Stressors, mental health and coping amongst forcibly displaced youth since the advent of COVID-19: A systematic review

Status of mental health in South Asian countries

While global studies demonstrated that features of urban living are associated with the risk of developing mental disorders, there remains a significant knowledge gap surrounding this topic in the Middle East and North Africa region. This study aims to assess the prevalence, severity, correlates, and treatment of mental disorders in Riyadh City by examining certain aspects of urban living such as exposure to traumatic events, early exposure to urbanization, and seeking treatment. The Saudi National Mental Health Survey is a community epidemiological survey in a nationally representative sample of citizens aged 15 to 65 in KSA. The World Health Organization Composite International Diagnostic Interview (CIDI 3·0) was used to estimate the 12-month prevalence of common mental disorders. The prevalence of any mental disorder in Riyadh City was 29.2%. The most common disorders were anxiety disorders and mood disorders. Female, young, and previously married respondents were at higher risk for developing mental disorders. Exposure to traumatic events was associated with all types of mental disorders. Only 2.9% of those with any mental disorder sought mental health treatments. We found a high prevalence of mental disorders in Riyadh City that could be attributed to certain features of urban living. These results may point to potential interventions in urban areas that can mitigate the adverse consequences of urban living and promote the salutogenic aspects of cities.

Mental health disorders disproportionately affect women during pregnancy and postpartum, with high prevalence in low-income countries. Mental health disorders during the antenatal period can lead to serious complications for both mother and child, including preterm birth, developmental issues and postpartum depression. However, mental health screening remains neglected during the antenatal period in resource-limited settings. We investigated the prevalence and determinants of common mental disorders (CMD) among women attending antenatal care (ANC) in selected health facilities of Lusaka, Zambia. A cross-sectional study was conducted between 26th April and 6th July 2024 in two purposively selected health facilities in low socioeconomic areas of Lusaka. A systematic sample of pregnant women in the third-trimester attending ANC were invited to participate. Common mental disorders were defined using a cut-off score of ≥8 on the WHO Self-Reporting Questionnaire (SRQ)-20, administered through face-to-face interviews. Logistic regression models were employed to identify determinants of common mental disorders. Stata 18 SE was used for analysis. We included 331 participants who were predominantly young adults (50.5% aged 20–29), married/cohabiting (69%), and almost a quarter (23.9%) living with HIV. Most had unplanned pregnancies (58.6%), experienced pregnancy-related body changes (73.1%) and had delivery concerns (68.6%). The study found a high prevalence of common mental disorders (65.8%). Participants who were less than 20 years, primary level education, had history of complications during previous pregnancy, were worried about the birth process and reported unpleasant body changes due to pregnancy exhibited higher prevalence for common mental disorders. On the other hand, women with medium or high social connectedness had lower odds of common mental disorders. The high burden of common mental health disorders among pregnant women in Lusaka, Zambia, underscores the importance of integrating mental health screening and support into routine antenatal care, with targeted attention to high-risk groups such as adolescents.

JS03-03 - Prevalence and Impact of Common Mental Disorders: International Similarities & Differences. Results of the Who World Mental Health (WMH) Surveys Initiative

