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1.
Rev. Ciênc. Plur ; 5(2): 129-142, ago. 2019.
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1021776

RESUMO

Introdução:O suicídio é tido como um fenômeno complexo, multicausal, fruto da interação de fatores de ordem filosófica, biológica, antropológica, psicológica, e social, considerado nos dias de hoje um grave problema de saúde pública.Objetivo:realizar uma análise documental dos materiais lançados pelo SUS relacionados às medidas a serem adotadas em casos e tentativas de suicídio, bem como nos meios previni-las.Método:trata-se de um estudo descritivo, no qual foram verificadas as portarias e manuscritos do SUS relacionadas ao suicídio, tendo sido consultados oito documentos oficiais.Resultados:a primeira portaria a tratar especificamente do assunto, Portaria nº 1.876, foi lançada em 2006, e instituiu as Diretrizes Nacionais para Prevenção do Suicídio, norteando as estratégias do Ministério da Saúde para atuação e contenção do fenômeno. A partir dela, outros documentos foram instituídos, visando o aprimoramento do acesso, acolhimento, e tratamento aos indivíduos predispostos a desenvolverem depressão, ou que estão em situações de risco, além de garantir maiores esforços e investimentos para grupos específicos. Conclusões:as portarias estabelecidas garantem ao usuário do SUS acolhimento e acompanhamento, desde o nível de atenção básica até a atenção especializada (AU).


Introduction:Suicide is considered as a complex phenomenon, multicausal, fruit of the interaction of factors of philosophical, biological, anthropological, psychological, and social, considered today a serious public health problem.Objective:to perform a documentary analysis of the materials released by the SUS related to the measures to be adopted in cases and suicide attempts, as well asin the means to prevent them.Methods:this is a descriptive study, in which the ordinances and SUS manuscripts related to suicide were verified, and eight official documents were consulted.Results:the first ordinance to deal specifically with the subject, Ordinance No. 1,876, was launched in 2006, and established the National Guidelines for Suicide Prevention, guiding the strategies of the Ministry of Health to act and restrain the phenomenon. From this, other documents were instituted, aimed at improving access, shelter, and treatment to individuals predisposed to develop depression, or who are at risk, as well as guaranteeing greater efforts and investments for specific groups.Conclusions:established ordinances guarantee hosting and follow-upto the SUS user, from basic care level to specialized care (AU).


Assuntos
Suicídio , Sistema Único de Saúde , Saúde Mental , Documento Governamental , Portarias , Transtornos Mentais/psicologia , Brasil , Epidemiologia Descritiva , Depressão/psicologia , Serviços de Saúde
2.
J Nurs Adm ; 49(10): 487-495, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31517756

RESUMO

OBJECTIVE: The purpose of this study was to evaluate the effects of the MINDBODYSTRONG for Healthcare Professionals Program on stress, anxiety, depressive symptoms, healthy lifestyle behaviors, and job satisfaction on newly licensed RNs (NLRNs) participating in a nurse residency program. BACKGROUND: The constellation of burnout, depression, and suicide in clinicians is a public health epidemic that affects the quality and safety of healthcare. The National Academy of Medicine's Action Collaborative on Clinician Well-being and Resilience has called for an increase in evidence-based interventions to combat this alarming problem. The MINDBODYSTRONG Program is a novel adaptation of an evidence-based cognitive behavioral skills-building intervention that provides a theory-based approach to improve the mental health, healthy lifestyle beliefs and behaviors, and job satisfaction of NLRNs. METHODS: A 2-group, cluster randomized controlled trial was used with 89 new nurses participating in a new-graduate nurse residency program. The experimental intervention, MINDBODYSTRONG, consisted of 8 manualized weekly 45-minute sessions. Data were collected at baseline, immediately following, and 3 months after intervention that measured stress, depressive symptoms, anxiety, healthy lifestyle beliefs and behaviors, and job satisfaction. Repeated-measures analysis of variance was used for data analysis. RESULTS: The intervention group scored significantly better with moderate to large positive effects on the mental health variables as well as healthy lifestyle beliefs and healthy lifestyle behaviors at both follow-up time points compared with the attention control group. Moderate to large positive effects also were found for job satisfaction. CONCLUSIONS: The MINDBODYSTRONG Program has excellent potential as an evidence-based intervention for improving the mental health, healthy lifestyle beliefs and behaviors, and job satisfaction, in NLRNs.


