Association between child asthma control and maternal mental health in Alagoas, Brazil

2017 ◽  
Vol 41 (S1) ◽  
pp. S695-S696
Author(s):  
C. Miranda ◽  
A.D. Costa ◽  
L.M. Dos Santos ◽  
J.A.P.M. Coelho ◽  
M.L. Medeiros

IntroductionMaternal mental health is very important to manage children with chronic health problems.ObjectiveTo evaluate the role of maternal common mental disorders (CMD) in the control of asthma in children by taking the maternal stressful life events (SLE) into account.AimsTo improve the management of childhood asthma by using a psychosocial approach.MethodsCross-sectional study involving mother-asthmatic child dyads assisted in paediatric pulmonology outpatient clinics. To characterize maternal CMD, the Self-report questionnaire (SRQ–20) with cut-off 7/8 was used. The global initiative for asthma control (GINA) questionnaire was used to define controlled and uncontrolled patients. The SLE questionnaire was also used.ResultsTable 1 suggests association between uncontrolled asthma with asthma severity and SLE, and a borderline association between uncontrolled asthma and maternal CMD. Table 2 indicates that, considering all independent variables simultaneously, asthma severity is the only variable statistically significant. It is also possible that with a larger sample size, maternal CMD and SLE would also become statistically significant.ConclusionsThe frequency of uncontrolled asthma is associated with asthma severity and tended to be higher in children whose mothers had CMD and were exposed to SLE.Disclosure of interestThe authors have not supplied their declaration of competing interest.Table 1Crude odd ratios (OR) for the association between asthma control in children, and selected variables (n = 272).Table 2Simultaneous effect of maternal CMD and selected risk factors on asthma control through logistic regression (n = 272).

2020 ◽  
Author(s):  
Aminu Taura Abdullahi ◽  
Zubaida Ladan Farouk ◽  
Abdulazeez Imam

Abstract BackgroundChildren with uncomplicated severe acute malnutrition are managed routinely within out-patient malnutrition treatment programs. These programs do not offer maternal mental health support services, despite maternal mental health playing a significant role in the nutritional status of children. Additionally, the burden of maternal Common Mental Disorders (CMDs) is poorly described among mothers of children attending these programs. This study thus determined the burden and risk factors for maternal CMDs among children attending out-patient malnutrition clinics in rural North-western Nigeria.MethodsWe conducted a cross-sectional study among 204 mothers of children with severe acute malnutrition who attending eight out-patient malnutrition clinics in Jigawa, North-western Nigeria. We used the World Health Organization Self-Reporting Questionnaire-20 (WHO SRQ-20) screening tool, a recognised and validated proxy measure for CMDs to identify mothers with CMDs. The prevalence of maternal CMDs was determined by identifying the proportion of mothers with SRQ scores of ≥8. Risk factors for CMD were determined using multivariable logistic regression. ResultsMaternal CMD prevalence in children attending these facilities was high at 40.7%. Non-receipt of oral polio vaccine (OPV) (AOR 6.23, 95%CI 1.85 to 20.92) increased the odds for CMD. While spousal age above 40 (AOR 0.95, 95%CI 0.90 to 0.99) and long years spent married (AOR 0.92, 95%CI 0.85 to 0.98) decreased the odds for CMD. ConclusionsOur findings indicate maternal CMD burden is high in out-patient malnutrition clinics in North-western Nigeria. Maternal mental health services would need to be integrated into the community management of acute malnutrition programs to provide more holistic care, and possibly improve long-term outcomes after discharge from these programs


2018 ◽  
Vol 23 (2) ◽  
pp. 238-257 ◽  
Author(s):  
Kimberly A Ehntholt ◽  
David Trickey ◽  
Jean Harris Hendriks ◽  
Hannah Chambers ◽  
Mark Scott ◽  
...  

Aim: To investigate whether the mental health of unaccompanied asylum-seeking children (UASC) was negatively affected by having their ages disputed and being detained. Method: Participants within this cross-sectional study were 35 UASC, aged between 13 and 17 when they were detained. Some years later, a team of child mental health professionals interviewed them to assess their current mental health and to determine, as far as possible, the impact that having their age disputed and being detained may have had on their mental health. The Structured Clinical Interview for DSM-IV (SCID-IV), Reactions of Adolescents to Traumatic Stress (RATS), Stressful Life Events (SLE) and Detention Experiences Checklist–UK version (DEC-UK) were administered. Results: The vast majority of UASC reported being negatively affected. Based on diagnostic interviews using the SCID-IV, self-report measures and contemporaneous records, the professionals reported a diagnosis of post-traumatic stress disorder (PTSD) developing in 29% ( n = 10), PTSD exacerbated in 51% ( n = 18), major depressive disorder (MDD) developing in 23% ( n = 8) and MDD exacerbated in 40% ( n = 14). A total of 3 years post-detention, 89% ( n = 31) met diagnostic criteria for psychiatric disorders and reported high PTSD symptoms. Conclusion: There was a high prevalence of psychiatric disorder. The additional stress of age dispute procedures and detention was judged to have been harmful.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aminu T. Abdullahi ◽  
Zubaida L. Farouk ◽  
Abdulazeez Imam

