Abstract Human Immunodeficiency Virus (HIV) has been widely associated with comorbid depression. This study examined the prevalence of depression by HIV status and its relationship to mental health service use in rural eastern Uganda using structured questionnaires. Participants with HIV ( n = 150) were recruited from local HIV clinics, while participants with negative or unknown HIV status ( n = 154) were randomly sampled from nearby villages. Participants were assessed for depression using the Patient Health Questionnaire-9, loneliness using the UCLA 3-item Loneliness Scale and general mental health status using a Likert-type self-report scale. Symptomatic HIV, asymptomatic HIV and HIV negative subgroups were compared on demographics, clinical characteristics and prior service use from traditional, religious and biomedical providers. The symptomatic HIV+ group reported significantly greater depressive symptoms, loneliness and poorer self-rated mental health than other groups, but no increase in mental health service use. Furthermore, among this group, more severe depressive symptoms were associated with decreased likelihood of mental health service use, possibly due to competing demands and limited mental health service availability. Religious leaders were the most common source of care with notable overlap between providers. This study highlights the importance of utilizing existing religious and biomedical pathways to increase access to mental health services.
Postpartum anxiety and depression are significant public health issues, negatively impacting maternal and child well-being and placing a substantial economic burden on society and healthcare systems. The Happy Mother Healthy Baby (HMHB) program has proved effective for improving outcomes for both mother and child in women with antenatal anxiety. This study assesses the economic viability of HMHB by comparing health care expenditures between the intervention (HMHB) and control groups, assessing statistical significance with T-tests. Results showed generally higher maternal healthcare costs for the HMHB group, with significant differences in provider visits (p = 0.01) and total costs (p = 0.02) during the third trimester, as well as marginally significant medication costs (p = 0.08) during the postnatal period. Postpartum healthcare costs for children in the HMHB group trended lower for provider visits, hospital stays and overall costs, though these results were not statistically significant. Subgroup analyses by education level showed similar results. Implementation costs for the full intervention were estimated at 10,641 Pakistani rupees per mother. Results suggest that implementing HMHB may be justified based on improved outcomes for mothers and children in conjunction with the low implementation costs and the potential for long-term cost savings associated with HMHB.
Evidence on the relationship between internet addiction (IA) and life satisfaction (LS) among university students remains limited, and underlying mechanisms are poorly understood. This study examined whether depression and anxiety mediate the relationship between IA and LS among 1,320 Indian university students (958 males, 362 females). Participants completed the Internet Addiction Test-Short Form (IAT-12), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Satisfaction with Life Scale (SWLS). Data were analyzed using SPSS v27 and PROCESS Macro.Clinically significant depression and anxiety were reported by 19.1% and 19.0% of participants, respectively, while 22.6% reported low life satisfaction. IA was positively associated with depression and anxiety and negatively associated with LS. Both depression and anxiety significantly mediated the IA-LS relationship, with depression exerting a stronger effect. Parallel mediation analyses confirmed independent effects of both mediators, while serial mediation analyses identified sequential pathways linking IA, depression, anxiety, and LS.Psychological distress accounted for a substantial proportion of the association between problematic internet use and lower life satisfaction. Findings highlight the importance of integrated university mental health strategies that promote digital well-being, facilitate early identification of psychological distress, and provide accessible psychosocial support.
Extreme weather events (EWEs) and resource insecurities are associated with adverse mental health outcomes, yet little is known about their impacts on older adults in climate-affected settings. We conducted a community-based cross-sectional survey 250 randomly sampled older adults from the Prospective Urban Rural Epidemiology cohort in Moshi, Tanzania (mean age 60.6 years, SD 11.1). Multivariable linear regression examined resource insecurity (food, water, sanitation), EWE exposure, social support, and resilience associations with depressive and anxiety symptoms. In adjusted analyses, low food security (aβ=0.86, 95% CI: 0.54, 1.18), very low food security (aβ=1.07, 95% CI: 0.73, 1.41), sanitation insecurity (aβ=0.05, 95% CI: 0.01, 0.09p = 0.022 e), and past-year EWE exposure (aβ=0.39, 95% CI: 0.07, 0.70) were associated with higher depressive symptoms. Low food security (aβ=0.51, 95% CI: 0.22, 0.79), very low food security (aβ=0.62, 95% CI: 0.32, 0.93), and water insecurity (aβ=0.53, 95% CI: 0.02, 1.03) were associated with higher anxiety ssymptoms, while resilience was associated with lower anxiety symptoms (aβ= −0.07, 95% CI: −0.14,−0.01). Findings highlight interconnected environmental and resource insecurity-related mental health vulnerabilities among older adults, underscoring the importance of integrating resource security and mental health into climate adaptation strategies for older adults in climate-affected low and middle-income settings.
Perinatal depression is a common, under-treated condition in Sri Lanka, where approximately one in five perinatal women experiences depressive symptoms and access to specialist mental health care is limited. The World Health Organization’s Thinking Healthy Programme (THP) is an evidence-based cognitive-behavioural intervention designed for delivery by non-specialist workers, but a locally validated Sinhala version for Public Health Midwife (PHM) delivery in Galle District was not available. We translated the THP manual from English into Sinhala using forward and back translation by four bilingual investigators, culturally adapted the draft using Bernal’s Ecological Validity Framework with a five-member multidisciplinary group and pre-tested the adapted version with five PHMs across five Medical Officer of Health areas in Galle District. We then validated the manual through a Modified Delphi process involving a nine-member multidisciplinary expert panel that assessed face, content and consensual validity over two iterative rounds and a final roundtable. The scale-level Content Validity Index was 0.96, with mean (SD) ratings of 3.8 (0.7) for relevance and 3.8 (0.1) for clarity. The panel reached unanimous consensus, supporting field-testing of THP delivery by PHMs.