The mental health of adolescents (10–19 years) remains an overlooked global health issue, particularly within the context of syndemic conditions such as HIV and pregnancy. Rates of pregnancy and HIV among adolescents within South Africa are some of the highest in the world. Experiencing pregnancy and living with HIV during adolescence have both been found to be associated with poor mental health within separate explorations. Yet, examinations of mental health among adolescents living with HIV who have experienced pregnancy/parenthood remain absent from the literature. As such, there exists no evidence-based policy or programming relating to mental health for this group. These analyses aim to identify the prevalence of probable common mental disorder among adolescent mothers and, among adolescents experiencing the syndemic of motherhood and HIV. Analyses utilise data from interviews undertaken with 723 female adolescents drawn from a prospective longitudinal cohort study of adolescents living with HIV (n = 1059) and a comparison group of adolescents without HIV (n = 467) undertaken within the Eastern Cape Province, South Africa. Detailed study questionnaires included validated and study specific measures relating to HIV, adolescent motherhood, and mental health. Four self-reported measures of mental health (depressive, anxiety, posttraumatic stress, and suicidality symptomology) were used to explore the concept of likely common mental disorder and mental health comorbidities (experiencing two or more common mental disorders concurrently). Chi-square tests (Fisher’s exact test, where appropriate) and Kruskal Wallis tests were used to assess differences in sample characteristics (inclusive of mental health status) according to HIV status and motherhood status. Logistic regression models were used to explore the cross-sectional associations between combined motherhood and HIV status and, likely common mental disorder/mental health comorbidities. 70.5% of participants were living with HIV and 15.2% were mothers. 8.4% were mothers living with HIV. A tenth (10.9%) of the sample were classified as reporting a probable common mental disorder and 2.8% as experiencing likely mental health comorbidities. Three core findings emerge: (1) poor mental health was elevated among adolescent mothers compared to never pregnant adolescents (measures of likely common mental disorder, mental health comorbidities, depressive, anxiety and suicidality symptoms), (2) prevalence of probable common mental disorder was highest among mothers living with HIV (23.0%) compared to other groups (Range:8.5–12.8%; Χ2 = 12.54, p = 0.006) and, (3) prevalence of probable mental health comorbidities was higher among mothers, regardless of HIV status (HIV & motherhood = 8.2%, No HIV & motherhood = 8.2%, Χ2 = 14.5, p = 0.002). Results identify higher mental health burden among adolescent mothers compared to never-pregnant adolescents, an increased prevalence of mental health burden among adolescent mothers living with HIV compared to other groups, and an elevated prevalence of mental health comorbidities among adolescent mothers irrespective of HIV status. These findings address a critical evidence gap, highlighting the commonality of mental health burden within the context of adolescent motherhood and HIV within South Africa as well as the urgent need for support and further research to ensure effective evidence-based programming is made available for this group. Existing antenatal, postnatal, and HIV care may provide an opportunity for mental health screening, monitoring, and referral.

Mental contamination (MC)-a sense of dirtiness experienced without contacting an identifiable pollutant-is a distressing and enduring experience among many survivors of sexual trauma. MC has been linked to more frequent use of avoidant coping behaviors (e.g., washing behavior, substance use, binge eating) and approach coping. However, it is unclear if specific approach and avoidant coping strategies are more consistently related to perseverative experiences of trauma-related MC, if the use of certain strategies predicts changes in MC, and if fluctuations in MC predict the use of certain strategies. The present study evaluated contemporaneous and prospective relationships between sexual trauma-related MC and use of 11 specific coping strategies among 41 women with a history of sexual trauma using an experience sampling design. Women completed twice-daily assessments of coping strategy use and MC for 14 days. Between-persons, women reporting more intense MC on average reported more frequent use of distraction, denial, giving up, self-blame, thought suppression, washing behavior, emotional processing, and emotional expression than those experiencing less intense MC. Within-person increases in MC were associated with more frequent concurrent use of all coping strategies except seeking support. Lastly, within-person increases in MC predicted more frequent use of giving up, substance use, and seeking support at the next assessment and within-person increases in substance use predicted less severe MC at the next assessment. Future work should aim to identify factors influencing the selection and/or quality of use of these specific coping strategies among individuals experiencing MC.

Background: Common mental disorders such as anxiety, depression and unexplained somatic symptoms and substance use disorders such as alcohol, khat and cigarette contributes to disability and distress to the population impeding productivity and affecting societal wellbeing. Recognizing this, the current study was conducted to be one input for policy maker’s efforts in reforming mental health care among the community in our country. Objective: This study assessed prevalence of common mental disorders and its associated factors among residents of Jimma town, March, 2015. Methodology: Community based cross sectional study was conducted in March, 2015 in Jimma town using interviewer administered structured questionnaire. A total of 745 residents were selected using multi stage probability sampling technique. Self-Reporting Questionnaire (SRQ) was used to determine the prevalence of common mental disorders. Data was analyzed with SPSS version 20. Binary logistic regression analysis was used for both bivariate and multivariate analysis. Strength of association of the variables was determined using odds ratio and 95% confidence interval. Results: From a total of 745 respondents, 729 completed the study from which 380 (52.1%) were females. The prevalence of common mental disorders was 33.6%. Variables such as older age, being female, housewife, unable to read and write, chewing khat and having chronic physical illness were significantly associated with higher prevalence of common mental disorders. While being married in marital status was found to be a protective factor from common mental disorders. Conclusion: There is a high prevalence of common mental disorders among residents of Jimma town. The risk of common mental disorders was higher in females, housewives, in those who were unable to read and write, in current khat users and in respondents who reported to have chronic physical illness. To improve the mental health status of the community, mental health training has to be given to general health care workers in the country. By doing so, appropriate intervention will be taken on factors contributing to common mental disorders.

