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1.
Artigo em Inglês | MEDLINE | ID: mdl-32771337

RESUMO

BACKGROUND: Psychological suffering by health professionals may be associated with the uncertainty of a safe workplace. Front-line professionals exposed and involved in the diagnosis and treatment of COVID-19 patients are more susceptible. METHOD: This review was conducted based on papers that were published at MEDLINE, BMJ, PsycINFO, and LILACS, the according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA). RESULTS: Health professionals had a higher level of anxiety (13.0 vs. 8.5%, p < 0.01, OR = 1.6152; 95%CI 1.3283 to 1.9641; p < 0.0001) and depression 12.2 vs. 9.5%; p = 0.04; OR = 1.3246; 95%CI 1.0930 to 1.6053; p = 0.0042), besides somatizations and insomnia compared to professionals from other areas. CONCLUSION: Health professionals, regardless of their age, showed significant levels of mental disorders. We observed a prevalence of anxiety and depression. Insomnia was a risk factor for both.


Assuntos
Infecções por Coronavirus , Pessoal de Saúde/psicologia , Transtornos Mentais/etiologia , Transtornos Mentais/psicologia , Doenças Profissionais/etiologia , Doenças Profissionais/psicologia , Pandemias , Pneumonia Viral , Humanos , Transtornos Mentais/epidemiologia , Doenças Profissionais/epidemiologia , Prevalência , Estresse Psicológico
3.
Transl Psychiatry ; 10(1): 337, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33009366

RESUMO

Data are scarce regarding the comorbid mental disorders and their management among COVID-19 patients. This study described the clinical characteristics and management of COVID-19 patients treated in psychiatric inpatient settings due to comorbid first-onset mental disorders in Wuhan, China. This electronic medical records-based study included 25 COVID-19 patients with first-onset mental disorders and 55 patients with first-onset mental disorders without COVID-19 (control group). Data collected included ICD-10 diagnoses of mental disorders, psychiatric and respiratory symptoms, treatments, and outcomes. Adjustment disorder (n = 11, 44.0%) and acute and transient psychotic disorders, with associated acute stress (n = 6, 24.0%) were main clinical diagnoses in the COVID-19 group while serious mental illnesses (i.e., schizophrenia, 24.5%) and alcohol use disorders (10.9%) were overrepresented in the control group. On admission, the most common psychiatric symptom in COVID-19 patients was insomnia symptoms (n = 18, 72.0%), followed by aggressive behaviors (n = 16, 64.0%), delusion (n = 10, 40.0%), and severe anxiety (n = 9, 36.0%). In addition to respiratory treatments, 76.0% COVID-19 patients received antipsychotics, 40.0% sedative-hypnotics, and 24.0% mood stabilizers. At the end of inpatient treatment, 4 (16.0%) COVID-19 patients were transferred to other hospitals to continue respiratory treatment after their psychiatric symptoms were controlled while the remaining 21 (84.0%) all recovered. Compared to the control group, COVID-19 group had significantly shorter length of hospital stay (21.2 vs. 37.4 days, P < 0.001). Adjustment disorder and acute and transient psychotic disorders are the main clinical diagnoses of COVID-19 patients managed in psychiatric inpatient settings. The short-term prognosis of these patients is good after conventional psychotropic treatment.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus , Hospitalização/estatística & dados numéricos , Transtornos Mentais , Pandemias , Pneumonia Viral , Psicotrópicos , China/epidemiologia , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/fisiopatologia , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Administração dos Cuidados ao Paciente/métodos , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Prognóstico , Escalas de Graduação Psiquiátrica , Psicotrópicos/classificação , Psicotrópicos/uso terapêutico , Avaliação de Sintomas/métodos , Avaliação de Sintomas/estatística & dados numéricos
4.
Pril (Makedon Akad Nauk Umet Odd Med Nauki) ; 41(2): 95-101, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-33011701

RESUMO

COVID-19 pandemic has provoked a huge change in daily functioning in millions of people worldwide. The epidemiological measures in prevention of possible infection have increased the possible risks on the mental and physical health. We have conducted a survey in order to investigate the needs and challenges of families with children with chronic respiratory diseases. In this order, we have created a questionnaire with general information about the family, general information about the child with chronic respiratory disease, overall physical and mental health before and during the pandemic, needs and mental health condition of the parents/caregivers. This survey showed that this group of families of children with respiratory disorders have suffered financially in significant way and has changed the way they perform professional and educational patterns due to the pandemic. Most of the children were stable in their physical health, but their mental health has deteriorated. This is probably due to the regular contact with the medical staff, but not with the mental health professionals. This group of children has a significant reduction in their physical activity and increase the hours in front of TV screens. The further effect on the physical and mental health is to be investigated.


