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1.
Trauma Violence Abuse ; 24(1): 86-96, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-33998329

RESUMEN

Mental health research focusing on journalists has largely tended to give precedence to trauma exposure and subsequent symptoms of posttraumatic stress disorder. However, there are several occupational factors that may be associated with the development of depressive symptoms in journalists. This systematic literature review aims to provide a concise, comprehensive, and systematic review of the quantitative literature relating to journalists' experiences of depressive symptoms. The systematic literature review method adopted was based on that prescribed by Fink and contains three main elements: sampling the literature, screening the literature, and extracting data. Key terms were developed and used to source appropriate studies from several electronic databases, a hand search of reference lists was conducted, and authors were contacted to suggest examples of their own work not yet sampled. The sample included 13 quantitative studies reported in English language. Journalists most at risk of experiencing depressive symptoms had (1) greater exposure to work-related and personal trauma, (2) experienced threats to themselves or their family, and (3) reduced levels of family and peer support, social acknowledgment, and education. An area for further investigation is the prevalence and experiences of specific depressive disorders within the journalist population. There are a number of theoretical and methodological issues that can be addressed in future research.


Asunto(s)
Depresión , Trastornos por Estrés Postraumático , Humanos , Trastornos por Estrés Postraumático/psicología
2.
Res Dev Disabil ; 131: 104370, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36343581

RESUMEN

BACKGROUND: In high-income and Western societies there is great understanding and awareness of autism spectrum disorder (ASD); however, for many low-middle income countries, research and knowledge is notably lacking. In Africa, there is a growing prevalence of ASD due to increased diagnosis, yet it is still a poorly understood condition. AIMS: Emerging literature has emphasised how cultural and societal beliefs underpin the level of understanding of ASD, and which typically results in lack of awareness and acceptance. As such it is important to investigate the cultural perceptions towards ASD within low-middle income communities of African culture, to further understand the challenges and barriers individuals with ASD face. The aim of the current study was to probe participants from the Swahili community, on the coast of Kenya, of their cultural views towards ASD. METHOD: Semi-structured interviews were conducted with seven participants, and the data analysed using thematic analysis. RESULTS: Three key themes developed from the data; stigma, lack of awareness, and Government responsibility. CONCLUSION: Cultural perceptions negatively impacted awareness and are exacerbated by lack of directive from the Government in providing appropriate diagnostic and educational support.


Asunto(s)
Trastorno del Espectro Autista , Humanos , Trastorno del Espectro Autista/diagnóstico , Trastorno del Espectro Autista/epidemiología , Kenia/epidemiología , Estigma Social , Pobreza , Renta
3.
Epidemiol Prev ; 46(5-6): In press, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36384255

RESUMEN

OBJECTIVES: to evaluate the impact of school closures, as a measure to contain the transmission of SARS-CoV-2 infection, on the psychological well-being of students of all levels starting from the 2020-2021 school year. DESIGN: a systematic literature review was conducted according to the PRISMA 2020 Guidelines. The literature search was conducted on 4 different databases: MedLine, Embase, PsycINFO, and L.OVE Platform. Quantitative observational studies published until 10.01.2022 were included. Studies conducted during the first pandemic wave, i.e., during the 2019-2020 school year and/or during the mandatory lockdown or confinement period, were excluded. The methodological quality of the studies was assessed with validated scales. Study selection, data extraction, and quality assessment were carried out independently by two authors. SETTING AND PARTICIPANTS: children, adolescents, and young people attending all levels of education (including universities) and, for reasons related to COVID-19, having a suspension of "in presence" school or attending classes remotely. MAIN OUTCOME MEASURES: a. outcomes directly related to mental health: suicides, emergency department visits, and hospitalizations for psychiatric problems; anxiety and depression, emotional difficulties, feelings of loneliness and isolation; b. well-being outcomes: sleep quality, perceived well-being (by child/adolescent/youth or referred by parents); c. health-related behaviours: tobacco smoking, alcohol, drug use. Outcomes related to school/academic performance, physical health, and those related to parents were not considered. RESULTS: after having removed duplicate articles, 2,830 records were retrieved with the bibliographic search. Twelve studies (2 uncontrolled before-after studies and 10 cross sectional surveys) were included, involving a total of 27,787 participants. Three studies involved university students, 2 involved high school students, and the remaining involved a mixed population of students attending primary and middle schools. The studies were conducted between September 2020 and April 2021. The methodological quality was rated as high in five studies and intermediate in the remaining studies. Due to the high heterogeneity of outcome measures and statistical analyses performed among the included studies, it was not possible to conduct a meta-analysis of the results of the considered publications. Nevertheless, the present review showed a clear signal of increase in mental health problems in relation to school closure or virtual instruction. In particular, results suggest evidence of association between school closure and risk of suicidal attempts or thoughts, mental health symptoms such as anxiety, depression, emotional disorders, psychological stress. Sleeping problems, drug and alcohol addiction were poorly studied. CONCLUSIONS: despite the limitations of the included studies and possible residual confounding and contamination due to restrictive measures and social isolation implemented during the pandemic, the available evidence confirms the negative impact on students' mental health associated with school closures and distance learning. Given the availability of vaccination also for young children, a long period of school closure should be avoided also in the case of the emergence of new pandemic waves.


