High Rates Of Mental Disorders Research Articles

The challenge of diagnosing cultural syndromes: A narrative review.

In 2022 the total world migrant population was 281 million (an increase of approximately 62% compared to year 2000), of whom 169 million were migrant workers. The number of refugees, asylum seekers and others in need of international protection increased by 22% compared to 2021. Research has shown that the forcibly displaced have high rates of mental disorders (including depression, post-traumatic stress disorder (PTSD) and anxiety), with an estimated prevalence almost 6 to 7 times higher than the general population. Given the increase of the overall migration phenomenon and the challenge raised by the cultural features concerning mental health, we consider that this is an area that requires close attention to ensure that culturally sensitive health services be available to the migrant and displaced population. The aim of this narrative review is to provide a background to the issue and take stock of what is currently available in the literature regarding culture-bound illnesses and the relevant diagnostic tools. A comprehensive search was performed in PubMed, Psychinfo, Embase, Google Scholar, organized in stages to assure inclusion of all the relevant studies. Of the 703 papers initially identified, only 30 papers finally satisfied the inclusion criteria. Eleven diagnostic scales were found, only two of which are being used for displaced people. Further work is required in this field, including a debate as to whether scales are indeed an appropriate tool for use with this population.

Hospital based one-stop crisis management centre at patan academy of health sciences: New avenues for the mental health professionals

Gender-based violence (GBV) is a public health concern with high rates of mental disorders. One Stop Crisis Management Centre (OCMC) was established in 2010 in different hospitals throughout the nation for the management of gender-based violence (GBV) against women by the Government of Nepal. With establishment of OCMC throughout the nation to tackle and manage these GBV, the role of mental health professionals has been highlighted in many ways. OCMC is full of opportunities and challenges to improve mental health issues of patients with GBV as well as define and recognize the roles and responsibilities of mental health experts.

Eating disorders and emotional dysregulation are associated with insufficient weight loss after bariatric surgery: a 1-year observational follow-up study

PurposeSubjects with obesity, especially those seeking bariatric surgery, exhibit high rates of mental disorders and marked psychopathological traits. The primary objective of this prospective, non-interventional study was to investigate whether the presence of different psychiatric disorders, attention deficit/hyperactivity disorder (ADHD) symptomatology and emotional dysregulation influenced weight loss at 1-year follow-up after surgery.MethodsSubjects consecutively referred for pre-surgical evaluation at the Obesity Center of Pisa University Hospital were recruited. Psychiatric diagnoses were made through the Mini-International Neuropsychiatric Interview (MINI) and ADHD symptomatology was assessed with the Wender–Reimherr Adult Attention Deficit Disorder Scale (WRAADDS). Emotional dysregulation was investigated through the WRAADDS and self-report questionnaires. After surgery, weight and obesity-related comorbidities were monitored during follow-up.ResultsOf the 99 participants recruited, 76 underwent surgery and 65 could be reevaluated 1 year after surgery. Subjects with insufficient weight loss (excess body mass index loss ≤ 53%, n = 15) had more frequent lifetime binge eating disorder (BED) and BED-mood disorders comorbidity than subjects with favorable post-surgical outcome. Additionally, they scored higher on both physician-administered and self-report scales assessing emotional dysregulation, which represents a nuclear symptom of ADHD in adults. At the logistic regression analysis, older age, higher preoperative excess body mass index and greater affective instability were predictors of reduced weight loss at 1-year follow-up.ConclusionEmotional dysregulation seems to be associated with a worse outcome after bariatric surgery. Further studies with larger samples and longer follow-up are needed to confirm the influence of different psychiatric disorders and psychopathological traits on post-surgical outcome.Level of evidenceV, prospective descriptive study.

Psychiatric disorders and comorbidity in a Spanish sample of prisoners at the end of their sentence: Prevalence rates and associations with criminal history.

