SSM. Mental health最新文献

{"title":"What matters for sustainable psychosocial interventions and who decides? Critical ethnography of a lay counselling program in Nepal","authors":"Parbati Shrestha ,&nbsp;Aruna Limbu ,&nbsp;Kusumlata Tiwari ,&nbsp;Liana E. Chase","doi":"10.1016/j.ssmmh.2024.100359","DOIUrl":"10.1016/j.ssmmh.2024.100359","url":null,"abstract":"<div><div>Lay counselling, or the delivery of talk-based therapeutic support by people without a clinical degree, is gaining popularity as a way of addressing global shortages of mental health professionals. In Nepal, lay counselors have made significant contributions to mental health and psychosocial care over the last two decades, particularly in the aftermath of major emergencies. However, research on the longer-term integration and sustainability of lay counselling interventions remains limited. This ethnographic study explored the meaning and importance of sustainability to different stakeholders in a lay counselling program implemented following Nepal's 2015 earthquake. We conducted participant observation in the everyday lives of five counsellors as well as four focus group discussions and 51 semi-structured interviews with counsellors and other key stakeholders. Our analysis revealed significant discrepancies in perceptions of sustainability; while organizations involved in implementing the program described it as a sustainability success due to continued government financing, counsellors emphasized their own and the government's failure to sustain high-quality service delivery in practice. Program-level barriers included inadequate budget and remuneration, lack of clinical supervision, and poor integration within existing systems. We also identified wider sociopolitical influences on sustainability, including the social positioning of counsellors, low understanding and acceptability of counselling, and a rapidly changing political landscape. These findings reveal the need for a critical approach to sustainability in global mental health, warning against superficial engagement that prioritizes continuity of government financing over quality of care and workers' rights. Advocating for an ecological orientation within sustainability research, we also discuss the importance of looking beyond program design factors to consider how local and national sociopolitical dynamics influence frontline service provision.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"6 ","pages":"Article 100359"},"PeriodicalIF":4.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663299","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":"Has population mental health returned to pre-pandemic levels, among and between racialized groups and by immigration status?","authors":"Caitlin Patler,&nbsp;Paola D. Langer","doi":"10.1016/j.ssmmh.2024.100362","DOIUrl":"10.1016/j.ssmmh.2024.100362","url":null,"abstract":"<div><div>The COVID-19 pandemic profoundly impacted population health, including mental health, in ways that were patterned unevenly by pre-existing systemic inequalities such as structural gendered racism and xenophobia. However, it remains unclear whether pandemic-related mental health deterioration has persisted over time. Drawing on theories of disruptive events and structural racism, we conceptualize the pandemic as a <em>prolonged macro-level disruptive event</em> with unequal ramifications for different racialized groups and by immigration status. We use six waves (2017–2022) of repeated cross-sectional data from the California Health Interview Survey (CHIS; N = 121,063) from men and women from nine racialized and immigration status groups (US-born citizens, naturalized citizens, and noncitizens of White, Latina/o, and Asian racialized groups, respectively). We use multivariable regression to examine changes in psychological distress within each group, and then assess patterns of racialized health disparities between Latina/o and Asian groups, respectively, compared to White US-born citizens, who occupy the most structurally privileged social status. Our analyses reveal several key findings. First, we observed persistent increases in psychological distress from 2020 through 2022, relative to the pre-pandemic period (2017–2019), for all racialized and immigration status groups, among men and women. Second, few groups had returned to pre-pandemic distress levels as of 2022. Third, there was a consistent health advantage for White US-born citizens across the pre-pandemic and pandemic years, whose highest post-pandemic distress measure was lower or equivalent to the pre-pandemic distress of US-born Latina/o and Asian groups. Fourth, the psychological distress gap between the White US-born population and US-born Latina/o and Asian groups, respectively, grew or held steady through 2022. Finally, the 2020–2022 period was associated with a reduction in pre-pandemic health advantages among Asian immigrant groups, relative to US-born White citizens, especially among men. Our findings provide strong evidence that population mental health has not recovered from the pandemic period.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"6 ","pages":"Article 100362"},"PeriodicalIF":4.