Asunto(s)
COVID-19 , Suicidio , Niño , Adolescente , Humanos , Preescolar , Salud Mental , COVID-19/epidemiología , Estudios Transversales , Control de Enfermedades Transmisibles , SARS-CoV-2 , Italia , Conductas Relacionadas con la Salud
4.
PLoS One ; 17(11): e0277562, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36417414

RESUMEN

BACKGROUND: Although research shows that the Covid-19 pandemic has led to declines in mental health, the existing research has not identified the pathways through which this decline happens. AIMS: The current study identifies the distinct pathways through which COVID-induced stressors (i.e., social distancing, disease risk, and financial stressors) trigger mental distress and examines the causal impact of these stressors on mental distress. METHODS: We combined evidence of objective pandemic-related stressors collected at the county level (e.g., lack of social contact, infection rates, and unemployment rates) with self-reported survey data from over 11.5 million adult respondents in the United States collected daily for eight months. We used mediation analysis to examine the extent to which the objective stressors influenced mental health by influencing individual respondents' behavior and fears. RESULTS: County-level, day-to-day social distancing predicted significantly greater mental distress, both directly and indirectly through its effects on individual social contacts, worries about getting ill, and concerns about finances. Economic hardships were indirectly linked to increased mental distress by elevating people's concerns about their household's finances. Disease threats were both directly linked to mental distress and indirectly through its effects on individual worries about getting ill. Although one might expect that social distancing from people outside the home would have a greater influence on people who live alone, sub-analyses based on household composition do not support this expectation. CONCLUSION: This research provides evidence consistent with the thesis that the COVID-19 pandemic harmed the mental well-being of adults in the United States and identifies specific stressors associated with the pandemic that are responsible for increasing mental distress.


Asunto(s)
COVID-19 , Salud Mental , Adulto , Humanos , COVID-19/epidemiología , Pandemias , Aislamiento Social , Distanciamiento Físico
5.
BMC Psychiatry ; 22(1): 702, 2022 11 14.
Artículo en Inglés | MEDLINE | ID: mdl-36376803

RESUMEN

BACKGROUND: Worldwide, mental health issues constitute a substantial threat to people's social, economic, and mental well-being and contribute significantly to many fatalities each year. In Bangladesh, people with mental health issues typically delay contacting health professionals because they prefer traditional or religious healers. Moreover, the situation is exacerbated by a lack of awareness, social stigma, and negative perception of sufferers of mental health issues on the part of families and the community. Therefore, this paper investigates the social perception and stigmatization of individuals living with mental health problems and their caregivers in Khulna, Bangladesh. METHODS: Data were collected from university students with concurring mental health issues as well as their closest caregivers, who had in-depth knowledge of the problem and a willingness to take care of the individuals with mental health issues. Following the criteria for data collection, eight individuals living with mental health problems and five caregivers were purposively selected for this research. A semi-structured in-depth interview guide was used for the confidential data collection process, which took place in November and December 2021, and each interview lasted 40-50 min on average. RESULTS: This study used thematic analysis to present the results; the findings showed that: individuals afflicted with mental health problems sought both medical and spiritual support to recover. Those with mental health issues who received positive family support recovered relatively faster than those who did not. However, negative social perception and stigmatization were the key impediments for individuals suffering from mental health problems and their families, as they found it difficult to discuss their issues with relatives and communities when attempting to access support or seek remedies. Moreover, the commonality of social stigmas, such as labeling mental health problems as equal to 'madness,' hindered disclosure to family members, peers, and the community. CONCLUSION AND RECOMMENDATIONS: In Bangladesh, the majority of individuals living with mental health problems are stigmatized and do not receive emotional support. Hence, we suggest nationwide community-based awareness-building programs to promote more positive perceptions of the fight against mental health disorders. Furthermore, counseling and awareness-building programs for effective discouragement of non-scientific remedies such as spiritual healing, as well as diagnosis and medication at the primary stage of sickness, are recommended for early detection and better medical assistance.