Assuntos
Terapia Comportamental/métodos , Esgotamento Profissional/prevenção & controle , Esgotamento Profissional/psicologia , Estilo de Vida Saudável , Transtornos Mentais/prevenção & controle , Transtornos Mentais/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Adulto , Atitude do Pessoal de Saúde , Feminino , Humanos , Satisfação no Emprego , Masculino , Adulto Jovem
3.
Psychiatr Hung ; 34(2): 113-127, 2019.
Artigo em Húngaro | MEDLINE | ID: mdl-31417002

RESUMO

Due to her childhood spent on the Atlantic coast, the element of sea had a major influence on both Sylvia Plath's artistic carreer and personality. In the present paper we intend to offer a literature psychological analysis of the water metaphor in the oeuvre, focused on the following themes; The vital water; The fearful water; The passionate water and The healing water. Our aim through the analysis of her poetry and novels is to explore the role of this dual symbol in the life of the poet with a well-known polarized personality. Why water has become adequate to express her ambivalences? Finally, how did the relationship with the water element affect the personal life and illness of the author, and what impact of these can be unveiled in the oeuvre?


Assuntos
Pessoas Famosas , Literatura Moderna/história , Metáfora , Água , Feminino , História do Século XX , Humanos , Transtornos Mentais/história , Transtornos Mentais/psicologia , Personalidade
4.
Psychiatr Hung ; 34(2): 131-140, 2019.
Artigo em Húngaro | MEDLINE | ID: mdl-31417003

RESUMO

AIM: The purpose of this present paper is to demonstrate the biographical antecedents and the adverse childhood experiences, which might have possibly contributed to those ambivalent feelings which can be observed in Sylvia Plath's confessional art in relation to her parents. METHOD: Biographical-, document- and artistic analyzes. The analyzed artistic pieces are the following: Johnny Panic and the Bible of Dreams, The Bell Jar, Collected poems (from The Colossus and Ariel books) and the Journals by Sylvia Plath. The reconstruction of the biography was conducted based on international textbooks. RESULTS: Sylvia Plath at the age of 30, on the 12th of October, 1962 wrote her famous poem, Daddy, which starts with these lines: "You do not do, you do not do /Any more, black shoe/In which I have lived like a foot For thirty years, poor and white,/Barely daring to breathe or Achoo. Daddy, I have had to kill you./You died before I had time/Marble-heavy, a bag full of God/Ghastly statue with one gray toe/Big as a Frisco seal/And a head in the freakish Atlantic /Where it pours bean green over blue/In the waters off beautiful Nauset./I used to pray to recover you. /Ach, du Dreck." A couple of months later, on the 11th of February 1963. Sylvia Plath committed suicide. Her journal entries and her works all testified that the emotional relationship with her parents significantly contributed to her genuine art and at the same time to the onset of her psychiatric illness. According to her journals, Sylvia Plath reported hate and ambivalent feelings several times to her psychiatrists. It is very likely, that the illness and death of Otto Plath and the emotional crises afterwards might have been that primary experience that might have exercised an adverse effect on Sylvia's life, and what have been composed very vividly in the poem called Daddy. CONCLUSIONS: Based on the analyzes of the biography, the journals and the poems, it can be stated, that the adverse childhood experiences, Sylvia had to experience during her father's illness, after his death, and during the restructuring of the family system are vital in the understanding of Sylvia Plath's art and her psychopathology.


Assuntos
Ira , Pessoas Famosas , Literatura Moderna/história , Transtornos Mentais/história , Transtornos Mentais/psicologia , Pais/psicologia , Feminino , História do Século XX , Humanos , Poesia como Assunto/história , Psicopatologia , Suicídio/história
5.
Soins Psychiatr ; 40(323): 21-24, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31402035

RESUMO

The acute crisis is often followed by boredom. Patients become impatient, restless, looking for ways to take their mind off things and entertain themselves. The occupational activity can then come to the rescue of these downtimes, offering solutions to encourage an encounter. Caregivers work together to 'bore' the patient. In this search for the encounter, they must take the risk of forgoing the occupational activity for the sake of the therapeutic.


