World Health Survey Research Articles

Validation of the Arabic Version of the Kessler Psychological Distress Scale (K6) among college students in Kuwait

IntroductionThe Kessler Psychological Distress Scale (K6) is a psychometrically robust measure of psychological distress for adult populations, the most commonly used screening measure in the general population. It is used in epidemiological surveys globally, including the World Health Organization and World Mental Health Survey. Recently, there has been a research interest in examining the psychometric properties of the K6 in college students’ populations.ObjectivesTo examine the reliability, validity and factor structure of the Arabic adaptation K6 in Kuwaiti college students.MethodsThe participants were 1402 individuals (509 males, 893 females) Kuwait University undergraduates, aged 18–35 years-old mean age = 21.50 ± 4.87. The Arabic versions of The Kessler Psychological Distress Scale (K6), The Depression Anxiety Stress Scales DASS-42, Beck Depression Inventory-II, and Beck Anxiety Inventory –BAI were administered to participants including demographics. The internal consistency reliability, factor structure, and convergent validity of the (K6) with DASS-42, BDI-II, & BAI were computed.ResultsInternal consistency was satisfactory for the K6 (Cronbach’s alpha =0.80 for males & 0.79 for females). The results revealed significant gender differences in distress with a favor for females (f=8.95, p. >.003). Principal component analyses (PCA) showed that a K6 one -component solution explains %61.51 of the total variance for males and %57.23 for females. The k6 correlates with DASS Stress (r=.76), DASS Depression (r=.57), DASS Anxiety (r=0.76), BAI (r=.73) and BDI-II (r=46).ConclusionsThe K6 provides satisfactory validation, and can be recommended as a measure of distress among Arab college students.Disclosure of InterestNone Declared

Impact of Socio-demographic Determinants on Individual Health in Bangladesh

This study aims to investigate the impact of socio-demographic factors on health in Bangladesh using the World Health Survey dataset. Using the seemingly unrelated regression models the study reveals that female compared to male faces more challenges in terms of problems regarding mobility, self-care, bodily pain, sleeping, remembering and depression. The study also finds that as the level of education increases the severity of facing these problems reduces. Furthermore, people who are never married widowed and separated or divorced experience more problems in terms of self-care, remembrance, sleeping as well as depression compared to those who are currently married.

Addressing discrepancies in estimates of road traffic deaths and injuries in Ethiopia

BackgroundThere are large discrepancies between official statistics of traffic injuries in African countries and estimates from the Global Burden of Disease (GBD) study and WHO’s Global Status Reports on Road...

Association between physical activity and comorbid anxiety/depression in 46 low- and middle-income countries

BackgroundEvidence on the association of low physical activity (PA) with depression or anxiety is well established. Yet, evidence on the association between PA and comorbid anxiety/depression remains scarce, especially in low- and middle-income countries (LMICs). Thus, this study explored this relationship among adults aged ≥18 years from 46 LMICs. MethodsCross-sectional, community-based data were analyzed from the World Health Survey (WHS). Multivariable multinomial logistic regression analysis was conducted to examine the association between low PA and comorbid anxiety/depression with no anxiety or depression as the base category. Results237,023 participants [mean (SD) age = 38.4 (16.0) years; 50.8 % female] were included in the analysis. Low PA was significantly associated with depression alone (OR = 1.33; 95%CI = 1.12–1.57) and anxiety alone (OR = 1.37; 95%CI = 1.23–1.53), while the OR was highest among those with comorbid anxiety/depression (OR = 1.75; 95%CI = 1.52–2.01). ConclusionLow PA is associated with particularly increased odds for comorbid anxiety/depression. Increasing PA may have a beneficial effect on the prevention of comorbid anxiety/depression. However, future longitudinal research establishing the direction of this relationship is warranted.

Effectiveness of using e-government platform "Absher" as a tool for noncommunicable diseases survey in Saudi Arabia 2019-2020: A cross-sectional study.