Assuntos
Doença Crônica/psicologia , Infecções por Coronavirus/psicologia , Transtornos Mentais/epidemiologia , Pneumonia Viral/psicologia , Quarentena/psicologia , Doenças Respiratórias/psicologia , Betacoronavirus , Criança , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Pandemias/prevenção & controle , Pais , Pneumonia Viral/prevenção & controle , República da Macedônia do Norte/epidemiologia , Doenças Respiratórias/virologia , Inquéritos e Questionários
5.
Transl Psychiatry ; 10(1): 339, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33024072

RESUMO

There were several studies about the psychiatric and mental health issues related to the severe adult respiratory syndrome (SARS) outbreak in 2003, however, the association between SARS and the overall risk of psychiatric disorders and suicides has, as yet, to be studied in Taiwan. The aim of this study is to examine as to whether SARS is associated with the risk of psychiatric disorders and suicide. A total of 285 patients with SARS and 2850 controls without SARS (1:10) matched for sex, age, insurance premium, comorbidities, residential regions, level of medical care, and index date were selected between February 25 and June 15, 2003 from the Inpatient Database Taiwan's National Health Insurance Research Database. During the 12-year follow-up, in which 79 in the SARS cohort and 340 in the control group developed psychiatric disorders or suicide (4047.41 vs. 1535.32 per 100,000 person-years). Fine and Gray's survival analysis revealed that the SARS cohort was associated with an increased risk of psychiatric disorders and suicide, and the adjusted subdistribution HR (sHR) was 2.805 (95% CI: 2.182-3.605, p < 0.001) for psychiatric disorders and suicide. The SARS cohort was associated with anxiety, depression, sleep disorders, posttraumatic stress disorder/acute stress disorder (PTSD/ASD), and suicide. The sensitivity analysis revealed that the SARS group was associated with anxiety, depression, sleep disorders, PTSD/ASD, and suicide after the individuals with a diagnosis of psychiatric disorders and suicide were excluded within the first year, and with anxiety, depression, and sleep disorders, while those in the first five years were excluded. In conclusion, SARS was associated with the increased risk of psychiatric disorders and suicide.


Assuntos
Infecções por Coronavirus , Transtornos Mentais , Saúde Mental/estatística & dados numéricos , Pandemias , Pneumonia Viral , Síndrome Respiratória Aguda Grave , Suicídio/estatística & dados numéricos , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Bases de Dados Factuais , Feminino , Humanos , Pacientes Internados/estatística & dados numéricos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Transtornos Mentais/virologia , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Medição de Risco , Fatores de Risco , Síndrome Respiratória Aguda Grave/epidemiologia , Síndrome Respiratória Aguda Grave/psicologia , Síndrome Respiratória Aguda Grave/terapia , Taiwan/epidemiologia
6.
Psychiatr Danub ; 32(Suppl 3): 349-352, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33030451

RESUMO

Sexual abuse in childhood is associated with many adverse consequences for survival during their lifetime. Numerous research studies clearly show the link between sexual abuse of children and the spectrum of unfavorable mental, social, sexual, interpersonal and behavioral as well as physical health consequences. Current research shows the strongest link between sexual abuse of children and the presence of depression, alcohol and abuse of other psychoactive substances and nutritional disorders in surviving women and anxiety-related disorders in male survivors. There is also an increased risk of re-victimization, especially for girls. Negative effects of mental health in children with sexual abuse include posttraumatic symptoms, depression, helplessness, negative evaluation, aggressive behavior and behavioral problems. Recent research links sexual assault on children with psychotic disorders, including schizophrenia and dysfunctional disorders, as well as personality disorders. Sexual abuse of children involving penetration is specifically identified as a risk factor for the development of psychotic and schizophrenic symptoms. Many studies have shown that sexual victimization in childhood is a significant risk factor for suicidal ideation and suicidal behaviors.