Assuntos
Tédio , Transtornos Mentais/enfermagem , Humanos , Transtornos Mentais/psicologia
6.
Soins Psychiatr ; 40(323): 29-34, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31402037

RESUMO

Art is used as a form of mediation in care units. In addition to its benefit as an occupational activity, it is rooted in the tangible which can help combat apragmatism and anxiety.While this practice helps patients give meaning to their existence, the group approach and the help of a therapist form part of personalised care projects. Work around the self-portrait is an illustration of this practice, between the occupational and the therapeutic.


Assuntos
Terapia pela Arte/métodos , Transtornos Mentais/terapia , Psicoterapia de Grupo , Autoavaliação , Ansiedade/prevenção & controle , Humanos , Transtornos Mentais/psicologia
7.
Soins Psychiatr ; 40(323): 35-38, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31402038

RESUMO

A plastic arts workshop makes no claims to provide therapeutic benefits. Patients are invited to attend without any clear objectives. This occupational activity soon becomes rooted in the care approach. Supported by the nurse, patients draw on their creativity and express a shared pleasure for artistic production. The story of Cyrille conveys a real journey, a vehicle for mental reconstruction, towards the path of possibilities.


Assuntos
Terapia pela Arte/métodos , Transtornos Mentais/terapia , Criatividade , Humanos , Transtornos Mentais/psicologia , Plásticos , Prazer
8.
Tijdschr Psychiatr ; 61(7): 445-454, 2019.
Artigo em Holandês | MEDLINE | ID: mdl-31372966

RESUMO

BACKGROUND: The more severe the psychiatric illness the more patients are dependent on social support and informal care. However, research showed that patients with severe mental illness (smi) have smaller networks than healthy controls.
AIM: To examine the relationship between network size and perceived social support on the one hand and healthcare consumption on the other.
METHOD: A group of 252 patients who got a crisis consultation in Amsterdam, was divided into patients with and without smi on the basis of two years of observation. Mental healthcare consumption was then measured over a period of three years. Bi- and multivariate analyses were used to determine which variables predict levels of mental healthcare consumption.
RESULTS: Both patient groups did not show any change in level of care consumption during the three follow-up years. In both smi patients and other patients, mental healthcare consumption increased with smaller network size (or 0,85; 95% ci 0,75-0,96). Patients with smi showed a more than threefold higher care consumption compared to non-smi patients (or 3.19; 95% ci 1.82-5.61) independent of network size and living situation.
CONCLUSION: smi patients live in conditions that undermine self-reliance: they have a small social network, they often live alone and they usually depend on welfare benefits. They also consume considerably more care than patients with milder disorders and this level of consumption did not decline during the three years of follow-up. A development of new social interventions will be needed to make this patient group more self-reliant and less dependent on care.


Assuntos
Custos de Cuidados de Saúde , Renda , Transtornos Mentais/psicologia , Isolamento Social , Feminino , Humanos , Masculino , Pessoas Mentalmente Doentes , Países Baixos , Índice de Gravidade de Doença
9.
Behav Sci Law ; 37(4): 452-467, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31355480

RESUMO

Mental health courts (MHCs) use a collaborative justice approach to provide a therapeutic alternative to the traditional justice process for defendants with mental illnesses directly relevant to their alleged criminal offenses. MHCs have proliferated in recent years, in light of early research reports documenting their successes. The aim of this paper is to provide further evaluation of the effects of MHCs by evaluating the impact of the Sacramento County MHC in California. We analyzed quantitative data and conducted interviews with stakeholders and MHC participants to understand how the MHC influenced individual participants' recidivism rates, mental health, and quality of life. Results from the quantitative data analysis indicate that defendants had a lower rate of recidivism after the MHC program than before it. Moreover, graduates were less likely to be rearrested and rehospitalized than non-graduates. Qualitative analyses revealed several core themes regarding participants' views on facilitators and barriers related to the MHC's success. These findings provide further insights into the effectiveness of MHCs.


