Depression and Psychological Trauma: An Overview Integrating Current Research and Specific Evidence of Studies in the Treatment of Depression in Public Mental Health Services in Chile

In the last two decades, different research has demonstrated the high prevalence of childhood trauma, including sexual abuse, among depressive women. These findings are associated with a complex, severe, and chronic psychopathology. This can be explained considering the neurobiological changes secondary to early trauma that can provoke a neuroendocrine failure to compensate in response to challenge. It suggests the existence of a distinguishable clinical-neurobiological subtype of depression as a function of childhood trauma that requires specific treatments. Among women with depression and early trauma receiving treatment in a public mental health service in Chile, it was demonstrated that a brief outpatient intervention (that screened for and focused on childhood trauma and helped patients to understand current psychosocial difficulties as a repetition of past trauma) was effective in reducing psychiatric symptoms and improving interpersonal relationships. However, in this population, this intervention did not prevent posttraumatic stress disorder secondary to the extreme earthquake that occurred in February 2010. Therefore in adults with depression and early trauma, it is necessary to evaluate prolonged multimodal treatments that integrate pharmacotherapy, social support, and interpersonal psychotherapies with trauma focused interventions (specific interventions for specific traumas).

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Depression, anxiety symptoms and substance use amongst sex workers attending a non-governmental organisation in KwaZulu-Natal, South Africa

South African Family Practice ◽

10.4102/safp.v59i3.4538 ◽

2017 ◽

Vol 59 (3) ◽

pp. 55

Author(s):

Vinola Poliah ◽

Saeeda Paruk

Keyword(s):

Mental Health ◽

Substance Use ◽

Suicidal Ideation ◽

Sex Workers ◽

Mental Health Problems ◽

Psychiatric Treatment ◽

Psychiatric Symptoms ◽

Anxiety Symptoms ◽

High Prevalence ◽

Self Reporting Questionnaire

Background: Sex work is a high-risk occupation for mental health problems as sex workers are vulnerable to high rates of violence, sexual coercion, stigma and HIV. Aim: To determine the prevalence of depressive and anxiety symptoms and substance use in sex workers.Method: A crosssectional questionnaire survey of all men and women attending the Sisonke health initiative, a non-profit non-governmental organisation (NGO), for sex workers was conducted over three months. A socio-demographic questionnaire, the Self Reporting Questionnaire (SRQ 20), the Patient Health Questionnaire (PHQ 9) and the WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST V3.0) were administered. Results: A total of 155 participants were surveyed. The prevalence of anxiety and depressive symptoms on the SRQ 20 and PHQ 9 total scores were 78.4% and 80.9% respectively. Some 40% of sex workers reported suicidal ideation in the year preceding the study. High rates of violence (n = 112, 72%) and childhood abuse (n = 107, 69%) were reported. The prevalence of HIV was 76.1%. The lifetime prevalence of substance use for nicotine (87.8%), alcohol (87.8%) and cannabis (87.7%) was high. Despite the high prevalence of psychiatric symptoms reported, only 15 (9.7%) participants were receiving psychiatric treatment at the time of the survey. Conclusions: The high prevalence of anxiety, depression, suicidal ideation, substance use and co-morbid HIV infection reported by sex workers and the significant treatment gap suggests an urgent need to provide an integrated health service that targets physical and mental health in sex workers. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2016.1272247

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Cumulative childhood trauma and complex psychiatric symptoms in pregnant women and expecting men

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04327-x ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Julia Garon-Bissonnette ◽

Marie-Ève Grisé Bolduc ◽

Roxanne Lemieux ◽

Nicolas Berthelot

Keyword(s):

Mental Health ◽

Risk Factors ◽

Pregnant Women ◽

Childhood Trauma ◽

Psychiatric Symptoms ◽

Anger Expression ◽

Simultaneous Presentation ◽

Childhood Trauma Questionnaire ◽

Distress Scale ◽

Psychiatric Problems

Abstract Background Women and men having been exposed to childhood trauma would be at high risk of various mental health symptoms while awaiting a child. This study aimed to evaluate the association between cumulative childhood trauma and the accumulation of symptoms belonging to different psychiatric problems in pregnant women and expecting men. Methods We first examined prevalence rates of childhood trauma across our samples of 2853 pregnant women and 561 expecting men from the community. Second, we evaluated the association between cumulative childhood trauma and symptom complexity (i.e., the simultaneous presentation of symptoms belonging to multiple psychiatric problems) using subsamples of 1779 pregnant women and 118 expecting men. Participants completed self-reported measures of trauma (Childhood Trauma Questionnaire) and psychiatric symptoms (PTSD Checklist for DSM-5; Kessler Psychological Distress Scale; State-Trait Anger Expression Inventory-2; Self and Interpersonal Functioning Scale). Results Trauma was more frequent in pregnant women than in expecting men and in participants reporting sociodemographic risk factors than in those not reporting any. A dose-response relationship was observed between the number of different traumas reported by pregnant women and expecting men and the complexity of their psychiatric symptoms, even when controlling for the variance explained by other risk factors. Women having been exposed to cumulative childhood trauma were 4.95 times more at risk of presenting comorbid psychiatric problems during pregnancy than non-exposed women. Conclusions Childhood trauma is frequent in the general population of pregnant women and expecting men and is associated with symptom complexity during the antenatal period. These findings call for delivering and evaluating innovative trauma-informed antenatal programs to support mental health and adaptation to parenthood in adults having been exposed to childhood trauma.