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663319","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":"State-level variation in the prevalence of child psychopathology symptoms in the US: Results from the ABCD study","authors":"Katherine M. Keyes ,&nbsp;Noah T. Kreski ,&nbsp;David Weissman ,&nbsp;Katie A. McLaughlin","doi":"10.1016/j.ssmmh.2024.100361","DOIUrl":"10.1016/j.ssmmh.2024.100361","url":null,"abstract":"<div><h3>Objective</h3><div>To estimate the prevalence of clinically meaningful youth mood, anxiety, behavioral, and attention symptoms across US states.</div></div><div><h3>Method</h3><div>Data are drawn from the Adolescent Brain Cognitive Development (ABCD) study baseline wave, which included 11,876 children ages 9–10. Statistical weighting strategies generated projected state-specific prevalence estimates for the 17 states where ABCD collected data based on state socio-demographics. Twenty dimensions of mental health were assessed with the Child Behavior Checklist using recommended cut-scores to assess clinical and sub-threshold symptoms.</div></div><div><h3>Results</h3><div>Psychopathology symptom prevalence varied by state and outcome. Projected prevalence of internalizing problems ranged from 11.0% [95% CI: 9.8%, 12.2%; Oklahoma] to 7.9% [95% CI: 6.9%, 9.0%; Maryland] across states. Projected prevalence of externalizing problems ranged from 6.9% [95% CI: 6.1%, 7.8%; South Carolina] to 4.5% [95% CI: 3.7%, 5.4%; California]. Regions with high symptoms included sections of the South (e.g., Oklahoma, South Carolina) and Vermont. Conduct problems had the most variability across states (i.e., greatest state-level prevalence 91% higher than the lowest). Attention problems had the least variability across states (greatest state-level prevalence 26% higher than the lowest).</div></div><div><h3>Conclusions</h3><div>Clinically meaningful psychopathology symptoms are common in children across the US, with substantial state-level variability in prevalence. Understanding variability in the prevalence of psychopathology symptoms across the US can help to inform resource allocation to increase the availability of youth mental health services.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"6 ","pages":"Article 100361"},"PeriodicalIF":4.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560790","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":"Perceptions around occupational mental well-being of community health workers and an intervention package for its promotion: A mixed-methods study in rural Chiapas, Mexico","authors":"Jack Sullivan ,&nbsp;Zeus Aranda ,&nbsp;Manvit Adusumilli ,&nbsp;Anna Martens ,&nbsp;Ariwame Jiménez","doi":"10.1016/j.ssmmh.2024.100360","DOIUrl":"10.1016/j.ssmmh.2024.100360","url":null,"abstract":"<div><h3>Background</h3><div>The challenging working conditions experienced by community health workers (CHWs) have an impact on their mental health, as detected by the NGO Compañeros En Salud (CES) in rural Mexico. In response to this situation, CES designed through a participatory process a package of interventions to promote the mental well-being of CHWs, beginning implementation in 2021. The objective of the present study was to learn how CES CHWs' work affects their mental well-being and to evaluate the intervention package to promote CHWs’ mental well-being implemented by CES.</div></div><div><h3>Methods</h3><div>In June–August 2023, 52 CHWs from the CES-supported communities participated in the study, responding to a survey and participating in 10 focus group discussions. Quantitative data were analyzed using statistical descriptive analysis and qualitative data using thematic analysis.</div></div><div><h3>Findings</h3><div>Participants highlighted the impact on their communities as one of the main aspects of their job that contribute positively to their mental well-being, as well as the challenging work-life balance as one of the main aspects that contribute negatively. As for the interventions, most participants considered them significant and positive for their mental well-being, highlighting positive aspects such as the possibility of creating community with their peers or a feeling of self-efficacy. However, the access to interventions was uneven among participants and most interventions presented areas for improvement, such as the periodicity of psychological distress screening or the response time to material needs.</div></div><div><h3>Conclusions</h3><div>Efforts to support CHW well-being in the areas they signal as needs can impact their experiences around work and their perceived well-being. Access to work materials, preparedness on clinical topics, and relationships with their teams are key areas that may have a bearing on CHWs' emotional and mental well-being. Interventions aimed at these areas can positively impact CHWs’ self-efficacy, their community with each other, and their interactions with patients.