BackgroundE-government platforms provide an opportunity to use a novel data source for population health surveillance (also known as e-health). Absher is a Saudi e-government platform with 23 million authenticated users, including residents and citizens in Saudi Arabia. All Absher users were invited to participate in a web-based survey to estimate the prevalence of noncommunicable diseases and their risk factors in Saudi Arabia.ObjectiveTo assess the potential of using an e-government platform (Absher) to administer web-based health surveys.MethodsA cross-sectional, web-based health survey was administered to Absher users between April 2019 and March 2020. The survey instrument included eight items and took <5 min to complete. The respondents' data were compared to Saudi Arabia's 2016 census. Descriptive summary statistics of the prevalence of major noncommuncable diseases are presented and compared to population-based prevalence data from Saudi Arabia's World Health Survey (WHS) 2019. All analysis was conducted using Stata 13.0.ResultsOverall, the Absher health survey had a 24.6% response rate, with most respondents being male (84%), Saudi (67%), and between 30 and 44 years of age (49%). Overall, the prevalence of noncommunicable diseases and risk factors among respondents was high for overweight (35%) and obesity (30%) and low for asthma (6%). The prevalence of diabetes, dyslipidemia, and hypertension was between 15 and 17% on average, and 26.5% were smokers. In comparison to population-based World Health Survey estimates, the Absher survey overestimated obesity, diabetes, dyslipidemia, hypertension, and smoking rates, and underestimated overweight, whereas asthma prevalence was similar for Absher and the WHS.ConclusionsWith improvements in the study design, the use of e-government platforms can provide a useful and potentially low-cost data source for public health research.

A Critical Analysis On National Surveillances On Physical Activity And Sedentary Behavior Among Chinese Adults

PURPOSE: Based on the importance of national physical activity (PA) and sedentary behaviour (SB) surveillance in health promotion, and no comprehensive review for national surveillance on PA and SB among Chinese adults. Therefore, this review aimed to comprehensively assess and summarise the studies on PA and SB surveillance among Chinese adult populations. METHODS: 10 national physical activity (PA) and sedentary behaviour (SB) surveillance surveys were included in this review, and EBSCO, PubMed, ScienceDirect and Web of Science were used to conduct a literature search in August 2021. The information regarding the first author, published year, project, study design, sample characteristics, PA and SB measures, the definition of PA and SB level in each study, and PA and SB level were independently extracted. Six items adapted from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and evaluation of the quality of prognosis studies in systematic reviews (QUIPS) were used to assess the quality of included studies. RESULTS: Finally, 5 national surveillance projects, including the Chinese Nutrition and Health Survey, International Collaborative Study of Cardiovascular Disease in Asia, the World Health Survey (2002-2003), Chinese National Health Services Survey and National Physical Fitness Surveillance were included. And 9 studies were retrieved from 5617 references. The published years ranged from 2005 to 2020. All the studies applied self-reported questionnaires to estimate the levels of PA and SB. Accordingly, a relatively lower level of PA among Chinese adults in this study. Besides, males were physically active than females. The levels of PA in urban regions are higher than those were in rural regions. Moreover, various cutoffs of sufficient PA and limited SB were used, and some studies did not use the well-recognized cutoffs. CONCLUSION: A few included studies would be a barrier for researchers inform effective policy or design efficient interventions aiming at increasing PA and decreasing SB. Moreover, considering the complexity of social, economic, and geographic disparities in China, estimating the overall PA and SB at various sociodemographic levels is needed. Although overall levels of PA and SB were collected, some key components of PA or SB are omitted.

Multimorbidity, depression with anxiety symptoms, and decrements in health in 47 low- and middle-income countries

BackgroundComorbid depression and anxiety is associated with worse health outcomes compared to depression or anxiety occurring in isolation, but there is little data on its association with multimorbidity. Thus, we investigated this association across 47 low- and middle-income countries, and further explored whether having anxiety symptoms in addition to depression is associated with significant declines in health outcomes among those with multimorbidity. MethodsCross-sectional, predominantly nationally representative, community-based data were analyzed from the World Health Survey. DSM-IV depression was assessed with the Composite International Diagnostic Interview. Anxiety symptoms referred to severe/extreme problems with worry or anxiety. Ten chronic conditions and health status across five domains (cognition, interpersonal activities, sleep/energy, self-care, pain/discomfort) were assessed. Multivariable regression analyses conducted. ResultsData included 237,952 adults aged ≥18 years [mean age (SD) 38.4 (16.0); 50.8 % females]. Compared to no chronic conditions, 2 (OR = 6.86; 95%CI = 5.59–8.42), 3 (OR = 12.33; 95%CI = 9.72–15.63), and ≥4 (OR = 26.55; 95%CI = 20.21–35.17) chronic conditions were associated with significantly higher odds for comorbid depression/anxiety symptoms (vs. no depression or anxiety symptoms) in the multinomial logistic regression model. Among those with depression and multimorbidity, anxiety symptoms were associated with significantly worse health status across all domains. LimitationsCross-sectional design, depression and anxiety symptoms were not based on a clinical assessment. ConclusionsComorbid depression/anxiety is common in people with multimorbidity, and anxiety symptoms in people with depression and multimorbidity signify worse health status. Future studies should assess the utility of screening for and treating comorbid depression/anxiety in patients with multimorbidity in terms of clinical outcomes.

