Risk and protective factors for drug dependence in two Moroccan high-risk male populations

Background Substance use is linked to biological, environmental, and social factors. This study provides insights on protective and risk factors for drug dependence in two Moroccan, high-risk, male samples. Methods Data from the “Mental and Somatic Health without borders” (MeSHe) survey were utilized in the present study. The MeSHe survey assesses somatic and mental health parameters by self-report from prison inmates (n = 177) and outpatients from an addiction institution (n = 54). The “Drug dependence” and the “No drug dependence” groups were identified based on the Arabic version of the Drug Use Disorder Identification Test’s (DUDIT) validated cutoff for identifying individuals with drug dependence, specifically in Morocco. Results The majority of participants who had at least high school competence (67.6%), were living in a partnership (53.7%), were a parent (43.1%), and/or had a job (86.8%) belonged to the “No drug dependence” group, while the presence of mental health problems was typical among the “Drug dependence” group (47.4%). A multivariable regression model (χ2 (df = 5, N = 156) = 63.90, p < 0.001) revealed that the presence of depression diagnosis remains a significant risk factor, while a higher level of education, having a child, and being employed are protective factors from drug dependence. Discussion Findings support the importance of increasing academic competence and treating depression as prevention from the persistence of drug addiction in male high-risk populations

Major Depression and Family Life - The family's way of living with a long-term illness

The overall aim was to explore the family’s experiences of major depression and the meaning of the illness for family life, for the ill person, the partner and the children. This thesis has a life-world perspective and is a qualitative explorative study using narrative interviews with families with parents who were identified as having major depression MD (Paper I-IV). A case study with a single family (n=3) was performed with a focus on describing what happens and how to manage the illness in a family (I). Group interviews with 7 families (n=18) were conducted to describe the ways of living with MD in families (II). Further, parents (n=8), who were identified as suffering from major depression, representing 8 families were interviewed to elucidate the meaning of depression in family life from the viewpoint of the ill parent (III). Interviews were also conducted with children and young adults (n=8), aged from 6 to 26 years, representing 6 families to elucidate the meaning of a parent’s major depression in family life from the children’s perspective (IV). The interview texts were analysed using qualitative methods; thematic content analysis (I-II) and phenomenological hermeneutic analysis (III-IV). The thesis shows that family members had different views and ways of interpreting and managing the family’s situation when the mother was suffering from major depression (I).The families faced demanding conditions in the presence of illness which they tried to manage together. The families’ situation (fatigue, loss of energy and being burdened with guilt) seemed to bring these families into stressful life situations (II). Depressed parents’ suffering and dignity were revealed as being simultaneously present and complicating family life. Dignity has to be repeatedly restored for oneself and the family, and the family’s dignity has to be restored in front of other outside the family circle (III). Children’s sense of responsibility and loneliness were elucidated. The children’s responsibility includes their striving for reciprocity, and in their loneliness is the children’s yearning for reciprocity. Children compensate with a sense of responsibility for an ill parent in family life and for their lack of health. Children’s family life shifts between responsibility and loneliness as they wait for reciprocity in family life to return to normal (IV). This thesis shows how a study using qualitative methods makes it possible for family members together and individually to talk about major depression as illness that is an intruder in their family life. The thesis elucidates how the depression complicates and involves the family member’s life as well as the ill person’s family life. All family members have their own life-world and try to balance everyday life from an individual perspective, which overshadows that managing the illness is a concern for the whole family

Focus on Every-day Life: Internet-based Support and Coaching for Young Adults with Neuropsychiatric Disorders - A Chat-log Analysis