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Evaluating the mental health impacts of the COVID-19 pandemic: perceived risk of COVID-19 infection and childhood trauma predict adult depressive symptoms in urban South Africa

Psychological Medicine ◽

10.1017/s0033291720003414 ◽

2020 ◽

pp. 1-13 ◽

Cited By ~ 4

Author(s):

Andrew Wooyoung Kim ◽

Tawanda Nyengerai ◽

Emily Mendenhall

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Childhood Trauma ◽

Perceived Risk ◽

Mental Healthcare ◽

Public Mental Health ◽

Health Impacts ◽

Psychological Resources ◽

Full Data ◽

Unit Increase

Abstract Background South Africa's national lockdown introduced serious threats to public mental health in a society where one in three individuals develops a psychiatric disorder during their life. We aimed to evaluate the mental health impacts of the COVID-19 pandemic using a mixed-methods design. Methods This longitudinal study drew from a preexisting sample of 957 adults living in Soweto, a major township near Johannesburg. Psychological assessments were administered across two waves between August 2019 and March 2020 and during the first 6 weeks of the lockdown (late March–early May 2020). Interviews on COVID-19 experiences were administered in the second wave. Multiple regression models examined relationships between perceived COVID-19 risk and depression. Results Full data on perceived COVID-19 risk, depression, and covariates were available in 221 adults. In total, 14.5% of adults were at risk for depression. Higher perceived COVID-19 risk predicted greater depressive symptoms (p < 0.001), particularly among adults with histories of childhood trauma, though this effect was marginally significant (p = 0.063). Adults were about two times more likely to experience significant depressive symptoms for every one unit increase in perceived COVID-19 risk (p = 0.021; 95% CI 1.10–3.39). Qualitative data identified potent experiences of anxiety, financial insecurity, fear of infection, and rumination. Conclusions Higher perceived risk of COVID-19 infection is associated with greater depressive symptoms during the first 6 weeks of quarantine. High rates of severe mental illness and low availability of mental healthcare amidst COVID-19 emphasize the need for immediate and accessible psychological resources.

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Validity in Mental Health Surveys

Canadian Psychiatric Association Journal ◽

10.1177/070674376601100303 ◽

1966 ◽

Vol 11 (3) ◽

pp. 167-178 ◽

Cited By ~ 14

Author(s):

Alexander H. Leighton ◽

Dorothea C. Leighton ◽

Robert A. Danley

Keyword(s):

Mental Health ◽

Psychiatric Disorder ◽

Health Surveys ◽

Psychiatric Treatment ◽

Psychiatric Symptoms ◽

Clinical Approach ◽

Psychiatric Case ◽

High Prevalence ◽

The Subject ◽

Symptom Patterns

In recent years a method of conducting mental health surveys has been developed which relies mainly on interviewing individuals according to a questionnaire. Subjects for the surveys are chosen by statistical techniques so that they will be representative of designated populations regardless of whether or not they have ever had psychiatric treatment. The questionnaires are administered by trained interviewers who as a rule are not psychiatrists; the data are later evaluated by psychiatrists who make a series of ratings on each individual in the survey. Inasmuch as surveys of this type show a very high prevalence of psychiatric disorder in many populations (from 10% to 60%), the question of validity becomes a matter of major importance. In the present study 123 individuals were examined and rated independently by both the survey technique and by a psychiatrist employing his usual clinical approach. After the psychiatrist had made his independent rating he was allowed to see the survey data and also to re-examine the subject again if he wished. He then made a final rating constituting his best judgment based on all information available. The degree of agreement is indicated in Tables I to IV. Table I deals with symptom patterns considered without regard to diagnostic implications. Thus, a given individual may have more than one of these symptom patterns. Table II concerns impairment by reason of psychiatric symptoms. Table III deals with a rating as to whether or not the subject is a psychiatric case: ‘A’ means almost certainly a psychiatric disorder of some sort; ‘B’ means probably; ‘C’ means doubtful; and ‘D’ means almost certainly not a psychiatric case. (Note that the group here studied was deliberately weighted with ‘A’ and ‘D’ ratings and hence is not representative of any population.) Table IV summarizes the agreements. While more work is needed, and studies of this kind should be repeated, the results so far show considerable agreement between the survey and clinical methods. This suggests that the large percentage figures obtained by surveys are properly matters of serious concern and that they have far-reaching implications for the teaching and practice of psychiatry.

