Background. Acute stress induced by a sudden burden of emergency conditions and traumatic events, such as wars, earthquakes, situations requiring isolation, pandemics, and disasters, can have pathological consequences on healthcare providers (HCPs) if not diagnosed early. Therefore, the objective of this investigation is to culturally validate the self-administered Acute Stress Scale (EASE) in the Turkish context. Method. The study consisted of 127 HCPs working with COVID-19 patients in services and clinics during the pandemic. The individual information form and EASE were used for data collection. Confirmatory factor analysis (CFA) was used to test the factor structure of the EASE. Results. All the statistical procedures showed that the Turkish version of the EASE scale is a valid and reliable measurement tool for the Turkish culture. The content validity index (CVI=0.84), intraclass correlation coefficient (ICC=0.912), and model fit indices (χ2/df=1.826, RMSEA=0.083, CFI=0.947, NFI=0.893, GFI=0.905) explained two-factor structure. Conclusion. Institutional approaches are necessary to support the psychological needs of HCPs. The Turkish version of the EASE scale demonstrated adequate reliability and validity properties. The scale could provide appropriate support during the early stages of acute stress among HCPs related to needs during isolation conditions or unexpected emergencies such as recent pandemics and epidemics in the future.
Introduction. Depression is the fourth leading cause of the global disease burden and worsens the outcome of comorbidities including HIV/AIDS. Depression is particularly problematic among persons living with HIV in sub-Saharan Africa where scarcity of cost-effective interventions is compounded by inadequate understanding of the disease. We examine risk factors for depression among persons living with HIV undergoing antiretroviral treatment in Uganda and discuss policy implications. Methods. A qualitative study using a narrative approach was conducted, the formative phase of a large study to develop a model for integrating depression management into routine HIV care in Uganda. Participants were purposively sampled at four public health facilities in Mpigi District. In-depth interviews were conducted with four clinicians, three supervisors, and 11 persons living with HIV and suffering from depression, as were three focus group discussions with lay health workers. Exit interviews were conducted with 17 persons living with HIV who completed/interrupted depression treatment but had not been interviewed. Only data collected from persons living with HIV and lay health workers were analysed for the purpose of this paper. A narrative thematic approach was used in data analysis. Findings. There were several pathways through which lack of family social support reportedly led to depression: worries about disclosure in discordant relationships, false perceptions of social support, stigmatisation and discrimination, and domestic violence. Economic/poverty and other causes were identified, but their role was less significant or moderated by family social support. Conclusion. Family social support plays a dominant role—both directly and indirectly—in influencing depression risk. We propose the mainstreaming of formal psychosocial support and a shift from individual to family-focused counselling that targets both persons living with HIV and their family.
Background:Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition typified by inattention, hyperactivity, and impulsivity. Comorbid psychiatric disorders are common among children and adolescents with ADHD. In this study, it was aimed to examine anxiety and somatic symptoms in children and adolescents with ADHD and the effect of methylphenidate treatment on these symptoms.Method:Three groups were formed, consisting of 37 children and adolescents diagnosed with ADHD and received methylphenidate treatment, 37 newly diagnosed, treatment-naive children and adolescents with ADHD diagnosis, and 37 children and adolescents without the diagnosis of ADHD. The symptoms of ADHD in children were examined by using the DSM-IV-based child and adolescent behavior disorders screening and rating scale, the symptoms of anxiety were examined by using the screen for child anxiety-related disorders (SCARED), and somatic symptoms were examined by using the DSM-5 level 2 somatic symptom scale.Results:In the newly diagnosed, treatment-naive with ADHD group, anxiety and somatic symptoms were found to be significantly higher compared to the ADHD group with methylphenidate treatment and the non-ADHD group. It was shown that the symptoms of panic disorder, generalized anxiety, and social phobia were observed more in the newly diagnosed, treatment-naive with ADHD group compared to the treatment group with ADHD.Conclusions:It was determined that children and adolescents diagnosed with ADHD had more anxiety and somatic symptoms. Anxiety and somatic symptoms increased as the severity of ADHD symptoms increased. Anxiety and somatic symptoms were lower than in ADHD children receiving methylphenidate treatment. Clinicians should keep in mind to evaluate anxiety and somatic symptoms in children and adolescents with ADHD before the treatment.