Asunto(s)
Abuelos , Estigma Social , Masculino , Humanos , Salud Mental , Bangladesh , Percepción Social , Estudiantes
6.
BMC Pregnancy Childbirth ; 22(1): 825, 2022 Nov 08.
Artículo en Inglés | MEDLINE | ID: mdl-36348304

RESUMEN

BACKGROUND: Pregnancy discrimination in the workplace is prevalent worldwide. However, few studies have examined the effects of pregnancy discrimination on mothers' perinatal mental health. We aimed to investigate the association between pregnancy discrimination and postpartum depressive symptoms, and the mediation effects of prenatal depressive symptoms on this association. METHODS: Our sample consisted of 285 Japanese women employed during pregnancy who completed a baseline online survey in May 2020 and a follow-up mail survey two months postpartum. Pregnancy discrimination was defined as exposure to any of 16 forms of disadvantageous treatment or harassment related to pregnancy, prohibited by national guidelines. Prenatal (assessed at baseline) and postpartum (assessed at follow-up) depressive symptoms were measured using the Edinburgh Postnatal Depression Scale. Multiple linear regression and mediation analyses were performed overall and stratified by regular (permanent) and non-regular (precarious) employees. RESULTS: Overall, 23.9% of participants experienced pregnancy discrimination during pregnancy. After adjusting for potential confounders, pregnancy discrimination was significantly associated with postpartum depressive symptoms (coefficient 1.76, 95% confidence interval [CI] 0.65-2.88). When stratified by employment type, these effects were observable among non-regular employees (coefficient 2.51, 95% CI 0.45-4.57) but not regular employees. Mediation analysis showed that prenatal depressive symptoms mediated 57.1% (95% CI 20.1-94.1%) of the association between pregnancy discrimination and postpartum depressive symptoms among all participants, with a greater effect among non-regular employees (64.1% [95% CI 18.5-109.8%]). CONCLUSIONS: Pregnancy discrimination has adverse effects on postpartum depressive symptoms, partially through prenatal depressive symptoms, especially among non-regular employees. To prevent perinatal depression in female workers, employers should comply with legislation and take preventive measures against pregnancy discrimination, while considering vulnerable employees.


Asunto(s)
Depresión Posparto , Embarazo , Femenino , Humanos , Depresión Posparto/diagnóstico , Depresión Posparto/epidemiología , Depresión Posparto/psicología , Estudios de Seguimiento , Depresión/diagnóstico , Depresión/epidemiología , Depresión/psicología , Periodo Posparto/psicología , Madres/psicología
7.
Epidemiol Psychiatr Sci ; 31: e79, 2022 Nov 09.
Artículo en Inglés | MEDLINE | ID: mdl-36348492

RESUMEN

AIMS: Mental health-related stigma and discrimination are a complex and widespread issue with negative effects on numerous aspects of life of people with lived experience of mental health conditions. Research shows that social contact is the best evidence-based intervention to reduce stigma. Within the context of a rapid development of remote technology, and COVID-19-related restrictions for face-to-face contact, the aim of this paper is to categorise, compare and define indirect social contact (ISC) interventions to reduce stigma and discrimination in mental health in low- and middle-income countries (LMICs). METHODS: MEDLINE, Global Health, EMBASE, PsychINFO, Cochrane Central Register of Control Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched using a strategy including terms related to 'stigma and discrimination', 'intervention', 'indirect social contact', 'mental health' and 'low- and middle-income countries'. Relevant information on ISC interventions was extracted from the included articles, and a quality assessment was conducted. Emerging themes were coded using a thematic synthesis method, and a narrative synthesis was undertaken to present the results. RESULTS: Nine studies were included in the review overall. One study was ineffective; this was not considered for the categorisation of interventions, and it was considered separately for the comparison of interventions. Of the eight effective studies included in synthesis, interventions were categorised by content, combination of stigma-reducing strategies, medium of delivery, delivery agents, target condition and population, as well as by active or passive interaction and follow-up. Most of the interventions used education and ISC. Recovery and personal experience were important content components as all studies included either one or both. Cultural adaptation and local relevance were also important considerations. CONCLUSIONS: ISC interventions were effective in overall terms for both the general public and healthcare providers, including medical students. A new definition of ISC interventions in LMICs is proposed. More research and better reporting of intervention details are needed to explore the effectiveness of ISC strategies in LMICs, especially in regions where little relevant research has been conducted.