Perceived stigma and discrimination among persons with mood and anxiety disorders: Results from the WHO World Mental Health Survey Portugal

Background and objectivesThe stigma attached to mental disorders remains a public health challenge, represents an important barrier to healthcare and widens existing social inequalities.This study aimed to characterize the association between perceived stigma and mental disorders. The two main objectives were to estimate the association between perceived stigma and 12-month anxiety and mood disorders, and to assess the factors associated with perceived stigma among persons with these mental disorders. MethodsA nationally representative sample of the Portuguese population was used. Participants were Portuguese-speaking adults, aged 18 or above and residing in permanent dwellings in the country's mainland. The survey was administered by trained lay interviewers using a computer assisted personal interview (CAPI) on a face-to-face setting. ResultsThe results showed a two-fold increase in the likelihood of experiencing stigma among individuals with 12-month anxiety and mood disorders, slightly higher in the latter, when compared with individuals without. Among the sub-sample with these mental disorders, participants retired (or others), with psychiatric comorbidity and with co-occurrence of psychiatric and physical disorders had higher odds of reporting perceived stigma. ConclusionsThe findings of this study highlight the need to consider stigma as a public health priority in Portugal and to develop policies to create awareness and promote the social inclusion of persons with mental disorders.

Increased risks for mental disorders among LGB individuals: cross-national evidence from the World Mental Health Surveys

PurposeLesbian,gay, and bisexual (LGB) individuals, and LB women specifically, have anincreased risk for psychiatric morbidity, theorized to result from stigma-baseddiscrimination. To date, no study has investigated the mental healthdisparities between LGB and heterosexual AQ1individuals in a largecross-national population-based comparison. The current study addresses thisgap by examining differences between LGB and heterosexual participants in 13cross-national surveys, and by exploring whether these disparities wereassociated with country-level LGBT acceptance. Since lower social support hasbeen suggested as a mediator of sexual orientation-based differences inpsychiatric morbidity, our secondary aim was to examine whether mental healthdisparities were partially explained by general social support from family andfriends.MethodsTwelve-monthprevalence of DSM-IV anxiety, mood, eating, disruptive behavior, and substancedisorders was assessed with the WHO Composite International DiagnosticInterview in a general population sample across 13 countries as part of theWorld Mental Health Surveys. Participants were 46,889 adults (19,887 males; 807LGB-identified).ResultsMaleand female LGB participants were more likely to report any 12-month disorder (OR2.2, p < 0.001 and OR 2.7, p < 0.001, respectively) and most individualdisorders than heterosexual participants. We found no evidence for anassociation between country-level LGBT acceptance and rates of psychiatricmorbidity between LGB and heterosexualAQ2 participants. However, among LBwomen, the increased risk for mental disorders was partially explained by lowergeneral openness with family, although most of the increased risk remainedunexplained.ConclusionThese results provide cross-national evidence for an association between sexual minority status and psychiatric morbidity, and highlight that for women, but not men, this association was partially mediated by perceived openness with family. Future research into individual-level and cross-national sexual minority stressors is needed.