This study examined, for the first time, the prevalence of mental disorders and comorbidities among inmates who were about to be released, and their association with criminal history. A Spanish sample of 140 prisoners at the end of their sentence was recruited from an occupational program. Psychiatric disorders were determined according to the Diagnostic and Statistical Manual of Mental Disorders criteria. Bivariate analyses followed by multivariate regression models were conducted to identify significant variables for repeat incarceration and violent offending. The lifetime prevalence of Axis I disorders was 81.4%, with substance use disorders (SUD) and attention deficit/hyperactivity disorder (ADHD) being the most common diagnoses (51.4 and 31.4%, respectively). The current prevalence of Axis I disorders was 59.0%, including learning disorders (38.6%), ADHD (16.4%), and SUD (5.71%) among the most frequent syndromes. Thirty-six (26.5%) participants met criteria for a current Axis II disorder, which commonly was an antisocial personality disorder (12.5%). The majority of the sample (60.8%) suffered from two or more comorbid disorders during their lifetime, although the current prevalence fell to 23.3%. Childhood ADHD increased the number of imprisonments, while inmates convicted of a violent crime were more likely to present a learning disorder. Having a lifetime diagnosis of SUD or multiple psychiatric disorders appeared to be associated with both repeat incarceration and violent offending. Given the high rate of mental disorders still present among subjects completing prison sentences and the challenges they may encounter to benefit from vocational programs, our results suggest that appropriate psychiatric care should be provided during imprisonment and after release to facilitate their community reintegration.

Patients With Prenatal Alcohol Exposure Frequently Misdiagnosed, Face Multiple Challenges

Patients With Prenatal Alcohol Exposure Frequently Misdiagnosed, Face Multiple Challenges

Creating Brave Spaces in Higher Education: A Short Interprofessional Education Exchange to Support Refugees’ Psychosocial Needs

Potential traumatic experiences, prior, during and after migration, are the most common risk factors consistently associated with higher rates of mental disorders among refugees. The complex nature of refugee social and health challenges requires a holistic and comprehensive approach to achieve health equity. That is why, interprofessional education and collaboration among health and psychosocial care professionals is becoming increasingly crucial to build strong foundations for socially relevant work for refugees. Academic institutions can provide learning activities to advance students’ interprofessional knowledge and competences before they enter the workforce. This study explored higher education students’ experiences and reflections on a short-term interprofessional exchange that aimed to promote mental health and psychosocial support for refugees. Participants were higher education students from Germany, Greece, Sweden, and Spain representing the fields of psychology, occupational therapy, social work, pedagogy, medicine, and nursing. A qualitative study compromising two focus groups carried out at the end and 18 months after the interprofessional exchanges. Thematic analysis resulted in four themes: a) from curiosity to responsible action, b) my cultural humility journey, c) companion stories, and d) brave spaces and a sense of hope. Interprofessional collaboration emerged as a key strategy in protecting human rights and providing equal opportunities in psychosocial support of refugees. Findings highlight the value of short-term interprofessional exchanges for preparing higher education students in health and social care to move and be responsive in intercultural societies and contexts.

Mental health and quality of life of Brazilian healthcare professionals during the COVID-19 pandemic

The COVID-19 pandemic can produce considerable impacts on the mental health of healthcare professionals, as they face several stressors at work. Purpose: This study aims to assess Brazilian healthcare professionals’ mental health and quality of life. Method: participants were divided into four groups according to their occupational fields: administrative(n=129), emergency (n=39), primary care (n=257) and specialties (n=51). Participants completed a sociodemographic questionnaire, the World Health Organization Quality of Life-BREF and the Self-Reporting Questionnaire. Data analysis: Data were analyzed with Variance Analysis, Chi-square, and linear and logistic regressions. Results: Results showed that health providers have an average quality of life but presented high rates of mental disorders, especially those working in emergency and primary care. Some risk factors, such as demographic (gender, age, educational attainment, marital status), lifestyle (physical activity, diet, religion, social support, leisure), and labor (job satisfaction, job congruence, presence of deaths at work) were observed. Conclusions: This research shows the importance of designing specific psychological interventions for this population, which seems to be at risk for more severe mental conditions.

Comorbidity of mental ill-health in tuberculosis patients under treatment in a rural province of South Africa: a cross-sectional survey

ObjectivesTuberculosis (TB) remains prevalent despite the availability of effective anti-TB medications, and accumulating evidence suggests a high rate of mental disorders in people with TB. This is because TB and...

Social and Emotional Learning and Internalizing Problems among Adolescents: The Mediating Role of Resilience.