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"6 ","pages":"Article 100360"},"PeriodicalIF":4.1,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142538831","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":"Unveiling the impacts of exposure and social proximity to suicidality on help-seeking behavior among the young generation","authors":"Sijia Li ,&nbsp;Alvin Junus ,&nbsp;Paul Siu Fai Yip","doi":"10.1016/j.ssmmh.2024.100357","DOIUrl":"10.1016/j.ssmmh.2024.100357","url":null,"abstract":"<div><div>Each suicide affects a wide circle of individuals and increases in suicide rate imply that a larger share of the population would be exposed to suicidality. This exposure may alter individuals' tendency to seek help when they face distress and is influenced by social proximity. However, limited evidence has clarified the direct and moderating effect of social proximity to suicidality on help-seeking behavior. Data were collected from a population-representative survey conducted in 2021. We recruited 1501 individuals aged 11–35 years with random sampling through mobile phone numbers. Exposure and social proximity to suicidality were measured as independent variables and help-seeking behaviors were outcomes, along with sociodemographics, psychological distress, and mental health risks as covariates. We employed latent class analysis to identify help-seeking behavior patterns and conducted multinomial logistic regressions with a three-way interaction to investigate the direct and moderating effects of social proximity to suicide ideation (SI), self-harm (SH), and suicide attempt (SA) on each help-seeking behavior pattern separately. Each unit increase in social proximity to SH was associated with a 30.9% higher likelihood of seeking help from family, friends, and partners even after controlling for distress and mental health risks. Furthermore, the three-way interaction (<em>β</em>₁₂₃ = 0.041, 95% CI [0.014, 0.069]) suggested joint moderating effects of social proximity among people who did not rely on family. The effect of social proximity to any single stage of suicidality was amplified only when people were not exposed to the other two stages. Closer social proximity to suicidality could heighten the probability of individuals seeking help from family, friends, and partners regardless of distress level, with SH exposure's effects being stronger than SI's and SA's. Initial exposure to any single stage of suicidality could have a stronger effect than subsequent exposures among individuals who did not rely on family.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"6 ","pages":"Article 100357"},"PeriodicalIF":4.1,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663321","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":"Power sharing in community-engaged research with Syrian refugees in Lebanon: Using community engagement to shape intervention fit to context","authors":"R. Nakkash ,&nbsp;M. Fares ,&nbsp;M. Tleis ,&nbsp;S. Mugharbil ,&nbsp;M. Antaby ,&nbsp;H. Al Masri ,&nbsp;L. Ghandour ,&nbsp;F. Al Halabi ,&nbsp;Y. Najjar ,&nbsp;B. Louis ,&nbsp;R. Afifi","doi":"10.1016/j.ssmmh.2024.100358","DOIUrl":"10.1016/j.ssmmh.2024.100358","url":null,"abstract":"<div><div>Our study assesses the community-engaged research approach (CEnR) followed during the planning phase for a randomized controlled trial designed to assess how young adult Syrian refugees living in the Bekaa region of Lebanon implementing PM+ with adults in their community will be impacted themselves. We aim to describe the community-engaged research process implemented in our study, and the impact of community engagement on the process of adaptation of the intervention, and the design of the study.</div></div><div><h3>Methods</h3><div>Community-engaged research (CEnR) was used to adapt this intervention to the context of the young adult Syrian refugee community in Lebanon by forming a community alliance committee (CAC). Twelve members from the Syrian refugee community in the Bekaa, Lebanon with different professional and socio-demographic characteristics who have lived experience or expertise related to mental health, education, health more generally, or young adults were invited to join a community alliance committee. Thematic analysis was conducted for two sources of data: (1) minutes of the CAC meetings; (2) in-depth interviews conducted with five CAC members. Findings demonstrate that community-engaged research increases rigor and relevance of the intervention and influenced outcomes, process, and context measures. Suggested modifications made by the CAC members enhanced the social and cultural relevance of the intervention, the measurement tools, and the study's approach.</div></div><div><h3>Conclusion</h3><div>Our results showed that a CEnR process contributes to building trust with the community, creating a safe space for everyone to share their inputs, and when integrating those inputs into the adaptation of the intervention, results in a more contextualized intervention.