Assuntos
Criminosos , Transtornos Mentais , Serviços de Saúde Mental , Saúde Mental , Reincidência , California , Criminosos/psicologia , Humanos , Transtornos Mentais/psicologia , Saúde Mental/legislação & jurisprudência , Qualidade de Vida , Comportamento Social , Justiça Social
10.
Prax Kinderpsychol Kinderpsychiatr ; 68(5): 419-437, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31250723

RESUMO

Family Psychiatry - The Attachment-Focused, Systemic-Oriented, Integrative Concept of the Family Therapy Centre (FaTC), an Acute Multi-Family Day Clinic Up to three quarters of the children of mentally ill parents develop a mental disorder during their lifetime. The transmission occurs essentially through dysfunctional interaction and disturbed attachment. Parent-child interaction is characterized by a vicious circle of escalating symptoms in the child and increasing helplessness in the parents. For this family psychiatric approaches are helpful, which address the interaction in addition to the individual disorders. The Family Therapy Centre (FaTC) Neckargemünd offers family psychiatric, integrated therapy for parents and children in an acute day clinic multi-family setting. The basic therapeutic principles are attachment orientation, mentalisation and systemic perspective with a multi-family therapy approach. Typical family psychiatric case constellations are presented, for which the concept seems particularly helpful: (1) Early childhood regulatory disorders in interaction with mentally ill parents, (2) mother with PTSD and expansive-aggressive preschool child and (3) adolescents with separation anxiety and depressive-anxious mother. The previous experiences are reflected by a moderated focus group of the entire FaTC team. The FaTC concept was evaluated as very helpful. It was positively judged that the family system is visibly present on site (and not only virtually). The focus is on interaction, therefore causal therapy can be offered rather than symptomatic treatment. Limitations of the concept are therapy of severely aggressive adolescents or parents who do not want to participate. The concept of the FaTC is currently being scientifically evaluated.


Assuntos
Filho de Pais Incapacitados/psicologia , Terapia Familiar/métodos , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Relações Pais-Filho , Pais/psicologia , Psiquiatria/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Terapia Familiar/organização & administração , Feminino , Grupos Focais , Humanos , Masculino , Psiquiatria/organização & administração
11.
BMC Public Health ; 19(Suppl 4): 544, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196033

RESUMO

BACKGROUND: Mental illness rates among young people is high, yet the frequency of help-seeking is low, especially among those from lower socioeconomic backgrounds. Understanding factors influencing help-seeking, such as mental illness beliefs, stigma and literacy among B40 individuals is important, but past studies are sparse. Hence, we aimed to examine the factors associated with mental help-seeking attitude among students from the B40 income bracket. Differences in beliefs toward mental illness, stigma and help-seeking attitudes among university and secondary school students were also investigated. METHODS: University and secondary school students from low-income households (N = 202) were involved in this cross-sectional study. Participants completed the Depression Literacy Questionnaire (D-Lit), General Help Seeking Questionnaire (GHSQ), Mental Help Seeking Attitudes Scale (MHSAS), Self-Stigma of Seeking Help Scale (SSOSH), and Beliefs toward Mental Illness (BMI). RESULTS: Mental help-seeking attitude had a significant relationship with self-stigma on seeking help (r = -.258, p < .001), general help-seeking attitude (r = .156, p = .027), and age (r = .187, p < .001). However, the strongest predictor for mental help-seeking attitude was self-stigma on seeking help (F (2,199) = 8.207, p < .001 with R2 of .076). University students had better depression literacy and lower levels of self-stigma and negative beliefs toward mental illness compared to secondary school students. CONCLUSION: Higher self-stigma and younger age were associated with negative mental help-seeking attitudes among students from low-income households. As self-stigma may be a barrier to actual mental help-seeking, efforts to reduce self-stigma in this population need to be intensified.


