A Systematic Review of Longitudinal Risk and Protective Factors and Correlates for Posttraumatic Stress and Its Natural History in Forcibly Displaced Children

Background: Posttraumatic stress (PTS) results in significant distress or functional impairment. Prevalence studies report higher rates of PTS in forcibly displaced children (FDC). Current evidence deriving mainly from cross-sectional studies is unable to make causal attributions. Given rising rates of forcible displacement reported by the United Nations High Commissioner for Refugees (UNHCR) in 2014, there is increasing need to determine the best policies and practice for engaging mental health needs of FDC. Methods: This systematic review identifies (1) longitudinal risk and protective factors and correlates for PTS and (2) its natural history in FDC, contributing to research identifying vulnerable subgroups and malleable factors for PTS and understanding its natural history. No meta-analysis was conducted due to heterogeneity; results were analyzed through narrative synthesis. Results: Eleven longitudinal studies were identified. All but one were prospective cohort designs. They identified prevalence rates between 20% and 48.7% at baseline, 10% and 48.3% at 1 year ( k = 7), 18% and 48% at 2–3 years ( k = 2), 8% and 38% at 6 years ( k = 2), and 35% at 12 years using nine measurement methods in seven independent samples. Evidence from multiple associations supported the following risk factors: exposure to traumatic stressors or other stress, older age, and prior psychopathology. Evidence predominantly supported the stability of PTS with some decline. Conclusion: While results should be interpreted with caution given small or unrepresentative samples, they suggest regular mental health screenings should be conducted for FDC, who are a vulnerable subgroup with variable onset and remission. Risk associations with prior psychopathology also suggest that screening upon arrival may be advisable for early intervention and prevention.

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Self-harm and suicidal behaviour in Ghana: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2021-053144 ◽

2021 ◽

Vol 11 (12) ◽

pp. e053144

Author(s):

Emmanuel Nii-Boye Quarshie ◽

Kwaku Oppong Asante ◽

Johnny Andoh-Arthur

Keyword(s):

Mental Health ◽

Systematic Review ◽

Global Health ◽

Protective Factors ◽

Suicide Prevention ◽

Suicidal Behaviour ◽

Observational Studies ◽

Risk And Protective Factors ◽

Prevalence Estimates ◽

Self Harm

IntroductionSelf-harm and suicidal behaviour represent major global health problems, which account for significant proportions of the disease burden in low-income and middle-income countries, including Ghana. This review aims to synthesise the available and accessible evidence on prevalence estimates, correlates, risk and protective factors, the commonly reported methods and reasons for self-harm and suicidal behaviour in Ghana.Methods and analysisWe will conduct a systematic review reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (2009) recommendations. Regional and global electronic databases (African Journals OnLine, African Index Medicus, APA PsycINFO, Global Health, MEDLINE and PubMed) will be searched systematically up to December 2021 for observational studies and qualitative studies that have reported prevalence estimates, correlates, risk and protective factors, methods and reasons for self-harm and suicidal behaviour in Ghana. The electronic database searches will be supplemented with reference harvesting and grey literature searching in Google Scholar and ProQuest Dissertations & Theses Global for postgraduate dissertations. Only records in English will be included. The Mixed Methods Appraisal Tool (2018) will be used to assess the methodological quality of included studies. Meta-analysis or narrative synthesis or both will be used, contingent on the extent of heterogeneity across eligible observational studies.Ethics and disseminationConsidering that this is a systematic review of accessible and available literature, we will not seek ethical approval. On completion, this review will be submitted to a peer-reviewed journal, be disseminated publicly at (mental) health conferences with focus on self-harm and suicide prevention. The important findings would also be shared with key national stakeholder groups in Ghana: Ghana Association for Suicide Prevention, Ghana Mental Health Authority, Ghana Psychological Association, Centre for Suicide and Violence Research, Accra and the Parliamentary Select Committee on Health.Prospero registration numberCRD42021234622.

