For adults in low- and middle-income countries living with mental disorders, perinatal depression, or post-traumatic stress disorder, what are the effects of lay health worker (LHW)-led interventions?

2021 ◽  
Author(s):  
Jane Burch ◽  
Sujoy Ray
2017 ◽  
Vol 210 (4) ◽  
pp. 247-254 ◽  
Author(s):  
Nexhmedin Morina ◽  
Mina Malek ◽  
Angela Nickerson ◽  
Richard A. Bryant

BackgroundThe majority of survivors of mass violence live in low- and middle-income countries (LMICs).AimsTo synthesise empirical findings for psychological interventions for children and adolescents with post-traumatic stress disorder (PTSD) and/or depression in LMICs affected by mass violence.MethodRandomised controlled trials with children and adolescents with symptoms of PTSD and/or depression in LMICs were identified. Overall, 21812 records were found through July 2016 in the Medline, PsycINFO and PILOTS databases; 21 met the inclusion criteria and were reviewed according to recommended guidelines.ResultsTwenty-one studies were included. Active treatments for PTSD yielded large pre-treatment to post-treatment changes (g = 1.15) and a medium controlled effect size (g = 0.57). Effect sizes were similar at follow-up. Active treatments for depression produced small to medium effect sizes. Finally, after adjustment for publication bias, the imputed uncontrolled and controlled effect sizes for PTSD were medium and small respectively.ConclusionsPsychological interventions may be effective in treating paediatric PTSD in LMICs. It appears that more targeted approaches are needed for depressive responses.


2011 ◽  
Vol 58 (2) ◽  
pp. 209-223 ◽  
Author(s):  
AISLINN MELCHIOR

Post-traumatic stress disorder (PTSD) made its first appearance in the Diagnostic and Statistical Manual of Mental Disorders in 1980, partly as a result of the ongoing treatment of veterans from the Vietnam War. Although PTSD is not only or even primarily a disorder caused by combat, combat is a regular trigger and my chief concern in what follows. Therefore I will not be examining such evidence as exists for the psychological traumas of civilians in the ancient world who were exposed to violence, rape, enslavement, or the execution of family members in the context of conquest. My focus is on the soldier.


Author(s):  
Arieh Y. Shalev ◽  
Anna C. Barbano ◽  
Wei Qi ◽  
Charles R. Marmar

Post-traumatic stress disorder (PTSD) follows an exposure to traumatic events and as such its onset and early development are better charted then those of most other mental disorders. It is not surprising, therefore, that major efforts have been dedicated to preventing its occurrence before, during and after trauma exposure. This chapter discusses the rationale, desirability, feasibility and outcome of interventions designed to prevent PTSD. Several efficient interventions have been documented. Barriers to their early implementations, however, greatly reduce their effectiveness and require urgent attention.


BJPsych Open ◽  
2018 ◽  
Vol 4 (5) ◽  
pp. 361-367
Author(s):  
Derrick Silove ◽  
Susan Rees ◽  
Mohammed Mohsin ◽  
Natalino Tam ◽  
Moses Kareth ◽  
...  

BackgroundFollowing years of controversy, a category of complex post-traumatic stress disorder (CPTSD) will be included in the forthcoming ICD-11.AimsTo test whether refugees with CPTSD differ from those with other common mental disorders (CMDs) in the degree of exposure to childhood adversities, adult interpersonal trauma and post-traumatic hardship.MethodSurvey of 487 West Papuan refugees (response rate 85.5%) in Papua New Guinea.ResultsRefugees with CPTSD had higher exposure to childhood adversities (CPTSD: mean 2.6, 95% CI 2.5–2.7 versus CMD: mean 1.15, 95% CI 1.10–1.20), interpersonal trauma (CPTSD: mean 9, 95% CI 8.6–9.4 versus CMD: mean 5.4, 95% CI 5.4–5.5) and postmigration living difficulties (CPTSD: mean 2.3, 95% CI 2–2.5 versus CMD mean 1.85, 95% CI 1.84–1.86), compared with those with CMDs who in turn exceeded those with no mental disorder on all these indices.ConclusionsThe findings support the cross-cultural validity of CPTSD as a reaction to high levels of exposure to recurrent interpersonal trauma and associated adversities.Declaration of interestNone.


2010 ◽  
Vol 5 (3) ◽  
pp. 181-187 ◽  
Author(s):  
Xu Xiong, MD, DrPH ◽  
Emily W. Harville, PhD ◽  
Donald R. Mattison, MD ◽  
Karen Elkind-Hirsch, PhD ◽  
Gabriella Pridjian, MD ◽  
...  

Objective: Little is known about the effects of disaster exposure and intensity on the development of mental disorders among pregnant women. The aim of this study was to examine the effect of exposure to Hurricane Katrina on mental health in pregnant women.Design: Prospective cohort epidemiological study.Setting: Tertiary hospitals in New Orleans and Baton Rouge, USA.Participants: Women who were pregnant during Hurricane Katrina or became pregnant immediately after the hurricane.Main outcome measures: Post-traumatic stress disorder (PTSD) and depression.Results: The frequency of PTSD was higher in women with high hurricane exposure (13.8 percent) than women without high hurricane exposure (1.3 percent), with an adjusted odds ratio (aOR) of 16.8 (95% confidence interval: 2.6-106.6) after adjustment for maternal race, age, education, smoking and alcohol use, family income, parity, and other confounders. The frequency of depression was higher in women with high hurricane exposure (32.3 percent) than women without high hurricane exposure (12.3 percent), with an aOR of 3.3 (1.6-7.1). Moreover, the risk of PTSD and depression increased with an increasing number of severe experiences of the hurricane.Conclusions: Pregnant women who had severe hurricane experiences were at a significantly increased risk for PTSD and depression. This information should be useful for screening pregnant women who are at higher risk of developing mental disorders after disaster.


2016 ◽  
Vol 47 (2) ◽  
pp. 227-241 ◽  
Author(s):  
E. J. Bromet ◽  
L. Atwoli ◽  
N. Kawakami ◽  
F. Navarro-Mateu ◽  
P. Piotrowski ◽  
...  

BackgroundResearch on post-traumatic stress disorder (PTSD) following natural and human-made disasters has been undertaken for more than three decades. Although PTSD prevalence estimates vary widely, most are in the 20–40% range in disaster-focused studies but considerably lower (3–5%) in the few general population epidemiological surveys that evaluated disaster-related PTSD as part of a broader clinical assessment. The World Mental Health (WMH) Surveys provide an opportunity to examine disaster-related PTSD in representative general population surveys across a much wider range of sites than in previous studies.MethodAlthough disaster-related PTSD was evaluated in 18 WMH surveys, only six in high-income countries had enough respondents for a risk factor analysis. Predictors considered were socio-demographics, disaster characteristics, and pre-disaster vulnerability factors (childhood family adversities, prior traumatic experiences, and prior mental disorders).ResultsDisaster-related PTSD prevalence was 0.0–3.8% among adult (ages 18+) WMH respondents and was significantly related to high education, serious injury or death of someone close, forced displacement from home, and pre-existing vulnerabilities (prior childhood family adversities, other traumas, and mental disorders). Of PTSD cases 44.5% were among the 5% of respondents classified by the model as having highest PTSD risk.ConclusionDisaster-related PTSD is uncommon in high-income WMH countries. Risk factors are consistent with prior research: severity of exposure, history of prior stress exposure, and pre-existing mental disorders. The high concentration of PTSD among respondents with high predicted risk in our model supports the focus of screening assessments that identify disaster survivors most in need of preventive interventions.


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