Assuntos
Alfabetização em Saúde , Transtornos Mentais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Estigma Social , Estudantes/psicologia , Adolescente , Atitude Frente a Saúde , Estudos Transversais , Depressão/psicologia , Feminino , Humanos , Malásia , Masculino , Saúde Mental , Instituições Acadêmicas , Inquéritos e Questionários , Universidades , Adulto Jovem
12.
Medicine (Baltimore) ; 98(25): e16110, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31232957

RESUMO

Functional dyspepsia (FD) is a common upper gastrointestinal disorder globally, but the current treatments for FD are still unsatisfactory. This study was aimed at investigating the effects of comfort care on symptoms, gastric motility, and mental state of patients with FD.One hundred consecutive patients with FD treated at the Wuhan Union Hospital (Wuhan, China) between 03/2016 and 02/2018 were randomized to routine nursing and comfort care on the basis of routine nursing (50 patients/group), all for 8 weeks. The primary endpoint was FD symptom score. The secondary endpoint included gastric emptying rate, gastric motility parameters, and depression and anxiety scores. The endpoints were assessed at baseline and after 8 weeks.There were no significant differences between the 2 groups for gender, age, body mass index, types of FD, and course of disease (P > .05). The symptom score in the comfort care group at week 8 was lower than in the routine nursing group (8.3 ±â€Š2.4 vs 10.2 ±â€Š2.4, P < .001). The gastric emptying rate in the comfort care group at week 8 was higher than in the routine nursing group (28.6 ±â€Š5.1 vs 24.3 ±â€Š5.5, P < .001). The fasting and postprandial dominant frequencies of electrogastrogram in the comfort care group at week 8 were higher than in the routine nursing group (1.9 ±â€Š0.9 vs 1.8 ±â€Š1.0, P = .004; 3.1 ±â€Š1.0 vs 2.1 ±â€Š0.9, P < .001). The postprandial dominant power of electrogastrogram in the comfort care group at week 8 was higher than in the routine nursing group (55.7 ±â€Š11.5 vs 42.3 ±â€Š12.5, P < .001). The cases of abnormal electrogastrogram rhythm in the comfort care group at week 8 were significantly less than in the routine nursing group (P = .003). The self-rating depression scale and self-rating anxiety scale in the comfort care group at week 8 were significantly lower than in the routine nursing group (42.5 ±â€Š6.9 vs 47.3 ±â€Š6.4, P = .001; 41.1 ±â€Š7.2 vs 46.3 ±â€Š6.9, P < .001).Comfort care reduces the symptoms of patients with FD, increases gastric emptying rate, improves gastric motility, relieves patient's depression and anxiety, and promotes the rehabilitation of the disease.


Assuntos
Dispepsia/complicações , Motilidade Gastrointestinal/fisiologia , Transtornos Mentais/etiologia , Conforto do Paciente/normas , Adulto , Distribuição de Qui-Quadrado , China , Dispepsia/terapia , Feminino , Esvaziamento Gástrico/fisiologia , Humanos , Masculino , Transtornos Mentais/psicologia , Conforto do Paciente/métodos , Estudos Prospectivos , Estatísticas não Paramétricas
13.
Tijdschr Psychiatr ; 61(6): 375-383, 2019.
Artigo em Holandês | MEDLINE | ID: mdl-31243747

RESUMO

BACKGROUND: In ambulant psychiatric care, intellectual disability (id) is often not recognised. Therefore, a Screener for Intelligence and Learning disabilities (scil) was recently introduced to assist recognition. However, because, current therapy is not adjusted for id-related problems, its effectiveness remains unknown.
AIM: To gain insight into adequate adaptation of interventions by professionals for patients with severe mental illness (smi) and id, to improve the quality of care without the need to develop a completely new program of therapy.
METHOD: A qualitative design (n=15) including 8 interviews and one focus group, among psychiatric practitioners and id experts.
RESULTS: Five main themes were identified to adjust therapy: treatment, communication, inclusion of the network, estimation of support needs and self-management. CONCLUSIONS To align therapy with the requirements of patients with smi and id, a patient-oriented approach to care is necessary. Simple but effective modifications, summarised in a toolkit, appear to contribute to this. To offer appropriate care to patients with smi and id, attention is needed for both a support-oriented and a recovery-oriented approach.


