Prevalence and correlates of depressive disorders in people with Type 2 diabetes: results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET‐DD) study, a collaborative study carried out in 14 countries

Aims To assess the prevalence and management of depressive disorders in people with Type 2 diabetes in different countries. Methods People with diabetes aged 18–65 years and treated in outpatient settings were recruited in 14 countries and underwent a psychiatric interview. Participants completed the Patient Health Questionnaire and the Problem Areas in Diabetes scale. Demographic and medical record data were collected. Results A total of 2783 people with Type 2 diabetes (45.3% men, mean duration of diabetes 8.8 years) participated. Overall, 10.6% were diagnosed with current major depressive disorder and 17.0% reported moderate to severe levels of depressive symptomatology (Patient Health Questionnaire scores >9). Multivariable analyses showed that, after controlling for country, current major depressive disorder was significantly associated with gender (women) (PPPPP<0.0001). The proportion of those with either current major depressive disorder or moderate to severe levels of depressive symptomatology who had a diagnosis or any treatment for their depression recorded in their medical records was extremely low and non-existent in many countries (0–29.6%). Conclusions Our international study, the largest of this type ever undertaken, shows that people with diabetes frequently have depressive disorders and also significant levels of depressive symptoms. Our findings indicate that the identification and appropriate care for psychological and psychiatric problems is not the norm and suggest a lack of the comprehensive approach to diabetes management that is needed to improve clinical outcomes

Prevalence and correlates of depressive disorders in people with Type 2 diabetes: results from the international prevalence and treatment of diabetes and depression (INTERPRET-DD) study, a collaborative study carried out in 14 countries

AIMS: To assess the prevalence and management of depressive disorders in people with Type 2 diabetes in different countries. METHODS: People with diabetes aged 18-65 years and treated in outpatient settings were recruited in 14 countries and underwent a psychiatric interview. Participants completed the Patient Health Questionnaire and the Problem Areas in Diabetes scale. Demographic and medical record data were collected. RESULTS: A total of 2783 people with Type 2 diabetes (45.3% men, mean duration of diabetes 8.8 years) participated. Overall, 10.6% were diagnosed with current major depressive disorder and 17.0% reported moderate to severe levels of depressive symptomatology (Patient Health Questionnaire scores >9). Multivariable analyses showed that, after controlling for country, current major depressive disorder was significantly associated with gender (women) (P<0.0001), a lower level of education (P<0.05), doing less exercise (P<0.01), higher levels of diabetes distress (P<0.0001) and a previous diagnosis of major depressive disorder (P<0.0001). The proportion of those with either current major depressive disorder or moderate to severe levels of depressive symptomatology who had a diagnosis or any treatment for their depression recorded in their medical records was extremely low and non-existent in many countries (0-29.6%). CONCLUSIONS: Our international study, the largest of this type ever undertaken, shows that people with diabetes frequently have depressive disorders and also significant levels of depressive symptoms. Our findings indicate that the identification and appropriate care for psychological and psychiatric problems is not the norm and suggest a lack of the comprehensive approach to diabetes management that is needed to improve clinical outcomes

Mental Health Care in Sub-Saharan Africa: "Opportunities and Challenges" Zone 14

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Severe mental illness at ART initiation is associated with worse retention in care among HIV-infected Ugandan adults

Please help populate SUNScholar with the full text of SU research output. Also - should you need this item urgently, please send us the details and we will try to get hold of the full text as quick possible. E-mail to [email protected]. Thank you.Journal Articles (subsidised)Geneeskunde en GesondheidswetenskappeInterne Geneeskund

Interest, competence, appearance, fitness and social relatedness as motives for physical activity in Ugandan outpatients with psychosis