Asunto(s)
COVID-19 , Trastornos Mentales , Humanos , Países en Desarrollo , Estigma Social , Salud Mental , Trastornos Mentales/terapia , Trastornos Mentales/psicología
8.
J Dent Educ ; 2022 Nov 08.
Artículo en Inglés | MEDLINE | ID: mdl-36349431

RESUMEN

OBJECTIVE: The COVID-19 pandemic has led to mental health hazards to healthcare providers in general and to undergraduate dental students. The present study undertakes a scoping review to identify and discuss the mental health issues and stressors impacting dental students globally during the COVID-19 pandemic. METHODS: A systematic search following the Joanna Briggs Institute's framework for scoping reviews was conducted on Embase, MEDLINE by Ovid, Web of Science, PsycInfo, CINAHL, and ERIC to identify peer reviewed publications published globally since the onset of the COVID-19 pandemic in March 2020 until June 22, 2021. Manual search was also performed on Google scholar. Eligible studies were selected based on the predetermined set of criteria and focused specifically on mental health issues experienced by undergraduate dental students in the context of COVID-19. RESULTS: Fifty-five publications were retained. Fifty-one reported stress, anxiety, or depression experienced by undergraduate dental students during the pandemic. Twenty-five studies employed validated psychometric instruments to explore mental health status among the same students. A total of 28 publications reported that the predominant concern for students was fear of infection, especially during patient interaction. Adapting to virtual learning, clinical skill deficit due to lack of/limited practical training and social isolation were other majorly reported stressors. CONCLUSIONS: Many mental health issues and stressors related to the COVID-19 pandemic have been identified. Mitigation of COVID-19-related stressors on dental students' mental health should be a priority across all dental academic institutions. Continued efforts should be made to create a supportive learning environment.

9.
Artículo en Inglés | MEDLINE | ID: mdl-36360865

RESUMEN

Mental health is largely shaped by the daily environments in which people live their lives, with positive components of mental health emphasising the importance of feeling good and functioning effectively. Promoting mental health relies on broad-based actions over multiple sectors, which can be difficult to measure. Different types of Impact Assessment (IA) frameworks allow for a structured approach to evaluating policy actions on different levels. A systematic review was performed exploring existing IA frameworks relating to mental health and mental wellbeing and how they have been used. A total of 145 records were identified from the databases, from which 9 articles were included in the review, with a further 6 studies included via reference list and citation chaining. Five different mental-health-related IA frameworks were found to be implemented in a variety of settings, mostly in relation to evaluating community actions. A Narrative Synthesis summarised key themes from the 15 included articles. Findings highlight the need for participatory approaches in IA, which have the dual purpose of informing the IA evaluation and advocating for the need to include mental health in policy development. However, it is important to ensure that IA frameworks are user-friendly, designed to be used by laypeople in a variety of sectors and that IA frameworks are operational in terms of time and monetary resources.


Asunto(s)
Participación de la Comunidad , Salud Mental , Humanos , Formulación de Políticas
10.
Clin Gerontol ; : 1-21, 2022 Nov 02.
Artículo en Inglés | MEDLINE | ID: mdl-36322620