Social anxiety disorder and childhood adversities in Portugal: Findings from the WHO world mental health survey initiative

Social anxiety disorder (SAD) is one of the most underrecognized and undertreated common mental disorders. This study aimed to describe its epidemiology and to understand the association between childhood adversities and SAD in the context of Portugal's collectivist culture. Data about SAD, childhood adversities, socio-demographic variables were collected from a nationally representative sample using well-validated scales employed for the World Mental Health Survey. Logistic and linear regression models were carried out to explore the association between childhood adversities and SAD prevalence and age of onset. The estimated lifetime prevalence of SAD was 4.68% and the 12-month prevalence was 3.14%. The mean age of onset was 13.6 ± 8.79. People with a college education had 3.42 higher odds of having SAD compared to people with no education or a primary school education. Most childhood adversities significantly increased the odds of a lifetime prevalence of SAD. Parental Maladjustment increased the odds of SAD when gender, age, and education were adjusted. The study findings show a relatively high prevalence of SAD in Portugal and confirms that females, younger people, students, and single people are more likely to have SAD. The study highlights the need to address experiences of parental maladjustment in interventions for people with SAD in Portugal.

The associations between traumatic experiences and subsequent onset of a substance use disorder: Findings from the World Health Organization World Mental Health surveys

AimExposure to traumatic events (TEs) is associated with substance use disorders (SUDs). However, most studies focus on a single TE, and are limited to single countries, rather than across countries with variation in economic, social and cultural characteristics. We used cross-national data to examine associations of diverse TEs with SUD onset, and variation in associations over time. MethodsData come from World Mental Health surveys across 22 countries. Adults (n = 65,165) retrospectively reported exposure to 29 TEs in six categories: “exposure to organised violence”; “participation in organised violence”; “interpersonal violence”; “sexual-relationship violence”; “other life-threatening events”; and those involving loved ones (“network traumas”). Discrete-time survival analyses were used to examine associations with subsequent first SUD onset. ResultsMost (71.0%) reported experiencing at least one TE, with network traumas (38.8%) most common and exposure to organised violence (9.5%) least. One in five (20.3%) had been exposed to sexual-relationship violence and 26.6% to interpersonal violence. Among the TE exposed, lifetime SUD prevalence was 14.5% compared to 5.1% with no trauma exposure. Most TE categories (except organised violence) were associated with increased odds of SUD. Increased odds of SUD were also found following interpersonal violence exposure across all age ranges (ORs from 1.56 to 1.78), and sexual-relationship violence exposure during adulthood (ORs from 1.33 to 1.44), with associations persisting even after >11 years. ConclusionSexual and interpersonal violence have the most consistent associations with progression to SUD; increased risk remains for many years post-exposure. These need to be considered when working with people exposed to such traumas.

Identifying eating disorders in adolescents and adults with overweight or obesity: A systematic review of screening questionnaires.

ObjectiveThis review aimed to examine the validity of self‐report screening questionnaires for identifying eating disorder (ED) risk in adults and adolescents with overweight/obesity.MethodFive databases were searched from inception to September 2020 for studies assessing validation of self‐report ED screening questionnaires against diagnostic interviews in adolescents and adults with overweight/obesity. The review was registered with PROSPERO (https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=220013).ResultsTwenty‐seven papers examining 15 questionnaires were included. Most studies validated questionnaires for adults (22 of 27 studies), and most questionnaires (12 of 15) screened for binge eating or binge‐eating disorder (BED). The Eating Disorder Examination Questionnaire (sensitivity = .16–.88, specificity = .62–1.0) and Questionnaire on Eating and Weight Patterns (sensitivity = .07–1.0, specificity = .0–1.0) were most frequently validated (six studies each). Five studies of three questionnaires were in adolescents, with the Adolescent Binge‐Eating Disorder Questionnaire having highest sensitivity (1.0) but lower specificity (.27). Questionnaires designed to screen for BED generally had higher diagnostic accuracy than those screening for EDs in general.DiscussionQuestionnaires have been well validated to identify BED in adults with overweight/obesity. Validated screening tools to identify other EDs in adults and any ED in adolescents with overweight/obesity are lacking. Thus, clinical assessment should inform the identification of patients with co‐morbid EDs and overweight/obesity.Public SignificanceIndividuals with overweight/obesity are at increased risk of EDs. This review highlights literature gaps regarding screening for ED risk in this vulnerable group. This work presents possibilities for improving care of individuals with overweight/obesity by reinventing ED screening tools to be better suited to diverse populations.