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“Eventually, I Admitted, ‘I Cannot Do This Alone’”: Exploring Experiences of Suicidality and Help-Seeking Drivers Among Australian Men

Frontiers in Sociology ◽

10.3389/fsoc.2021.727069 ◽

2021 ◽

Vol 6 ◽

Author(s):

Zac E. Seidler ◽

Michael J. Wilson ◽

John L. Oliffe ◽

David Kealy ◽

Nicholas Toogood ◽

...

Keyword(s):

Mental Health ◽

Help Seeking ◽

Public Mental Health ◽

Full Time ◽

Suicidal Thoughts ◽

Qualitative Survey ◽

And Behaviors ◽

Relationship Breakdown ◽

Early Trauma ◽

Suicidal Thoughts And Behaviors

While research has explored the intersection between masculinities and men’s experiences of suicidality, comparatively little attention has been paid to the stories surrounding suicidal men’s decision to seek help. The ways in which men experiencing suicidal thoughts and behaviors embody masculinities alongside their enlistment of mental health services remains largely unknown. The present study explored 262 Australian men’s stories surrounding the impetus for help-seeking for suicidal thoughts and behaviors. The sample comprised men ranging in age from 17 to 74 years (M = 40.99; SD = 15.92 years), with most participants residing in a metropolitan area (55.3%), employed full time (43.1%), non-indigenous (95.4%) and heterosexual (73.7%). Participants elaborated on their reasons for help-seeking via an open-text qualitative survey, delivered as part of a larger study exploring help-seeking experiences of Australian men. Thematic analysis of responses generated four themes highlighting the diversity of experience across men, with some highlighting impacts of emasculating early trauma(s) on their suicidality, while others reflected an impulsiveness tied to situational stressors that fractured their masculine identity (e.g., relationship breakdown; job loss). Many men had epiphanies as they reached the limits of their self-reliance and came to terms with their need for help. As their suicidality was witnessed by—and began to impact—those around them, the sight of their previously masked pain by others often facilitated their help-seeking journey. The present findings underscore the complex and multifactorial role of masculinities in men’s suicidality and their paths to help-seeking. Important inroads for future public mental health promotion efforts are discussed, in terms of leveraging self-reliant and caring masculinities in helping men to develop healthy coping in the context of suicidality.

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Evaluating the Mental Health Impacts of the COVID-19 Pandemic in Urban South Africa: Perceived Risk of COVID-19 Infection and Childhood Trauma Predict Adult Depressive Symptoms

10.1101/2020.06.13.20130120 ◽

2020 ◽

Cited By ~ 6

Author(s):

Andrew Wooyoung Kim ◽

Tawanda Nyengerai ◽

Emily Mendenhall

Keyword(s):

Mental Health ◽

South Africa ◽

Depressive Symptoms ◽

Childhood Trauma ◽

Perceived Risk ◽

Mental Healthcare ◽

Public Mental Health ◽

Health Impacts ◽

Psychological Resources ◽

Full Data

ABSTRACTSouth Africa’s national lockdown introduced serious threats to public mental health in a society where one in three individuals develop a psychiatric disorder during their life. We aimed to evaluate the mental health impacts of the COVID-19 pandemic using a mixed methods design. This longitudinal study drew from a preexisting sample of 957 adults living in Soweto, a major township near Johannesburg. Psychological assessments were administered across two waves: between August 2019-March 2020 and during the first six weeks of the lockdown (late March-early May 2020). Interviews on COVID-19 experiences were administered in the second wave. Multiple regression models examined relationships between perceived COVID-19 risk and depression. Full data on perceived COVID-19 risk, depression, and covariates were available in 221 adults. 14.5% of adults were at risk for depression. Higher perceived COVID-19 risk predicted greater depressive symptoms (p < 0.001) particularly among adults with histories of childhood trauma, though this effect was marginally significant (p = 0.062). Adults were two times more likely to experience significant depressive symptoms for every one unit increase in perceived COVID-19 risk (p = 0.016; 95% CI [1.14, 3.49]). Qualitative data identified potent experiences of anxiety, financial insecurity, fear of infection, and rumination. Higher perceived risk of COVID-19 infection is associated with greater depressive symptoms among adults with histories of childhood trauma during the first six weeks of quarantine. High rates of severe mental illness and low availability of mental healthcare amidst COVID-19 emphasize the need for immediate and accessible psychological resources in South Africa.

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