A FOCUS ON EVERY DAY LIFE: INTERNET-BASED SUPPORT AND COACHING FOR YOUNG ADULTS WITH NEUROPSYCHIATRIC DISORDERS - A CHAT LOG ANALYSIS eCoaching Background Few studies conducting qualitative research regarding treatment, daily living, and need of support for young adults with neuropsychiatric disorders such as ADHD, autism spectrum conditions, and Tourette’s disorder have been published. The objective of this study is to describe how young adults with neuropsychiatric disorders function and manage their everyday life based on chat log analysis. Methods This study is part of a larger intervention project, NP Young Coaching, a structured internet-based support and coaching program for young adults with neuropsychiatric disorders. Twelve young adults between age 15 and 25 years were included in the study. They received coaching during eight weeks over the internet (chat and e-mail) twice a week. The texts composed in the chat sessions constituted the data for the analysis, and the 12 chat logs consisted of 445 pages. Qualitative content analysis was conducted in NVivo 9. The text was divided into meaning units. All the meaning units were labelled with codes which were compared regarding differences and similarities, and thereafter sorted into subthemes and themes. Results Two themes became visible: ‘ways of functioning in everyday life’ with the subthemes; ‘difficult things’, ‘stress and rest’ and ‘when feelings and thoughts are a concern’, and the theme ‘ways of managing everyday life’ with the subthemes; ‘decide and carry out’ and ‘making choices for life’. The young adults described their ways of functioning which showed that they were dealing with difficult things such as being treated unfairly, feeling offended by teachers and peers and being undeservedly accused for behaving egoistically. They also experienced hard words from teasing siblings, friends and parents, which was a source of sorrow. The young adults described that their feelings of stress were caused by being too busy and feeling too unfocused in social situations. Tiredness was the starting point of feeling stressed and led to guilt for not getting things done. The young adults were drained of energy and had serious sleeping problems. Feelings and thoughts were a concern when they were dissatisfied with their bodies, felt obsessive, and felt anxious. Feelings of discomfort were described as a consequence of losing control in personal emotional downturns. Ways of managing everyday life included decisions to plan and following those plans. To enable that, control was important as well as time management. The young adults made choices for life and wanted to succeed. They had high expectations of themselves, and strove for high scores and described distinct ideas about what would be their future profession. Conclusions This study led to a more in-depth knowledge about these young adults’ everyday lives through support and coaching over the Internet, and showed their ability to use the chat for expressing what every-day life meant to them. The implications of the findings are that by using e-coaching for this population, new opportunities are available for health care professionals to acknowledge these young adults’ problems, and online coaching could facilitate the contact between the young adult and the medical and healthcare service

Experiences of an internet-based support and coaching model for adolescents and young adults with ADHD and autism spectrum disorder - a qualitative study

Background: There is a great demand for non-medical treatment and support targeting the needs of adolescents and young adults with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). There is also a lack of qualitative studies providing in-depth insight into these individuals own experiences within this area. The current study aimed to explore how adolescents and young adults with ADHD, ASD or both experienced taking part in an internet-based support and coaching intervention. Methods: Sixteen participants with ASD, ADHD or both who had participated in an 8-week internet-based support and coaching model, were interviewed using semi-structured interviews. Data was analyzed using qualitative content analysis. Results: Analysis yielded three themes; Deciding to participate, Taking part in the coaching process and The significance of format. Various motives for joining were expressed by participants, such as viewing the technology as familiar and appealing and expecting it to be better suited to their situation. There was also a previously unfulfilled need for support among participants. In deciding to take part in the intervention the coaches competence and knowledge were considered essential, often in the light of previously negative experiences. Taking part in the coaching process meant feeling reassured by having someone to turn to in view of shared obstacles to seeking and receiving help. The support was used for talking through and receiving advice on matters related to their diagnosis. Findings further revealed appreciation for aspects relating to the format such as communicating through the written word, being in ones own home and an experience of immediacy. Some disadvantages were voiced including incomplete personal interaction and failing technology. There were also suggestions for greater flexibility. Conclusions: The in-depth qualitative data obtained from this study suggest that the current model of support and the internet-based format have specific qualities that could play an important role in the support of adolescents and young adults with ADHD and ASD. Although not a replacement for face-to-face interaction, it could be a promising complement or alternative to other support and treatment options.Funding Agencies|Health and Medical Care Committee of the Regional Executive Board, Region Vastra Gotaland; Health and Medical Care Committee of the Regional Executive Board, Region Halland; Vardal Institute; Swedish Institute for Health Sciences; Fredrik and Ingrid Thurings Foundation; Department of Health Sciences at University West</p

Internet-Based Support and Coaching With Complementary Clinic Visits for Young People With Attention-Deficit/Hyperactivity Disorder and Autism : Controlled Feasibility Study