Association between depression and subjective cognitive complaints in 47 low- and middle-income countries

People with depression and subjective cognitive complaints (SCC) may be at particularly high risk for developing dementia. However, to date, studies on depression and SCC are limited mainly to single high-income countries. Thus, the aim of the present study was to investigate the association between depression and SCC in adults from low- and middle-income countries (LMICs). Cross-sectional, community-based data were analyzed from the World Health Survey. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). ICD-10 Diagnostic Criteria for Research was used for the diagnosis of subsyndromal depression, brief depressive episode, and depressive episode. Multivariable linear regression was conducted to explore the associations. Data on 237,952 individuals aged ≥18 years [mean (SD) age 38.4 (16.0) years; females 50.8%] were analyzed. After adjustment for potential confounders (age, sex, education, anxiety), compared to no depressive disorder, subsyndromal depression (b-coefficient 7.91; 95%CI = 5.63–10.18), brief depressive episode (b-coefficient 10.37; 95%CI = 8.95–11.78), and depressive episode (b-coefficient 13.57; 95%CI = 12.33–14.81) were significantly associated with higher mean SCC scores. The association was similar in all age groups (i.e., 18–44, 45–64, and ≥65 years), and both males and females. All depression types assessed were associated with worse SCC among adults in 47 LMICs. Future longitudinal studies are needed to investigate whether older people with depression and SCC are at higher risk for dementia onset in LMICs.

Early menarche and adult major depressive disorder among Japanese women: The role of childhood traumatic experience and socioeconomic conditions in young adulthood.

The aim of this study is to examine the long-term impact of early menarche with adult depression, and to assess whether this association was explained by childhood traumatic experience and socioeconomic condition in early adulthood. The data were derived from World Mental Health Survey Japan Second, a cross-sectional survey conducted among Japanese community residents between 2013 and 2015. We used the data of female respondents aged 20-75 years (N = 1171). Hazard ratio (HR) of the onset of major depression up to 40 years was calculated for an early-menarche group and a non-early-menarche group, respectively. Kaplan-Meier curve and log-rank statistics were used to examine the difference in failure. Cox proportional hazard models were administered for the association of major depression with early-menarche and early-life psychosocial factors. Risk for major depressive disorders were three to four times higher in an early-menarche group, and the differences in survival functions were significant (p < 0.001). HR of early menarche was 2.79 (95% CI = 1.29-6.02), and was slightly changed when childhood traumatic experience and socioeconomic conditions in young adulthood were added in the model (HR = 2.88, 95% CI = 1.30-6.38; HR = 3.19, 95% CI = 1.41-7.21). Early menarche was significantly associated with increased risk for depression by the age of 40 years. Childhood trauma and socioeconomic hardship in early adulthood did not account for the association. Both physical and psychosocial risk factors in early life need to be addressed for preventing women's depression.

Determinants of effective treatment coverage for major depressive disorder in the WHO World Mental Health Surveys

BackgroundMost individuals with major depressive disorder (MDD) receive either no care or inadequate care. The aims of this study is to investigate potential determinants of effective treatment coverage.MethodsIn order to examine obstacles to providing or receiving care, the type of care received, and the quality and use of that care in a representative sample of individuals with MDD, we analyzed data from 17 WHO World Mental Health Surveys conducted in 15 countries (9 high-income and 6 low/middle-income). Of 35,012 respondents, 3341 had 12-month MDD. We explored the association of socio-economic and demographic characteristics, insurance, and severity with effective treatment coverage and its components, including type of treatment, adequacy of treatment, dose, and adherence.ResultsHigh level of education (OR = 1.63; 1.19, 2.24), private insurance (OR = 1.62; 1.06, 2.48), and age (30–59yrs; OR = 1.58; 1.21, 2.07) predicted effective treatment coverage for depression in a multivariable logistic regression model. Exploratory bivariate models further indicate that education may follow a dose—response relation; that people with severe depression are more likely to receive any services, but less likely to receive adequate services; and that in low and middle-income countries, private insurance (the only significant predictor) increased the likelihood of receiving effective treatment coverage four times.ConclusionsIn the regression models, specific social determinants predicted effective coverage for major depression. Knowing the factors that determine who does and does not receive treatment contributes to improve our understanding of unmet needs and our ability to develop targeted interventions.

