Generic quality of life (QOL) instruments often fail to capture the specific challenges faced by patients with schizophrenia. The Schizophrenia Quality of Life Questionnaire Short Form – Clinical Practice (S-QOL 18) is a brief, disease-specific tool developed to assess subjective QOL in this population. Although validated in several languages, no validated version exists in Lebanese Arabic. This study aims to translate and validate the Lebanese Arabic version of the SQoL-18 and assess its psychometric properties. A cross-sectional study was conducted between June and August 2025 among 124 long-term inpatients with schizophrenia at the Psychiatric Hospital of the Cross, Lebanon. The S-QoL-18 was translated into Lebanese Arabic following forward–backward translation procedures. Factor analysis supported a six-factor structure explaining 61.3
Despite growing recognition of the increasing global mental health burden, treatment gaps persist in many LMICs. In West Africa, access to primary care for mental health conditions such as stress-related disorders, anxiety, depression, schizophrenia, bipolar disorder, and substance use disorder remains constrained by multiple interrelated barriers. Although individual studies have explored determinants of access to care, there has been limited synthesis of the factors influencing primary mental health care across West Africa. To identify factors influencing access to primary care for selected mental health conditions (depression, bipolar disorders, schizophrenia, anxiety disorders, stress disorders, and substance use disorders) among adults in West Africa. Using the Arksey and O’Malley review approach, five electronic databases (PubMed, Embase, PsycINFO, Cairn.info, and Google Scholar) were searched for studies published between 1st January 2002 and 31st January 2026. Studies were eligible if they involved adults living with mental health conditions or their caregivers (population), reported factors influencing primary care access for these conditions (concept), and were conducted in any of the 15 Economic Community of West African States (ECOWAS) countries (context). Records were screened by two independent reviewers using Rayyan. Data were extracted and analysed thematically using a conceptual framework derived from Levesque et al.’s access model and Leichter’s contextual framework. This review adheres to the PRISMA Extension for Scoping Reviews (PRISMA-ScR) reporting standards. After removing duplicates, 1,929 titles and abstracts were screened, resulting in 41 articles eligible for full-text review. Following full-text screening, 26 eligible studies (reported across 29 publications) were included in the final analysis. The included studies identified determinants of primary care access across three interacting domains: patient-level (perceptions of care, care-seeking behaviour, healthcare reaching, healthcare payment, and healthcare engagement), primary healthcare facility-level (approachability, acceptability, availability and accommodation, affordability, and appropriateness), and contextual factors (social norms, cultural beliefs, traditions, and socioeconomic status). Appropriateness of care and healthcare engagement were the most reported domains. Access to primary care for mental health in West Africa is shaped by multiple, interrelated factors across patient, facility, and contextual levels. Effective interventions must be multifaceted, culturally sensitive, and contextually relevant.
The World Health Organization and the United Nations Children’s Fund call for multisectoral action to ensure the inclusion and well-being of children with developmental disabilities globally. Ethiopia has made policy efforts to support optimisation of early childhood development, but children with neurodevelopmental disabilities (NDDs) have additional, specific needs. This scoping review and policy analysis aimed to identify barriers and opportunities for multi-sectoral planning to address social determinants shaping the lives of Ethiopian children with NDDs and their families within the current Ethiopian policy context. A scoping review was conducted of Ethiopian research studies and policy documents. After screening, eligible evidence sources were included, and data were charted using a structured extraction form. Critical appraisal of empirical studies was conducted using the Mixed-Methods Appraisal Tool 2018. Using Lund et al.’s model for social determinants of mental disorders in relation to the Sustainable Development Goals, a qualitative framework synthesis of the identified studies was conducted, followed by an analysis of policies. The search identified 44 research studies (29 published and 15 theses) and 17 Ethiopian policy documents. The findings show that Ethiopian children with NDDs and their families experience intersecting challenges across four social determinant domains: economic, socio-cultural, neighbourhood, and demographic. Accessing services and ensuring social protection, inclusion, and safety of children with NDDs are prominent challenges fueled by stigma. Challenges are heightened for female caregivers, especially single mothers. Caregivers experience psychological distress, including suicidality. Spirituality and support from families, communities, and community-based organisations help cope. Formal support is scarce; the few identified interventions involve caregiver and healthcare worker training. The integration of services for children with NDDs into primary healthcare services is a potential strategy to increase access to services. Ethiopian children with NDDs and their caregivers experience intersecting challenges in accessing services, social protection and inclusion, and safeguarding. Ethiopian policies offer opportunities by prioritising social welfare, equity, protection of vulnerable communities, and early childhood development. However, policies lack explicit recognition and measures for children with NDDs. Multisectoral efforts involving robust research, inclusive policy development and implementation are needed to strengthen support for children with NDDs and their families.
Optimizing psychiatric outcomes, such as reducing coercive measures and chlorpromazine dosage, is crucial for ensuring patient autonomy and deinstitutionalization amid the increasing prevalence of mental disorders. Ensuring equitable psychiatric care regardless of location is a pressing healthcare priority. International evidence suggests regional disparities in care quality; however, nationwide database studies in Japan remain limited. We aimed to clarify regional differences in clinical outcomes, including mortality, seclusion and restraint use, and chlorpromazine dosage reduction, among inpatients with schizophrenia and mood disorders in Japan. This retrospective observational study used data from Japan’s nationwide Diagnosis Procedure Combination database (fiscal years 2016–2022) of acute-care hospitals with psychiatric departments. Inpatients with schizophrenia or mood disorders were included. Outcomes included in-hospital mortality, seclusion, physical restraint, and chlorpromazine-equivalent dose (CPZE) reduction. Regional disparities were evaluated using urban–rural classifications and seven regional blocks. Multivariate logistic and Fine–Gray proportional hazards regression analyses were performed, adjusting for patient and hospital factors. Among 38,124 patients, significant regional disparities were observed in physical restraint and chlorpromazine dosage reduction but not in mortality. For schizophrenia, depopulated areas had lower odds of restraint use (p < 0.01). For mood disorders, CPZE reduction was significantly less likely in Regional core city and depopulated areas (p < 0.01). Although urban–rural classification showed no difference in seclusion, regional block analysis revealed marked variations. Significant regional disparities exist in psychiatric inpatient outcomes in Japan, particularly regarding physical restraint and medication adjustment. These findings highlight the need for standardized care and policies to ensure equitable outcomes across regions.