© 2017 Elsevier Ltd Objective Motivating people with psychosis to meet recommended physical activity levels is a public health priority. It remains unclear whether physical activity motives differ between male and female patients, those with and without cardio-metabolic risks, those who exercise alone versus in group and in aerobic exercise versus resistance training. The aim of this study was to explore differences in PA motives related to several patient characteristics in Ugandan outpatients with psychosis. Methods 48 patients (24♀; 33.3 ± 9.6 years) completed the Motives for Physical Activity Measure – Revised (MPAM-R), Patient-centred Assessment and Counselling for Exercise questionnaire, the Brief Symptoms Inventory - 18 (BSI -18), were asked for their physical activity participation in the last 7 days and screened for abdominal obesity, overweight, hypertension, smoking, medication use and the presence of chronic conditions. Results A multivariate analysis of variance demonstrated main effects for stages of physical activity behavior change (Wilks λ = 0.40, F = 2.98, P = 0.043) and gender (Wilks λ = 0.45, F = 3.45, P = 0.031). There were no interaction effects between stage of change and gender (Wilks λ = 0.35, F = 1.89, P = 0.089). Men scored higher on appearance (P = 0.046) and interest/enjoyment (P = 0.042). Higher (P < 0.05) MPAM-R were observed in action and maintenance behaviour stages versus pre-action stages but there were no differences between the action and maintenance stage. There were no significant correlates between MPAM-R and BSI-18 scores. Conclusions Extrinsic (fitness, appearance, social benefits) and intrinsic (interest, competence) motives are equally important in adopting and maintaining physical activity in people with psychosis. Socio-cultural role patterns should be considered, also in Western settings (e.g., in refugees).status: publishe

Associations of the built environment with physical activity and sedentary time in Ugandan outpatients with mental health problems

BACKGROUND: This study investigated whether reported neighborhood variables explained variance in time spent walking, exercising, and being sedentary, in addition to mental health and demographic variables among Ugandan outpatients with mental illness. METHODS: Ninety-nine outpatients (78 men; 31.1 [8.6] y) of the Butabika National Referral Hospital in Uganda completed the Neighborhood Environment Walkability Scale for Africa, the Simple Physical Activity Questionnaire, and the Brief Symptoms Inventory-18. Multiple regression analyses were performed. RESULTS: Seven percent of the variance in walking time was explained by the variance in anxiety/depression and an additional 13% by the variance in perceived mixed land use and the availability of roads and walking paths. Eight percent of the variance in exercise time was explained by variance in age and an additional 6% by the variance anxiety/depression. The availability of recreational space added 8%. Six percent of variance in time spent sedentary was explained by family income, while availability of roads and walking paths added another 6%. CONCLUSIONS: This study shows the relevance of availability of roads and walking paths and recreational space for more physical activity and less sedentary behavior in people with mental illness. This is particularly relevant in low-income countries where a rapid urbanization is taking place.status: accepte

Adherence to physical activity recommendations and physical and mental health risk in people with severe mental illness in Uganda

This study investigated cardio-metabolic risk factors among patients with severe mental illness who do or do not meet the recommendations of 150 min per week of physical activity. A secondary aim was to assess whether those that do meet the recommendations report lower levels of mental health symptoms. 107 (60♀) Ugandan inand outpatients (mean age=34.4±9.7 years) with severe mental illness (depression=7, bipolar disorder=55, schizophrenia=45) completed the Physical Activity Vital Sign (PAVS) method and Brief Symptoms Inventory −18. Participants were also screened for abdominal obesity (waist circumference>90 cm), overweight (body mass index≥25) and hypertension (systolic pressure≥140 mmHg and/or diastolic pressure≥90 mmHg).48.6% (n = 52) of patients met the physical activity recommendations as assessed by the PAVS method. 41.1% (n = 44) were overweight, 40.2% (n = 43) had abdominal obesity and 23.4% (n = 25) had hypertension. Those who did not meet the physical activity recommendations were significantly older, had a higher BSI-18 somatisation score, and had a higher risk of overweight [relative risk (RR) = 2.88, 95% confidence interval (CI) = 1.59–4.99], abdominal obesity (RR = 1.82, 95%CI = 1.13–2.93), and hypertension (RR = 2.16, 95%CI = 0.99–4.73). The PAVS is a feasible method of assessing physical activity among patients with severe mental illness in a low resource setting. The PAVS may have clinical utility for physical and mental health risk stratification.status: publishe

The INTERPRET-DD study of diabetes and depression: a protocol

Aim People with diabetes are at an increased risk of developing depression and other psychological disorders. However little is known about the prevalence, correlates, or care pathways in countries other than the UK and the US. A new study, the International Prevalence and Treatment of Diabetes and Depression (INTERPRET-DD) Study aims to address this dearth of knowledge and identify optimal pathways to care across the globe. Method INTERPRET-DD is a two-year longitudinal study, taking place in 16 countries’ diabetes out-patients facilities, investigating the recognition and management of depressive disorders in people with type 2 diabetes. Clinical interviews are used to diagnose depression, with clinical and other data obtained from medical records and through patient interviews. Pathways to care and the impact of treatment for previously unrecognised depression on clinical outcomes and emotional well-being are being investigated. Results Initial evidence indicates a range of pathways to care exist, with few of these based on available recommendations for treatment. Pilot data indicates that the instruments we are using to measure both symptoms and clinical diagnosis of depression are acceptable in our study population and easy to use. Conclusions Our study will increase the understanding of the impact of co-morbid diabetes and depression and identify the most appropriate (country specific) pathways via which patients receive their care. It addresses an important public health problem and lead to recommendations for best practice relevant to the different participating centres with regard to the identification and treatment of people with co-morbid diabetes and depression