(1) Background: The high rates of mental disorders in adolescence presented in the literature often exclude internalizing problems. Although there is extensive data on the effectiveness of SEL skills in improving resilience, few studies included evidence in their reports on the relationship between SEL skills and internalizing problems. The present study aims to deepen the understanding of the relationship between SEL, resilience, and internalizing problems, by investigating the mediating effect of resilience between SEL components and internalizing problems. (2) Methods: Adolescents (N = 968 adolescents, aged between 11 and 18 years old; M = 13.30; SD = 1.92) from 30 schools from the NE region of Romania were invited to fill out questionnaires on social and emotional learning, internalizing problems, and resilience. (3) Results: The results show that resilience mediates the link between self-awareness and internalizing problems, between self-management and internalizing problems, between relationship skills and internalizing problems, and between responsible decision-making and internalizing problems. (4) Conclusions: These findings revealed the need for social and emotional learning interventions that include resilience-oriented approaches in order to decrease internalizing problems in adolescents. Moreover, we suggest that more culturally appropriate interventions are required to better investigate the interaction between SEL components, resilience, and internalizing problems.

Barriers to the Use of the Mental Health Treatment Requirement as Part of a Community-Based Criminal Sentence for Mentally Disordered Offenders

AimsDue to the high rates of mental disorder in prison there have been a number of initiatives to divert mentally disordered offenders out of custody. One of these is the Mental Health Treatment Requirement (MHTR): a criminal sentence available as part of a Community Order, offered as an alternative to short-term custodial sentences in an attempt to address recidivism and encourage concordance with community psychiatric treatment. In spite of the prevalence of mental disorder amongst offenders, MHTRs represent less than 1% of all community sentences. Here we aim to identify obstacles to the use of the MHTR at sentencing and to suggest ways of overcoming them.MethodsA literature review and brief case series will be used to identify and illustrate what may be obstructing or limiting the use of the MHTR. The terms ‘MHTR’ and ‘Mental Health Treatment Requirement’ were searched on Google, Google Scholar, Athens, and PubMed, and results analysed for recurrent themes. The issues encountered clinically by one of the authors who referred three defendants for MHTRs in psychiatric sentencing reports in 2021 were reviewed with the same purpose.ResultsThe main barriers to the use of the MHTR which were identified were issues related to a lack of clinician awareness and experience, homelessness and housing, and service structure and provision. There may be a reluctance for Community Mental Health Teams (CMHTs) to accept offenders onto their caseloads, and there are challenges in obtaining assessments and recommendations for MHTRs. There are difficulties in securing an MHTR for homeless defendants on remand for whom identifying housing prior to sentencing, and thus a CMHT to supervise the MHTR, can be challenging. The MHTR assessment and referral process is more lengthy and cumbersome than that for most other disposals, leaving the defendant awaiting sentencing (potentially in custody) while the referral is processed.ConclusionSuggested solutions to improve access to the MHTR include increasing clinician awareness and confidence by providing teaching and training, and multi-agency meetings to enhance communication and create an understanding amongst professionals of duties, roles, and responsibilities. Initiatives to identify housing for homeless remand prisoners before their release, as well as ensuring the availability of community services to supervise treatment, would overcome some of the obstacles identified and increase availability of the MHTR. Funding for additional staff to conduct the assessment and referrals process would also be likely to improve uptake.

Audit of fidelity of implementation of the older prisoner health and social care assessment and plan (OHSCAP)

ABSTRACT Numbers of older prisoners have been increasing in recent years and there is no national strategy addressing their care. Older prisoners have more physical health needs, complex social care needs and high rates of mental disorder compared with younger prisoners. These needs are often not identified or addressed. We developed the Older prisoner Health and Social Care Assessment and Plan (OHSCAP), a structured approach for identifying and managing the health and social care needs of older prisoners. It consists of an assessment, care plan and review of needs. The current study aims to establish the fidelity of implementation of the OHSCAP as part of a larger RCT. Compliance, context and competence fidelity were audited to assess compliance with training and the manual, adequacy of completion and identification of needs and quality of care planning. Results showed that the OHSCAP was not implemented as intended with needs identified not being consistently translated into care plan actions, little evidence to suggest that prisoner involvement in the care planning process and difficulties in collaborative working. Implications with respect to effectively embedding complex interventions within prisons, along with wider policy-related issues affecting the entire prison estate are discussed.