Abstract Background Children with uncomplicated severe acute malnutrition are managed routinely within out-patient malnutrition treatment programs. These programs do not offer maternal mental health support services, despite maternal mental health playing a significant role in the nutritional status of children. Additionally, the burden of maternal Common Mental Disorders (CMDs) is poorly described among mothers of children attending these programs. This study thus determined the burden and risk factors for maternal CMDs among children attending out-patient malnutrition clinics in rural North-western Nigeria. Methods We conducted a cross-sectional study among 204 mothers of children with severe acute malnutrition who attending eight out-patient malnutrition clinics in Jigawa, North-western Nigeria. We used the World Health Organization Self-Reporting Questionnaire-20 (WHO SRQ-20) screening tool, a recognised and validated proxy measure for CMDs to identify mothers with CMDs. The prevalence of maternal CMDs was determined by identifying the proportion of mothers with SRQ scores of ≥8. Risk factors for CMD were determined using multivariable logistic regression. Results Maternal CMD prevalence in children attending these facilities was high at 40.7%. Non-receipt of oral polio vaccine (OPV) (AOR 6.23, 95%CI 1.85 to 20.92) increased the odds for CMD. While spousal age above 40 (AOR 0.95, 95%CI 0.90 to 0.99) and long years spent married (AOR 0.92, 95%CI 0.85 to 0.98) decreased the odds for CMD. Conclusions Our findings indicate maternal CMD burden is high in out-patient malnutrition clinics in North-western Nigeria. Maternal mental health services would need to be integrated into the community management of acute malnutrition programs to provide more holistic care, and possibly improve long-term outcomes after discharge from these programs.


2013 ◽  
Vol 17 (6) ◽  
pp. 1318-1327 ◽  
Author(s):  
Phuong H Nguyen ◽  
Kuntal K Saha ◽  
Disha Ali ◽  
Purnima Menon ◽  
Swetha Manohar ◽  
...  

AbstractObjectiveWe assessed associations of maternal common mental disorders (CMD) with undernutrition and two common illnesses in children aged 0–5 years.DesignCross-sectional survey. Maternal CMD was measured using the WHO Self-Reporting Questionnaire-20. Child undernutrition was defined as stunting, underweight or wasting. Child illnesses included diarrhoea and acute respiratory infections (ARI). Multivariate logistic regression was used to test these associations adjusting for confounders at child, maternal and household levels.SettingBangladesh, Vietnam and Ethiopia.SubjectsMothers with children aged 0–5 years from 4400 households in Bangladesh, 4029 households in Vietnam and 3000 households in Ethiopia.ResultsThe prevalence of maternal CMD was high, ranging from 31 % in Vietnam to 49 % in Bangladesh. Child undernutrition was more prevalent in Bangladesh and Ethiopia than in Vietnam. Symptoms of ARI and diarrhoea were also prevalent. In multivariate analysis, maternal CMD was associated with child stunting in Bangladesh (OR = 1·21; 95 % CI 1·03, 1·41) and with child underweight in Vietnam (OR = 1·27; 95 % CI 1·01, 1·61); no association was found with wasting. Maternal CMD was strongly associated with diarrhoea and ARI in all three countries.ConclusionsMaternal CMD, which affected nearly half of women in Bangladesh and one-third in Vietnam, was an important determinant of child stunting and underweight, respectively. No such association was found in Ethiopia, although CMD affected 39 % of women. Maternal CMD was strongly associated with childhood illnesses in all three countries. Interventions to support maternal mental health are important for women's own well-being and could make important contributions to improving child health and nutrition.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. Caminati ◽  
L. Cegolon ◽  
M. Bacchini ◽  
N. Segala ◽  
A. Dama ◽  
...  