Background:The individual placement and support (IPS) model for persons with severe mental illness has proven to be more effective than traditional vocational approaches in improving competitive work over 18 months. In this study, the longer-term effects of IPS over 30 months were investigated in a Danish setting.Method:In a randomized clinical trial, we compared the effects of IPS, IPS enhanced with cognitive remediation and work-related social skills training (IPSE), and service as usual (SAU). At three locations in Denmark, 720 patients with serious mental illnesses were randomly assigned to the three groups. Competitive employment, education, and hospital admissions were tracked for 30 months using Danish national registers.Results:The beneficial effects of IPS on competitive employment and education at the 18-month follow-up were sustained over the 30-month follow-up period. Participants receiving IPS or IPSE were more likely to obtain competitive employment or education than those who received service as usual (IPS 65%, IPSE 65%, SAU 53%, p = 0.006), and they worked on average more weeks competitively (IPS 25 weeks, IPSE 21 weeks, SAU 17 weeks; IPS vs. SAU p = 0.004 and IPSE vs. SAU p = 0.007). Moreover, participants in the two IPS groups had fewer outpatient visits during the 30-month follow-up. However, this was only statistically significant when comparing IPSE with SAU p = 0.017.Conclusion:In conclusion, IPS and IPS enhanced with cognitive remediation and work-related skills training demonstrated that the vocational effects of the interventions are retrained over 30 months in a Danish context.
Background. Globally, about 450 million people suffer from mental disorders of which about 11% are assumed to be prisoners. The presence of mental illness among prisoners contributes to an increase in the risk of suicide, violence, morbidity, and mortality. In Ethiopia, there is a paucity of data particularly from resource-limited areas to assist policy maker’s efforts in reforming mental health care. Objective. This study is aimed at assessing common mental disorders and its associated factors among prisoners in North Wollo zone correctional institutions, Northeastern Ethiopia. Method. Institution-based cross-sectional study was conducted on 401 study participants from January–February 2021. A simple random sampling technique was employed to enroll the study participants. Structured interviewer-administered Self Reporting Questionnaires-20 (SRQ-20) developed by the World Health Organization was used to collect the data. Data were checked for completeness, coded and entered into Epi data version 4.2, and transferred to SPSS version 23.0 for final analysis. Binary logistic regression analysis was carried out to identify factors associated with common mental disorders. Statistical significance was declared at p values < 0.05 in the final model. Results. The prevalence of common mental disorders was found to be 63.6% (95% CI 58.9, 68.3). After adjusting for confounding factors using multiple logistic regression, having children (AOR=3.7, 95% CI: 1.93, 7.36), poor social support (AOR=6.6, 95% CI: 2.93, 14.93), history of mental illness (AOR=6.5, 95% CI: 1.78, 24.3), one- to five-year prison stay (AOR=2.6, 95% CI: 1.38, 5.04), greater than five-year prison stay (AOR=5.7, 95% CI: 2.05, 16.27), experiencing one stressful life event (AOR=5.2, 95% CI: 1.83, 15.01), experiencing two or more stressful life events (AOR=7.3, 95% CI: 2.98, 17.9), unavailability of reading materials (AOR=4.3, 95% CI: 1.63, 11.43), and greater than or equal to eleven years of sentences (AOR=4.4, 95 CI: 1.82, 10.70) were factors significantly associated with common mental disorders. Conclusion. Common mental disorders are highly prevalent among prisoners in this study area. The result of this study suggests the importance of screening and providing psychiatric counseling to this highly vulnerable population.