Prevalence of mental disorders in refugees and asylum seekers: a systematic review and meta-analysis

Studies have identified high rates of mental disorders in refugees, but most used self-report measures of psychiatric symptoms. In this study, we examined the percentages of adult refugees and asylum seekers meeting diagnostic criteria for major depressive disorder (MDD), post-traumatic stress disorder, bipolar disorder (BPD), and psychosis. A systematic literature search in three databases was conducted. We included studies examining the prevalence of MDD, post-traumatic stress disorder, BPD, and psychosis in adult refugees according to a clinical diagnosis. To estimate the pooled prevalence rates, we performed a meta-analysis using the Meta-prop package in Stata (PROSPERO: CRD42018111778). We identified 7048 records and 40 studies (11 053 participants) were included. The estimated pooled prevalence rates were 32% (95% CI 26-39%; I 2 = 99%) for MDD, 31% (95% CI 25-38%; I 2 = 99.5%) for post-traumatic stress disorder, 5% (95% CI 2-9%; I 2 = 97.7%) for BPD, and 1% (95% CI 1-2%; I 2 = 0.00%) for psychosis. Subgroup analyses showed significantly higher prevalence rates of MDD in studies conducted in low-middle income countries (47%; 95% CI 38-57%, p = 0.001) than high-income countries studies (28%; 95% CI 22-33%), and in studies which used the Mini-International Neuropsychiatric Interview (37%; 95% CI 28-46% p = 0.05) compared to other diagnostic interviews (26%; 95% CI 20-33%). Studies among convenience samples reported significant (p = 0.001) higher prevalence rates of MDD (35%; 95% CI 23-46%) and PTSD (34%; 95% CI 22-47%) than studies among probability-based samples (MDD: 30%; 95% CI 21-39%; PTSD: 28%; 95% 19-37%). This meta-analysis has shown a markedly high prevalence of mental disorders among refugees. Our results underline the devastating effects of war and violence, and the necessity to provide mental health intervention to address mental disorders among refugees. The results should be cautiously interpreted due to the high heterogeneity.

Mental disorders into adulthood among adolescents placed in residential care: A prospective 10-year follow-up study.

Child welfare and juvenile justice placed youths show high levels of psychosocial burden and high rates of mental disorders. It remains unclear how mental disorders develop into adulthood in these populations. The aim was to present the rates of mental disorders in adolescence and adulthood in child welfare and juvenile justice samples and to examine their mental health trajectories from adolescence into adulthood. Seventy adolescents in shared residential care, placed by child welfare (n=52, mean age=15years) or juvenile justice (n=18, mean age=17years) authorities, were followed up into adulthood (child welfare: mean age=25years; juvenile justice: mean age=27years). Mental disorders were assessed based on the International Classification of Diseases 10th Revision diagnoses at baseline and at follow-up. Epidemiological information on mental disorders was presented for each group. Bivariate correlations and structural equation modeling for the relationship of mental disorders were performed. In the total sample, prevalence rates of 73% and 86% for any mental disorder were found in adolescence (child welfare: 70%; juvenile justice: 83%) and adulthood (child welfare: 83%; juvenile justice: 94%) respectively. General psychopathology was found to be stable from adolescence into adulthood in both samples. Our findings showed high prevalence rates and a high stability of general psychopathology into adulthood among child welfare and juvenile justice adolescents in Swiss residential care. Therefore, continuity of mental health care and well-prepared transitions into adulthood for such individuals is highly warranted.

Prevalence and Predictors of Depression Among Eritrean Refugees in Ethiopia: A Cross-Sectional Survey.