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"6 ","pages":"Article 100358"},"PeriodicalIF":4.1,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663298","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":"Maternal suicidality in Pakistan: Developing a critical feminist grounded theory to inform suicide prevention programs","authors":"Gul Saeed ,&nbsp;Sidra Mumtaz ,&nbsp;Javeria Tanveer ,&nbsp;Erum Hamid ,&nbsp;Sidra Jehan ,&nbsp;Maria Atiq ,&nbsp;Maria Kanwal ,&nbsp;Siham Sikander ,&nbsp;Najia Atif ,&nbsp;Atif Rahman ,&nbsp;Ashley Hagaman","doi":"10.1016/j.ssmmh.2024.100356","DOIUrl":"10.1016/j.ssmmh.2024.100356","url":null,"abstract":"<div><div>South Asia has the highest rate of suicide fatalities for women globally. However, the underlying factors and processes that contribute to suicidal behavior among women in Pakistan remain underexplored and existing interventions worldwide are dominated by Western-informed suicide theories. We employed a decolonized form of grounded theory, informed by critical feminist theory and Pakistani feminist scholarship, to explore the experiences of suicidal thoughts and behaviors among 12 mothers with a chronic history of suicidality in rural Rawalpindi, Pakistan. Data were collected using in-depth interviews and analyzed in Urdu by female Pakistani scholars. Results generated a grounded theory of suicide among women in Pakistan characterized by four key dimensions: <em>susraal </em>(in-laws’ home) creates an intolerable and lonely ecosystem; struggle negotiating the morality of motherhood vis-a-vis psychological and social suffering; diminished<em> sabr </em>(patience), unresolved grief, and longing for<em> sukoon </em>(peace); and religious faith anchoring women’s value for her life and afterlife. Women's suicidal thoughts and behaviors were largely contextualized by their positionality within their <em>susraal </em>characterized by neglect, invalidation, abuse, and loneliness. Resulting from these dynamics were feelings of abandonment, resentment, disrespect, and helplessness, reducing women’s threshold for maintaining <em>sabr</em>. While suicide attempts were prompted by anger and the desire to escape, women described that suicidal death threatened their relationship with Allah and peace in their afterlife. Among women’s reasons for living, a unique duty toward their children was the strongest reason followed by trust in Allah's plan. This study advances suicide theory, providing a decolonized approach to illuminate insights into the complex and context-specific factors that influence suicide among women in Pakistan. Findings can help guide the development of culturally appropriate suicide prevention interventions sensitive to Pakistan’s unique sociocultural and religious context and ultimately, reduce the burden of suicide.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"6 ","pages":"Article 100356"},"PeriodicalIF":4.1,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699494","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":"The ties that bind: Understanding the mental health consequences of the Windrush Scandal and hostile immigration policies on survivors in the UK","authors":"Karlie Janes ,&nbsp;Patrick Vernon ,&nbsp;Dawn Estefan ,&nbsp;Farah Sheibani ,&nbsp;Glenda Caesar ,&nbsp;Rochelle A. Burgess","doi":"10.1016/j.ssmmh.2024.100352","DOIUrl":"10.1016/j.ssmmh.2024.100352","url":null,"abstract":"<div><div>The Home Office Windrush Scandal of 2018 has had major implications for the wellbeing of survivors and is thought to have affected more than 15,000 individuals. The Government led compensation scheme to provide retribution to those impacted has been consistently argued as insufficient, in part linked to under appreciation of mental health consequences of the scandal. However, there is limited evidence which documents the nature of mental health issues that survivors and families have faced. This need for further evidence intersects with the need to protect a highly vulnerable community from further traumatisation. Our study contributes to this gap through a content analysis of survivor testimonies (n = 96) published in publicly available media sources between 2017 and 2023. Analysis explored social pathways to the development of mental distress and experiences of potential mental health consequences. Our analysis was informed by a complex trauma and complex racial trauma framework. Findings demonstrate that the scandal disrupted numerous social domains linked to livelihoods and positive wellbeing, driving survivors into homelessness, and experiences of dehumanization within state systems. This shaped survivors’ experiences of emotional distress, resulting in symptoms linked to depression, chronic stress, and anxiety disorders. Our work illuminates new details about the nature of trauma faced by survivors. Findings suggest the need for systems that provide targeted mental health supports that also address social disruption, to fully respond to the harms created by the scandal.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"6 ","pages":"Article 100352"},"PeriodicalIF":4.