Assuntos
Abuso Sexual na Infância/psicologia , Abuso Sexual na Infância/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Transtornos de Ansiedade/epidemiologia , Criança , Humanos , Transtornos Psicóticos/epidemiologia , Comportamento Sexual
8.
Cien Saude Colet ; 25(9): 3401-3411, 2020 Sep.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32876269

RESUMO

Pandemics such as that of COVID-19 affect a relatively large number of people and impose new rules and social habits on the world population. Information about the pandemic is constant in the media. Moreover, social distancing has been adopted in Brazil to prevent the spread of COVID-19, which may have economic and psychosocial consequences. This study aimed to verify the factors associated with indicators of mental disorders symptoms in residents of Rio Grande do Sul during the initial period of the social distancing policy. The study was approved by CONEP. There were 799 participants, aged between 18 and 75 years (M = 36.56; SD = 12.88); 82.7% were women, who answered a sociodemographic questionnaire of social distancing and the Self-Report Questionnaire (SRQ-20). The results indicated that having decreased income in the period, being part of the risk group and being more exposed to information about deaths and infected, are factors that can significantly harm mental health in this pandemic period. Investigating social determinants that contribute to greater vulnerability to the mental illness of the population is vital in the field of collective health for the planning of public actions and policies.


Assuntos
Infecções por Coronavirus/epidemiologia , Transtornos Mentais/epidemiologia , Saúde Mental , Pneumonia Viral/epidemiologia , Isolamento Social/psicologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Infecções por Coronavirus/psicologia , Feminino , Política de Saúde , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/psicologia , Fatores de Risco , Adulto Jovem
9.
Cien Saude Colet ; 25(9): 3465-3474, 2020 Sep.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32876270

RESUMO

This work aims to systematize a set of scientific evidence presented in international papers that identify the main problems affecting health professionals directly involved in coping with the COVID-19 pandemic and point out actions and strategies for the protection and healthcare of these professionals. The risk of infection is the main issue and has led to absence from work, illness, death, and intense psychological distress, expressed in generalized anxiety and sleep disorders, fear of becoming ill and infecting colleagues and relatives. In the Brazilian reality, this work revives the analysis of the chronic problems affecting health workers, resulting from the underfinancing of the Brazilian Unified Health System (SUS), the sector's spending freeze, the deterioration of services and workforce's insecurity, and points out the acute challenges of work management and staff training, given the expanded hospital bed infrastructure and reorganization of the work process in primary care to face the pandemic, emphasizing the necessary measures for the protection and promotion of the physical and mental health of health professionals and workers.


Assuntos
Infecções por Coronavirus/epidemiologia , Pessoal de Saúde/psicologia , Transtornos Mentais/epidemiologia , Pneumonia Viral/epidemiologia , Adaptação Psicológica , Brasil/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Humanos , Saúde Mental , Programas Nacionais de Saúde/organização & administração , Pandemias , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Estresse Psicológico/epidemiologia
10.
Acta Biomed ; 91(3): e2020011, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32921709

RESUMO

During the COVID-19 epidemic, home care and remote working showed important technological innovations, leading to review all public mental health policies. In this article, some considerations based on the Italian COVID-19 experience in order to plan post-COVID psychiatric interventions are reported.


Assuntos
Betacoronavirus , Infecções por Coronavirus/psicologia , Serviços de Emergência Psiquiátrica/organização & administração , Transtornos Mentais/etiologia , Pandemias , Pneumonia Viral/psicologia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Humanos , Itália/epidemiologia , Transtornos Mentais/epidemiologia , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia
11.
Artigo em Alemão | MEDLINE | ID: mdl-32940746

RESUMO

BACKGROUND: According to estimates, between 337,000 and 650,000 people in Germany live without a permanent residence. They are highly deprived in terms of health. Studies on the health situation are rare and methodologically heterogeneous. Previous reviews have focused on mental illness. OBJECTIVES: The aim of this paper is to provide an overview of current research on somatic diseases of homeless people in Germany. METHODS: Based on a systematic literature review for the years 2009-2019, the methodological approaches, sample access, recruitment, and health aspects reported in the studies are compared. RESULTS: By means of a systematic literature search, eight peer-reviewed journal articles were identified. Often the term "homelessness" was not operationalised. The average age of homeless participants was between 40.9 years and 67 years, and the proportion of women was between 0 and 35.3%. Frequently the sample was taken from accommodation and medical services for homeless people. One recruitment strategy was "respondent-driven sampling" in conjunction with incentives. The respondents most frequently reported cardiovascular diseases (17%-37.2%), musculoskeletal diseases (≥20%), and respiratory diseases (7%-24%). Depending on the recruitment site, infectious diseases were common (tuberculosis, hepatitis B and C). CONCLUSION: Somatic health studies of homeless people are often selective. Older men with lower educational backgrounds living in large German cities appear to be overrepresented, and there is no uniform use of the term "homelessness." Compared with representative population data for Germany, increased risks of somatic illness were observed; cohort characteristics can explain these to a limited extent. Biographical and intersectional approaches are needed to capture multiple and cumulative exposure situations in homelessness.