BackgroundDepressive disorders place an enormous burden on society and ranked fourth in the global disease burden accounting for 4.4% of the total disability-adjusted life years and 11.9% of total years lived with disability. Depression is associated with high level of morbidity and it is the most common contributor to suicide. Refugees have higher rates of mental disorders, in particular depression than those usually found in the non-war affected general population. There is a dearth of evidence in Ethiopia regarding the mental health of refugees.ObjectiveThis study aimed to assess the prevalence of depression and associated factors among Eritrean refugees in Tigray North Ethiopia.MethodsA cross-sectional study was conducted at Maiayni refugee camp. A total of 800 participants were interviewed using systematic random sampling method. Pretested, structured and interviewer administered questionnaire that included socio demographic, clinical, behavioral, Harvard trauma questionnaire, and the patient health questionnaire (PHQ-9) was used. Descriptive statistics and binary logistic regression analyses were carried out.ResultsWith 786 (98.3%) of response rate, the prevalence of depression was found to be 37.8%, 95% confidence interval (34.2, 41.2). The odds of depression was higher in females [(AOR=8.92 95% CI (5.21, 15.25)], older age [(AOR=2.72 95% CI (1.03–7.16)], those who never attended school [(AOR=3.09 95% CI (1.16–8.24)], among the unemployed [(AOR=2.36 95% CI (1.16–4.83)], those with poor social support [(AOR=8.67 95% CI (4.24–17.77)], past psychiatric history [(AOR=4.76 95% CI (1.94–11.67)], family history of a psychiatric disorder [(AOR=3.96 95% CI (1.93–8.13)], those who were using substances [(AOR=4.08 95% CI (2.51–6.65)], and among those who stayed for longer than a year at the camp [(AOR=4.18 95% CI (2.47–7.08))].ConclusionThe study revealed that depression is a major mental health and public health problem among Eritrean refugees in Ethiopia. Several socio-demographic, psychosocial, behavioral and clinical factors were significant predictors of depression among the study participants. Mental health service provision for the refugees needs to be part of the support.

The mental health trajectories of male prisoners and their female (ex-)partners from pre- to post-release.

There are high rates of mental disorders among prisoners. Prisoners are also likely to have difficulties with intimate relationships, perhaps related to the imprisonment, but their mental health may be relevant. There is a dearth of research on intimate relationship qualities and mental health of offenders and their partners over time. To explore mental health and relationship trajectories among men in prison, and their partners, before the men's release, through a time 6 months post-release, and then again 8 years later, and to test associations between relationship quality and mental health. Data stem from the Economic and Social Research Council (ESRC)-funded longitudinal 'Families and Imprisonment Research' (FAIR) project on paternal imprisonment and family resilience. Inclusion criteria for the study were men serving a short- to medium-term prison sentence who were within 4 months of release; with a current or ex-partner with whom they have at least one child; and for whom there were data on mental health and relationship factors during imprisonment, and at 6 months and 8 years post-release. Similar data were also obtained for their (ex-)partners. The main sample comprised 39 men and 39 women who were in the same 'family set' for the first two waves, and after 8 years, 26 men and 30 women were retained. Just over 40% of the men and their (ex-)partners each disclosed that they had a mental health problem preceding his release. Proportions fluctuated slightly over time, with some dissonance between self-perceived disorder and self-ratings on a symptoms rating scale. Twenty-nine couples sustained their relationship during the transition between prison and release, but after 8 years, only four remained together. There was little evidence of association between measures of mental health and relationship quality among either the men or their partners. The findings challenge assumptions about the extent to which partners can play fully supportive roles in a former prisoner's transition from institutional life back into the community, as partners are also likely to be experiencing difficulties during this time. Thus, former prisoners and their families should be afforded equal access to support and assistance during offender rehabilitation.

Mental health in immigration detention: A comparison of foreign national ex-prisoners and other detainees.

People held in immigration removal centres have a range of vulnerabilities relating both to disappointment at imminent removal from the country of hoped-for residence and various antecedent difficulties. An important subgroup in the UK is of foreign national ex-prisoners who have served a period of incarceration there. Prisoners generally have higher rates of mental disorders than the general population. It is, however, not clear whether foreign national ex-prisoners in UK immigration removal centres have higher rates of mental disorders than other detainees. To compare the screened prevalence of mental disorders, levels of unmet needs and time in detention between foreign national ex-prisoners and others in Immigration Removal Centres in England. We conducted a secondary analysis of cross-sectional survey data from a previously published study in one Immigration Removal Centre. The 28 foreign national ex-prisoners had been in immigration detention for longer and reported greater levels of unmet needs than the other 66 detainees. The highest levels of unmet needs among the foreign national ex-prisoners were in the areas of psychological distress and intimate relationships. After adjusting for time spent in detention, there was evidence to suggest that foreign national ex-prisoners had a higher screened prevalence of substance use disorders, autism spectrum disorders and attention-deficit hyperactivity disorder than the other detainees. This study supports the view that foreign national ex-prisoners are a vulnerable group within immigration detention who have needs for enhanced and specialist service provision, including appropriate arrangements for health screening and active consideration to alternatives to their detention.

