scholarly journals The association between income inequality and adult mental health at the subnational level—a systematic review

Author(s):  
Marc S. Tibber ◽  
Fahreen Walji ◽  
James B. Kirkbride ◽  
Vyv Huddy

Abstract Purpose A systematic review was undertaken to determine whether research supports: (i) an association between income inequality and adult mental health when measured at the subnational level, and if so, (ii) in a way that supports the Income Inequality Hypothesis (i.e. between higher inequality and poorer mental health) or the Mixed Neighbourhood Hypothesis (higher inequality and better mental health). Methods Systematic searches of PsycINFO, Medline and Web of Science databases were undertaken from database inception to September 2020. Included studies appeared in English-language, peer-reviewed journals and incorporated measure/s of objective income inequality and adult mental illness. Papers were excluded if they focused on highly specialised population samples. Study quality was assessed using a custom-developed tool and data synthesised using the vote-count method. Results Forty-two studies met criteria for inclusion representing nearly eight million participants and more than 110,000 geographical units. Of these, 54.76% supported the Income Inequality Hypothesis and 11.9% supported the Mixed Neighbourhood Hypothesis. This held for highest quality studies and after controlling for absolute deprivation. The results were consistent across mental health conditions, size of geographical units, and held for low/middle and high income countries. Conclusions A number of limitations in the literature were identified, including a lack of appropriate (multi-level) analyses and modelling of relevant confounders (deprivation) in many studies. Nonetheless, the findings suggest that area-level income inequality is associated with poorer mental health, and provides support for the introduction of social, economic and public health policies that ameliorate the deleterious effects of income inequality. Clinical registration number PROSPERO 2020 CRD42020181507.

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016694 ◽  
Author(s):  
Sareh Zarshenas ◽  
Laetitia Tam ◽  
Angela Colantonio ◽  
Seyed Mohammad Alavinia ◽  
Nora Cullen

IntroductionMany studies have assessed the predictors of morbidity/mortality of patients with traumatic brain injury (TBI) in acute care. However, with the increasing rate of survival after TBI, more attention has been given to discharge destinations from acute care as an important measure of clinical priorities. This study describes the design of a systematic review compiling and synthesising studies on the prognostic factors of discharge settings from acute care in patients with TBI.Methods and analysisThis systematic review will be conducted on peer-reviewed studies using seven databases including Medline/Medline in-Process, Embase, Cochrane Database of Systematic Reviews, Cochrane CENTRAL, PsycINFO, CINAHL and Supplemental PubMed. The reference list of selected articles and Google Scholar will also be reviewed to determine other relevant articles. This study will include all English language observational studies that focus on adult patients with TBI in acute care settings. The quality of articles will be assessed by the Quality in Prognostic Studies tool.Ethics and disseminationThe results of this review will provide evidence that may guide healthcare providers in making more informed and timely discharge decisions to the next level of care for patient with TBI. Also, this study will provide valuable information to address the gaps in knowledge for future research.Trial registration numberTrial registration number (PROSPERO) is CRD42016033046.


Author(s):  
Elisa T. Bushman ◽  
Gabriella Cozzi ◽  
Rachel G. Sinkey ◽  
Catherine H. Smith ◽  
Michael W. Varner ◽  
...  

Abstract Objective Headaches affect 88% of reproductive-aged women. Yet data are limited addressing treatment of headache in pregnancy. While many women experience improvement in pregnancy, primary and secondary headaches can develop. Consequently, pregnancy is a time when headache diagnosis can influence maternal and fetal interventions. This study was aimed to summarize existing randomized control trials (RCTs) addressing headache treatment in pregnancy. Study Design We searched PubMed, CINAHL, EMBASE, ClinicalTrials.gov, Cochrane Library, CINAHL, and SCOPUS from January 1, 1970 through June 31, 2019. Studies were eligible if they were English-language RCTs addressing treatment of headache in pregnancy. Conference abstracts and studies investigating postpartum headache were excluded. Three authors reviewed English-language RCTs addressing treatment of antepartum headache. To be included, all authors agreed each article to meet the following criteria: predefined control group, participants underwent randomization, and treatment of headache occurred in the antepartum period. If inclusion criteria were met no exclusions were made. Our systematic review registration number was CRD42019135874. Results A total of 193 studies were reviewed. Of the three that met inclusion criteria all were small, with follow-up designed to measure pain reduction and showed statistical significance. Conclusion Our systematic review of RCTs evaluating treatment of headache in pregnancy revealed only three studies. This paucity of data limits treatment, puts women at risk for worsening headache disorders, and delays diagnosis placing both the mother and fetus at risk for complications.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e027534 ◽  
Author(s):  
Vincy Chan ◽  
Danielle Toccalino ◽  
Angela Colantonio