Assuntos
Pessoas em Situação de Rua , Transtornos Mentais/epidemiologia , Tuberculose , Adulto , Idoso , Estudos de Coortes , Feminino , Alemanha/epidemiologia , Humanos , Masculino
12.
J Prim Care Community Health ; 11: 2150132720953682, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32865107

RESUMO

INTRODUCTION: COVID-19 is causing an enormous psychological burden for most people. This study aims to assess individual changes in mental health and health status before and after the COVID-19 outbreak, and to explore potential predictors of change. METHODS: A cross-sectional study in Germany (n = 15 037) were conducted. Demographics, depression and anxiety symptoms (PHQ-2, GAD-2), distress (DT), and health status (EQ-5D-3L) were assessed. Additionally, all instruments used were adapted to measure the participants' mental health and health status before the COVID-19 outbreak. COVID-19-related fear, trust in governmental actions to face COVID-19, and the subjective level of information about COVID-19 were examined. RESULTS: Overall, the participants showed a significant increase in depression and anxiety symptoms, and distress, while health status deteriorated since the COVID-19 outbreak. Impairment in mental health was predicted by COVID-19-related fear. Pre-existing mental illness predicted an increase in depression symptoms and a deterioration in health status. Trust in governmental actions and the subjective level of information predicted less increase in psychological burden. CONCLUSIONS: Our data revealed that there have been changes in mental health and health status at an individual level since the outbreak of COVID-19. In order to maintain mental health, the observed predictors should be addressed.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Surtos de Doenças , Transtornos Mentais/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Adolescente , Adulto , Idoso , Estudos Transversais , Medo/psicologia , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Fatores de Risco , Adulto Jovem
14.
BMJ Open ; 10(9): e040229, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32873685

RESUMO

INTRODUCTION: The current COVID-19 pandemic has resulted in high rates of infection and death, as well as widespread social disruption and a reduction in access to healthcare services and support. There is growing concern over how the pandemic, as well as measures put in place to curb the pandemic, will impact people with mental disorders. We aim to study the effect of pandemics and epidemics on mental health outcomes for people with premorbid mental disorders. METHODS AND ANALYSIS: With our predefined search strategy, we will search five databases for studies reporting on mental health outcomes in people with pre-existing mental disorders during pandemic and epidemic settings. Search dates are planned as follows: 5 May 2020 and 23 July 2020. The following databases will be searched: MEDLINE/PubMed, CINAHL, PsycINFO, MedRxiv and EMBASE. Data will be screened and extracted in duplicate by two independent reviewers. Studies involving non-clinical populations or patients diagnosed with a mental disorder during a pandemic/epidemic will be excluded. We will include data collected from all pandemics and epidemics throughout history, including the present COVID-19 pandemic. If possible, study findings will be combined in meta-analyses, and subgroup analyses will be performed. We hope that this review will shed light on the impact of pandemics and epidemics on those with pre-existing mental disorders. Knowledge generated may inform future intervention studies as well as healthcare policies. Given the potential implications of the current pandemic measures (ie, disruption of healthcare services) on mental health, we will also compile a list of existing mental health resources. ETHICS AND DISSEMINATION: No ethical approval is required for this protocol and proposed systematic review as we will only use data from previously published papers that have themselves received ethics clearance and used proper informed consent procedures. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number: CRD42020179611.


Assuntos
Infecções por Coronavirus , Transtornos Mentais , Serviços de Saúde Mental/provisão & distribução , Saúde Mental , Pandemias/estatística & dados numéricos , Pneumonia Viral , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Acesso aos Serviços de Saúde , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Projetos de Pesquisa , Revisões Sistemáticas como Assunto
15.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32958610