Socioeconomic Inequality in Health Domains in Oman: Evidence from Oman World Health Survey

&#x0D; Socioeconomic inequality in health domains is a major challenge in public health in both developed and developing countries. The objective of this study was to assess the socioeconomic inequalities in various health domains in Oman. Data for the study was obtained from the 2008 World Health Survey in Oman, which covered a nationally representative sample of 3,370 Omani adults. Overall self-rated health (SRH) status and the functional difficulties with eight health domains: mobility; self-care, pain and discomfort, cognition, interpersonal activities, vision, sleep and energy, and affect, were used as the outcome variables. Level of education and wealth quintiles were used as the proxy measures of the socioeconomic status (SES). Both descriptive and inferential statistical techniques were used for data analysis. The results revealed significant socioeconomic inequalities in health outcomes for most of the health domains and for overall SRH in Oman. Adults with no education as well as with poorest wealth quintiles had significantly higher rate of poor health. For most of the health domains, a descending gradient in the prevalence of poor health with the level of education and wealth quintiles have been observed. However, education-related inequalities in poor health across the eight domains and the overall health status were found to be more pronounced and consistent than the wealth-related inequalities in poor health. Wealth quintiles showed no significant association with overall SRH and many health domains. The prevailing educational and wealth related inequalities in health underscores the need for policy-making in regard to reduce the inequalities in specific domains of health and overall health. There is a need for research to examine the ways in which socioeconomic factors mediate changes in health domains as well as overall health. The results from this study are of relevance to public health policymakers in developing interventions for specific health domains and overall health status.

Psychotic experiences among informal caregivers: findings from 48 low- and middle-income countries.

PurposeInformal caregivers may be at high risk for psychotic experiences (PE) due to caregiving related stress, sleep issues, or other potential mechanisms, but this has not been previously investigated in the general adult population. Thus, we examined the association between caregiving and PE, and its mediators, in a large sample of adults from 48 low- and middle-income countries (LMICs).MethodsCross-sectional, community-based data from the World Health Organization (WHO) World Health Survey were analyzed. Informal caregivers referred to those who provided help to a relative or friend (adult or child) in the past year, because this person has a long-term physical or mental illness or disability, or is getting old and weak. PE were assessed using the WHO Composite International Diagnostic Interview psychosis screen. Multivariable logistic regression and mediation analyses were conducted.ResultsData on 224,842 individuals were analyzed. The mean (SD) age was 38.3 (16.0) years (range 18–120 years) and 50.7% were females. After adjustment for age, sex, and country, in the overall sample, caregiving was associated with 1.67 (95%CI = 1.56–1.79) times higher odds for PE. Sleep/energy explained the largest proportion of the association between caregiving and PE (13.9%), followed by pain/discomfort (11.5%), perceived stress (7.6%), depression (6.2%), and cognition (3.5%).ConclusionCaregivers in LMICs are at higher risk of PE. Future studies are warranted to gain a further understanding of the underlying mechanisms, and to assess whether addressing the identified mediators can lead to lower risk for PE among caregivers.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00127-022-02312-z.

Suicidal behavior and associated factors among prisoners in Dilla town, Dilla, Ethiopia 2020: An institutional based cross-sectional study.

BackgroundSuicide is a serious cause of mortality worldwide and is a psychiatric emergency. Among prisoners, it is the leading cause of death compared to the general population. However, suicide in prison is a neglected public health issue especially in middle- and low-income countries including Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of suicidal behavior among prisoners in Dilla Town Correctional Center, South Ethiopia.MethodsAn institution-based cross- sectional study was conducted from May13- June 13, 2020 in the Dilla Town Correctional Center. The simple random sampling technique was used to select 650 prisoners. Data were collected by face-to—to-face interview. Suicidal ideation and attempts were assessed by using the suicidality module of World Mental Health survey initiative version of the World Health Organization composite International diagnostic interview. Data were coded, entered with EP-data version 3.1, and analyzed by using Statistical Package for Social Science version 24. Multivariate binary logistic regression analysis was used to determine the significant association between explanatory variables and outcome variables at 95% CI.The resultsThe prevalence of suicidal ideation and attempt among prisoners were 21.9% (95%CI, 18.4–25.2) and 13.1% (95%CI, 10.6–15.8), respectively. Female sex [(AOR) = 2.6, 95%CI, (1.39, 8.2)], divorced/widowed [AOR = 3.67, 95%CI, (2.05, 6.58)], family history of mental illness [AOR = 2.49, 95%CI, (1.41, 4.38)], common mental disorder [AOR = 1.98, 95%CI, (1.25, 3.16)] and poor social support [AOR = 2.68, 95%CI, (1.42, 5.06)] were statistically associated with suicidal ideation. Whereas, female sex [AOR = 3.24, 95%CI, (1.89, 9.4)], previous incarceration [AOR = 2.38, 95%CI, (1.2, 5.16)], and family history of mental illness [AOR = 2.08, 95%CI, (1.11, 3.9)] were associated with suicide attempt.ConclusionThe prevalence of suicidal ideation and attempts among prisoners were high. The special attention in early screening and treatment of suicide among prisoners and collaborating with health institutions is important for better management and prevention.

