management both during and after their work absence to help prevent subsequent CMD and non-CMD related leaves.

Down syndrome is the most common genetic cause of intellectual disability and Alzheimer's disease. In the general population, common mental disorders (CMDs), including anxiety, depression and obsessive-compulsive disorder, are linked to cognitive decline and higher risk for dementia. It is not known how CMDs affect longer-term cognitive outcomes in Down syndrome, and there is often diagnostic uncertainty in older people with Down syndrome and psychiatric comorbidity. To study the influence of CMDs on cognitive ability and whether they are related longitudinally to development of clinical signs of Alzheimer's disease in Down syndrome. We followed 115 individuals with Down syndrome, 27 of whom were diagnosed with a CMD, over approximately 3 years. Changes in cognitive and behavioural outcomes between baseline and follow-up assessment were analysed, with comparisons made between those with and without a comorbid CMD. Age, gender, apolipoprotein E status and level of intellectual disability were included as covariates. No significant association between presence of a CMD and poorer performance on cognitive tasks or informant-rated decline over time was observed (P > 0.05). Our results suggest that a diagnosis of a CMD does not have a significant negative effect on long-term cognitive or behavioural outcomes in individuals with Down syndrome. In individuals with stable or treated CMD, subsequent cognitive decline is likely indicative of Alzheimer's disease rather than a consequence of mental disorder.

Common mental and musculoskeletal disorders as predictors of disability retirement among Finns

Because comorbidity between mental and physical disorders is commonly found in patients, it would be expected that this pattern would also be reflected at the family level. During a recent population-based survey of common mental disorders, respondents were asked about the presence of selected mental and physical disorders in their relatives. The aim of this research was to describe the within-family co-occurrence of selected common physical and mental disorders in a population-based sample. Subjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007. A modified version of the World Mental Health Survey Initiative of the Composite International Diagnostic Interview (WMH-CIDI 3.0, henceforth CIDI) was used to identify lifetime-ever common psychiatric disorders (anxiety disorders, depression, drug or alcohol disorders). The respondents were asked if any of their relatives had one of a list of psychiatric (anxiety, bipolar disorder, depression, drug or alcohol problem, schizophrenia) or general physical disorders (cancer, heart problems, intellectual disability, memory problems). We examined the relationship between the variables of interest using logistic regression, adjusting for potential confounding factors. Compared to otherwise-well respondents, those who had a CIDI diagnosis of major depressive disorders, anxiety disorders, or drug or alcohol abuse/dependence were significantly more likely to have first-degree relatives with (a) the same diagnosis as the respondent, (b) other mental disorders not identified in the respondent, and (c) a broad range of general physical conditions. Individuals with common mental disorders report greater familial co-occurrence for a range of mental and physical disorders. When eliciting family histories, clinicians should remain mindful that both mental and physical disorders can co-occur within families.

BackgroundThe postpartum period is associated with an increased risk of maternal mental disorders. The combined effect of having the mother's infant admitted to a tertiary hospital in a low-resource setting and the need to exclusively breastfeed the infant may exaggerate this risk. This study aimed to determine the breastfeeding support provided to mothers whose infants were hospitalised in Nigerian tertiary hospital nurseries and the prevalence of common mental health disorders among this population.MethodsThis was a national cross-sectional study involving mothers of hospitalised infants from eleven Nigerian tertiary hospitals between May and August 2022. To assess mothers' mental health and breastfeeding support, we utilised the WHO self-reporting Questionnaire 20 and an adapted WHO/UNICEF ten-step breastfeeding support package.ResultsOf the 1,120 mothers recruited from neonatal nurseries in the six geopolitical zones in Nigeria, only 895 had a complete dataset for analysis. The mean age of the mothers was 29.9 ± 6.2; with 54.7% belonging to the low-socioeconomic class. Most of the mothers (835, 93.3%) received antenatal care, and 591: 66.0% were delivered at term. Overall, less than half (427; 47.7%) of the mother received optimal breastfeeding support. One in every four, 216; 24.0% of nursing mothers (95% CI: 21.235 to 26.937%) had common mental disorders (CMD). Pre-pregnant mental health disorders were reported in 41; 4.6% of the nursing mothers. Overall, the lowest performing areas of breastfeeding support were family-centred care (198, 22.1%), practical skill demonstration in the ward (n = 279, 31.2%), and antenatal clinics (n = 294, 32.8%). CMDs were significantly associated with the healthcare provider's practical breastfeeding skill demonstration and the provision of storage facilities for breastmilk and family-centered-care. Across Nigeria's six geopolitical zones, there was an inverse relationship between optimal breastfeeding support and the proportion of mothers with CMDs. The northern zone provided better breastfeeding support and had fewer CMDs than the southern region of the country.ConclusionCommon mental disorders are prevalent among nursing mothers in Nigerian tertiary hospital nurseries, and they are inversely related to breastfeeding support. Urgently required in tertiary hospitals for improved and sustainable breastfeeding practices are a focus on family-centred care and enhanced health workers’ practical breastfeeding support skills.