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A systematic review of risk and protective factors of mental health in unaccompanied minor refugees

European Child & Adolescent Psychiatry ◽

10.1007/s00787-020-01678-2 ◽

2020 ◽

Author(s):

Edgar Höhne ◽

Anna Swantje van der Meer ◽

Inge Kamp-Becker ◽

Hanna Christiansen

Keyword(s):

Mental Health ◽

Protective Factors ◽

Predictive Factors ◽

Mental Health Problems ◽

Risk And Protective Factors ◽

Poor Mental Health ◽

Qualitative Synthesis ◽

Cross Sectional ◽

Unaccompanied Minor Refugees ◽

Minor Refugees

Abstract In recent years, there has been a rising interest in the mental health of unaccompanied minor refugees (UMR), who are a high-risk group for mental disorders. Especially the investigation of predictive factors of the mental health of young refugees has received increasing attention. However, there has been no review on this current issue for the specific group of UMR so far. We aimed to summarize and evaluate the existing findings of specific risk and protective factors to identify the most verified influences on the mental health of UMR. Therefore, we conducted a systematic literature search. Study designs were limited to quantitative cross-sectional and longitudinal designs. Eight databases were searched in four different languages and article reference lists of relevant papers were screened. 27 studies were included (N = 4753). Qualitative synthesis revealed the number of stressful life events to be the most evaluated and verified risk factor for mental health of UMR. A stable environment and social support, on the other hand, can protect UMR from developing poor mental health. Besides that, several other influencing factors could be pointed out, such as type of accommodation, family contact, gender and cultural competences. Because of the large heterogeneity of outcome measures, quantitative synthesis was not possible. This review helps to improve our understanding of determinants of UMRs mental health and thus to provide more targeted treatment. Furthermore, it provides information on how to prevent the development of mental health problems by specifying factors that can be modified by different health and immigration sectors in advance. Further research is needed focusing on the interaction between the various predictive factors.

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Understanding Mental Health in the Context of Adolescent Pregnancy and HIV in Sub-Saharan Africa: A Systematic Review Identifying a Critical Evidence Gap

AIDS and Behavior ◽

10.1007/s10461-020-03138-z ◽

2021 ◽

Author(s):

Kathryn J. Roberts ◽

Colette Smith ◽

Lucie Cluver ◽

Elona Toska ◽

Lorraine Sherr

Keyword(s):

Mental Health ◽

Systematic Review ◽

Mental Disorder ◽

Protective Factors ◽

Adolescent Pregnancy ◽

Common Mental Disorder ◽

Risk And Protective Factors ◽

Sub Saharan Africa ◽

Sub Saharan ◽

Living With Hiv

AbstractAdolescent (10–19 years) mental health remains an overlooked global health issue. Rates of adolescent pregnancy within sub-Saharan Africa are some of the highest in the world and occur at the epicentre of the global HIV epidemic. Both experiencing adolescent pregnancy and living with HIV have been found to be associated with adverse mental health outcomes, when investigated separately. Poor mental health may have implications for both parent and child. The literature regarding mental health within groups experiencing both HIV and adolescent pregnancy is yet to be summarised. This systematic review sought to identify (1) the prevalence/occurrence of common mental disorder amongst adolescents who are living with HIV and have experienced pregnancy, (inclusive of adolescent fathers) in sub-Saharan Africa (2) risk and protective factors for common mental disorder among this group, and (3) interventions (prevention/treatment) for common mental disorder among this group. A systematic search of electronic databases using pre-defined search terms, supplemented by hand-searching, was undertaken in September 2020. One author and an independent researcher completed a title and abstract screening of results from the search. A full-text search of all seemingly relevant manuscripts (both quantitative and qualitative) was undertaken and data extracted using pre-determined criteria. A narrative synthesis of included studies is provided. Quality and risk of bias within included studies was assessed using the Newcastle-Ottawa scale. A systematic keyword search of databases and follow-up hand searching identified 2287 unique records. Of these, thirty-eight full-text quantitative records and seven full-text qualitative records were assessed for eligibility. No qualitative records met the eligibility criteria for inclusion within the review. One quantitative record was identified for inclusion. This study reported on depressive symptomology amongst 14 pregnant adolescents living with HIV in Kenya, identifying a prevalence of 92.9%. This included study did not meet the high methodological quality of this review. No studies were identified reporting on risk and protective factors for common mental disorder, and no studies were found identifying any specific interventions for common mental disorder for this group, either for prevention or for treatment. The limited data identified within this review provides no good quality evidence relating to the prevalence of common mental disorder among adolescents living with HIV who have experienced pregnancy in sub-Saharan Africa. No data was available relating to risk and protective factors or interventions for psychological distress amongst this group. This systematic review identifies a need for rigorous evidence regarding the mental health of pregnant and parenting adolescents living with HIV, and calls for granular interrogation of existing data to further our understanding of the needs of this group. The absence of research on this topic (both quantitative and qualitative) is a critical evidence gap, limiting evidence-based policy and programming responses, as well as regional development opportunities.

