Physical injury and psychotic experiences in 48 low- and middle-income countries

2019 ◽  
pp. 1-8 ◽  
Author(s):  
A. Stickley ◽  
T. Sumiyoshi ◽  
Z. Narita ◽  
H. Oh ◽  
J. E. DeVylder ◽  
...  
Keyword(s):  
Mental Health ◽  
Meta Analysis ◽  
World Health ◽  
Multivariable Logistic Regression Analysis ◽  
Psychotic Experiences ◽  
Mental Health Systems ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractBackgroundPsychotic experiences (PEs) may be associated with injuries, but studies focusing specifically on low- and middle-income countries (LAMICs) are scarce. Thus, the current study examined the link between injuries and PEs in a large number of LAMICs.MethodCross-sectional data were used from 242 952 individuals in 48 LAMICs that were collected during the World Health Survey in 2002–2004 to examine the association between traffic-related and other (non-traffic-related) forms of injury and PEs. Multivariable logistic regression analysis and meta-analysis were used to examine associations while controlling for a variety of covariates including depression.ResultsIn fully adjusted analyses, any injury [odds ratio (OR) 2.07, 95% confidence interval (CI) 1.85–2.31], traffic injury (OR 1.84, 95% CI 1.53–2.21) and other injury (OR 2.09, 95% CI 1.84–2.37) were associated with higher odds for PEs. Results from a country-wise analysis showed that any injury was associated with significantly increased odds for PEs in 39 countries with the overall pooled OR estimated by meta-analysis being 2.46 (95% CI 2.22–2.74) with a moderate level of between-country heterogeneity (I2 = 56.3%). Similar results were observed across all country income levels (low, lower-middle and upper-middle).ConclusionsDifferent types of injury are associated with PEs in LAMICs. Improving mental health systems and trauma capacity in LAMICs may be important for preventing injury-related negative mental health outcomes.

scholarly journals Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

2021 ◽  
Vol 18 (5) ◽  
pp. 2439
Author(s):  
Brendon Stubbs ◽  
Kamran Siddiqi ◽  
Helen Elsey ◽  
Najma Siddiqi ◽  
Ruimin Ma ◽  
...  
Keyword(s):  
Health Survey ◽  
Low Income ◽  
World Health ◽  
Low Income Countries ◽  
Multivariable Logistic Regression Analysis ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Low And Middle Income

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

scholarly journals Psychotic experiences and subjective cognitive complaints among 224 842 people in 48 low- and middle-income countries

2018 ◽  
Vol 29 ◽  
Author(s):  
A. Koyanagi ◽  
B. Stubbs ◽  
E. Lara ◽  
N. Veronese ◽  
D. Vancampfort ◽  
...  
Keyword(s):  
Cognitive Deficits ◽  
Sleep Problems ◽  
World Health ◽  
Psychotic Experiences ◽  
Cognitive Complaints ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
Subjective Cognitive Complaints ◽  
Low And Middle Income

Abstract Aims Cognitive deficits are an important factor in the pathogenesis of psychosis. Subjective cognitive complaints (SCCs) are often considered to be a precursor of objective cognitive deficits, but there are no studies specifically on SCC and psychotic experiences (PE). Thus, we assessed the association between SCC and PE using data from 48 low- and middle-income countries. Methods Community-based cross-sectional data of the World Health Survey were analysed. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 to 10 with higher scores representing more severe SCC. The Composite International Diagnostic Interview was used to identify past 12-month PE. Multivariable logistic regression and mediation analyses were performed. Results The final sample consisted of 224 842 adults aged ⩾18 years [mean (SD) age 38.3 (16.0) years; 49.3% males]. After adjustment for sociodemographic factors, a one-unit increase in the SCC scale was associated with a 1.17 (95% CI 1.16–1.18) times higher odds for PE in the overall sample, with this association being more pronounced in younger individuals: age 18–44 years OR = 1.19 (95% CI 1.17–1.20); 45–64 years OR = 1.15 (95% CI 1.12–1.17); ⩾65 years OR = 1.14 (95% CI 1.09–1.19). Collectively, other mental health conditions (perceived stress, depression, anxiety, sleep problems) explained 43.4% of this association, and chronic physical conditions partially explained the association but to a lesser extent (11.8%). Conclusions SCC were associated with PE. Future longitudinal studies are needed to understand temporal associations and causal inferences, while the utility of SCC as a risk marker for psychosis especially for young adults should be scrutinised.