Assuntos
Atitude do Pessoal de Saúde , Deficiência Intelectual/terapia , Transtornos Mentais/terapia , Assistência Centrada no Paciente , Comunicação , Grupos Focais , Humanos , Deficiência Intelectual/epidemiologia , Deficiência Intelectual/psicologia , Programas de Rastreamento , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Assistência Centrada no Paciente/organização & administração , Pesquisa Qualitativa , Índice de Gravidade de Doença
14.
Tijdschr Psychiatr ; 61(5): 326-334, 2019.
Artigo em Holandês | MEDLINE | ID: mdl-31180571

RESUMO

BACKGROUND: Mental health complaints are among the most important causes for drop-out in the of labour market. At the same time, work has a positive influence on people's psychological health.
AIM: To describe and evaluate the integrated approach of specialist mental health care and Employee Insurance Agency (UWV).
METHOD: The integrated approach was evaluated for a group of 15 clients with anxiety and depressive disorders. Experiences with the approach were explored by treatment evaluation reports and semi-structured interviews with clients, practitioners, an insurance physician, a labour expert and several reintegration coaches. The degree of work participation was measured with the Participation Scale and the complaints were measured by regular ROM measurements.
RESULTS: The degree of work participation increased during the integrated approach: 8 clients found an unpaid work experience placement, 2 found a paid job. No indications were found that the approach negatively influenced complaint recovery. The interviews showed that clients felt helped and that they experienced a clearly supportive network of committed professionals.
CONCLUSION: The integrated approach, including work-focused therapy, was evaluated positively by all stakeholders and seems to contribute to work participation.


Assuntos
Comunicação Interdisciplinar , Transtornos Mentais/reabilitação , Retorno ao Trabalho/psicologia , Terapia Cognitivo-Comportamental , Emprego/psicologia , Humanos , Seguro Saúde , Transtornos Mentais/psicologia , Saúde Mental , Países Baixos , Projetos Piloto , Reabilitação Vocacional , Licença Médica
15.
Presse Med ; 48(6): 609-624, 2019 Jun.
Artigo em Francês | MEDLINE | ID: mdl-31151849

RESUMO

The purpose of this article is to describe complex psychiatric disorders, to recall "minimal classical" explorations in psychiatry, to describe the concept of "complex psychiatric disorders" and to propose a systematized method of exploration. Some organic diseases are well known for their links with psychiatric disorders (manic syndrome and hyperthyroidism, depressive syndrome and corticotropic insufficiency, anxiety disorder and heart disease, etc.). Many other neurological, autoimmune, metabolic, paraneoplastic or endocrine pathologies can have essentially psycho-behavioral manifestations before being neurological or systemic. A large number of factors (nutritional, toxic, immunological, etc.), often ignored, influence the links between organicity and psychiatric pathologies. It is necessary to optimize the medical management of these patients in whom the psychiatric diagnosis masks a curable organo-psychiatric cause.


Assuntos
Transtornos Mentais/diagnóstico , Humanos , Transtornos Mentais/complicações , Transtornos Mentais/psicologia
16.
BMC Public Health ; 19(1): 725, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31182064

RESUMO

BACKGROUND: Depression, the world's leading cause of disability, disproportionately affects women. Women in India, one of the most gender unequal countries worldwide, face systemic gender disadvantage that significantly increases the risk of common mental disorders. This study's objective was to examine the factors influencing women's participation in psychosocial support groups, within an approach where community members work together to collectively strengthen their community's mental health. METHODS: This community-based qualitative study was conducted from May to July 2016, across three peri-urban sites in Dehradun district, Uttarakhand, Northern India. Set within an NGO-run mental health project, data were collected through focus group discussions with individuals involved in psychosocial support groups including women with psychosocial disabilities as well as caregivers (N = 10, representing 59 women), and key informant interviews (N = 8) with community members and mental health professionals. Data were analyzed using a thematic analysis approach. RESULTS: The principal barrier to participating in psychosocial support groups was restrictions on women's freedom of movement. Women in the community are not normally permitted to leave home, unless going to market or work, making it difficult for women to leave their home to participate in the groups. The restrictions emanated from the overall community's attitude toward gender relations, the women's own internalized gender expectations, and most significantly, the decision-making power of husbands and mothers-in-law. Other factors including employment and education shaped women's ability to participate in psychosocial support groups; however, the role of these additional factors must be understood in connection to a gender order limiting women's freedom of movement. CONCLUSIONS: Mental health access and gender inequality are inseparable in the context of Northern India, and women's mental health cannot be addressed without first addressing underlying gender relations. Community-based mental health programs are an effective tool and can be used to strengthen communities collectively; however, attention towards the gender constraints that restrict women's freedom of movement and their ability to access care is required. To our knowledge, this is the first study to clearly document and analyze the connection between access to community mental health services in South Asia and women's freedom of movement.