Background: Individuals with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) can experience obstacles in traditional health care situations due to difficulties associated with their impairment. Objective: This controlled study aims to investigate the feasibility of an internet-based support and coaching intervention (IBSC), including 2 weekly chat sessions and 2 complementary clinic visits with coaches over the course of 8 weeks, for adolescents and young adults with ADHD and/or ASD in 2 naturalistic routine care settings. Methods: Individuals with ADHD and/or ASD aged 15-32 years were recruited in 2 clinical settings, where they received either IBSC (n=24) or treatment as usual (TAU; n=20). Outcome measures included self-report questionnaires assessing quality of life (Manchester Short Assessment for Quality of Life), sense of coherence (Sense Of Coherence 29), self-esteem (Rosenberg Self-Esteem Scale), and anxiety and depressive symptoms (Hospital Anxiety and Depression Scale [HADS] and Montgomery-Åsberg Depression Rating Scale-Self-reported, respectively). Results: Significant between-group effects were observed in measures of anxiety (HADS) at postintervention (P=.02) as well as at the 6-month follow-up (P=.004). Significant between-group effects were also noted for depressive symptoms (HADS) postintervention (P=.04). The between-group effects were partially explained by a deterioration in the TAU group. A significant increase in self-esteem (P=.04) as well as a decrease in anxiety (P=.003) at the 6-month follow-up was observed in the intervention group following IBSC. Findings from a qualitative study of the intervention are consistent with the results. Conclusions: The findings from this study suggest that IBSC holds promise as a feasible complement or alternative to traditional face-to-face health care meetings

Utveckling av ett nytt yrke inom socialpsykiatrisk vård

The program in Social Psychiatric Care is a three-year program at the university level leading to a vocational qualification in social psychiatric care and a bachelor's degree in the field of Health Sciences. Until the spring of 2018, six litters have graduated. Students in the social psychiatric care program often have personal interest, previous professional experience from the business areas or inspiration from related friends working in the field of activity. Personal experiences of problems in the fields of activity are also prominent among the students. Students believe that personal experience, willingness and ability is important in order to work within the profession. Characteristics of the students are also an interest and a clear empathetic willingness to work with people and they consider that the profession primarily requires characteristics such as altruism, empathy, social skills and deeper knowledge and understanding in the field. Upon completion of education, students want a career role where they can help other people, feel motivated, or they aim for specific positions or areas of activity. Both managers and alumni from the Social Psychiatric Care program value the broad professional competence that the program leads to. Psychiatric competence is emphasized as particularly valuable by both alumni and managers. This competence means that they also complement the other professions in the activities. Students consider themselves possessed a professional identity that involves introducing psychiatric and custody skills to organizations that previously lacked these perspectives. Something that also brings new approaches to patients, users and clients. Being able to use knowledge from several disciplines are considered to be a strength and competence that are well-needed in environments where people with mental ill health are cared for. The alumni perceive their knowledge as both interdisciplinary and interprofessional.Programmet i Socialpsykiatrisk vård är ett treårigt program på högskolenivå som leder till en yrkesexamen inom socialpsykiatrisk vård och en kandidatexamen i huvudområdet Vårdvetenskap. Fram till våren 2018 har sex kullar tagit sin examen. Studenter i programmet för Socialpsykiatrisk vård har ofta ett personligt intresse, tidigare yrkeserfarenhet från verksamhetsområdena eller inspiration från närstående/vänner som arbetar inom verksamhetsområdet. Även personliga erfarenheter av problem inom verksamhetsområdena är framträdande bland studenterna. Studenterna anser att den personliga erfarenheten, viljan och förmågan är viktigt för att kunna verka inom yrket. Utmärkande egenskaper hos studenterna är också ett specifikt intresse och en tydlig empatisk vilja av att arbeta med människor och de anser att yrket framförallt kräver egenskaper som altruism, empati, social kompetens samt en fördjupad kunskap och förståelse inom området. Efter avslutad utbildning önskar studenterna få möjligt till en yrkesroll där de kan hjälpa andra människor, eller så har de sikte på en specifik befattning eller ett speciellt verksamhetsområde. Såväl chefer som alumner från programmet Socialpsykiatrisk vård värdesätter den breda yrkeskompetens som programmet leder till. Den psykiatriska kompetensen betonas som särskilt värdefull av både alumner och chefer. Denna kompetens innebär att de också utgör ett komplement till övriga professioner inom verksamheterna. Studenterna anser sig ha erövrat en professionell identitet som handlar om att föra in psykiatriska och vårdande kunskaper till organisationer som tidigare saknat dessa perspektiv. Något som också medför nya förhållningssätt till patienter, brukare och klienter. Att kunna använda kunskap från flera discipliner anses som en styrka och en kompetens som är välbehövd i miljöer där personer med psykisk ohälsa vårdas. Alumnerna uppfattar sin kunskap som både tvärdisciplinär och interprofessionell

