Prevalence and determinants of depression among caregivers of children with leukaemia in Iraq

Background: Depression in caregivers of leukaemic children is usually overlooked and hence missed, as doctors mostly focused on patient’s evaluation and condition. Early attention to symptoms of depression may help to prevent the devel-opment of a more serious depression over time.Aims: This study was conducted to estimate the prevalence, assess severity and identify determinants of depressive dis-order among caregivers of children with leukaemia in Baghdad, Iraq, 2014. Methods: This cross sectional study was conducted on a convenience sample of caregivers of 250 leukaemia children aged <15 years admitted to Child Welfare Teaching Hospital, Baghdad, Iraq. Socio-demographic variables were collected and the presence of depressive disorder was assessed using the Arabic Version of Beck Depression Inventory II (BDI-II); those with a score of >16 were considered depressed. Results: The prevalence of depression was 72% (95% CI: 66–77.5%); classified to 18.9% having borderline clinical depres-sion, 36.7% moderate depression, 27.8% severe depression and 16.7% extreme depression. Presence of depression was sig-nificantly higher among younger age caregivers, disease duration of >12 months and frequent hospital admission. Conclusions: The high prevalence of depression among care givers of leukaemia patients urge health care professionals to pay more attention to the psychological aspects of the families of leukaemia patients and ensure referring them for psychiatric support.

Contexte : La dépression chez les aidants d’enfants leucémiques est souvent négligée et donc non diagnostiquée, les médecins se concentrant la plupart du temps sur l’évaluation et l’état des patients. Une attention précoce accordée aux symptômes de la dépression pourrait permettre de prévenir le développement d’un stade plus avancé de cette affection.Objectifs : La présente étude a été conduite dans le but d’estimer la prévalence, d’évaluer la sévérité et d’identifier les déterminants des troubles dépressifs chez les aidants d’enfants atteints de leucémie à Bagdad (Iraq) en 2014. Méthodes : La présente étude transversale a été réalisée sur un échantillon de commodité de 250 aidants d’enfants leucémiques âgés de moins de 15 ans admis au Centre hospitalier universitaire pour la protection de l’enfance à Bagdad. Les variables socio-démographiques ont été recueillies et la présence de troubles dépressifs a été évaluée à l’aide de la version arabe de l’Inventaire de dépression de Beck II (BDI-II). Les répondants ayant un score supérieur à 16 étaient considérés comme dépressifs. Résultats : La prévalence de la dépression était de 72 % (IC à 95 % : 66 %-77,5 %), parmi lesquels 18,9 % ont été diagnostiqués en dépression clinique limite, 36,7 % en dépression modérée, 27,8 % en dépression sévère et 16,7 % en dépression extrême. La présence de cette affection était significativement plus élevée parmi les aidants plus jeunes ; elle durait généralement plus de 12 mois et nécessitait des hospitalisations fréquentes. Conclusions : La prévalence élevée de la dépression parmi les aidants de patients leucémiques doit inciter les professionnels de la santé à accorder une attention plus soutenue à l’état psychologique des familles des patients et à s’assurer qu’elles soient orientées en vue de bénéficier d’un soutien psychiatrique.

Mental health promotion and mental health care in refugees and migrants: policy brief

For all refugees and migrants, the process of migration can be complex and stressful as it involves leaving the home country and adapting to a different environment, culture and life situation. Moreover, refugees and migrants can be exposed to stressful events before departure, during transit and after arrival, and they may struggle to fully integrate in the social context of the host countries. All can lead to mental health disorders, although prevalence is highly variable across studies and population groups.

Mental health promotion and mental health care in refugees and migrants: technical guidance

The experience of migration can be complex and stressful, related to events before departure, during travel and transit, and after arrival. Consequently, refugees and migrants can suffer from mental disorders, although prevalence is highly variable across studies and population groups. This technical guidance reviews the prevalence of some disorders such as post-traumatic stress disorder and depressive and anxiety disorders. Based on best-available evidence regarding risk factors and areas for intervention, eight key priority action areas are identified for consideration by policy-makers regarding the mental health of refugees and migrants. While different countries may be more or less able to adapt depending on their baseline capacity, areas and models for intervention to promote mental health and provide good mental health care to refugee and migrant groups include social integration, facilitating access to care, fostering engagement with care and treating patients with manifest disorders.

Early experiences of abuse and current depressive disorders in Iranian women

Early experience of abuse may be viewed as a risk factor for mental disorders in women later in life. This case-control study in Isfahan screened 709 women aged 20-45 years using the Beck Depression Inventory and structured clinical interviews for Diagnostic Statistical Manual-IV criteria. Lifetime history of abuse was determined using a standard questionnaire. Among the women 35.1% had experienced fear of or actual abuse [physical, sexual or both] in childhood or adolescence. The risk of having major depression in adult life was significantly higher in women who experienced abuse in childhood and adolescence [OR 4.3], severe degrees of abuse [OR 3.9] or multiple forms of abuse [OR 3.8]

Quality assurance/monitoring of mental health services by service users and carers: Empowerment in Mental Health – Working together towards Leadership: a meeting in partnership with the European Commission hosted by EUFAMI: 27–28 October 2010, Leuven, Belgium

This paper summarizes what is currently known about the empowerment of people with mental health problems and their families/carers in relation to the quality assurance and monitoring of mental health services. It includes evidence from the literature about what works, as well as implications and options for policy-makers. It concludes with a number of practical recommendations for policy-makers, service providers and others.