CINP 2005 Regional Meeting, 20-22 April 2005

List of abstract titles and authors:1. Antipsychotics across the spectrum: An overview of their mechanisms of actionAnissa Abi-Dargham2. Recent advances in the treatment of common anxiety disordersChrister Allgulander3. Psychiatry in Africa: The myths, the realities and the exoticO Gureje4. Mental Health policy developmet in Kenya and Tanznia - A DFID funded projectRachel Jenkins, David Kima, Joseph Mbatia, Frank Njenga5. Vascular factors in Alzheimer's diseaseR N Kalaria6. Depression as an immunologically based Neurodegenerative disorderBrian Leonard7. Eight years of progress in Arican PsychiatryF Njenga8. Treatment of Depression: Present and futureDr R.M. Pinder9. Imaging the Serotinergic system in impulsive aggressive personality disorder patientsLarry J Siever, Antonia S. New, Mari Goodman, Monte Buchsbaum, Erin Hazlett, Karen O'Flynn, Anissa Abi-argham, Marc Lauelle10. Mode of action of Atypical antipsychotic rugs: Focus on A2 AdrnoceptorsT.H. SvenssonNeuroscience: Selected Abstracts11. Chemical odulato of Fronto-execuitive functions: Neropsychiatric implicationsTrevor W Robbins12. Neural mechanisms of recognition memory and of social atacntProf. G Horn13. Estrogen signling after estrogen receptor ß (ERß)Jan-Ake Gustafsson14. Getting Lost: Hippocampal contributions to agerelated memory dysfunctionCarol BarnesMetals and the brain: Selected abstracts15. Modeling the contributin of iron mismanagement to Neurological disordersProf. J R C Connor16. Aluminium-triggered fibrillogenesis of B-AmyloidsProf. PZ Zatta, Dr D Drago, Mr G Tognon, Dr F RicchelliPsychiatry in Africa:17. Psychosocal aspects of Khat use among the youth of NairobiMs T M Khamis18. PTSD among motor vehicle accident survivors, KenyaDr F A Ongecha19. Psychiatric relities within African context - The Kenyan case StudyProf. D M N Ndetei20. Adolescent-parenta interactions from infancy, Nairobi KenyaDr L K Ksakhala, Prof. D M N Ndetei21. Alcohol use ong young persons: A focus group study in Southwest NigeriaO A Obeijide22. Personality disorders and personality traits among tyoe 2 Diabetic patientsProf. O El Rufaie, Dr M Sabosy, Dr M S Abuzeid23. Association of traumatic experiences with depression among Nigerian adolescentsDr O Omigbodun, Dr K BakareMs O B Yusuf, Dr O Esan24. Prevalence of depression among women attending outpatient clinics in MalawiDr M Tugumisirize, Prof. Agn, Dr Musisi25. Non-fatal suicidalbehaviour at the Johannesburg General HospitalDr M Y H Moosa, Prof. F Y Jeenah, Dr A Pillay, Pof. M Vorstere, Dr R Liebenberg26. Integrating mental health into general primary health care - Uganda's experienceDr N Kigozi27. Depression among Nigerian survivors of stroke:Prevalance and associated factorsDr F.O Fatoye Dr M A Komolafe, Dr A. O Adewuya, Dr B.A. Eegunranti Prof. M.A. Lawal28. NGO Involvement mental health care -The way forwardDr Basangwa29. Prevalen of Attenton Deficit Hyperactivity sorder among African school childrenDr E KashalaProf. T Tylleskar, Dr I Elgen, Dr K Sommerfelt30. Barriers to effective mental health care in NigeriaMs L. Kola31. Quay of life evaluation in patients with HIV-I infection with respect to the impact of Phyttherapy (Traditional Herb in Zimbabwe)M B Sebit, S K Chandiwaa, A S Latif, E Gomo, S W Acuda, F Makoni, J Vush