Assuntos
Serviços Comunitários de Saúde Mental/estatística & dados numéricos , Liberdade , Relações Interpessoais , Participação do Paciente/psicologia , Participação Social/psicologia , Adulto , Ásia , Atitude , Tomada de Decisões , Depressão/psicologia , Emprego/psicologia , Família , Feminino , Grupos Focais , Identidade de Gênero , Humanos , Índia , Transtornos Mentais/psicologia , Saúde Mental , Pesquisa Qualitativa , Grupos de Autoajuda , Cônjuges , Saúde da Mulher
17.
BMC Public Health ; 19(1): 702, 2019 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-31174504

RESUMO

BACKGROUND: Social inclusion is a human right for all people, including people with mental illness. It is also an important part of recovery from mental illness. In Timor-Leste, no research has investigated the social experiences of people with mental illness and their families. To fill this knowledge gap and inform ongoing mental health system strengthening, we investigated the experiences of social inclusion and exclusion of people with mental illness and their families in Timor-Leste. METHODS: Eighty-five participants from the following stakeholder groups across multiple locations in Timor-Leste were interviewed: (1) people with mental illness and their families; (2) mental health and social service providers; (3) government decision makers; (4) civil society members; and (5) other community members. Framework analysis was used to analyse interview transcripts. RESULTS: People with mental illness in Timor-Leste were found to face widespread, multi-faceted sociocultural, economic and political exclusion. People with mental illness were stigmatised as a consequence of beliefs that they were dangerous and lacked capacity, and experienced instances of bullying, physical and sexual violence, and confinement. Several barriers to formal employment, educational, social protection and legal systems were identified. Experiences of social inclusion for people with mental illness were also described at family and community levels. People with mental illness were included through family and community structures that promoted unity and acceptance. They also had opportunities to participate in activities surrounding family life and livelihoods that contributed to intergenerational well-being. Some, but not all, Timorese people with mental illness benefited from disability-inclusive programming and policies, including the disability pension, training programs and peer support. CONCLUSIONS: These findings highlight the need to combat social exclusion of people with mental illness and their families by harnessing local Timorese sociocultural strengths. Such an approach could centre around people with mental illness and their families to: increase population mental health awareness; bolster rights-based and culturally-grounded mental health services; and promote inclusive and accessible services and systems across sectors.


Assuntos
Transtornos Mentais/psicologia , Discriminação Social/psicologia , Distância Social , Estigma Social , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Participação dos Interessados/psicologia , Timor-Leste
18.
Z Kinder Jugendpsychiatr Psychother ; 47(4): 345-358, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31099287

RESUMO

Various socioeconomic factors as predictors of internalizing and externalizing disorders in children and adolescents Abstract. Objective: Socioeconomic status (SES) is an important risk factor for psychiatric disorders in children and adolescents. Various SES parameters are included in research efforts. This paper investigates the predictive value of different individual SES measures and the combination thereof regarding internalizing and externalizing disorders in children and adolescents. Method: We used data from N = 381 8- to 14-year-olds who had been recruited in child and adolescent psychiatric facilities and in the general population. Based on a diagnostic parent interview (K-SADS-PL), we divided the sample into internalizing and externalizing groups and a healthy control group. The SES data of both parents were collected. Education, occupational status, and income were integrated as single factors as well as combined factor to form the SES index. Additionally, we assessed unemployment. Results: Using multivariate analyses, we controlled for age and sex. All single factors turned out to be significant risk factors for internalizing and externalizing disorders. Occupational status was the most important single factor. The explained variance for the SES index was as high as for occupational status. Unemployment was not predictive when examined simultaneously with the SES index. Conclusion: Future studies should integrate the SES as risk factor and use the SES index or occupational status as single factor. The integration of unemployment is not necessarily needed.