scholarly journals Association between Active School Travel and Depressive Symptoms among 51,702 Adolescents in 26 Low- and Middle-Income Countries

2020 ◽  
Author(s):  
Shu-an Liu ◽  
Si-Tong Chen ◽  
Brendon Stubbs ◽  
Qian Yu ◽  
Mark Griffiths ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Meta Analysis ◽  
Multivariable Logistic Regression Analysis ◽  
School Travel ◽  
Middle Income ◽  
Effective Prevention ◽  
Middle Income Countries ◽  
Active School Travel ◽  
Low And Middle Income

Purpose: Little is known about the role of active school travel (AST) on mental health among adolescents. Thus, this study aimed to explore the association between AST and depressive symptoms among adolescents aged 12-15 yeas from 26 low- and middle-income countries (LMICs).Methods: Data from the Global school-based Student Health Survey were analyzed in 51,702 adolescents [mean (SD) age 13.8 (1.0) years; 49.3% girls). Self-reported measures assessed depressive symptoms during the past 12 months, and AST. Participants reporting yes for depressive symptoms and having 5 or more days for walking or cycling to school were regarded as having depressive symptoms and AST. Multivariable logistic regression analysis was performed and a countrywide meta-analysis undertaken. Results: The prevalence of depressive symptoms and AST were 30.0% and 37.0%, respectively. Compared with those not having AST, adolescents with AST were less likely to have self-reported depressive symptoms (OR = 0.88, 95%CI: 0.85-0.93) regardless of gender. Countrywide meta-analysis demonstrated that having AST versus not having AST was associated with 12% decreased odds for depressive symptoms (OR = 0.88; 95% CI: 0.82-0.94) but with a moderate between-country heterogeneity (I2 = 59.0%). Conclusion: The current study indicates that AST may be an effective prevention against depressive symptoms among adolescents from LMICs. However, when implementing interventions based on AST to reduce depressive symptoms, more country-specific factors should be taken into consideration. Future studies should adopt improved study design to confirm or negate our research findings, which informs public mental health interventions.

Depression and physical health multimorbidity: primary data and country-wide meta-analysis of population data from 190 593 people across 43 low- and middle-income countries

2017 ◽  
Vol 47 (12) ◽  
pp. 2107-2117 ◽  
Author(s):  
B. Stubbs ◽  
D. Vancampfort ◽  
N. Veronese ◽  
K. G. Kahl ◽  
A. J. Mitchell ◽  
...  
Keyword(s):  
Physical Health ◽  
Depressive Episode ◽  
Meta Analysis ◽  
The Philippines ◽  
World Health ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
Subsyndromal Depression ◽  
Low And Middle Income

BackgroundDespite the known heightened risk and burden of various somatic diseases in people with depression, very little is known about physical health multimorbidity (i.e. two or more physical health co-morbidities) in individuals with depression. This study explored physical health multimorbidity in people with clinical depression, subsyndromal depression and brief depressive episode across 43 low- and middle-income countries (LMICs).MethodCross-sectional, community-based data on 190 593 individuals from 43 LMICs recruited via the World Health Survey were analysed. Multivariable logistic regression analysis was done to assess the association between depression and physical multimorbidity.ResultsOverall, two, three and four or more physical health conditions were present in 7.4, 2.4 and 0.9% of non-depressive individuals compared with 17.7, 9.1 and 4.9% among people with any depressive episode, respectively. Compared with those with no depression, subsyndromal depression, brief depressive episode and depressive episode were significantly associated with 2.62, 2.14 and 3.44 times higher odds for multimorbidity, respectively. A significant positive association between multimorbidity and any depression was observed across 42 of the 43 countries, with particularly high odds ratios (ORs) in China (OR 8.84), Laos (OR 5.08), Ethiopia (OR 4.99), the Philippines (OR 4.81) and Malaysia (OR 4.58). The pooled OR for multimorbidity and depression estimated by meta-analysis across 43 countries was 3.26 (95% confident interval 2.98–3.57).ConclusionsOur large multinational study demonstrates that physical health multimorbidity is increased across the depression spectrum. Public health interventions are required to address this global health problem.

scholarly journals Epidemiology of depression with psychotic experiences and its association with chronic physical conditions in 47 low- and middle-income countries