Abstract Background Asthma control and monitoring still represents a challenge worldwide. Although the international guidelines suggest the interplay between secondary and primary care services as an effective strategy to control the disease, community pharmacies’ are seldom involved in asthma control assessment. The present cross-sectional study aimed at providing a picture of the relationship between asthma severity and control in community pharmacies within the health district of the city of Verona (Veneto Region, North-Eastern Italy). Methods A call for participation was launched through the Pharmacists’ Association of Verona. Patients referring to the participating pharmacies with an anti-asthmatic drug medical prescription and an asthma exemption code were asked to complete the Asthma Control Test (ACT) and a brief questionnaire collecting information on their age, sex, smoking status, aerobic physical exercise and usual asthma therapy, which also defined asthma severity. A multinomial logistic regression model was fitted to investigate the risk of uncontrolled as well as poorly controlled vs. controlled asthma (base). Results were expressed as relative risk ratios (RRR) with 95% confidence interval (95%CI). Results Fifty-seven community pharmacies accepted to participate and 584 asthmatic patients (54% females; mean-age: 51 ± 19 years) were consecutively recruited from 1st January to 30th June 2018 (6 months). Based upon ACT score 50.5% patients had a controlled asthma, 22.3% a poorly controlled and 27.2% uncontrolled. A variable proportion of patients with uncontrolled asthma were observed for every level of severity, although more frequently with mild persistent form of asthma. Most patients (92%) self-reported regular compliance with therapy. At multinomial regression analysis, patients under regular asthma treatment course (RRR = 0.33; 95%CI: 0.15; 0.77) were less likely to have an ACT< 16 compared to those not taking medications regularly. Conclusions Overall, our findings highlighted an unsatisfactory asthma control in the general population, independently of the severity level of the disease. Community pharmacies could be a useful frontline interface between patients and the health care services, supporting an effective asthma management plan, from disease assessment and monitoring treatment compliance to referral of patients to specialist medical consultancies.


2021 ◽  
pp. 002076402110025
Author(s):  
Bárbara Almeida ◽  
Ana Samouco ◽  
Filipe Grilo ◽  
Sónia Pimenta ◽  
Ana Maria Moreira

Background: Physicians, including psychiatrists and general practitioners (GPs), have been reported as essential sources of stigma towards people diagnosed with a mental disorder (PDMDs), which constitutes an important barrier to recovery and is associated with poorer clinical outcomes. Therefore, psychiatrists and GPs are key populations where it is crucial to examine stigma, improve attitudes and reduce discrimination towards psychiatric patients. Aims: This study is the first to explore mental health-related stigma among Portuguese psychiatrists and GPs, examining the differences between these two specialities and assessing whether sociodemographic and professional variables are associated with stigma. Method: A cross-sectional study was performed between June 2018 and August 2019. A consecutive sample of 55 Psychiatrists and 67 GPs working in Porto (Portugal) filled a 25-item self-report questionnaire to assess their attitudes towards PDMDs in clinical practice. The instrument was designed by the authors, based on previous mental health-related stigma studies and validated scales. The questionnaire includes 12 stigma dimensions ( Autonomy, Coercion, Incompetence, Dangerousness, Permanence, Pity, Responsibility, Segregation, Labelling, Diagnostic Overshadowing, Shame and Parental Incompetence), and its total score was used to measure Overall Stigma (OS). Sample characteristics were examined using descriptive statistics, and the factors affecting stigma were assessed through regression analysis. Results: GPs exhibit significantly higher OS levels than psychiatrists, and present higher scores in the dimensions of dangerousness, parental incompetence, diagnostic overshadowing and responsibility. Besides medical speciality, several other sociodemographic variables were associated with sigma, including age, gender, having a friend with a mental disorder, professional category, agreement that Psychiatry diverges from core medicine and physician’s interest in mental health topics. Conclusions: Our data suggest that both psychiatrists and GPs hold some degree of stigmatizing attitudes towards PDMDs. Overall, these results bring new light to stigma research, and provide information to tailor anti-stigma interventions to Portuguese psychiatrists and GPs.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahmad N. AlHadi ◽  
Mohammed A. Alarabi ◽  
Khulood M. AlMansoor