Assuntos
Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Fatores Socioeconômicos , Adolescente , Criança , Humanos , Transtornos Mentais/economia , Transtornos Mentais/psicologia , Pais/psicologia , Fatores de Risco
19.
BMC Public Health ; 19(1): 651, 2019 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-31138239

RESUMO

BACKGROUND: The HIV/AIDS epidemic continues to threaten the health and wellbeing of millions in the United States and worldwide. Syndemic theory suggests that HIV/AIDS can cooccur with other afflictions. As close to 20% of US adults live with a mental health condition, it is critical to understand the correlation between HIV risk behaviors and mental health needs, as well as protective factors such as social support in intervening the association between mental distress and HIV risk behaviors. Furthermore, as past research has shown mixed results concerning the function of social support on HIV risks by gender, it is important to conduct a gender-specific analysis. METHODS: To assess the relationship between mental health needs, social support, and HIV risk behaviors, and to assess if social support can be a buffer, weakening the effect of mental health needs on HIV risk, in 2018, we analyzed representative, cross-sectional data from 2016 BRFSS collected from 33,705 individuals from four states in the United States, stratified by gender. Weighted logistic regression analyses, adjusted for age, race, marital status, education, and annual income, assessed the correlation between mental health needs, social support, and HIV risk behaviors. Furthermore, interaction analyses were performed to see if social support modifies the slope of mental health needs as a function of HIV risk behaviors. RESULTS: For both genders, the odds of participating in HIV risk behaviors increase with mental health needs and decrease with the level of social support. Furthermore, social support mitigates the association between mental health needs and HIV risk behavior involvement for males, as males receiving high level of social support have least odds of HIV risk behaviors relative to males receiving low level of social support. Notably, for females, social support does not serve as a buffer against HIV risk behaviors when their mental health needs increase. CONCLUSION: The study contributes to the knowledge base of HIV prevention and highlights the important role of mental health and social support against HIV risk behaviors when developing gender-specific prevention strategies.


Assuntos
Infecções por HIV/psicologia , Necessidades e Demandas de Serviços de Saúde , Transtornos Mentais/psicologia , Assunção de Riscos , Apoio Social , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Sistema de Vigilância de Fator de Risco Comportamental , Correlação de Dados , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Fatores Sexuais , Estados Unidos , Adulto Jovem
20.
Nord J Psychiatry ; 73(4-5): 219-228, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31066600

RESUMO

Objective: Misophonia is a neurophysiological disorder, phenotypically characterized by heightened autonomic nervous system arousal which is accompanied by a high magnitude of emotional reactivity to repetitive and pattern-based auditory stimuli. This study identifies the prevalence of psychiatric symptoms in misophonia sufferers, the association between severity of misophonia and psychiatric symptoms, and the association between misophonia severity and gender. Methods: Fifty-two misophonia sufferers, 30 females (mean age = 40.93 ± 15.29) and 22 males (mean age = 51.18 ± 15.91) were recruited in our study and they were diagnosed according the criteria proposed by Schröder et al. The participants were evaluated by the A-MISO-S for the severity of misophonia and the MINI to assess the presence of psychiatric symptoms. Results: The most common comorbid symptoms reported by the misophonia patients were respectively PTSD (N = 8, 15.38%), OCD (N = 6, 11.53%), MDD (N = 5, 9.61%), and anorexia (N = 5, 9.61%). Misophonia severity was associated with the symptoms of MDD, OCD, and PTSD as well as anorexia. There was an indication of a significant difference between men and women in the severity of misophonic symptoms. Conclusion: Our findings highlight the importance of recognizing psychiatric comorbidity among misophonia sufferers. The presence of these varying psychiatric disorders' features in individuals with misophonia suggests that while misophonia has unique clinical characteristics with an underlying neurophysiological mechanism, may be associated with psychiatric symptoms. Therefore, when assessing individuals with misophonia symptoms, it is important to screen for psychiatric symptoms. This will assist researchers and clinicians to better understand the nature of the symptoms and how they may be interacting and ultimately allocating the most effective therapeutic strategies.


Assuntos
Estimulação Acústica/efeitos adversos , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Testes Neuropsicológicos , Transtorno Fonológico/epidemiologia , Transtorno Fonológico/psicologia , Adulto , Idoso , Comorbidade , Feminino , Humanos , Masculino , Transtornos Mentais/diagnóstico , Pessoa de Meia-Idade , Prevalência , Transtorno Fonológico/diagnóstico
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