2016 ◽  
Vol 47 (3) ◽  
pp. 531-542 ◽  
Author(s):  
A. Koyanagi ◽  
H. Oh ◽  
B. Stubbs ◽  
J. M. Haro ◽  
J. E. DeVylder
Keyword(s):  
Urban Setting ◽  
World Health ◽  
Published Data ◽  
Psychotic Experiences ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
Physical Conditions ◽  
Chronic Physical Conditions ◽  
Low And Middle Income

BackgroundThe co-existence of depression and psychotic experiences (PEs) is associated with more pronounced adverse health outcomes compared to depression alone. However, data on its prevalence and correlates are lacking in the general adult population, and there is no published data on its association with chronic physical conditions.MethodCross-sectional, community-based data from 201 337 adults aged ⩾18 years from 47 low- and middle-income countries from the World Health Survey were analyzed. The presence of past 12-month PE and DSM-IV depression was assessed with the Composite International Diagnostic Interview (CIDI). Information on six chronic medical conditions (chronic back pain, edentulism, arthritis, angina, asthma, diabetes) were obtained by self-report. Multivariable logistic regression analysis was performed.ResultsThe crude overall prevalence of co-morbid depression/PEs was 2.5% [95% confidence interval (CI) 2.3–2.7%], with the age- and sex-adjusted prevalence ranging from 0.1% (Sri Lanka, Vietnam) to 9.03% (Brazil). Younger age, urban setting, current smoking, alcohol consumption, and anxiety were significant correlates of co-existing depression/PEs. Co-occurring depression/PEs was associated with significantly higher odds for arthritis, angina, and diabetes beyond that of depression alone after adjusting for sociodemographics, anxiety, and country, with odds ratios (depression/PEs v. depression only) being: arthritis 1.30 (95% CI 1.07–1.59, p = 0.0086); angina 1.40 (95% CI 1.18–1.67, p = 0.0002); diabetes 1.65 (95% CI 1.21–2.26, p = 0.0017).ConclusionsThe prevalence of co-existing depression/PEs was non-negligible in most countries. Our study suggests that when depression/PE or a chronic condition (e.g. arthritis, angina, diabetes) is detected, screening for the other may be important to improve clinical outcomes.

scholarly journals Injury and depression among 212 039 individuals in 40 low- and middle-income countries

2019 ◽  
Vol 29 ◽  
Author(s):  
A. Stickley ◽  
H. Oh ◽  
T. Sumiyoshi ◽  
M. McKee ◽  
A. Koyanagi
Keyword(s):  
Mental Health ◽  
Health Survey ◽  
Meta Analysis ◽  
World Health ◽  
Care Providers ◽  
Middle Income ◽  
Middle Income Countries ◽  
Traffic Injury ◽  
The World ◽  
Low And Middle Income

Abstract Aims Although injuries have been linked to worse mental health, little is known about this association among the general population in low- and middle-income countries (LAMICs). This study examined the association between injuries and depression in 40 LAMICs that participated in the World Health Survey. Methods Cross-sectional information was obtained from 212 039 community-based adults on the past 12-month experience of road traffic and other (non-traffic) injuries and depression, which was assessed using questions based on the World Mental Health Survey version of the Composite International Diagnostic Interview. Multivariable logistic regression analysis and meta-analysis were used to examine associations. Results The overall prevalence (95% CI) of past 12-month traffic injury, other injury, and depression was 2.8% (2.6–3.0%), 4.8% (4.6–5.0%) and 7.4% (7.1–7.8%), respectively. The prevalence of traffic injuries [range 0.1% (Ethiopia) to 5.1% (Bangladesh)], and other (non-traffic) injuries [range 0.9% (Myanmar) to 12.1% (Kenya)] varied widely across countries. After adjusting for demographic variables, alcohol consumption and smoking, the pooled OR (95%CI) for depression among individuals experiencing traffic injury based on a meta-analysis was 1.72 (1.48–1.99), and 2.04 (1.85–2.24) for those with other injuries. There was little between-country heterogeneity in the association between either form of injury and depression, although for traffic injuries, significant heterogeneity was observed between groups by country-income level (p = 0.043) where the pooled association was strongest in upper middle-income countries (OR = 2.37) and weakest in low-income countries (OR = 1.46). Conclusions Alerting health care providers in LAMICs to the increased risk of worse mental health among injury survivors and establishing effective trauma treatment systems to reduce the detrimental effects of injury should now be prioritised.

scholarly journals Impact of maternal mental health interventions on child-related outcomes in low- and middle-income countries: a systematic review and meta-analysis

