Pain and mental health symptom patterns and treatment trajectories following road trauma: a registry-based cohort study

Abstract Purpose To describe medium-term physical and mental health and social outcomes following adolescent sexual assault, and examine users’ perceived needs and experiences. Method Longitudinal, mixed methods cohort study of adolescents aged 13–17 years recruited within 6 weeks of sexual assault (study entry) and followed to study end, 13–15 months post-assault. Results 75/141 participants were followed to study end (53% retention; 71 females) and 19 completed an in-depth qualitative interview. Despite many participants accessing support services, 54%, 59% and 72% remained at risk for depressive, anxiety and post-traumatic stress disorders 13–15 months post-assault. Physical symptoms were reported more frequently. Persistent (> 30 days) absence from school doubled between study entry and end, from 22 to 47%. Enduring mental ill-health and disengagement from education/employment were associated with psychosocial risk factors rather than assault characteristics. Qualitative data suggested inter-relationships between mental ill-health, physical health problems and disengagement from school, and poor understanding from schools regarding how to support young people post-assault. Baseline levels of smoking, alcohol and ever drug use were high and increased during the study period (only significantly for alcohol use). Conclusion Adolescents presenting after sexual assault have high levels of vulnerability over a year post-assault. Many remain at risk for mental health disorders, highlighting the need for specialist intervention and ongoing support. A key concern for young people is disruption to their education. Multi-faceted support is needed to prevent social exclusion and further widening of health inequalities in this population, and to support young people in their immediate and long-term recovery.

Download Full-text

The COVID-19 pandemic and maternal mental health in a fragile and conflict-affected setting in Tumaco, Colombia: a cohort study

The Lancet Global Health ◽

10.1016/s2214-109x(21)00217-5 ◽

2021 ◽

Author(s):

Andrés Moya ◽

Pieter Serneels ◽

Alethea Desrosiers ◽

Vilma Reyes ◽

María José Torres ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

Maternal Mental Health

Download Full-text

Positive and negative aspects of mental health after unspecified living kidney donation: A cohort study

British Journal of Health Psychology ◽

10.1111/bjhp.12549 ◽

2021 ◽

Author(s):

Emma K. Massey ◽

Mathilde C. Pronk ◽

Willij C. Zuidema ◽

Willem Weimar ◽

Jacqueline Wetering ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

Kidney Donation ◽

Living Kidney Donation

Download Full-text

Relationships with caregivers and mental health outcomes among adolescents living with HIV: a prospective cohort study in South Africa

BMC Public Health ◽

10.1186/s12889-020-10147-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yulia Shenderovich ◽

Mark Boyes ◽

Michelle Degli Esposti ◽

Marisa Casale ◽

Elona Toska ◽

...

Keyword(s):

Mental Health ◽

South Africa ◽

Cohort Study ◽

Mental Health Problems ◽

Health Problems ◽

Sub Saharan Africa ◽

Depression Symptoms ◽

Sub Saharan ◽

Positive Caregiving ◽

Living With Hiv

Abstract Background Mental health problems may impact adherence to anti-retroviral treatment, retention in care, and consequently the survival of adolescents living with HIV. The adolescent-caregiver relationship is an important potential source of resilience. However, there is a lack of longitudinal research in sub-Saharan Africa on which aspects of adolescent-caregiver relationships can promote mental health among adolescents living with HIV. We draw on a prospective longitudinal cohort study undertaken in South Africa to address this question. Methods The study traced adolescents aged 10–19 initiated on antiretroviral treatment in government health facilities (n = 53) within a health district of the Eastern Cape province. The adolescents completed standardised questionnaires during three data collection waves between 2014 and 2018. We used within-between multilevel regressions to examine the links between three aspects of adolescent-caregiver relationships (caregiver supervision, positive caregiving, and adolescent-caregiver communication) and adolescent mental health (depression symptoms and anxiety symptoms), controlling for potential confounders (age, sex, rural/urban residence, mode of infection, household resources), n=926 adolescents. Results Improvements in caregiver supervision were associated with reductions in anxiety (0.98, 95% CI 0.97–0.99, p=0.0002) but not depression symptoms (0.99, 95% CI 0.98–1.00, p=.151), while changes in positive caregiving were not associated with changes in mental health symptoms reported by adolescents. Improvements in adolescent-caregiver communication over time were associated with reductions in both depression (IRR=0.94, 95% CI 0.92–0.97, p<.0001) and anxiety (0.91, 95% CI 0.89–0.94, p<.0001) symptoms reported by adolescents. Conclusions Findings highlight open and supportive adolescent-caregiver communication and good caregiver supervision as potential factors for guarding against mental health problems among adolescents living with HIV in South Africa. Several evidence-informed parenting programmes aim to improve adolescent-caregiver communication and caregiver supervision, and their effect on depression and anxiety among adolescents living with HIV should be rigorously tested in sub-Saharan Africa. How to improve communication in other settings, such as schools and clinics, and provide communication support for caregivers, adolescents, and service providers through these existing services should also be considered.