Patterns and correlates of patient-reported helpfulness of treatment for common mental and substance use disorders in the WHO World Mental Health Surveys.

Patient-reported helpfulness of treatment is an important indicator of quality in patient-centered care. We examined its pathways and predictors among respondents to household surveys who reported ever receiving treatment for major depression, generalized anxiety disorder, social phobia, specific phobia, post-traumatic stress disorder, bipolar disorder, or alcohol use disorder. Data came from 30 community epidemiological surveys - 17 in high-income countries (HICs) and 13 in low- and middle-income countries (LMICs) - carried out as part of the World Health Organization (WHO)'s World Mental Health (WMH) Surveys. Respondents were asked whether treatment of each disorder was ever helpful and, if so, the number of professionals seen before receiving helpful treatment. Across all surveys and diagnostic categories, 26.1% of patients (N=10,035) reported being helped by the very first professional they saw. Persisting to a second professional after a first unhelpful treatment brought the cumulative probability of receiving helpful treatment to 51.2%. If patients persisted with up through eight professionals, the cumulative probability rose to 90.6%. However, only an estimated 22.8% of patients would have persisted in seeing these many professionals after repeatedly receiving treatments they considered not helpful. Although the proportion of individuals with disorders who sought treatment was higher and they were more persistent in HICs than LMICs, proportional helpfulness among treated cases was no different between HICs and LMICs. A wide range of predictors of perceived treatment helpfulness were found, some of them consistent across diagnostic categories and others unique to specific disorders. These results provide novel information about patient evaluations of treatment across diagnoses and countries varying in income level, and suggest that a critical issue in improving the quality of care for mental disorders should be fostering persistence in professional help-seeking if earlier treatments are not helpful.

Prevalence and Factors Associated With Suicidal Ideation Among Adult Eritrean Refugees in Northern Ethiopia

BackgroundThe present study assessed the prevalence of and factor associated with suicidal ideations among adult Eritrean refugees in Tigray, Ethiopia.MethodsA community-based cross-sectional study was carried out among 400 adult refugees living in the Mai-Aini refugee camp in Tigray, Northern Ethiopia from September 2019 to May 2020. The response variable was suicidal ideation and was measured using World Mental Health (WMH) Survey Initiative Version of the World Health Organization Composite International Diagnostic Interview. We applied bivariate and multivariate logistic regression to determine predictors for suicide ideations. Odds ratios and p-values were determined to check the associations between variables, and a p-value <0.05 was considered as a cut-off for statistical significance.ResultsThe prevalence of suicidal ideations was 20.5% (95% CI: 16.4%, 24.5%). Having previous history of trauma [AOR = 2.3, 95% CI: 1.4, 4.5], a history of chronic illness [AOR = 2.9, 95% CI: 1.3, 6.5], a family history of mental disorder [AOR = 3.08, 95% CI: 1.3, 7.06], and history of post-traumatic stress disorder [AOR = 5.7, 95% CI: 2.8, 11.5] were significantly associated with suicidal ideations.ConclusionsThis study showed that during the stay in the refugee camp, there was a high prevalence of suicide ideations compared to the prevalence of suicide ideations among the general populations of Ethiopia, Europe, and China, and the lifetime pooled prevalence across 17 countries. Having previous history of trauma, a history of chronic illness, a family history of mental disorder, and history of post-traumatic stress disorder were the factors statistically associated with the suicidal ideation.