RESUMEN

OBJECTIVES: To systematically review articles that reported the impacts of social isolation on the physical and mental health of healthy older adults during the coronavirus disease 2019 (Covid-19) quarantine. METHODS: Electronic search was performed in PubMed, EMBASE, Web of Science, Scopus, and BIREME databases. It included cohort and cross-sectional studies published between January 2020 and January 2022 which evaluated the impacts of social isolation on the physical and mental health of older adults during quarantine. The study was registered in PROSPERO (CRD42021269720). RESULTS: Out of 8,505 studies identified, 17 met the inclusion criteria, with moderate to excellent quality. The majority of the older population perceived changes in their physical and mental health. Impacts differed in cohorts according to sex, age group, income, social participation, exercising before and during confinement, and living alone or with other people. CONCLUSIONS: The long period of social isolation dictated by the COVID-19 pandemic caused changes in most older adults`, reducing levels of physical activity and/or generating depression, anxiety, fear, and mood problems. Follow-up studies are necessary to observe the evolution of these impacts. CLINICAL IMPLICATIONS: Public policies must be developed to promote the emotional and physical health of the older adult population in the post-pandemic period.

11.
Eur J Psychotraumatol ; 13(2): 2132598, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36325257

RESUMEN

Background: Military members report higher instances of trauma exposure and subsequent posttraumatic stress disorder (PTSD) relative to civilians. Encounters with children in war and conflict settings may have particularly unsettling consequences. However, the nature of these consequences has yet to be systematically examined. Objective: This systematic review sought to identify and document deployment-related encounters with children and associated outcomes reported by military personnel, as well as identify any current training programs, policies, or procedures in place regarding encountering children during deployment. Method: A total of 17 studies with 86 independent samples were included. Analyses were based primarily on qualitative data. Results: Based on the review, 77 military personnel samples documented their experiences encountering children during deployment. Most commonly, child encounters included armed children, porters/human shields, suicide bombers, and ambiguous interactions. Outcomes from encountering children during deployment were diverse, occurring both during the encounter, and described by many as persisting years following the exposure. Consequences of encounters as described by military personnel included: hesitation to complete mission objectives, mental health concerns, moral struggles, social isolation, and sleep disturbances. Of the 86 included reports, only nine provided information regarding training at any stage (pre-, during, or post-deployment) in relation to encountering children. Much of the available information underscored the lack of training, with six reports highlighting the lack of pre-deployment training and five reports describing the lack of policies, including rules of engagement, as they relate to encountering children during deployment. Only two reports described post-deployment procedures made available to military personnel following exposure to children while on deployment. Conclusions: Results from this review will be used to identify available research, develop and support training initiatives, and increase awareness regarding implications of encountering children during deployment. We further provide recommendations regarding research needs, policy implementation, and current training gaps.


Antecedentes: Los miembros de las fuerzas militares reportan mayor exposición al trauma y posterior trastorno de estrés postraumático (TEPT), comparados con civiles. Los encuentros con niños en escenarios de guerra y conflictos pueden tener consecuencias particularmente inquietantes, sin embargo, la naturaleza de estas consecuencias aún no se ha examinado sistemáticamente.Objetivo: Esta revisión sistemática buscó identificar y documentar los encuentros con niños relacionados con el despliegue militar, y los resultados asociados reportados por el personal militar, así como identificar cualquier programa de capacitación, política o procedimiento vigente en relación con el encuentro con niños durante el despliegue militar.Método: Se incluyeron un total de 17 estudios con 86 muestras independientes. Los análisis se basaron principalmente en datos cualitativos.Resultados: Según la revisión, 77 muestras de personal militar documentaron experiencias al encontrarse con niños durante el despliegue. Más comúnmente, los encuentros con niños incluyeron niños armados, porteadores/escudos humanos, terroristas suicidas e interacciones ambiguas. Los resultados del encuentro con niños durante el despliegue fueron diversos, ocurriendo durante el encuentro, y siendo descritos por muchos como persistentes años después de la exposición. Las consecuencias de los encuentros descritas por el personal militar incluyeron: vacilación para completar los objetivos de la misión, problemas de salud mental, luchas morales, aislamiento social y trastornos del sueño. De los 86 informes incluidos, solo nueve proporcionaron información sobre la capacitación en cualquier etapa (antes, durante o después del despliegue militar) en relación con el encuentro con los niños. Gran parte de la información disponible subrayó la falta de capacitación, con seis informes que destacaron la falta de capacitación previa al despliegue y cinco informes que describieron la falta de políticas, incluidas las reglas de participación, en relación con el encuentro con niños durante el despliegue. Solo dos informes describieron los procedimientos posteriores al despliegue puestos a disposición del personal militar después de la exposición a los niños durante el despliegue.Conclusiones: Los resultados de esta revisión se utilizarán para identificar la investigación disponible, desarrollar y apoyar iniciativas de capacitación y aumentar la conciencia sobre las implicaciones de encontrarse con niños durante el despliegue militar. Además, brindamos recomendaciones sobre las necesidades de investigación, la implementación de políticas y las brechas de capacitación actuales.


