PLOS mental health最新文献

{"title":"The social determinants of adolescent anxiety and depression in peri-urban South Africa.","authors":"Laura Rossouw, Kathryn Watt, Leslie L Davidson, Chris Desmond","doi":"10.1371/journal.pmen.0000173","DOIUrl":"10.1371/journal.pmen.0000173","url":null,"abstract":"<p><p>The environment in which adolescents live impacts their mental health, through social determinants. We examine the impact of social determinants on anxiety, and depression in adolescents (aged 13-19) in peri-urban KwaZulu-Natal, South Africa. Using structural equation modelling, we identify direct relationships between social determinants and depression/anxiety, as well as indirect pathways between social determinants. Our findings indicate that living with the biological mother, the perception of family and peer support, school enrolment, and a positive sense of school membership may protect adolescent's mental health. Conversely, exposure to community violence may be directly detrimental to adolescent mental health and indirectly harm mental health through the negation of a sense of school membership. Understanding the potential direct and indirect pathways between social determinants and adolescents' mental health in resource-constrained contexts can inform interventions to protect young people's well-being through the identification of appropriate entry points closer to and further from the adolescent and their household.</p>","PeriodicalId":520078,"journal":{"name":"PLOS mental health","volume":"1 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in Mental Illness Stigma by Disorder and Gender: Population-Based Vignette Randomized Experiment in Rural Uganda.","authors":"Yang Jae Lee, Ryan Christ, Rita Mbabazi, Jackson Dabagia, Alison Prendergast, Jason Wykoff, Samhitha Dasari, Dylan Safai, Shakira Nakaweesi, Swaib Rashid Aturinde, Michael Galvin, Dickens Akena, Scholastic Ashaba, Peter Waiswa, Robert Rosenheck, Alexander C Tsai","doi":"10.1371/journal.pmen.0000069","DOIUrl":"10.1371/journal.pmen.0000069","url":null,"abstract":"<p><p>Understanding and eliminating mental illness stigma is crucial for improving population mental health. In many settings, this stigma is gendered, from the perspectives of both the stigmatized and the stigmatizers. We aimed to find the differences in the level of stigma across different mental disorders while considering the gender of the study participants as well as the gender of the people depicted in the vignettes. This was a population-based, experimental vignette study conducted in Buyende District of Eastern Uganda in 2023. We created 8 vignettes describing both men and women with alcohol use disorder, major depressive disorder, generalized anxiety disorder, and schizophrenia consistent with DSM-5 criteria. Participants from 20 villages in rural Buyende District of Uganda (N=379) were first read a randomly selected vignette and administered a survey eliciting their attitudes (Personal Acceptance Scale [PAS] and Broad Acceptance Scale [BAS]) towards the person depicted in the vignette. We used analysis of variance (ANOVA) with Bonferroni-adjusted, empirical p-values to compare levels of acceptance across disorders and genders. Attitudes towards people with mental illness, as measured by the PAS, varied across different mental disorders (p=0.002). In pairwise mean comparisons, the greater acceptance of anxiety disorder vs. schizophrenia was statistically significant (Mean [SD] PAS: 2.91 [3.15] vs 1.62 [1.95], p=0.008). Secondary analyses examining differences in acceptance across gender combinations within mental disorders showed that PAS varied across gender combinations for depression (p=0.017), suggesting that acceptance is higher for women with depression than men with depression. In this population-based vignette study from rural Uganda, we found that people with schizophrenia were less accepted compared to people with anxiety disorders. We also found that there was greater acceptance of women with depression than men with depression. Anti-stigma initiatives may need to be targeted to specific disorders and genders.</p>","PeriodicalId":520078,"journal":{"name":"PLOS mental health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11345708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating family life with Hypoplastic Left Heart Syndrome: A qualitative study.","authors":"Michael D Green, Alejandra Prevost-Reilly, Devin M Parker, Elizabeth Carpenter-Song","doi":"10.1371/journal.pmen.0000208","DOIUrl":"10.1371/journal.pmen.0000208","url":null,"abstract":"<p><p>Hypoplastic Left Heart Syndrome (HLHS) is a critical congenital heart abnormality that, prior to 1980, offered no treatment options beyond comfort care. Surgical advancements have since transformed the prognosis, yet the lived experience of affected families remains complex and multifaceted. This study aims to elucidate the psychosocial challenges accompanying the biomedical management of HLHS, exploring both family and provider perspectives to identify opportunities for more holistic care. We conducted semi-structured interviews with five families and two healthcare providers involved in HLHS management a New England health system. Interview transcripts were analyzed inductively to identify emergent themes, with a focus on the lived experience of families and the perceived role of providers in influencing this experience. Our study illuminates the extensive psychosocial challenges and emotional distress encountered by families dealing with HLHS, indicating a disparity between the advanced biomedical treatments available and the broader, more integrative care needs of patients. Despite healthcare professionals' technical proficiency, there exists a pivotal need for empathetic engagement and support that encompasses the full scope of the patient and family experience. Our findings advocate for an integrated care model that incorporates George Engel's biopsychosocial aspects of health, aligning with the emotional and psychological needs of families. The study underscores the importance of socially conscious care and suggests that enhancing empathetic communication and support in clinical practice can improve both patient outcomes and family well-being in the context of chronic and complex conditions like HLHS.</p>","PeriodicalId":520078,"journal":{"name":"PLOS mental health","volume":"1 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micro-costing analysis of a combination intervention for improved mental health and HIV risk behaviors among school-going adolescent girls in Uganda.","authors":"Yesim Tozan, Joshua Kiyingi, Sooyoung Kim, Flavia Namuwonge, Florence Namuli, Vicent Ssentumbwe, Rashida Namirembe, Edwinnah Kasidi, Ozge Sensoy Bahar, Mary M Mckay, Fred M Ssewamala","doi":"10.1371/journal.pmen.0000201","DOIUrl":"10.1371/journal.pmen.0000201","url":null,"abstract":"<p><p>Suubi4Her is a combination intervention that integrates a savings-led family-based economic empowerment intervention through youth development accounts with a family strengthening intervention delivered via multiple family groups. It aims to improve mental health and reduce HIV risk behaviors among school-going adolescent girls in Uganda. This micro-costing study was conducted as part of a three-armed randomized control trial between 2017-2022, involving 1,260 participants aged 14-17 years across 47 secondary schools. Adopting a provider perspective, we prospectively identified, measured, and computed the costs associated with all program activities. These costs were then aggregated and divided by the actual number of adolescent girls in each study arm to conservatively obtain the per-adolescent costs for each arm. The per-adolescent costs of economic empowerment intervention alone and in combination with the family strengthening intervention were US$476 and US$812, respectively. Personnel costs were the key cost driver due to the intensive supervision of intervention delivery and quality assurance efforts. This study is the first to estimate the economic costs of an evidence-based combination intervention targeting the multifaceted risk factors underlying HIV risk among adolescent girls in a low-resource setting. The per-adolescent cost of US$812 for the Suubi4Her intervention falls within the cost range reported for other family-based interventions (US$500-US$900); however, published comparisons are limited. Accurate and reliable cost estimates are key to assessing the feasibility, affordability, and economic value of interventions. There is a pressing need for more costing studies on evidence-based combination interventions, especially in low-resource settings (Trial registration: Clinical Trials NCT03307226; IRB approvals: Washington University in St. Louis (IRB #201703102), the Uganda Virus Research Institute (GC/127/17/07/619), and the Uganda National Council of Science and Technology (SS4406).</p>","PeriodicalId":520078,"journal":{"name":"PLOS mental health","volume":"1 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}