Global mental health and HIV care: gaps and research priorities.

ObjectiveThis study aimed to examine the effects of low-quality employment trajectories on severe common mental disorders (CMD) according to Swedish and foreign background.MethodsIn this longitudinal study based on Swedish population registries (N=2 703 687), low- and high-quality employment trajectories were the main exposures observed across five years (2005–2009), with severe CMD as outcome variable (2010–2017). Adjusted hazard ratios (HR) were calculated by means of Cox regression models and stratified according to Swedish and foreign background [first-generation (i) EU migrants, (ii) non-EU migrants, (iii) second-generation migrants, (iv) Swedish-born of Swedish background] and sex. The reference group was Swedish-born of Swedish background in a constant high-quality employment trajectory.ResultsSecond-generation migrants had an increased risk of CMD compared to Swedish-born of Swedish background when following low-quality employment trajectories [eg, male in constant low-quality HR 1.54, 95% confidence interval (CI) 1.41–1.68]. Female migrant workers, especially first-generation from non-EU countries in low-quality employment trajectories (eg, constant low-quality HR 1.66, 95% CI 1.46–1.88), had a higher risk of CMD compared to female Swedish-born of Swedish background. The risk for CMD according to employment trajectories showed little differences between first- and second-generation migrants.ConclusionLow-quality employment trajectories appear to be determinants of risk for CMD in association with Swedish or foreign background of origin and sex. Our study shows a higher risk for severe CMD in second-generation and non-EU migrant compared to Swedish-born of Swedish background in constant low-quality employment. Further qualitative research is recommended to understand the mechanism behind the differential mental health impact of low-quality employment trajectories according to foreign background.

Background: Cannabis is one of the most commonly used illegal psychoactive substances and its use often coexists with mental health disorders. Objectives: This study explores the relationships between cannabis use disorders and some common mental health disorders. Methods: Admissions to all New South Wales (NSW) hospitals were analyzed. The data were extracted from the NSW Department of Health Inpatient Statistics Data Collection for the period 1 July 2006 to 30 June 2007. Readmissions within 28 days were excluded. Data extraction and analyses were performed by using the SAS program. Chi-square tests and odds ratio were used to examine the association between cannabis use disorder and mental health disorders. Results: Of the 1.8 million admissions, associations between cannabis use disorders and mental health disorders were strong (odds ratio = 7.8–10.7, p < .001). Inpatients (53.8%) who used cannabis had at least one identifiable mental disorder. Higher comorbidity rates were observed for females (39.6%) and for those aged between 30 and 49 years. Cannabis use disorder comorbid with the most common mental disorders were: anxiety disorder (3.4%), bipolar affective disorder (5.7%), major depressive disorder (10.9%), personality disorder (9.2%), schizophrenia (15.0%), and severe stress disorder (8.7%). Cannabis use disorder has strong associations with these mental health disorders (odds ratio 4.8–34.8). The average length of stay (ALOS) for cannabis use disorders was 9.0 days and the ALOS for the most common mental health disorders was 11.0 days. Conclusions and implications: This study provides detailed information about the association between cannabis use disorders and mental health disorders and extends our understanding of comorbidity presentations in inpatient admissions.