2020 ◽  
Vol 29 ◽  
Author(s):  
W. A. Tol ◽  
M. C. Greene ◽  
M. E. Lasater ◽  
K. Le Roch ◽  
C. Bizouerne ◽  
...  
Keyword(s):  
Mental Health ◽  
Exclusive Breastfeeding ◽  
Home Visiting ◽  
Health Workers ◽  
Maternal Mental Health ◽  
Meta Analysis ◽  
Middle Income ◽  
Middle Income Countries ◽  
Child Height ◽  
Low And Middle Income

Abstract Aims Observational studies have shown a relationship between maternal mental health (MMH) and child development, but few studies have evaluated whether MMH interventions improve child-related outcomes, particularly in low- and middle-income countries. The objective of this review is to synthesise findings on the effectiveness of MMH interventions to improve child-related outcomes in low- and middle-income countries (LMICs). Methods We searched for randomised controlled trials conducted in LMICs evaluating interventions with a MMH component and reporting children's outcomes. Meta-analysis was performed on outcomes included in at least two trials. Results We identified 21 trials with 28 284 mother–child dyads. Most trials were conducted in middle-income countries, evaluating home visiting interventions delivered by general health workers, starting in the third trimester of pregnancy. Only ten trials described acceptable methods for blinding outcome assessors. Four trials showed high risk of bias in at least two of the seven domains assessed in this review. Narrative synthesis showed promising but inconclusive findings for child-related outcomes. Meta-analysis identified a sizeable impact of interventions on exclusive breastfeeding (risk ratio = 1.39, 95% confidence interval (CI): 1.13–1.71, ten trials, N = 4749 mother–child dyads, I2 = 61%) and a small effect on child height-for-age at 6-months (std. mean difference = 0.13, 95% CI: 0.02–0.24, three trials, N = 1388, I2 = 0%). Meta-analyses did not identify intervention benefits for child cognitive and other growth outcomes; however, few trials measured these outcomes. Conclusions These findings support the importance of MMH to improve child-related outcomes in LMICs, particularly exclusive breastfeeding. Given, the small number of trials and methodological limitations, more rigorous trials should be conducted.

scholarly journals Stemming the tide: promoting mental health and preventing mental disorders in low- and middle-income countries

2015 ◽  
Vol 2 ◽  
Author(s):  
W. A. Tol
Keyword(s):  
Mental Health ◽  
Health Promotion ◽  
Mental Disorders ◽  
Global Mental Health ◽  
Action Plan ◽  
Mental Health Promotion ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

The first World Health Organization's global action plan for mental health recognizes the importance of mental health promotion and prevention of mental disorders, through the inclusion of one of four objectives focused on this crucial area of research and practice. This paper aims to provide an ‘aerial view’ of the field of mental health promotion and prevention of mental disorders with a focus on low- and middle-income countries. Starting with reasons why promotion and prevention need to take center stage in global mental health efforts, the paper provides a framework and four general principles to guide such efforts: a socio-ecological perspective (place); an inter-sectoral and interdisciplinary approach (collaboration), a developmental perspective (timing), and a participatory and empowerment approach (strengths), or PaCTS. Evidence-based examples of mental health promotion, universal, selective, and indicated prevention are described.

scholarly journals The potential of low-intensity and online interventions for depression in low- and middle-income countries

2016 ◽  
Vol 3 ◽  
Author(s):  
C. L. H. Bockting ◽  
A. D. Williams ◽  
K. Carswell ◽  
A. E. Grech
Keyword(s):  
Mental Health ◽  
World Health ◽  
Online Interventions ◽  
Treatment Protocols ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Intensity ◽  
The World ◽  
Health Gap ◽  
Low And Middle Income

The World Health Organization (WHO) reports that low- and middle-income countries (LMICs) are confronted with a serious ‘mental health gap’, indicating an enormous disparity between the number of individuals in need of mental health care and the availability of professionals to provide such care (WHO in 2010). Traditional forms of mental health services (i.e. face-to-face, individualised assessments and interventions) are therefore not feasible. We propose three strategies for addressing this mental health gap: delivery of evidence-based, low-intensity interventions by non-specialists, the use of transdiagnostic treatment protocols, and strategic deployment of technology to facilitate access and uptake. We urge researchers from all over the world to conduct feasibility studies and randomised controlled studies on the effect of low-intensity interventions and technology supported (e.g. online) interventions in LMICs, preferably using an active control condition as comparison, to ensure we disseminate effective treatments in LMICs.

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