Asunto(s)
Personal Militar , Trastornos por Estrés Postraumático , Niño , Humanos , Personal Militar/psicología , Despliegue Militar , Trastornos por Estrés Postraumático/psicología , Familia/psicología , Salud Mental
12.
Dtsch Med Wochenschr ; 147(22): 1481-1487, 2022 11.
Artículo en Alemán | MEDLINE | ID: mdl-36318912

RESUMEN

After several years of declining tobacco consumption, the number of smokers in Germany is currently stagnating or rising again. The reasons seem to be manifold, e. g. stress caused by the pandemic with social isolation, rising cost of living and war in Europe.With tobacco use still widespread in the German population, evidence-based tobacco cessation is rarely implemented.According to recent studies, e-cigarettes are involved in the pathogenesis of lung disease, cardiac and vascular damage. In addition, their ingredients also have carcinogenic effects. However, clinical studies on long-term use are not yet available.E-cigarettes as a consumer product are not superior to nicotine replacement products and addiction-reducing medications recommended in guidelines. In the therapeutic setting, they are slightly more effective than nicotine replacement products. However, they are usually consumed continuously and thus perpetuate nicotine dependence. Their use increases the risk of relapse to tobacco smoking.Despite the various new approaches, such as Internet-based offerings, app, etc., talks and pharmacotherapy are the gold standard and more effective than any therapy on its own.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Cese del Hábito de Fumar , Tabaquismo , Humanos , Dispositivos para Dejar de Fumar Tabaco , Fumar/epidemiología , Tabaquismo/terapia
13.
J Vis Exp ; (189)2022 Nov 11.
Artículo en Inglés | MEDLINE | ID: mdl-36440892

RESUMEN

Anxiety disorders are one of the leading causes of disability in the United States (US). Current treatments are not always effective and less than 50% of patients achieve full remission. A critical step in developing a novel anxiolytic is to develop and utilize an animal model, such as mice, to study pathological changes and test drug target(s), efficacy, and safety. Current approaches include genetic manipulation, chronic administration of anxiety-inducing molecules, or the administration of environmental stress. These methods, however, may not realistically reflect anxiety induced throughout daily life. This protocol describes a novel anxiety model, which mimics the intentional or unintentional patterns of social isolation in modern life. The social isolation-induced anxiety model minimizes perceived distractions and invasiveness and utilizes wild type C57BL/6 mice. In this protocol, 6- to 8-week-old mice (male and female) are singly housed in opaque cages to visually block the external environment, such as neighboring mice, for 4 weeks. No environmental enrichments (such as toys) are provided, bedding material is reduced by 50%, any treatment of drug is administered as an agar form, and the exposure/handling of the mice is minimized. Socially isolated mice generated using this protocol exhibit greater anxiety-like behavior, aggression, as well as decreased cognition.


Asunto(s)
Ansiedad , Roedores , Masculino , Femenino , Ratones , Animales , Ratones Endogámicos C57BL , Ansiedad/etiología , Aislamiento Social , Trastornos de Ansiedad
14.
Arch Psychiatr Nurs ; 41: 11-19, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36428038

RESUMEN

Despite the severe consequences, the treatment gap for depression, epilepsy, and schizophrenia continues to be a major concern in low and middle-income countries (LMICs). We conducted a systematic review of literature on barriers and facilitators of treatment-seeking behaviors from the perspective of individuals living with depression, epilepsy, and schizophrenia and stakeholders in LMICs. Knowledge deficits, beliefs, and stigma were barriers to treatment-seeking across disorders. The most cited facilitators were demographics, socioeconomic status, and collaboration with traditional healers. Culturally sensitive interventions in collaboration with stakeholders within the community can facilitate treatment-seeking behaviors among people living with depression, epilepsy, and schizophrenia.