RESUMO

BACKGROUND: Gender-incongruent (GI) youth have high rates of mental health problems. Although gender-affirming medical care (GAMC) provides psychological benefit, some GI youth present to care at older ages. Whether a relationship exists between age of presentation to GAMC and mental health difficulties warrants study. METHODS: A cross-sectional chart review of patients presenting to GAMC. Subjects were classified a priori as younger presenting youth (YPY) (<15 years of age at presentation) or older presenting youth (OPY) (≥15 years of age). Self-reported rates of mental health problems and medication use were compared between groups. Binary logistic regression analysis was used to identify determinants of mental health problems. Covariates included pubertal stage at presentation, social transition status, and assigned sex. RESULTS: Of 300 youth, there were 116 YPY and 184 OPY. After presentation, more OPY than YPY reported a diagnosis of depression (46% vs 30%), had self-harmed (40% vs 28%), had considered suicide (52% vs 40%), had attempted suicide (17% vs 9%), and required psychoactive medications (36% vs 23%), with all P < .05. After controlling for covariates, late puberty (Tanner stage 4 or 5) was associated with depressive disorders (odds ratio 5.49; 95% confidence interval [CI]: 1.14-26.32) and anxiety disorders (odds ratio 4.18 [95% CI: 1.22-14.49]), whereas older age remained associated only with psychoactive medication use (odd ratio 1.31 [95% CI: 1.05-1.63]). CONCLUSIONS: Late pubertal stage and older age are associated with worse mental health among GI youth presenting to GAMC, suggesting that this group may be particularly vulnerable and in need of appropriate care.


Assuntos
Fatores Etários , Disforia de Gênero/psicologia , Disforia de Gênero/terapia , Transtornos Mentais/epidemiologia , Transexualidade/psicologia , Transexualidade/terapia , Adolescente , Antipsicóticos/uso terapêutico , Transtornos de Ansiedade/epidemiologia , Criança , Estudos Transversais , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Revelação , Humanos , Modelos Logísticos , Transtornos Mentais/tratamento farmacológico , Saúde Mental , Puberdade , Comportamento Autodestrutivo/epidemiologia , Fatores Sexuais , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos
16.
PLoS Med ; 17(9): e1003306, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32941435

RESUMO

BACKGROUND: The higher mortality rates in people with severe mental illness (SMI) may be partly due to inadequate integration of physical and mental healthcare. Accurate recording of SMI during hospital admissions has the potential to facilitate integrated care including tailoring of treatment to account for comorbidities. We therefore aimed to investigate the sensitivity of SMI recording within general hospitals, changes in diagnostic accuracy over time, and factors associated with accurate recording. METHODS AND FINDINGS: We undertook a cohort study of 13,786 adults with SMI diagnosed during 2006-2017, using data from a large secondary mental healthcare database as reference standard, linked to English national records for 45,706 emergency hospital admissions. We examined general hospital record sensitivity across patients' subsequent hospital records, for each subsequent emergency admission, and at different levels of diagnostic precision. We analyzed time trends during the study period and used logistic regression to examine sociodemographic and clinical factors associated with psychiatric recording accuracy, with multiple imputation for missing data. Sensitivity for recording of SMI as any mental health diagnosis was 76.7% (95% CI 76.0-77.4). Category-level sensitivity (e.g., proportion of individuals with schizophrenia spectrum disorders (F20-29) who received any F20-29 diagnosis in hospital records) was 56.4% (95% CI 55.4-57.4) for schizophrenia spectrum disorder and 49.7% (95% CI 48.1-51.3) for bipolar affective disorder. Sensitivity for SMI recording in emergency admissions increased from 47.8% (95% CI 43.1-52.5) in 2006 to 75.4% (95% CI 68.3-81.4) in 2017 (ptrend < 0.001). Minority ethnicity, being married, and having better mental and physical health were associated with less accurate diagnostic recording. The main limitation of our study is the potential for misclassification of diagnosis in the reference-standard mental healthcare data. CONCLUSIONS: Our findings suggest that there have been improvements in recording of SMI diagnoses, but concerning under-recording, especially in minority ethnic groups, persists. Training in culturally sensitive diagnosis, expansion of liaison psychiatry input in general hospitals, and improved data sharing between physical and mental health services may be required to reduce inequalities in diagnostic practice.


Assuntos
Hospitalização/tendências , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Comorbidade , Grupos Étnicos , Feminino , Hospitais Gerais , Humanos , Masculino , Transtornos Mentais/psicologia , Grupos Minoritários , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Sistema de Registros , Fatores Socioeconômicos , Reino Unido/epidemiologia
17.
PLoS Med ; 17(9): e1003337, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32956381