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532756","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":"Barriers and enablers to a coordinated MHPSS response in Lebanon: A case study of the MHPSS Taskforce","authors":"Rozane El Masri ,&nbsp;Thurayya Zreik ,&nbsp;Sandy Chaar ,&nbsp;Rayane Ali ,&nbsp;Joseph Elias ,&nbsp;Bassel Meksassi ,&nbsp;Felicity L. Brown ,&nbsp;Ibrahim Bou-Orm ,&nbsp;Martin McKee ,&nbsp;Michele Asmar ,&nbsp;Bayard Roberts ,&nbsp;Michelle Lokot ,&nbsp;Rabih El Chammay","doi":"10.1016/j.ssmmh.2024.100354","DOIUrl":"10.1016/j.ssmmh.2024.100354","url":null,"abstract":"<div><div>During humanitarian crises, under-resourced and overstretched health systems may not be able to fully meet mental health and psychosocial support (MHPSS) needs of affected populations, including refugees, internally displaced persons and host communities. Health system governance is vital to humanitarian health response, but there has been little research on this, particularly for MHPSS. We present a case study of a national MHPSS coordination mechanism (the MHPSS Taskforce) in Lebanon, a country which has experienced multiple crises and hosts over 2 million refugees. The aim was to explore the barriers and enablers facing the MHPSS Taskforce in responding to the needs of displaced and host populations in Lebanon. Interviews were conducted with 34 key stakeholders, including Taskforce members, representatives from non-governmental organisations, United Nations agencies, and government Ministries. Our findings show that the positioning of MHPSS within the humanitarian cluster system acts as a barrier to mounting an effective response, with the MHPSS Taskforce sometimes siloed rather than integrated across clusters. Coordination within the Taskforce was reported to be effective in some respects, but limited by a lack of clarity about its decision-making processes, affiliation, mandate, and inclusion of regional perspectives and key groups such as mental health services users in Lebanon. While the technical capacity of the Taskforce is strong, limited funding and staffing were seen to impact its capacity to effectively oversee the MHPSS response in Lebanon. Key recommendations include: the need for stronger mechanisms and operating procedures for interagency and inter-sectoral collaboration on MHPSS within the humanitarian cluster system; greater clarity on the role of the Taskforce and key Taskforce actors, streamlined reporting channels and greater inclusion of diverse perspectives, particularly mental health service users; and greater financial and human resources within coordination mechanisms to support the national MHPSS response in Lebanon.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"6 ","pages":"Article 100354"},"PeriodicalIF":4.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422092","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":"Understanding depression and the PHQ-9 items among people living with HIV: A multiple methods qualitative study in Yaoundé, Cameroon","authors":"Natalia Zotova ,&nbsp;Dana Watnick ,&nbsp;Rogers Awoh Ajeh ,&nbsp;Elodie Flore Tchiengang Moungang ,&nbsp;Julie Laure Nguemo Noumedem ,&nbsp;Guy Calvin Nko'o Mbongo'o ,&nbsp;Kathryn Anastos ,&nbsp;Marcel Yotebieng ,&nbsp;the CA-IeDEA Consortium","doi":"10.1016/j.ssmmh.2024.100353","DOIUrl":"10.1016/j.ssmmh.2024.100353","url":null,"abstract":"<div><div>People living with HIV (PLWH) are disproportionately affected by depression, which often remains underdiagnosed and untreated, negatively impacting quality of life and treatment outcomes. Low resource settings often lack clinical professionals to identify depression, therefore screening tools such as the PHQ-9 allow for broader depression screening. This qualitative study among PLWH in Yaoundé Cameroon aimed to a) explore local understandings of depression and mental distress and b) assess comprehension and interpretation of the PHQ-9 items and response categories.</div><div>This study was nested in a larger study that assessed performance of the PHQ-9 among PLWH in Central, East, and West Africa. In Yaoundé, Cameroon, 30 in-depth interviews (IDIs) and 24 cognitive interviews (CIs) were conducted with PLWH to explore how depression is experienced and to examine understanding and interpretation of the PHQ-9 items. Thematic analysis was used to identify emergent themes across IDIs focusing on shared understandings of depression. An interpretivist content analysis of CIs incorporated understandings of PHQ-9 items into cognitive processes of interpretation, retrieval, judgment, and response formulation.</div><div>Out of 54 unique study participants, 15% (n = 8) had depressive symptoms (PHQ-9 score &gt;9). The PHQ-9 items related to somatic manifestations of depression were understood as intended by most participants, while other items were not consistently understood and interpreted. “Thinking too much” and similar cognitive manifestations were central for local understandings of depression. Cognitive and somatic symptoms commonly intertwined and were often linked to experiences living with HIV. Local understanding of depression may not align with Western defined depression criteria, and symptoms related to HIV may conflate symptoms of depression. Incorrect interpretations of almost half of the PHQ-9 items suggests this tool may have limited validity in PLWH, and warrants the need for further testing and adaptation. Further research should be done to develop culturally relevant screening tools among PLWH.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"6 ","pages":"Article 100353"},"PeriodicalIF":4.1,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422228","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}