To Vaccinate or Not to Vaccinate-Reasons of Willingness and Reluctance of Students against SARS-CoV-2 Vaccination-An International Experience.

Despite the vaccine against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) being reported to be safe and effective, the unwillingness to vaccinate and doubts are still common. The aim of this international study was to assess the major reasons for the unwillingness to vaccinate in a group of students from Poland (n = 1202), Bangladesh (n = 1586), India (n = 484), Mexico (n = 234), Egypt (n = 566), Philippines (n = 2076), Pakistan (n = 506), Vietnam (n = 98) and China (n = 503). We conducted an online cross-sectional study that aimed to assess (1) the percentage of vaccinated and unvaccinated students and (2) the reasons associated with willingness/unwillingness to the vaccine. The study included 7255 respondents from 9 countries with a mean age of 21.85 ± 3.66 years. Only 22.11% (n = 1604) of students were vaccinated. However, the majority (69.25%, n = 5025) expressed a willingness to be vaccinated. More willing to vaccinate were students in informal relationships who worked mentally, used psychological/psychiatric services before the pandemic, and studied medicine. There are cultural differences regarding the reasons associated with the unwillingness to vaccinate, but some 'universal' might be distinguished that apply to the whole group.

Development and implementation of guidelines for the management of depression: a systematic review.

OBJECTIVE: To evaluate the development and implementation of clinical practice guidelines for the management of depression globally. METHODS: We conducted a systematic review of existing guidelines for the management of depression in adults with major depressive or bipolar disorder. For each identified guideline, we assessed compliance with measures of guideline development quality (such as transparency in guideline development processes and funding, multidisciplinary author group composition, systematic review of comparative efficacy research) and implementation (such as quality indicators). We compared guidelines from low- and middle-income countries with those from high-income countries. FINDINGS: We identified 82 national and 13 international clinical practice guidelines from 83 countries in 27 languages. Guideline development processes and funding sources were explicitly specified in a smaller proportion of guidelines from low- and middle-income countries (8/29; 28%) relative to high-income countries (35/58; 60%). Fewer guidelines (2/29; 7%) from low- and middle-income countries, relative to high-income countries (22/58; 38%), were authored by a multidisciplinary development group. A systematic review of comparative effectiveness was conducted in 31% (9/29) of low- and middle-income country guidelines versus 71% (41/58) of high-income country guidelines. Only 10% (3/29) of low- and middle-income country and 19% (11/58) of high-income country guidelines described plans to assess quality indicators or recommendation adherence. CONCLUSION: Globally, guideline implementation is inadequately planned, reported and measured. Narrowing disparities in the development and implementation of guidelines in low- and middle-income countries is a priority. Future guidelines should present strategies to implement recommendations and measure feasibility, cost-effectiveness and impact on health outcomes.

Comparison between primary care evaluation of mental disorders patient questionnaire and the self-reporting questionnaire as screening tools for psychiatric disorders at the UP-PGH Pain Clinic

OBJECTIVE: To compare the validities of two instruments- the Primary Care Evaluation of Mental Disorders Patient Questionnaire (PRIME-MD PQ) and the Self-Reporting Questionnaire (SRQ)- in terms of discriminating between patients with and without psychiatric disorders seen at the UP-PGH Pain Clinic. DESIGN: Cross-sectional, criterion standard SETTING: Pain Clinic at the Department of Outpatient Services SUBJECTS: A total of 102 adult patients assessed by three pain fellow physicians MAIN OUTCOME MEASURES: Positive or negative results for mental disorders using PRIME-MD PQ and SRQ as screening procedure plotted against psychiatric interview whether positive or negative using a two-by-two contingency table RESULTS: There was good agreement between PRIME-MD PQ and psychiatric interview (k=0.67) whereas poor correlation between SRQ and psychiatric interview (k=0.51). However, with the removal of one item eliciting grandiosity from the "psychotic" items, agreement with the SRQ rose to k=0.76 when all items on psychosis are eliminated (shorter version of SRQ), agreement was almost excellent (k=0.79). CONCLUSION: The modified version of SRQ is slightly superior to the PRIME-MD PQ in discriminating between patients with and without psychiatric disorders at the Pain Clinic.

Survey of community reactions to mental disorders from an urban poor community

This study was undertaken in conjunction with a program aimed at promoting community-oriented medical education and introducing community-based mental health care to primary care. The findings of this study will be used in selecting priorities and designing interventions for the community. Attitudes towards mental disorders were studied in an urban community using standardized interviews with key informants The informants were given descriptions of common mental disorders, and they knew an average of two individuals who matched the given descriptions. The primary source of help for physical health problems as well as psychological symptoms was found to be modern health services Traditional healers seemed to be less sought after except in cases of "possession." The most commonly identified conditions were substance-related problems, mental retardation, and epilepsy. Perception of mental illness and their social consequences have been graphically represented as "attitude profiles," where differences in responses to the six mental conditions were elicited. Most respondents showed negative reactions towards psychotic disorders while depression and anxiety garnered more optimistic responses. Epilepsy and mental retardation, although perceived as grave, were believed not to bring about serious consequences.

Comparison between primary care evaluation of mental disorders patient questionnaire and the self reporting questionnaire as screening tools for psychiatric disorders at the UP-PGH Pain Clinic

This research aims to compare the validity of two (2) screening instruments - PRIME-MD PQ and SRQ - in terms of their ability to discriminate patients with psychiatric disorders from those without at the UP-PGH Pain Clinic. This is a cross sectional study 102 of patients evaluated by 3 pain fellow physicians and reviewed by 1 psychiatrist. There was good agreement between PRIME-MD PQ and psychiatric interview (k=0.67) compared to the correlation between SRQ and psychiatric interview (k=0.51). However, with the removal of the item in the SRQ eliciting grandiosity from the "psychotic" items, agreement of the psychiatric interview with the modified SRQ (without item 22) rose to k=0.76. When all items on psychosis were eliminated (SRQ-20), agreement was even better (k=0.79). Both shorter versions of SRQ (Modified SRQ & SRQ-20) were superior to the PRIME-MD PQ in discriminating between patients with and without psychiatric disorders at the pain clinic.