RESUMO

BACKGROUND: Globally, the number of refugees and asylum seekers has reached record highs. Past research in refugee mental health has reported wide variation in mental illness prevalence data, partially attributable to methodological limitations. This systematic review aims to summarise the current body of evidence for the prevalence of mental illness in global refugee populations and overcome methodological limitations of individual studies. METHODS AND FINDINGS: A comprehensive search of electronic databases was undertaken from 1 January 2003 to 4 February 2020 (MEDLINE, MEDLINE In-Process, EBM Reviews, Embase, PsycINFO, CINAHL, PILOTS, Web of Science). Quantitative studies were included if diagnosis of mental illness involved a clinical interview and use of a validated assessment measure and reported at least 50 participants. Study quality was assessed using a descriptive approach based on a template according to study design (modified Newcastle-Ottawa Scale). Random-effects models, based on inverse variance weights, were conducted. Subgroup analyses were performed for sex, sample size, displacement duration, visa status, country of origin, current residence, type of interview (interpreter-assisted or native language), and diagnostic measure. The systematic review was registered with PROSPERO (CRD) 42016046349. The search yielded a result of 21,842 records. Twenty-six studies, which included one randomised controlled trial and 25 observational studies, provided results for 5,143 adult refugees and asylum seekers. Studies were undertaken across 15 countries: Australia (652 refugees), Austria (150), China (65), Germany (1,104), Italy (297), Lebanon (646), Nepal (574), Norway (64), South Korea (200), Sweden (86), Switzerland (164), Turkey (238), Uganda (77), United Kingdom (420), and the United States of America (406). The prevalence of posttraumatic stress disorder (PTSD) was 31.46% (95% CI 24.43-38.5), the prevalence of depression was 31.5% (95% CI 22.64-40.38), the prevalence of anxiety disorders was 11% (95% CI 6.75-15.43), and the prevalence of psychosis was 1.51% (95% CI 0.63-2.40). A limitation of the study is that substantial heterogeneity was present in the prevalence estimates of PTSD, depression, and anxiety, and limited covariates were reported in the included studies. CONCLUSIONS: This comprehensive review generates current prevalence estimates for not only PTSD but also depression, anxiety, and psychosis. Refugees and asylum seekers have high and persistent rates of PTSD and depression, and the results of this review highlight the need for ongoing, long-term mental health care beyond the initial period of resettlement.


Assuntos
Transtornos Mentais/epidemiologia , Refugiados/psicologia , Ansiedade/epidemiologia , Transtornos de Ansiedade , Depressão/epidemiologia , Transtorno Depressivo , Feminino , Humanos , Masculino , Saúde Mental/tendências , Prevalência , Transtornos de Estresse Pós-Traumáticos/epidemiologia
20.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32943535

RESUMO

Potential long-lasting adverse effects of child maltreatment have been widely reported, although little is known about the distinctive long-term impact of differing types of maltreatment. Our objective for this special article is to integrate findings from the Mater-University of Queensland Study of Pregnancy, a longitudinal prenatal cohort study spanning 2 decades. We compare and contrast the associations of specific types of maltreatment with long-term cognitive, psychological, addiction, sexual health, and physical health outcomes assessed in up to 5200 offspring at 14 and/or 21 years of age. Overall, psychological maltreatment (emotional abuse and/or neglect) was associated with the greatest number of adverse outcomes in almost all areas of assessment. Sexual abuse was associated with early sexual debut and youth pregnancy, attention problems, posttraumatic stress disorder symptoms, and depression, although associations were not specific for sexual abuse. Physical abuse was associated with externalizing behavior problems, delinquency, and drug abuse. Neglect, but not emotional abuse, was associated with having multiple sexual partners, cannabis abuse and/or dependence, and experiencing visual hallucinations. Emotional abuse, but not neglect, revealed increased odds for psychosis, injecting-drug use, experiencing harassment later in life, pregnancy miscarriage, and reporting asthma symptoms. Significant cognitive delays and educational failure were seen for both abuse and neglect during adolescence and adulthood. In conclusion, child maltreatment, particularly emotional abuse and neglect, is associated with a wide range of long-term adverse health and developmental outcomes. A renewed focus on prevention and early intervention strategies, especially related to psychological maltreatment, will be required to address these challenges in the future.


Assuntos
Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Adolescente , Comportamento do Adolescente , Asma/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Austrália/epidemiologia , Estatura , Criança , Cognição , Estudos de Coortes , Gorduras na Dieta/administração & dosagem , Escolaridade , Feminino , Humanos , Inteligência , Estudos Longitudinais , Transtornos Mentais/epidemiologia , Gravidez , Gravidez na Adolescência/estatística & dados numéricos , Qualidade de Vida , Comportamento Sexual , Transtornos do Sono-Vigília/epidemiologia , Evasão Escolar/estatística & dados numéricos , Desemprego/estatística & dados numéricos , Adulto Jovem
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