Problematization of perspectives on health promotion and empowerment in mental health nursing – within the research network “MeHNuRse” and the Horatio conference, 2012

Mental illness is increasing worldwide, while a trend towards an ever more specialized health care takes place. This development creates great demands on nurses to work from a holistic perspective of nursing. The health perspective emphasizes cooperation and communication with those who suffer from long-term mental illness, focusing on their independence and health. From a health perspective, every human being is an actor in his/her own life with an inherent ability to make their own choices. However, persons who suffer from long-term mental illness are at risk of losing power and control over areas of their lives and their health. Mental health nurses are in position to support these persons in promoting health and to regain control over their lives. The emphasis of this paper is thus to discuss mental health nurses responsibility to provide health promoting nursing care, through interpretation of the concepts of empowerment, emancipation, self-efficacy and self-management how can mental health nurses work from a health-promoting perspective in relation to these concepts. The focus of this paper is the challenge of real health promotion in mental health nursing discussed at a workshop at the European Horatio festival in Stockholm 2012 with over 600 participating mental health nurses and researchers from European countries. © 2014 P. D. Jönsson et al

Changes in Adolescents’ Psychosocial Functioning and Well-Being as a Consequence of Long-Term COVID-19 Restrictions

This work studied self-reports from adolescents on how the COVID-19 pandemic has changed their behaviors, relationships, mood, and victimization. Data collection was conducted between September 2020 and February 2021 in five countries (Sweden, the USA, Serbia, Morocco, and Vietnam). In total, 5114 high school students (aged 15 to 19 years, 61.8% females) responded to our electronic survey. A substantial proportion of students reported decreased time being outside (41.7%), meeting friends in real life (59.4%), and school performance (30.7%), while reporting increased time to do things they did not have time for before (49.3%) and using social media to stay connected (44.9%). One third of the adolescents increased exercise and felt that they have more control over their life. Only a small proportion of adolescents reported substance use, norm-breaking behaviors, or victimization. The overall COVID-19 impact on adolescent life was gender-specific: we found a stronger negative impact on female students. The results indicated that the majority of adolescents could adapt to the dramatic changes in their environment. However, healthcare institutions, municipalities, schools, and social services could benefit from the findings of this study in their work to meet the needs of those young people who signaled worsened psychosocial functioning, increased stress, and victimization

Mental health profile and its relation with parental alcohol use problems and/or the experience of abuse in a sample of Moroccan high school students : An explorative study

Background: Studies on mental health are scarce from Arab countries, especially studies focusing on adolescents. In addition to the neurobiological and physiological changes that occur during adolescent development, psychological, societal and cultural influences have strong effects on adolescents’ behavior and on their somatic and mental health. The present study aimed (1) to describe the mental health profile, operationalized as psychological distress, of a sample of Moroccan adolescents, and (2) to investigate how specific psychosocial factors (parental alcohol use problems and the experience of physical and/or psychological abuse) may affect adolescents’ mental health. Methods: The sample included 375 adolescents from conveniently selected classes of four high schools in the city of Tetouan in Morocco. The participants responded to an anonymous survey containing, beside other inventories, the Brief Symptom Inventory (BSI) and identified those reporting parental alcohol use problems and/or the previous experience of abuse. The sample characteristics were defined using descriptive statistics. The effects of the defined psychosocial factors were identified using the Kruskal-Wallis test, followed by the post hoc Fisher’s least significant difference test. Results: The most common problems found in high school students from an urban region of Morocco were memory problems, concentration difficulties, restlessness, fear, nervosity and feelings of inadequacy during interpersonal interactions. The female students reported significantly higher psychological distress levels when compared to the male students (p &lt; 0.001). The adolescents reporting parental alcohol use problems and the experience of physical/psychological abuse showed significantly higher levels of psychological distress (p = 0.02), especially symptoms of somatization (p &lt; 0.001), hostility (p = 0.005) and anxiety (p = 0.01), than those not reporting any of these psychosocial factors. Conclusion: The mental health profile of female adolescents from an urban area of Morocco is worse than that of their male fellow students. Adolescents reporting parental alcohol use problems and/or the experience of physical/psychological abuse need synchronized support from social- A nd healthcare services. © 2019 The Author(s)