Global Mental Health最新文献

{"title":"Early intervention in psychosis programs in Africa, Asia and Latin America; challenges and recommendations.","authors":"Els van der Ven, Xinyu Yang, Franco Mascayano, Karl J Weinreich, Eric Yh Chen, Charmaine Yz Tang, Sung-Wan Kim, Jonathan K Burns, Bonginkosi Chiliza, Greeshma Mohan, Srividya N Iyer, Thara Rangawsamy, Ralph de Vries, Ezra S Susser","doi":"10.1017/gmh.2024.78","DOIUrl":"https://doi.org/10.1017/gmh.2024.78","url":null,"abstract":"<p><strong>Background: </strong>While early intervention in psychosis (EIP) programs have been increasingly implemented across the globe, many initiatives from Africa, Asia and Latin America are not widely known. The aims of the current review are (a) to describe population-based and small-scale, single-site EIP programs in Africa, Asia and Latin America, (b) to examine the variability between programs located in low-and-middle income (LMIC) and high-income countries in similar regions and (c) to outline some of the challenges and provide recommendations to overcome existing obstacles.</p><p><strong>Methods: </strong>EIP programs in Africa, Asia and Latin America were identified through experts from the different target regions. We performed a systematic search in Medline, Embase, APA PsycInfo, Web of Science and Scopus up to February 6, 2024.</p><p><strong>Results: </strong>Most EIP programs in these continents are small-scale, single-site programs that serve a limited section of the population. Population-based programs with widespread coverage and programs integrated into primary health care are rare. In Africa, EIP programs are virtually absent. Mainland China is one of the only LMICs that has begun to take steps toward developing a population-based EIP program. High-income Asian countries (e.g. Hong Kong and Singapore) have well-developed, comprehensive programs for individuals with early psychosis, while others with similar economies (e.g. South Korea and Japan) do not. In Latin America, Chile is the only country in the process of providing population-based EIP care.</p><p><strong>Conclusions: </strong>Financial resources and integration in mental health care, as well as the availability of epidemiological data on psychosis, impact the implementation of EIP programs. Given the major treatment gap of early psychosis in Africa, Latin America and large parts of Asia, publicly funded, locally-led and accessible community-based EIP care provision is urgently needed.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"12 ","pages":"e3"},"PeriodicalIF":3.3,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathways to care for psychosis in rural Uganda: Mixed-methods study of individuals with psychosis, family members, and local leaders.","authors":"Yang Jae Lee, Kayera Sumaya Nakaziba, Sophie Waimon, Grace Agwang, Kailash Menon, Sam Samuel, Aaron Damon Dyas, Travor Nkolo, Haba Ingabire, Jason Wykoff, Olivia Hobbs, Rauben Kazungu, Job Basiimwa, Robert Rosenheck, Scholastic Ashaba, Alexander C Tsai","doi":"10.1017/gmh.2024.143","DOIUrl":"https://doi.org/10.1017/gmh.2024.143","url":null,"abstract":"<p><strong>Background: </strong>Low- and middle-income countries (LMICs) bear a disproportionate burden of mental illness, with limited access to biomedical care. This study examined pathways to care for psychosis in rural Uganda, exploring factors influencing treatment choices.</p><p><strong>Methods: </strong>We conducted a mixed-methods study in Buyende District, Uganda, involving 67 in-depth interviews and 4 focus group discussions (data collection continued until thematic saturation was reached) with individuals with psychotic disorders, family members, and local leaders. Structured questionnaires were administered to 41 individuals with psychotic disorders.</p><p><strong>Results: </strong>Three main themes emerged: (1) Positive attitudes towards biomedical providers, (2) Barriers to accessing biomedical care (3) Perceived etiologies of mental illness that influenced care-seeking behaviors. While 81% of participants eventually accessed biomedical care, the median time to first biomedical contact was 52 days, compared to 7 days for any care modality.</p><p><strong>Conclusions: </strong>Despite a preference for biomedical care, structural barriers and diverse illness perceptions led many to seek pluralistic care pathways. Enhancing access to biomedical services and integrating traditional and faith healers could improve mental health outcomes in rural Uganda.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"11 ","pages":"e130"},"PeriodicalIF":3.