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Transdiagnostic Risk and Protective Factors for Psychopathology in Young People: Systematic Review Protocol

JMIR Research Protocols ◽

10.2196/19779 ◽

2020 ◽

Vol 9 (8) ◽

pp. e19779

Author(s):

Samantha Jane Lynch ◽

Matthew Sunderland ◽

Nicola Claire Newton ◽

Cath Chapman

Keyword(s):

Systematic Review ◽

Young People ◽

Protective Factors ◽

Clinical Decision Making ◽

Mental Health Problems ◽

Meta Analysis ◽

Clinical Decision ◽

Risk And Protective Factors ◽

Eligibility Criteria ◽

Cross Sectional

Background Mental and substance use disorders are among the leading causes of burden of disease worldwide, with risk of onset peaking between the ages of 13 and 24 years. Comorbidity is also common among young people and complicates research, diagnosis and assessment, and clinical decision making. There is increasing support for empirically derived models of psychopathology that overcome issues of comorbidity and provide a transdiagnostic framework for investigating the specificity and generality of risk and protective factors for psychopathology. Objective This systematic review aims to identify transdiagnostic risk and protective factors for psychopathology in young people by synthesizing and evaluating findings from research investigating empirically based models of psychopathology. Methods Searches will be conducted in Medline, EMBASE, and PsycINFO databases. Reference lists of selected articles will also be hand searched for other relevant publications. All studies will be screened against eligibility criteria designed to identify studies that examined empirical models of psychopathology in relation to risk and/or protective factors in young people with a mean age between 10 and 24 years. Study quality will be assessed using the Joanna Briggs Institute Critical Appraisal Checklists for Cohort Studies and Analytical Cross-Sectional Studies. Findings will be summarized in a narrative synthesis, and a meta-analysis will be conducted if sufficient data are available. Results This review is ongoing. At the time of submission, full-text screening was completed, and hand searching of selected articles was underway. Results are expected to be completed by the end of 2020. Conclusions This protocol is for a systematic review of evidence for transdiagnostic risk and protective factors associated with empirically based models of psychopathology in young people. To our knowledge, the critical synthesis of this evidence will be the first to date and will provide a better understanding of the factors that contribute to the onset and maintenance of psychopathology in young people. Insights drawn from the review will provide critical new knowledge to improve the targeting of interventions to prevent or reduce mental health problems. Trial Registration This systematic review is registered with PROSPERO (CRD42020161368) and is available via Open Science Framework. International Registered Report Identifier (IRRID) DERR1-10.2196/19779

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Burnout Syndrome in Brazilian Medical Doctors: A Cross-Sectional Examination of Risk and Protective Factors

Frontiers in Health Services ◽

10.3389/frhs.2021.760034 ◽

2021 ◽

Vol 1 ◽

Author(s):

Natalia Dalla Costa Becker ◽

Adilson Carlos da Rocha ◽

Franciele Aní Caovilla Follador ◽

Guilherme Welter Wendt ◽

Lirane Elize Defante Ferreto ◽

...

Keyword(s):

Mental Health ◽

Protective Factors ◽

Maslach Burnout Inventory ◽

Risk And Protective Factors ◽

Cross Sectional Study ◽

Composite Score ◽

Burnout Syndrome ◽

Medical Doctors ◽

Cross Sectional ◽

Convenience Sampling

Objectives: This investigation sought to identify the prevalence of Burnout Syndrome (BS) among Brazilian medical doctors (BS) and the associations with risk factors and protective factors.Methods: Out of 206 registered MD from a medium-sized municipality, 121 were enrolled in this cross-sectional study. Convenience sampling was used. Based on Cohen's f2, a power of 98% and a 0.05 alpha was achieved. MD responded to sociodemographic questions and to the Portuguese-version of the Maslach Burnout Inventory–Human Services Survey (MBI). Risk and protective factors linked with BS were examined with regression analyses.Results: The age of the participants ranged from 25 to 69 years (M = 40.89; SD = 10.13) and 73.6% were male. The prevalence of BS was 7.5%. Differential aspects were related to BS. For instance, while not reporting satisfaction with the institution (β = 16.16, p < 0.001) and not practicing physical exercise (β = 7.39, p = 0.014) were associated with higher scores in the BS composite score, those who did not intend to change their careers (β = −17.15, p < 0.001) and participants who saw mental health specialists (β = −8.99, p = 0.007) scored lower, accounting for nearly a half of the BS composite score (R2 = 46%).Conclusion: The prevalence of BS in this study falls within the range previously reported among healthcare professionals (i.e., 2.6–11.8%). Moreover, data suggested that commitment with the occupation and with the participant's own mental health could boost reactions against the deleterious effects of the BS. In this sense, organizations can develop strategies for preventing BS, a process that is known to be chronic and, to some extent, preventable.