Public health psychiatry: an idea whose time has come

Public health psychiatry: an idea whose time has come

The prevalence of mental illness and unmet needs of police custody detainees.

Internationally, there is evidence of high rates of mental disorders amongst police custody detainees but this literature is limited, and there has been little research into the unmet needs of police detainees in the UK, orelsewhere. Such research could support better focussedinterventions for improving health and recidivism outcomes. To examine psychiatric and developmental morbidity amongst police detainees, and ascertain differences in need between morbidity categories. We used a cross-sectional study design and interviewed a 40% sample of people entering police custody in one South London police station over a 2-week period. A series of standardised measures was administered to screen for the presence of mental illness, general health and social care needs. A cohort of 134 people was generated, of whom nearly one-third (39, 29%) had current mental illness (major depression and/or psychosis); more had a lifetime diagnosis (54, 40%). Just under a fifth met the threshold for post-traumatic stress disorder (11, 8%). Clinically relevant alcohol or daily cannabis use affected about one quarter of the sample. Twenty-one percent (or 28) screened positive for personality disorder, 11% (or 15) for attention deficit hyperactivity disorder and 4% (6) for intellectual disability. Nearly one-fifth (24, 18%) were at risk for suicide. Those with psychosis, and those deemed at risk for suicide, had the highest levels of unmet need and, indeed, overall need. The most frequent unmet need was for accommodation. Our findings not only confirm high rates of mental health problems amongst police detainees but also demonstrate their high risk of suicide and high levels of unmet need, especially as regards accommodation. This underscores the need to provide mental health services in police stations, to help identify and resolve these issues at this early stage in the criminal justice system. Extending accommodation capacity to help some arrestees may help to save lives and interrupt cycling through the criminal justice system.

Mental health, suicidal behavior and sexual orientation in Portugal

IntroductionSexual minority individuals consistently report higher rates of mental disorders and suicidal behavior than heterosexuals. However, much of this research is limited to Anglo-Saxon studies and no information on Portuguese reality is available.ObjectivesThe purpose of this study is to compare levels of mental functioning and suicidal behavior among heterosexual, bisexual, and homosexual individuals in Portugal.MethodsUsing online surveys, 1140 individuals (62.40% women, Mage = 36.83, SDage = 13.39, 76.4% heterosexual, 9.4% bisexual, and 14.2% gay or lesbian) completed the BSI subscales for depression and anxiety symptoms, as well as the Suicide Behaviors Questionnaire-Revised.ResultsSelf-identified bisexual participants presented higher levels of depressive and anxiety symptoms and higher levels of suicidal ideation and likelihood of suicidal behavior than homosexual and heterosexual participants (who scored the lowest); yet, homosexual participants showed higher levels of suicide attempts. Also, depression and anxiety symptoms were strongly and positively correlated with all dimensions of suicidal behavior. Finally, hierarchical multiple regression analysis showed that higher levels of depression and non-heterosexual sexual orientations were significant predictors of suicidal ideation and the likelihood of suicidal behavior.ConclusionsThe present study adds to the evidence that sexual minority individuals are at risk of increased mental health problems and suicidal behavior, compared to heterosexuals, and reiterates the need for local political and legislative efforts to normalize LGB identities, fighting continued institutional heterosexism, interpersonal intolerance. Mental health providers and mental health policymakers need to consider these results if they want to address inequalities in mental health and in suicidality among these minority groups.

Dynamics of Mental Health and Healthcare Use among Children and Young Adults

AbstractDespite the high rates of mental disorder in adolescents and young adults, treatment utilisation is low. Using Australian longitudinal administrative and survey data, we show an increasing proportion of young people are accessing nervous system scripts as they age. Younger cohorts have increasingly accessed these scripts earlier; usage is generally higher among disadvantaged groups and in regions with better mental health service access. Less than half of all young adults facing very high psychological distress in 2018 had recently accessed mental health care. Instead of professional help, young people turn to friends and family for help with personal and emotional problems.