Asunto(s)
Epilepsia , Esquizofrenia , Humanos , Países en Desarrollo , Esquizofrenia/terapia , Depresión/terapia , Epilepsia/terapia , Estigma Social
15.
Artículo en Inglés | MEDLINE | ID: mdl-36429782

RESUMEN

Identification and recognition of experiences of rural pregnant women with substance use disorder is needed to inform public policy and medical training. This paper reviews and qualitatively synthesizes literature exploring the experiences of this population. Embase, PubMed, and Web of Science were used to identify literature through August 2022 using the search terms, such as pregnancy, substance use or abuse, stigma, and rural. Cited and citing research were also considered. Exclusion criteria included articles that failed to consider rural pregnant women's perspectives on stigma experienced, included potential confounds, occurred outside of the United States or Canada, and were published before January 2000. Nine articles met the inclusion criteria. Data were synthesized by the listed authors and assessed for common themes. A review of the articles revealed three common themes: stigma occurs in community settings, stigma occurs in healthcare settings, and comprehensive care is important to ensure appropriate support to this population. Stigma as a barrier seems to improve when women have strong social support and access to comprehensive care networks. Addressing this stigma through programs, such as peer social guidance and comprehensive health centers, may provide appropriate support to pregnant, rural women with SUD to further navigate their health needs.


Asunto(s)
Mujeres Embarazadas , Trastornos Relacionados con Sustancias , Femenino , Humanos , Estados Unidos , Embarazo , Estigma Social , Población Rural , Trastornos Relacionados con Sustancias/epidemiología , Grupo Paritario
16.
Artículo en Inglés | MEDLINE | ID: mdl-36361212

RESUMEN

For people with mental illnesses, stigma represents a barrier to social participation. Health professionals, including students, often hold stigma toward such individuals, Further, people with a mental illness often have self-stigma. This study aimed to both develop and examine the effectiveness of a new program based on co-production with dialogue for reducing stigma among both health science students and people with mental illnesses. This was a quasi-experimental study, with a pre- and post-test design and no control group. The sample comprised 28 university students majoring in occupational therapy and 20 community-dwelling people with mental illnesses. The Co-Production with Dialogue Program for Reducing Stigma (CPD-RS) was administered to this sample. Link's Devaluation Discrimination Scale (DDS) was used to assess whether the program reduced stigma. Compared to their preintervention scores, the students' postintervention DDS scores significantly decreased, persisting for at least one month, but those of people with mental illnesses showed no significant change. Both the students and the people with mental illnesses evaluated the program as "positive" through a questionnaire administered two months after the intervention. These results suggest that the CPD-RS reduces health science students' stigma toward people with mental illnesses and fosters mutual understanding between the two groups.


Asunto(s)
Trastornos Mentales , Estigma Social , Humanos , Trastornos Mentales/terapia , Encuestas y Cuestionarios , Estudiantes
17.
J Psychosom Res ; 163: 111054, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36272378

RESUMEN

OBJECTIVE: The aim of this study was to analyze physicians' and medical students' (MS) beliefs and attitudes toward people with psychotic disorders. METHODS: This systematic review follows the PRISMA guidelines. It was conducted on 5 databases (Pubmed, PsycINFO, Pascal & Francis, Scopus and EMBASE) with a keyword string combining words for physicians' and students' professional status, attitudes toward people, and psychotic disorders. No limitations on publication dates were imposed. RESULTS: This review includes 39 articles, among which quantitative studies are in the majority, and general practioners are mainly represented. Schizophrenia is the main condition used to illustrate psychotic disorders and measure stigmatizing attitudes. Physicians' and MS' beliefs toward people with psychotic disorders are mainly represented by dangerousness and unpredictability. They can be reinforced with socio-demographic criteria (age and female gender) or physicians' beliefs about the disease's etiology. The desire for social distance is higher toward patients with schizophrenia compared to other psychiatric disorders, and medical care could be impacted with a tendency to refer them at psychiatric specific care or to anticipate their difficulties and to modify their treatment plan. Stigma scores remain globally high during medical training. Even if specific anti-stigma trainings have a positive impact on beliefs and attitudes, these effects do not last in time. CONCLUSION: This review highlights the importance to explore physicians' and medical students' representations about patient with psychosis to understand better their difficulties in the management of these patients.