Download Full-text

Impact of The Daily Mile on children’s physical and mental health, and educational attainment in primary schools: iMprOVE cohort study protocol

BMJ Open ◽

10.1136/bmjopen-2020-045879 ◽

2021 ◽

Vol 11 (5) ◽

pp. e045879

Author(s):

Bina Ram ◽

Anna Chalkley ◽

Esther van Sluijs ◽

Rachel Phillips ◽

Tishya Venkatraman ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Cohort Study ◽

Educational Attainment ◽

Primary School ◽

Primary Schools ◽

Intervention Group ◽

Control Group ◽

Physical And Mental Health ◽

School Year

IntroductionSchool-based active mile initiatives such as The Daily Mile (TDM) are widely promoted to address shortfalls in meeting physical activity recommendations. The iMprOVE Study aims to examine the impact of TDM on children’s physical and mental health and educational attainment throughout primary school.Methods and analysisiMprOVE is a longitudinal quasi-experimental cohort study. We will send a survey to all state-funded primary schools in Greater London to identify participation in TDM. The survey responses will be used for non-random allocation to either the intervention group (Daily Mile schools) or to the control group (non-Daily Mile schools). We aim to recruit 3533 year 1 children (aged 5–6 years) from 77 primary schools and follow them up annually until the end of their primary school years. Data collection taking place at baseline (children in school year 1) and each primary school year thereafter includes device-based measures of moderate-to-vigorous physical activity (MVPA) and questionnaires to measure mental health (Strengths and Difficulties Questionnaire) and educational attainment (ratings from ‘below expected’ to ‘above expected levels’). The primary outcome is the mean change in MVPA minutes from baseline to year 6 during the school day among the intervention group compared with controls. We will use multilevel linear regression models adjusting for sociodemographic data and participation in TDM. The study is powered to detect a 10% (5.5 min) difference between the intervention and control group which would be considered clinically significant.Ethics and disseminationEthics has been approved from Imperial College Research Ethics Committee, reference 20IC6127. Key findings will be disseminated to the public through research networks, social, print and media broadcasts, community engagement opportunities and schools. We will work with policy-makers for direct application and impact of our findings.

Download Full-text

Health of mothers of children with a life-limiting condition: a comparative cohort study

Archives of Disease in Childhood ◽

10.1136/archdischild-2020-320655 ◽

2021 ◽

pp. archdischild-2020-320655

Author(s):

Lorna K Fraser ◽

Fliss EM Murtagh ◽

Jan Aldridge ◽

Trevor Sheldon ◽

Simon Gilbody ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

Secondary Care ◽

Incidence Rates ◽

Health Conditions ◽

Clinical Practice Research Datalink ◽

Physical And Mental Health ◽

Term Condition ◽

Limiting Condition

ObjectiveThis study aimed to quantify the incidence rates of common mental and physical health conditions in mothers of children with a life-limiting condition.MethodsComparative national longitudinal cohort study using linked primary and secondary care data from the Clinical Practice Research Datalink in England. Maternal–child dyads were identified in these data. Maternal physical and mental health outcomes were identified in the primary and secondary care datasets using previously developed diagnostic coding frameworks. Incidence rates of the outcomes were modelled using Poisson regression, adjusting for deprivation, ethnicity and age and accounting for time at risk.ResultsA total of 35 683 mothers; 8950 had a child with a life-limiting condition, 8868 had a child with a chronic condition and 17 865 had a child with no long-term condition.The adjusted incidence rates of all of the physical and mental health conditions were significantly higher in the mothers of children with a life-limiting condition when compared with those mothers with a child with no long-term condition (eg, depression: incidence rate ratio (IRR) 1.21, 95% CI 1.13 to 1.30; cardiovascular disease: IRR 1.73, 95% CI 1.27 to 2.36; death in mothers: IRR 1.59, 95% CI 1.16 to 2.18).ConclusionThis study clearly demonstrates the higher incidence rates of common and serious physical and mental health problems and death in mothers of children with a life-limiting condition. Further research is required to understand how best to support these mothers, but healthcare providers should consider how they can target this population to provide preventative and treatment services.

Download Full-text