IntroductionIn the most populous province of Canada, one in five adults and one in six students report a lifetime history of traumatic brain injury (TBI). These individuals were also more likely to report elevated psychological distress and use illicit substances compared with those without TBI. The need for integrated health services has been recognised globally, yet efforts to develop more comprehensive and effective care for TBI and mental health and/or addictions (MHA) continue to be challenged by the siloing of the two systems. This protocol is for a systematic review that describes the current types of integrated care for TBI and MHA and identifies the barriers and facilitators to integrating healthcare for these populations.Methods and analysisThis review will systematically search MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, Sociological Abstracts, and Dissertations & Theses Global. References of eligible articles will also be searched for additional relevant studies. The search strategy will include the use of text words and subject headings relevant to the concepts ‘TBI,’ ‘substance abuse, gambling, or mental health,’ ‘integrated healthcare,’ ‘barriers and facilitators,’ and ‘healthcare access.’ Two reviewers will independently screen all articles based on predetermined inclusion and exclusion criteria and perform quality assessment on eligible studies. A narrative synthesis will be conducted using the data abstracted by the two reviewers.Ethics and disseminationFindings from the systematic review will be published in peer-reviewed journals, presented at scientific meetings, and summarised for key stakeholders in the field of TBI and/or MHA. This protocol will form a systematic review that holds the potential to impact policy and planning in the development of integrated person-centred care for TBI and MHA and addresses a recognised gap in TBI care.Trial registration numberCRD42018108343


2016 ◽  
Vol 28 (4) ◽  
pp. 379-388 ◽  
Author(s):  
Gillian M. Mulvale ◽  
Tram D. Nguyen ◽  
Ashleigh M. Miatello ◽  
Mark G. Embrett ◽  
Patricia A. Wakefield ◽  
...  

2020 ◽  
Author(s):  
Samia Tasnim ◽  
Nusrat Fahmida Trisha ◽  
Qiping Fan ◽  
Abida Sultana ◽  
Shayla Haque Mishu ◽  
...  

Background:High burden of mental disorders among sexual minorities including lesbian, gay, bisexual, and transgender population is well documented. Digital platforms are increasingly being used by sexual minorities to communicate with each other, but there is no systematic review of digital interventions that can improve mental health among sexual minorities. This systematic review identified and evaluated the digital interventions for mental health among different sexual minorities.Methodology:We searched literature from six major databases and included studies published in the English language, describing interventions that have a component to improve mental health among any of the sexual minorities delivered through any of the digital platforms, and reporting mental health outcomes.Results:Among 1936 citations, only 11 studies fulfilled our criteria. In those studies, most (n=9) interventions were implemented in the U.S. The interventions included varying components including on increasing acceptance and affirmation, increase social support and health education, cognitive behavioral therapy to manage stress, depression, anxiety and other mental health conditions. Only 6 studies had randomized control design. Most of the studies reported reduction in bi/homonegativity and increased affirmation, decreased smoking and substance abuse, improved coping skills, reduced level of depression, anxiety, and stress among participants in the intervention groups.Conclusion:To our knowledge, this is the first systematic review that evaluated digital intervention for mental health among sexual and gender minorities. Despite a low number of studies and heterogeneity across studies, the findings suggest potential improvements in mental health among sexual and gender minorities using digital interventions.


2020 ◽  
Author(s):  
Md Mahbub Hossain ◽  
Neetu Purohit ◽  
Nusrat Khan ◽  
E. Lisako J. McKyer ◽  
Ping Ma ◽  
...  