Asunto(s)
Médicos Generales , Trastornos Psicóticos , Esquizofrenia , Estudiantes de Medicina , Humanos , Femenino , Estudiantes de Medicina/psicología , Estigma Social , Actitud del Personal de Salud
18.
Actas Esp Psiquiatr ; 50(5): 216-225, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36273381

RESUMEN

Stigma associated with psychological problems is a major concern that negatively affects people living with different symptomatology, sometimes with serious consequences for their health.


Asunto(s)
Trastornos Mentales , Suicidio , Humanos , Salud Mental , Trastornos Mentales/psicología , Estigma Social
19.
J Perinat Neonatal Nurs ; 36(4): 353-361, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36288441

RESUMEN

The opioid epidemic has greatly increased the number of pregnant women with opioid use and newborns exposed to opioids in utero. Mothers with opioid use disorder can face stigma by nurses in perinatal care settings, contributing to negative care experiences. A survey was distributed to nurses caring for mothers and newborns exposed to opioids in a large urban hospital in the Pacific Northwest United States (n = 89) from March to July 2019. Survey measures included participant characteristics, attitude toward substance use in pregnancy and postpartum (stigma, compassion satisfaction, comfort, and knowledge), and open-ended questions. Relationships among variables and questionnaire items were examined using Pearson's correlations, 2-sample t tests, and simultaneous multiple linear regression. Qualitative description was used to analyze open-ended questions. Nurses' stigma was negatively correlated with compassion satisfaction (r = -0.63), feeling knowledgeable (r = -0.36), and comfortable in providing care to this population (r = -0.44). Nurses identified defensiveness, lack of trust, and inadequate social support as key challenges in this patient population. Nurses suggested more support for mothers and nurses, increased nursing education, and clinical guidelines to improve clinical practice and foster therapeutic relationships. Findings highlight potential strategies to improve nursing care for chemically dependent mothers and their infants. These strategies may offer practical approaches to reduce stigma, develop therapeutic relationships, and improve patient outcomes.


Asunto(s)
Enfermería Neonatal , Atención de Enfermería , Trastornos Relacionados con Opioides , Lactante , Humanos , Femenino , Recién Nacido , Embarazo , Empatía , Analgésicos Opioides
20.
BMC Psychiatry ; 22(1): 640, 2022 10 11.
Artículo en Inglés | MEDLINE | ID: mdl-36221085

RESUMEN

BACKGROUND: ADHD in adults is a common and debilitating neurodevelopmental mental health condition. Yet, diagnosis, clinical management and monitoring are frequently constrained by scarce resources, low capacity in specialist services and limited awareness or training in both primary and secondary care. As a result, many people with ADHD experience serious barriers in accessing the care they need. METHODS: Professionals across primary, secondary, and tertiary care met to discuss adult ADHD clinical care in the United Kingdom. Discussions identified constraints in service provision, and service delivery models with potential to improve healthcare access and delivery. The group aimed to provide a roadmap for improving access to ADHD treatment, identifying avenues for improving provision under current constraints, and innovating provision in the longer-term. National Institute for Health and Care Excellence (NICE) guidelines were used as a benchmark in discussions. RESULTS: The group identified three interrelated constraints. First, inconsistent interpretation of what constitutes a 'specialist' in the context of delivering ADHD care. Second, restriction of service delivery to limited capacity secondary or tertiary care services. Third, financial limitations or conflicts which reduce capacity and render transfer of care between healthcare sectors difficult. The group recommended the development of ADHD specialism within primary care, along with the transfer of routine and straightforward treatment monitoring to primary care services. Longer term, ADHD care pathways should be brought into line with those for other common mental health disorders, including treatment initiation by appropriately qualified clinicians in primary care, and referral to secondary mental health or tertiary services for more complex cases. Long-term plans in the NHS for more joined up and flexible provision, using a primary care network approach, could invest in developing shared ADHD specialist resources. CONCLUSIONS: The relegation of adult ADHD diagnosis, treatment and monitoring to specialist tertiary and secondary services is at odds with its high prevalence and chronic course. To enable the cost-effective and at-scale access to ADHD treatment that is needed, general adult mental health and primary care must be empowered to play a key role in the delivery of quality services for adults with ADHD.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Adulto , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno por Déficit de Atención con Hiperactividad/psicología , Trastorno por Déficit de Atención con Hiperactividad/terapia , Accesibilidad a los Servicios de Salud , Humanos , Atención Primaria de Salud , Derivación y Consulta , Reino Unido/epidemiología
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