ObjectiveTo investigate whether maternal common mental disorders (CMD) in the postnatal period are prospectively associated with child development at 2.5 and 3.5 years in a rural low‐income African setting.MethodsThis study was nested within the C‐MaMiE (Child outcomes in relation to Maternal Mental health in Ethiopia) population‐based cohort in Butajira, Ethiopia, and conducted from 2005 to 2006. The sample comprised of 496 women who had recently given birth to living, singleton babies with recorded birth weight measurements, who were 15 to 44 years of age, and residing in six rural sub‐districts. Postnatal CMD measurements were ascertained 2 months after delivery. Language, cognitive, and motor development were obtained from the child 2.5 and 3.5 years after birth using a locally adapted version of the Bayley Scales of Infant Development (3rd Ed). Maternal CMD symptoms were measured using a locally validated WHO Self‐Reporting Questionnaire. A linear mixed‐effects regression model was used to analyze the relationship between postnatal CMD and child development.ResultsAfter adjusting for confounders, there was no evidence for an association between postnatal CMD and overall child development or the cognitive sub‐domain in the preschool period. There was no evidence of effect modification by levels of social support, socioeconomic status, stunting, or sex of the child.ConclusionsPrevious studies from predominantly urban and peri‐urban settings in middle‐income countries have established a relationship between maternal CMD and child development, which contrasts with the findings from this study. The risk and protective factors for child development may differ in areas characterized by high social adversity and food insecurity. More studies are needed to investigate maternal CMD’s impact on child development in low‐resource and rural areas.

Common mental disorders (CMD) is used to describe depressive and anxiety disorders. Community prevalence rates worldwide are estimated between 15%-30%. Mental health services however are mainly geared towards those with the more severe forms of mental disorder. Although the prevalence of CMD is high, little is known about help-seeking behaviour for people with CMD in community settings, particularly in developing countries. The main aim of this research is to investigate the patterns of help-seeking behaviour for CMD in an urban Malaysian community and identifying the determinants of helpseeking behaviour. A two-stage cross-sectional survey was conducted in a Malaysian urban community. Participants aged between 18-45 years, were randomly selected from an electoral register. A total of 614 participants were interviewed and assessed. In addition to background information and self-reported help-seeking behaviour, all participants were presented with a vignette depicting a person with depression and were questioned to assess level of recognition, causal beliefs of depression, recommended help-seeking behaviour and stigmatizing attitude towards sufferers. All were screened with the General Health Questionnaire (GHQ-12) and probable cases of CMD were further interviewed with the diagnostic Mini International Neuropsychiatric Interview (MINI). Stage 2 was conducted to carry out a descriptive study of pathways to care of participants with diagnosed CMD. Prevalence of CMD was 8.8%, and the risk factors associated with CMD were age, marital status, ethnicity, unemployment, and status as student. Following adjustment, only age remained significantly associated with CMD. About one third (33.1%) of the study sample had engaged in general help-seeking behaviour in the past 4 weeks. The types of help sought were namely biomedical and complimentary or alternative medicine (CAM). Those who sought help were more likely to be female, older and diagnosed with CMD (p<O.05). Similar factors were found to be significantly associated with seeking biomedical care (p<O.05). In relation to the study's main interest of the associations between help-seeking and CMD, the results indicated that people with CMD were more than 2 times more likely to utilize biomedical care (p = 0.016), where help-seeking may not have specifically addressed CMD in particular. Explanatory Models for CMD were investigated across domains of recognition levels, causal attributions and stigmatising attitudes. Almost all the participants recognized CMD as a problem (96.910) although only half (5 1.8%) belived CMD amounted to an illness. Six different causal attributions to CMD were generated namely psychological, physical, employment, relationship, financial and supernatural. For help-seeking specifically for CMD, the results were analysed for a hypothetical case via responses to vignette, as well as actual cases based on diagnosis. The major factors predicting biomedical help seeking for the vignette were recognition of depression as a problem, as an illness and fmancial causal attribution. Of the confinned CMD cases, only 42.6% have sought any kind of help for their problems and almost none sought specialised mental health care. Based on the findings, it is evident that a substantial number of people in the community have CMD and they generally utilize biomedical sources at the primary care level more than those not diagnosed with CMD. Although socio-demoraphic factors were predictive of help-seeking behaviour in general, they were not predictive of help-seeking for CMD. Results indicated Explanatory Models were predictive of help-seeking behaviour specifically for CMD. Help-seeking behaviour generated for CMD were mostly in line with the biomedical approach, followed by self-help and lastly CAM. Implementing policies to integrate care for CMD into primary care, promoting awareness, recognizing roles of other sectors, supporting self-help and ensuring accessibility to care would ensure people receive the appropriate care they need.

The prognosis of common mental disorders in adolescents: a 14-year prospective cohort study