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Prevalence and correlates of loneliness in India: A systematic review

10.31235/osf.io/x4ctz ◽

2020 ◽

Author(s):

Md Mahbub Hossain ◽

Neetu Purohit ◽

Nusrat Khan ◽

E. Lisako J. McKyer ◽

Ping Ma ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

English Language ◽

Meta Analysis ◽

Empirical Studies ◽

The Elderly ◽

Current Evidence ◽

Physical And Mental Health ◽

Prevalence Studies ◽

Factors Associated

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.

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Student Pandemic Experience: Protocol and baseline characteristics for a mobile prospective cohort study of university student mental health (Preprint)

10.2196/preprints.30504 ◽

2021 ◽

Author(s):

Chris Brogly ◽

Michael A. Bauer ◽

Daniel J. Lizotte ◽

MacLean L. Press ◽

Arlene MacDougall ◽

...

Keyword(s):

Public Health ◽

Mental Health ◽

Physical Activity ◽

Health Service ◽

Protective Factors ◽

Service Utilization ◽

Health Service Utilization ◽

Risk And Protective Factors ◽

Cross Sectional ◽

Student Mental Health

BACKGROUND The COVID-19 pandemic is a public health emergency that poses challenges for the mental health of approximately 1.4 million university students in Canada. Preliminary evidence has shown that the COVID-19 pandemic had a detrimental impact on undergraduate student mental health and well-being, however existing data are predominantly limited to cross-sectional survey-based studies. Due to the evolving nature of the pandemic, longer-term prospective surveillance efforts are needed to better anticipate risk and protective factors during a pandemic. OBJECTIVE The overarching aim of this research is to use a mobile surveillance system to identify risk and protective factors for undergraduate mental health. Factors will be identified from weekly self-report data (e.g., affect, living accommodation) and device sensor data (e.g., physical activity, device usage) to prospectively predict self-reported mental health and service utilization. METHODS Undergraduate students at Western University, Canada, will be recruited via e-mail to complete an internet baseline questionnaire with the option to participate in the study on a weekly basis using the Student Pandemic Experience (SPE) mobile application (app) for Android/iOS. The app collects sensor samples (e.g., GPS coordinates, steps) and self-reported weekly mental health and wellness surveys. Student participants can opt-in to link their mobile data with campus-based administrative data capturing health service utilization. Risk and protective factors that predict mental health outcomes are expected to be estimated by 1) cross-sectional associations between student characteristics (e.g., demographics) and key psychosocial factors (e.g., affect, stress, social connection) and behaviors (e.g., physical activity, device usage) and 2) longitudinal associations between psychosocial and behavioral factors and campus-based health service utilization. RESULTS Data collection began November 9th, 2020 and will be ongoing through to at least August 31st, 2021. Retention from the baseline survey (N=427) to app sign-up was 315/427 (74%), with approximately 175-215 (55-68%) of app participants actively responding to weekly surveys. From November 9th, 2020 to May 1st, 2021, 3363 responses to the app surveys and 18914 sensor samples (consisting of up to 68 individual data items each, e.g., GPS coordinates, steps) were collected from the 315 participants that signed up for the app. CONCLUSIONS Identifying risk and resilience factors for student mental health during this public health crisis is critical for informing optimal campus-based strategies and program development during the pandemic and beyond.