Support for cancer patients: the Bahrain experience

Cancer, a disease people avoid talking about, is the second leading cause of death in Bahrain. The Bahrain Cancer Society established a support group in 1993 with the goals of helping patients and their families cope with this disease and increasing public awareness concerning early detection. Services provided by the group include a weekly 2- hour session to encourage patients to express their feelings and concerns, distribution of informational booklets and visits to people at home and in hospital. Furthermore, the group organizes recreational activities for children with cancer. Patients or their families can also page the group to discuss their problems. The main goal of this paper is to share the Bahrain experience of supporting cancer patients, their families and friends

Is unintended pregnancy a risk factor for depression in Iranian women?

A study was carried out to determine the association between unintended pregnancy and pre- and postpartum depression in 163 women in Kermanshah city, Islamic Republic of Iran. Using the self-administered Beck Depression Inventory for educated women and a special interview for illiterate women, 105 intended and 58 unintended pregnancies were studied. Of the 58 women with unintended pregnancy, 43% reported attempting to abort the fetus. Depression at 37 weeks' gestation was slightly higher in the unintended than the intended pregnancy group [53.4% versus 41.0%; relative risk = 1.3] and depression 10 days postpartum was much higher in the unintended group [48.7% versus 25.6%; relative risk = 1.9]. Screening for depression is recommended for pregnant women with unintended pregnancy

Primary care psychiatry: pertinent Arabian perspectives

There is substantive evidence of significant psychiatric morbidity among primary care patients, mainly in the form of anxiety and depressive disorders. A careful critical approach is essential for ensuring the cultural relevance, validity and reliability of the psychiatric screening instruments used to identify such morbidity. Most psychiatric morbidity among primary care patients passes undetected by the primary care practitioners. This will inevitably lead to unnecessary investigation and medication and the continuation of suffering for patients. Comorbidity and physical presentation in most instances contribute significantly to failure to detect psychiatric disorders. To deal with this problem of hidden psychiatric morbidity, carefully designed educational and training programmes need to be tailored to address the particular weaknesses and needs of primary care doctors

Comprehensive health assessment of senior citizens in Al-Karak governorate, Jordan

The health status, mental well-being and functional capacity of senior citizens was assessed in a community-based survey of people > or = 60 years in 2004. Analysis was performed using logistic and linear regression analyses. Of the 300 subjects enrolled [53.3% women], 74.4% were affected by chronic diseases, 24.3% were classified as depressed and 44.0% had a negative health perception. Dependence in instrumental activities of daily living [92.0%] was more frequent than dependence in basic activities [28.0%]. Women were more likely to be depressed, and suffer memory impairment and limitation of functional capacity. Increase in depressive symptoms was independently predicted by increased age, living alone, poor functional capacity, memory impairment and negative perception of health. Low summary performance in instrumental and basic activities was independently predicted by increased age, lack of education, high number of reported symptoms, depression and memory impairment. Depression, poor functional capacity and memory impairment reinforced each other resulting in a state of dependency

Psychosis in a patient with Usher syndrome: a case report

The present report is the case of a 26-year-old man, born with Usher syndrome. The patient had had a significant hearing impairment since birth and had developed retinitis pigmentosa. He had originally been diagnosed with a depressive disorder and treated with antidepressants, with no subsequent improvement in his mental state. Following a deterioration in his mental state he was admitted for reassessment at the Queen Elizabeth Psychiatric Hospital, Birmingham, and antidepressants were stopped. It subsequently became apparent from observations, interviews with the patient and information from the patient's carers and relatives that he had a psychotic illness. Treatment was started with the antipsychotic drug risperidone, after which he showed significant improvement. The association between Usher syndrome and psychosis is discussed

Psychosocial assessment of geriatric subjects in Abha City, Saudi Arabia

Psychosocial assessment of geriatric subjects was carried out through a home-based survey of people aged 65 years and over [n = 810] in the catchment areas of 3 primary health care centres. All the participants had a structured interview and were given a short version of the geriatric depression scale. Depression was found in 17.5% of the subjects, more commonly in women [27.7% versus 12.7%]. The combined effect of impaired perceived health status [52.4%] and functional capacity [26.6%], loneliness [4.5%], single status [24.3%], and lack of education [80.5%] explained 23.7% of the variance in depression score by multiple regression analysis. Depression is a problem among the geriatric population in the region, especially women. Periodic home psychosocial screening of geriatrics is recommended

From molecules to mind

This paper describes the relation between genes at the molecular level and the brain at the organ level, and biological, social and environmental factors. The malleability of the brain and the effect of external factors and experience on influencing gene expression and brain structure and function are discussed

Wellbeing measures in primary health care/the DepCare Project: report on a WHO meeting: Stockholm, Sweden, 12–13 February 1998

People with depression are often not treated optimally or treated at all. Manydepressed people do not seek help and, in most countries, only a few generalpractitioners are well equipped to diagnose and measure outcome for people whoseek treatment. The WHO Regional Office for Europe held a meeting on qualityassurance for mental health in 1993, as part of a broader project supported by theEuropean Forum of Medical Associations; it looked at indicators for acute depressioncare. The Regional Office held a meeting on patient outcome measures in mentalhealth in 1995 to review the results of studies made since the first meeting and torecommend further application and dissemination of indicators for long-term, acuteand community care. The objective of the Meeting on the Use of Wellbeing Measuresin Primary Health Care – the DepCare Project was to discuss guidelines for carryingout a range of studies in several European countries, and the use of screening tools toidentification and manage depression and psychological problems and stress-relateddisorders, with a focus on quality of care. The participants decided to set up acommon database hosted by the Regional Office.