Introduction: Loneliness is a critical psychosocial problem that affects mental health and wellbeing of the individuals and communities. This systematic review synthesized the current evidence on the prevalence and correlates of loneliness from empirical studies conducted in India.Methods: Adopting the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, eight major databases and additional sources were searched. Studies were evaluated using following criteria: peer-reviewed journal articles, published in English language, presenting any quantitative form of evidence on loneliness, and studies conducted in India among the Indian population. A meta-analysis of the prevalence studies and narrative synthesis of the overall status and factors associated with loneliness were conducted.Results: Among 1290 studies, only 13 met our criteria. All the studies reported a high burden of loneliness among the participants. The pooled prevalence among 3169 participants was 41% (95% confidence interval [CI] 18% - 63%). The burden of loneliness was higher among the elderly participants (44%, 95% CI 5% - 83%) compared to younger participants (24%, 95% CI 22% - 27%). Factors associated with loneliness included aging, family structure, marital status, religious practices, group membership, educational attainment, source and level of income, psychological attributes, and comorbid physical and mental health conditions among the affected individuals. Conclusion: This review identified and evaluated the status and severity of loneliness and its correlates, which may inform future studies examining complex psychopathological and social dynamics associated with loneliness. Lastly, the current evidence necessitates the development of multipronged interventions to address the risk factors and alleviate the burden of loneliness in India.


BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e031857
Author(s):  
Rebecca A Jones ◽  
Emma R Lawlor ◽  
Simon J Griffin ◽  
Esther M F van Sluijs ◽  
Amy L Ahern

IntroductionThe effects of interventions targeting weight loss on physical health are well described, yet the evidence for mental health is less clear. It is essential to better understand the impact of weight management interventions on mental health to optimise care and minimise risk of harm. We will assess the effect of behavioural weight management interventions on mental health in adults with overweight and obesity.Methods and analysisThe systematic review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. We will include behavioural weight management interventions with a diet and/or physical activity component focusing on weight loss for adults with a body mass index ≥25 kg/m2. Randomised controlled trials (RCTs) and cluster RCTs will be the only eligible study designs. Outcomes of interest will be related to mental health. The following databases were searched from inception to 07 May 2019: MEDLINE, Embase, Cochrane database (CENTRAL), PsycINFO, ASSIA, AMED and CINAHL. The search strategy was based on four concepts: (1) adults, defined as ≥18 years, with overweight/obesity, defined as BMI ≥25kg/m², (2) weight management interventions, (3) mental health outcomes and (4) study design. The search was restricted to English-language published papers, with no other restrictions applied. Two stage screening for eligibility will be completed by two independent reviewers, with two independent reviewers completing data extraction and risk of bias assessment. Data permitting, a random-effects meta-analysis of outcomes, subgroup analyses and meta-regression will be conducted. If not appropriate, narrative synthesis and ‘levels of evidence’ assessment will be completed.Ethics and disseminationEthical approval is not required as primary data will not be collected. The completed systematic review will be disseminated in a peer-reviewed journal, at conferences and contribute towards the lead author’s PhD thesis.PROSPERO registration numberCRD42019131659.


2019 ◽  
Vol 21 (7) ◽  
pp. 493-512 ◽  
Author(s):  
Jani Nöthling ◽  
Stefanie Malan-Müller ◽  
Naeemah Abrahams ◽  
Sian Megan Joanna Hemmings ◽  
Soraya Seedat

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e036280
Author(s):  
Akilew A. Adane ◽  
Helen D. Bailey ◽  
Rhonda Marriott ◽  
Brad M. Farrant ◽  
Scott W. White ◽  
...  

IntroductionMaternal mental health disorders such as anxiety and depression are major public health concerns. Evidence shows a link between maternal mental health disorders and preterm birth and low birth weight. However, the impacts of maternal mental health disorders on stillbirth and infant mortality have been less investigated and inconsistent findings have been reported. Thus, using the available literature, we plan to examine whether prenatal maternal mental health disorders impact the risk of stillbirth and infant mortality.Methods and analysisThis systematic review and meta-analysis will adhere to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and will be registered with the International Prospective Register of Systematic Reviews. Systematic searches will be conducted (from database inception to December 2019) in Medline, Embase, PsycINFO and Scopus for studies examining the association of prenatal mental health disorders and stillbirth and infant mortality. The search will be limited to studies published in English language and in humans only, with no restriction on the year of publication. Two independent reviewers will evaluate records and assess the quality of individual studies. The Newcastle–Ottawa scales and GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach will be used to assess the methodological quality and bias of the included studies. In addition to a narrative synthesis, a random-effects meta-analysis will be conducted when sufficient data are available. I2 statistics will be used to assess between-study heterogeneity in the estimated effect size.Ethics and disseminationAs it will be a systematic review and meta-analysis based on previously published evidence, there will be no requirement for ethical approval. Findings will be published in a peer-reviewed journal and will be presented at various conferences.PROSPERO registration number159834.


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