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Mental burden and its risk and protective factors during the early phase of the SARS-CoV-2 pandemic: systematic review and meta-analyses

Globalization and Health ◽

10.1186/s12992-021-00670-y ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Angela M. Kunzler ◽

Nikolaus Röthke ◽

Lukas Günthner ◽

Jutta Stoffers-Winterling ◽

Oliver Tüscher ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

General Population ◽

Protective Factors ◽

Early Phase ◽

Healthcare Workers ◽

Meta Analysis ◽

Risk And Protective Factors ◽

Comparative Data ◽

Meta Analyses

Abstract Background Mental burden due to the SARS-CoV-2 pandemic has been widely reported for the general public and specific risk groups like healthcare workers and different patient populations. We aimed to assess its impact on mental health during the early phase by comparing pandemic with prepandemic data and to identify potential risk and protective factors. Methods For this systematic review and meta-analyses, we systematically searched PubMed, PsycINFO, and Web of Science from January 1, 2019 to May 29, 2020, and screened reference lists of included studies. In addition, we searched PubMed and PsycINFO for prepandemic comparative data. Survey studies assessing mental burden by the SARS-CoV-2 pandemic in the general population, healthcare workers, or any patients (eg, COVID-19 patients), with a broad range of eligible mental health outcomes, and matching studies evaluating prepandemic comparative data in the same population (if available) were included. We used multilevel meta-analyses for main, subgroup, and sensitivity analyses, focusing on (perceived) stress, symptoms of anxiety and depression, and sleep-related symptoms as primary outcomes. Results Of 2429 records retrieved, 104 were included in the review (n = 208,261 participants), 43 in the meta-analysis (n = 71,613 participants). While symptoms of anxiety (standardized mean difference [SMD] 0.40; 95% CI 0.15–0.65) and depression (SMD 0.67; 95% CI 0.07–1.27) were increased in the general population during the early phase of the pandemic compared with prepandemic conditions, mental burden was not increased in patients as well as healthcare workers, irrespective of COVID-19 patient contact. Specific outcome measures (eg, Patient Health Questionnaire) and older comparative data (published ≥5 years ago) were associated with increased mental burden. Across the three population groups, existing mental disorders, female sex, and concerns about getting infected were repeatedly reported as risk factors, while older age, a good economic situation, and education were protective. Conclusions This meta-analysis paints a more differentiated picture of the mental health consequences in pandemic situations than previous reviews. High-quality, representative surveys, high granular longitudinal studies, and more research on protective factors are required to better understand the psychological impacts of the SARS-CoV-2 pandemic and to help design effective preventive measures and interventions that are tailored to the needs of specific population groups.

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Prevalence and correlates of loneliness in India: A systematic review

10.31124/advance.11533026 ◽

2020 ◽

Author(s):

Md Mahbub Hossain ◽

Neetu Purohit ◽

Nusrat Khan ◽

E. Lisako J. McKyer ◽

Ping Ma ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

English Language ◽

Meta Analysis ◽

Empirical Studies ◽

The Elderly ◽

Current Evidence ◽

Physical And Mental Health ◽

Prevalence Studies ◽

Factors Associated

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.

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272Transdiagnostic Risk and Protective Factors for Psychopathology in Young People: A systematic review

International Journal of Epidemiology ◽

10.1093/ije/dyab168.406 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Miss Samantha Lynch ◽

Matthew Sunderland ◽

Nicola C Newton ◽

Cath Chapman

Keyword(s):

Mental Health ◽

Systematic Review ◽

Substance Use ◽

Young People ◽

Protective Factors ◽

Substance Use Disorders ◽

Risk And Protective Factors ◽

Mental Health Disorders ◽

Diagnostic Systems ◽

Health Disorders

Abstract Focus of Presentation Mental health and substance use disorders are among the leading causes of burden of disease worldwide. These disorders often emerge during adolescence, with risk of onset peaking between the ages 13 and 24. Despite decades of research, the underlying causes of mental health disorders remain unclear. This in part may be due to limitations of existing, categorical diagnostic systems, such as low specificity demonstrated by the high rates of co-occurring mental health disorders. A growing body of research supports a move towards dimensional, empirically derived models of psychopathology, such as the Hierarchical Taxonomy of Psychopathology (Hi-TOP) model. The present systematic review seeks to identify risk and protective factors for psychopathology in young people that occur across traditional diagnostic categories by synthesising and evaluating findings from research investigating empirically based models of psychopathology. Findings Findings will be summarised in a narrative synthesis and grouped by broad research domain, such as genetic, neurobiological, cognitive social and environmental. Conclusions/Implications The implications of these findings for the development of prevention and early intervention programs will be discussed. Key messages Empirically based models of psychopathology provide a vital opportunity to advance our knowledge of the risk and protective factors for mental health and substance use disorders, and in turn lead to the development or enhancement of prevention programs.

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