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences and needs of unaccompanied irregular migrant minors who arrive in Spain on small boats: A qualitative study.","authors":"Ousmane Berthe-Kone, José Granero Molina, Cayetano Fernández-Sola, María Del Mar Jiménez-Lasserrotte, Maria Auxiliadora Robles-Bello","doi":"10.1017/gmh.2024.146","DOIUrl":"https://doi.org/10.1017/gmh.2024.146","url":null,"abstract":"<p><p>The European Union receives thousands of unaccompanied irregular migrant minors every year, but little is known about their life experiences during the migration process. The aim of this study is to describe their experiences as minors when they arrived in Spain in small boats, which will help to understand their psychosocial and health needs. A descriptive qualitative study was undertaken. In-depth interviews were conducted with 18 unaccompanied irregular migrants (15 men and 3 women) from different African countries with a mean age of 20.05 years (SD = 2.77). Thematic analysis was used to analyse the data. Three main themes emerged such as (1) unaccompanied irregular migrant minors: risking it all for a better life; (2) redefining your identity as a means of adaptation and (3) obtaining legal status to avoid deportation. Unaccompanied migrant minors risk their lives on the migration journey, but do not always find better conditions in the destination country. The unaccompanied irregular migrant minors are forced to rebuild their lives at a high cost; they experience rejection from the host society and their culture of origin, which has a negative impact on their physical and psychological health over time.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"11 ","pages":"e132"},"PeriodicalIF":3.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of physical multimorbidity on cognitive decline trajectories among adults aged 50 years and older with different wealth status: a 17-year population-based cohort study.","authors":"Chen Chen, Shan Zhang, Ning Huang, Mingyu Zhang, JinXin Fu, Jing Guo","doi":"10.1017/gmh.2024.141","DOIUrl":"https://doi.org/10.1017/gmh.2024.141","url":null,"abstract":"<p><p>This study aimed to investigate the effects of physical multimorbidity on the trajectory of cognitive decline over 17 years and whether vary across wealth status. The study was conducted in 9035 respondents aged 50+ at baseline from nine waves (2002-2019) of the English Longitudinal Study of Aging. A latent class analysis was used to identify patterns of physical multimorbidity, and mixed multilevel models were performed to determine the association between physical multimorbidity and trajectories of cognitive decline. Joint analyses were conducted to further verify the influence of wealth status. Four patterns of physical multimorbidity were identified. Mixed multilevel models with quadratic terms of time and status/patterns indicated significant non-linear trajectories of multimorbidity on cognitive function. The magnitude of the association between complex multisystem patterns and cognitive decline increased the most as follow-up progressed. Individuals with high wealth and hypertension/diabetes patterns have significantly lower composite global cognitive <i>z</i> scores over time as compared with respiratory/osteoporosis patterns. Physical multimorbidity at baseline is associated with the trajectory of cognitive decline, and the magnitude of the association increased over time. The trend of cognitive decline differed in specific combinations of wealth status and physical multimorbidity.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"11 ","pages":"e131"},"PeriodicalIF":3.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in severity of depression symptoms in overweight, obese and normal weight Palestinian children and adolescents.","authors":"Hadeel Agbaria, Fayez Mahamid, Dana Bdier","doi":"10.1017/gmh.2024.126","DOIUrl":"https://doi.org/10.1017/gmh.2024.126","url":null,"abstract":"<p><p>Obesity is related to a wide variety of medical and psychological comorbidities which has short- and long-term effects on children's mental health. One of the most significant ones is depression. Thus, the current study utilized a descriptive methodology to explore the differences in depressive symptoms among overweight, obese, and normal-weight Palestinian children and adolescents. Data was collected from 270 Palestinian children and adolescents, aged (9-16) years: 85 with normal weight, 95 with over-weight and 90 obese. Findings showed that participants who are over-weight or obese exhibited more depressive symptoms than those with a normal weight. These findings showed that Palestinian children and adolescents who are over-weight or obese do experience depression and thus interventions should take this into account. In particular, it seems that over-weight boys or adolescents need more direct help in losing weight while obese children and adolescents who feel more helpless about their weight need serious psychological interventions. it is critical to offer psychological treatment as part of any weight loss intervention program for children and adolescents. Especially as these adolescents' families might encourage them to avoid seeking professional help and deal with the problem in the family.