Mental health is a key issue for populations affected by conflict. The evidence base on the mental health of internally displaced Colombians is undefined, as well as protective strategies utilised by this group. This systematic literature review aims to identify and assess the evidence base on the mental health of Colombian internally displaced persons (IDPs). Specific objectives are to examine (1) prevalence and incidence rates of common mental disorders (CMDs) amongst adult Colombian IDPs, (2) risk factors associated with CMDs amongst this group, and (3) coping strategies used by these displaced persons. A database search was conducted in May 2021. Included studies reported quantitative and/or qualitative mental health outcomes of CMDs, and/or coping strategies, among Colombian IDPs. The search yielded 34 articles. Study quality ranged from adequate to poor, with several containing serious shortcomings. PTSD prevalence ranged from 1.2%-97.3%, anxiety from 0.0%-60.0%, depression from 5.1%-100%, and problematic alcohol use from 8.0%-33.5%. Factors significantly associated with CMDs were inconsistent. Seeking social support and problem-solving strategies were the two most-commonly reported coping strategies. Associations between mental health and coping were largely unreported. As the evidence base is weak, there is a clear need for better quality research in this area.

Perceived Need for Mental Health Care and Service Use Among Adults in Western Europe: Results of the ESEMeD Project

A cross-sectional study of 392 late adolescents and young adults (mean age 18.2 years) was undertaken to examine the relationship between coping styles and psychological health. Coping styles were assessed through the Coping Styles Questionnaire (Roger, Jarvis, & Najarian, 1993). Using separate regression models of psychological distress and psychological wellbeing, the direct effects and moderator models of coping were tested with, regard to approach and avoidant coping. It was hypothesised that approach coping would have buffer effects on distress and wellbeing and that avoidant coping would have direct effects on distress and wellbeing. Results indicated that there were no buffer effects for either approach or avoidant coping, but there were direct effects for both. The use of approach coping was associated with increased wellbeing, while avoidant coping was related to increased distress levels. Implications for effective primary intervention techniques for adolescent wellbeing and distress are discussed.

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

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.

Think globally, act locally

The purpose of the study was to assess common mental disorders and the related use and need for mental health care among clinically not yet active and clinically active medical students. All medical students (n=2266) at one Dutch medical university were approached. Students from study years 1-4 were defined as clinically not yet active and students from study years 5 and 6 as clinically active. An electronic survey was used to detect common mental disorders depression (BSI-DEP), anxiety (BSI-ANG), stress (4DSQ) and post-traumatic stress disorder (IES). The use of mental health services in the past 3 months and the need for mental health services were asked for. The prevalence of common mental disorders, the use and need for mental health services and differences between groups were calculated. The response rate was 52%: 814 clinically not yet active and 316 clinically active students. The prevalence of common mental disorders among clinically not yet active and clinically active students was 54% and 48%, respectively. The use of mental health services was 14% in clinically not yet active and 12% in clinically active students with common mental disorders (n.s.). The need for mental health services by clinically not yet active and clinically active students was 52% and 46%, respectively (n.s.). The prevalence of probable common mental disorders are higher among clinically not yet active than among clinically active students. The need of mental health services exceeds use, but is the same in the two groups of students.

The objective of the present study was to provide updated data from nine European countries about the impact of social inequalities in the prevalence of common mental disorders. Cross-sectional household survey of a representative sample of the adult general population of Belgium, Bulgaria, Germany, Italy, The Netherlands, Northern Ireland, Portugal, Romania and Spain. In total, 34,395 individuals were included. Social inequalities in 12-month mood, anxiety and alcohol-related disorders were evaluated. In Europe, income seems not to be related to the prevalence of mental disorders. Unemployment and disablement are associated with mental disorders. Lower educational level augments the risk for mood disorders. Living in small (rural) areas decreases the risk for mood disorders and living in urban settings increases it. Northern Ireland, Portugal and Belgium are the countries with the highest risks for mental disorders. Despite some contradictions with previous literature, in Europe there are social inequalities in the prevalence of mental disorders. However, income showed not to be associated with inequalities in mental health. Being younger, unemployed or disabled, with no education or incomplete primary studies, living in urban settings, and in Northern Ireland, Portugal or Belgium were associated to an augmented prevalence of mental disorders. Policy makers could focus on mental health promotion and mental disorders prevention programmes for risk groups such as unemployed/disabled individuals. Support to vulnerable groups (unemployed or those with less education) and mental health literacy can improve European citizens' mental health.