Abstract Background The COVID-19 pandemic has had a major impact on people’s lives globally. The outbreak in Saudi Arabia worsened when the number of cases and deaths rose in March and April of 2020, leading to a national lockdown. This study aimed to assess the factors associated with mental health symptoms in a sample of people residing in Saudi Arabia during the COVID-19 pandemic. Methods We conducted an observational cross-sectional study using an online survey distributed via social media, completed by 3032 respondents from all Saudi regions. We collected demographic data, illness history, and scores of validated self-report scales to assess mental health symptoms, intolerance of uncertainty, and coping strategies. Results In total, respondents indicated moderate to very severe symptoms during the pandemic as follows: 20.9% for depression, 17.5% for anxiety, and 12.6% for stress. Younger age, female gender, and history of mental illness were associated with higher levels of depression, anxiety, stress, and insomnia. Intolerance of uncertainty and certain coping strategies (such as denial or self-blame) were associated with more severe symptoms. Conclusions Mental health is a key concern during the COVID-19 pandemic, especially for the identified vulnerable groups. Agencies concerned with mental health during crises may use the studied associated factors of mental health symptoms to generate targeted policies or interventions.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julien Fakhoury ◽  
Claudine Burton-Jeangros ◽  
Liala Consoli ◽  
Aline Duvoisin ◽  
Delphine Courvoisier ◽  
...  

Abstract Background Undocumented migrants live and work in precarious conditions. Few studies have explored the mental health consequences of such environment. The objective of this study is to describe the mental health of migrants at different stages of a regularization program. Methods This cross-sectional study included migrants undocumented or in the process of regularization. We screened for symptoms of anxiety, depression and sleep disturbance using validated tools. We created a composite outcome of altered mental health including these components plus self-report of a recent diagnosis of mental health condition by a health professional. Results We enrolled 456 participants of whom 246 (53.9%) were undocumented. They were predominantly women (71.9%) with a median age of 43.3 (interquartile range: 15.5) years, from Latin America (63.6%) or Asia (20.2%) who had lived in Switzerland for 12 (IQR: 7) years. Overall, 57.2% presented symptoms of altered mental health. Prevalence of symptoms of anxiety, depression and sleep disturbance were 36% (95% confidence interval: 31.6–40.6%), 45.4% (95% CI: 40.8–50.1%) and 23% (95% CI: 19.2–27.2), respectively. Younger age (adjusted odd ratio: 0.7; 95% CI: 0.5–0.9 for each additional decade), social isolation (aOR: 2.4; 95% CI: 1.4–4.2), exposure to abuse (aOR: 1.9; 95% CI: 1.1–3.5), financial instability (aOR: 2.2; 95% CI: 1.4–3.7) and multi-morbidity (aOR: 3.2; 95% CI: 1.7–6.5) were associated with increased risk of having altered mental health while being in the early stages of the process of regularization had no effect (aOR: 1.3: 95% CI: 0.8–2.2). Conclusions This study highlights the need for multi-pronged social and health interventions addressing the various domains of undocumented migrants living difficulties as complement to legal status regularization policies. Protection against unfair working conditions and abuse, access to adequate housing, promoting social integration and preventive interventions to tackle the early occurrence of chronic diseases may all contribute to reduce the burden of altered mental health in this group. More research is needed to assess the long-term impact of legal status regularization on mental health.


Author(s):  
Paul E. Bebbington ◽  
Sally McManus ◽  
Jeremy W. Coid ◽  
Richard Garside ◽  
Terry Brugha

Abstract Purpose Prisoners experience extremely high rates of psychiatric disturbance. However, ex-prisoners have never previously been identified in representative population surveys to establish how far this excess persists after release. Our purpose was to provide the first community-based estimate of ex-prisoners’ mental health in England using the data from the 2014 Adult Psychiatric Morbidity Survey (APMS). Methods APMS 2014 provides cross-sectional data from a random sample (N = 7546) of England’s household population aged 16 or above. Standardised instruments categorised psychiatric disorders and social circumstances. Participants who had been in prison were compared with the rest of the sample. Results One participant in seventy had been in prison (1.4%; 95% CI 1.1–1.7; n = 103). Ex-prisoners suffered an excess of current psychiatric problems, including common mental disorders (CMDs), psychosis, post-traumatic disorder, substance dependence, and suicide attempts. They were more likely to screen positive for attention-deficit/hyperactivity disorder and autistic traits, to have low verbal IQ, and to lack qualifications. They disclosed higher rates of childhood adversity, including physical and sexual abuse and local authority care. The odds (1.88; 95% CI 1.02–3.47) of CMDs were nearly doubled in ex-prisoners, even after adjusting for trauma and current socioeconomic adversity. Conclusions Prison experience is a marker of enduring psychiatric vulnerability, identifying an important target population for intervention and support. Moreover, the psychiatric attributes of ex-prisoners provide the context for recidivism. Without effective liaison between the criminal justice system and mental health services, the vulnerability of ex-prisoners to relapse and to reoffending will continue, with consequent personal and societal costs.


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