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"11 ","pages":"e127"},"PeriodicalIF":3.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No prediction without prevention: A global qualitative study of attitudes toward using a prediction tool for risk of developing depression during adolescence.","authors":"Brandon A Kohrt, Syed Shabab Wahid, Katherine Ottman, Abigail Burgess, Anna Viduani, Thais Martini, Silvia Benetti, Olufisayo Momodu, Jyoti Bohara, Vibha Neupane, Kamal Gautam, Abiodun Adewuya, Valeria Mondelli, Christian Kieling, Helen L Fisher","doi":"10.1017/gmh.2024.136","DOIUrl":"https://doi.org/10.1017/gmh.2024.136","url":null,"abstract":"<p><p>Given the rate of advancement in predictive psychiatry, there is a threat that it outpaces public and professional willingness for use in clinical care and public health. Prediction tools in psychiatry estimate the risk of future development of mental health conditions. Prediction tools used with young populations have the potential to reduce the worldwide burden of depression. However, little is known globally about adolescents' and other stakeholders' attitudes toward use of depression prediction tools. To address this, key informant interviews and focus group discussions were conducted in Brazil, Nepal, Nigeria and the United Kingdom with 23 adolescents, 45 parents, 47 teachers, 48 health-care practitioners and 78 other stakeholders (total sample = 241) to assess attitudes toward using a depression prediction risk calculator based on the Identifying Depression Early in Adolescence Risk Score. Three attributes were identified for an acceptable depression prediction tool: it should be understandable, confidential and actionable. Understandability includes depression literacy and differentiating between having a condition versus risk of a condition. Confidentiality concerns are disclosing risk and impeding educational and occupational opportunities. Prediction results must also be actionable through prevention services for high-risk adolescents. Six recommendations are provided to guide research on attitudes and preparedness for implementing prediction tools.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"11 ","pages":"e129"},"PeriodicalIF":3.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The structure of the multidimensional scale of perceived social support: a meta-analytic confirmatory factor analysis.","authors":"Hakan Koğar, Esin Yılmaz Koğar","doi":"10.1017/gmh.2024.118","DOIUrl":"https://doi.org/10.1017/gmh.2024.118","url":null,"abstract":"<p><p>One of the most popular instruments used to assess perceived social support is the Multidimensional Scale of Perceived Social Support (MSPSS). Although the original structure of the MSPSS was defined to include three specific factors (significant others, friends and family), studies in the literature propose different factor solutions. In this study, we addressed the controversial factor structure of the MSPSS using a meta-analytic confirmatory factor analysis approach. For this purpose, we utilized studies in the literature that examined and reported the internal structure of the MSPSS. However, we used summary data from 59 samples of 54 studies (total <i>N</i> = 27,905) after excluding studies that did not meet the inclusion criteria. We tested five different models discussed in the literature and found that the fit indices of the correlated 3-factor model and the bifactor model were quite good. Therefore, we also examined both models' factor loadings and omega coefficients. Since there was no sharp difference between the two models and the theoretical structure of the scale was represented by the correlated three factors, we decided that the correlated three-factor model was more appropriate for the internal structure of the MSPSS. We then examined the measurement invariance for this model according to language and sample type (clinical and nonclinical) and found that metric invariance was achieved. As a result, we found that the three-factor structure of the MSPSS was supported in this study.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"11 ","pages":"e126"},"PeriodicalIF":3.3,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying systems theory to global mental health.","authors":"Mark J D Jordans","doi":"10.1017/gmh.2024.147","DOIUrl":"10.1017/gmh.2024.147","url":null,"abstract":"<p><p>In recent years the evidence base for psychological interventions in low- and -middle-income countries (LMIC) has rapidly accrued, demonstrating that task-shifting models result in desired outcomes. Next, it is important to look at how this evidence translates into practice. In doing so, this paper argues that the field of global mental health might benefit from applying a system theory or system science perspective. Systems thinking aims to understand how different components are connected and interdependent within a larger emergent entity. At present much of the research efforts into psychological interventions in LMIC are focusing on single interventions, with little focus on how these interventions sit in, or influence, a larger system. Adopting systems theory and system dynamics tools can help in; (i) better analyzing and understanding the key drivers of mental health problems and services, (ii) optimizing mental health services; and (iii) understanding the organization of people, institutions and resources required for rolling out and scaling-up mental health services. This paper reflects on some of these merits of a systems perspective, as well as provides some examples.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"12 ","pages":"e2"},"PeriodicalIF":3.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Data-driven supervision to optimize the effectiveness of proactive case detection for mental health care among children: a proof-of-concept study.","authors":"Myrthe van den Broek, M Claire Greene, Anthony F Guevara, Sandra Agondeze, Erimiah Kyanjo, Olivier Irakoze, Rosco Kasujja, Brandon A Kohrt, Mark J D Jordans","doi":"10.1017/gmh.2024.150","DOIUrl":"10.1017/gmh.2024.150","url":null,"abstract":"<p><p>This proof-of-concept study evaluated an optimization strategy for the Community Case Detection Tool (CCDT) aimed at improving community-level mental health detection and help-seeking among children aged 6-18 years. The optimization strategy, CCDT+, combined data-driven supervision with motivational interviewing techniques and behavioural nudges for community gatekeepers using the CCDT. This mixed-methods study was conducted from January to May 2023 in Palorinya refugee settlement in Uganda. We evaluated (1) the added value of the CCDT+ in improving the accuracy of detection and mental health service utilization compared to standard CCDT, and (2) implementation outcomes of the CCDT+. Of the 1026 children detected, 801 (78%) sought help, with 656 needing mental health care (PPV = 0.82; 95% CI: 0.79, 0.84). The CCDT+ significantly increased detection accuracy, with 2.34 times higher odds compared to standard CCDT (95% CI: 1.41, 3.83). Additionally, areas using the CCDT+ had a 2.05-fold increase in mental health service utilization (95% CI: 1.09, 3.83). The CCDT+ shows promise as an embedded quality-optimization process for the detection of mental health problems among children and enhance help-seeking, potentially leading to more efficient use of mental health care resources.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"12 ","pages":"e4"},"PeriodicalIF":3.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic factors associated with trajectories of depression among urban refugee youth in Kampala, Uganda: A longitudinal cohort study.","authors":"Zerihun Admassu, Sikky Shiqi Chen, Carmen H Logie, Moses Okumu, Frannie MacKenzie, Robert Hakiza, Daniel Kibuuka Musoke, Brenda Katisi, Aidah Nakitende, Peter Kyambadde, Lawrence Mbuagbaw","doi":"10.1017/gmh.2024.135","DOIUrl":"https://doi.org/10.1017/gmh.2024.135","url":null,"abstract":"<p><strong>Background: </strong>There is a high prevalence of depression among refugee youth in low- and middle-income countries, yet depression trajectories are understudied. This study examined depression trajectories, and factors associated with trajectories, among urban refugee youth in Kampala, Uganda.</p><p><strong>Methods: </strong>We conducted a longitudinal cohort study with refugee youth aged 16-24 in Kampala, Uganda. We assessed depression using the Patient Health Questionnaire-9 and conducted latent class growth analysis (LCGA) to identify depression trajectories. Sociodemographic and socioecological factors were examined as predictors of trajectory clusters using multivariable logistic regression.</p><p><strong>Results: </strong>Data were collected from n = 164 participants (n = 89 cisgender women, n = 73 cisgender men, n = 2 transgender persons; mean age: 19.9, standard deviation: 2.5 at seven timepoints; n = 1,116 observations). Two distinct trajectory clusters were identified: \"sustained low depression level\" (n = 803, 71.9%) and \"sustained high depression level\" (n = 313, 28.1%). Sociodemographic (older age, gender [cisgender women vs. cisgender men], longer time in Uganda), and socioecological (structural: unemployment, food insecurity; interpersonal: parenthood, recent intimate partner violence) factors were significantly associated with the sustained high trajectory of depression.</p><p><strong>Conclusions: </strong>The chronicity of depression highlights the critical need for early depression screening with urban refugee youth in Kampala. Addressing multilevel depression drivers prompts age and gender-tailored strategies and considering social determinants of health.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"11 ","pages":"e125"},"PeriodicalIF":3.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}