Psychological distress among mothers of young children in rural Ghana and Uganda and its association with child health and nutritional status

Depression and anxiety, the most common mental disorders (CMD), are highly prevalent among women of childbearing age, but are even higher among mothers in low- and middle-income countries (LMIC), possibly due to mothers' disproportionate exposure to multiple risk factors, such as poverty, gender disparities and violence, and a high prevalence of medical illness. The extra burden imposed by maternal CMD in LMIC can be nothing short of catastrophic, affecting infant and child growth and leading to preventable illness and death among children. One possible mechanism, by which maternal CMD lead to compromised child development, is through negatively affecting mothers' health-promoting behaviors (e.g., contraceptive use, participation in antenatal care) and child-care practices (e.g., vaccination uptake, cessation of breastfeeding, sanitation practices). The aim of this study was three-fold. First, to assess psychological distress among mothers of young children (aged 0-5 years) as measured by the Kessler 6 (K6), a brief screening instrument for nonspecific psychological distress in Ghana and Uganda. Second, to identify sociodemographic, socioeconomic, obstetric, and psychosocial correlates of maternal psychological distress in Ghana and Uganda. Third, to explore the relationship between maternal psychological distress, child health-promoting practices, and child health outcomes and nutritional status. The study utilized cross-sectional baseline data from the Millennium Villages Project. One hundred mothers in Ghana and 100 in Uganda who had at least one child up to 5 years at the time of baseline collection participated in the study. Results provided evidence for the adequate reliability and validity of the K6 in our study. Several correlates of maternal distress were identified in the study, some of which were common for both sites, while others where site-specific. Maternal distress was associated with maternal sanitation practices in Uganda. An exploratory analysis revealed a significant relationship between maternal distress and risk for child undernutrition. These findings offer partial support for the relationship between maternal psychological distress and poor child health outcomes. Discussion of the study findings focuses on the social roots of maternal distress in SSA. The clinical implications of the study and recommendations for future research are discussed

Psychological Interventions for Young People With Psychotic Disorders : A Systematic Review

Publisher Copyright: Copyright © 2022 Gergov, Milic, Löffler-Stastka, Ulberg, Vousoura and Poulsen.Background: Psychotic disorders are commonly accompanied by intense psychological burden, and psychological interventions are usually needed in order to reduce the symptoms and help in maintaining or improving the level of psychological and social functioning after the onset of psychosis. The evidence-base for treating young people at risk for psychosis and adults with psychotic disorders is accumulating. Yet, pervasive systematic literature reviews that would include patients from the full age range being the most essential period for the risk of developing a psychotic disorder, a wide range of psychological interventions, and various types of clinical trials, have been lacking. The aim of this systematic review is to fill the gap by presenting the current research evidence from clinical trials on the effectiveness of psychological interventions for treating young people (12–30) with psychotic disorders. Methods: A systematic search was conducted in PubMed and PsycINFO followed by a 3-step screening process based on the PICOS strategy. Risk of bias of the included studies was assessed by the Mixed Methods Appraisal Tool (MMAT). Extracted data from the included studies is reported using a narrative synthesis. Results: Of the 1,449 publications screened, 40 from 25 studies were included in the review. Of these, 10 studies reported results from cognitive or behavioral therapy, nine from cognitive remediation therapy (CRT), and six from other types of therapies (i.e., integrative interventions combining psychoeducation and family/group interventions). All but one study found the target interventions to be effective, but the results mostly did not differ significantly from the control conditions in reducing symptoms and improving functioning, preventing relapses and hospitalization, or improving psychological or family variables. The most consistent findings were from CRT, showing more improvement in cognitive functioning compared to control conditions while not being superior in reducing symptom severity. Integrative interventions might be effective in treating young people suffering from psychotic disorders. Conclusion: There is some evidence that psychological interventions are effective for young people with psychotic disorders. However, with regard to symptom severity, psychotherapy does not outperform control conditions, and the results do not strongly favor any specific type of treatment. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020166756], identifier [CRD42020166756].Peer reviewe

Changes in perinatal mental healthcare during the COVID-19 pandemic: a protocol for a collaborative research study between the COST actions RISEUP-PPD and DEVOTION

Introduction Significant changes in routine maternity care have been introduced globally in response to the COVID-19 pandemic to reduce infection risk, but also due to lack of medical facilities, staff shortages and the unpredictable nature of the disease. However, it is yet to be established if specialised perinatal mental health (PMH) services have been similarly affected. As a Task Force in PMH and COVID-19 pandemic within Riseup-PPD COST Action, this study aims to identify changes in PMH practices, policies and protocols during the COVID-19 pandemic in Europe. Methods and analysis An online survey of experts in the PMH who are members of the COST Action ‘Riseup-PPD’ and the COST Action ‘’DEVOTION” across 36 European countries will be conducted. A questionnaire on changes in PMH care practices during the COVID-19 Pandemic will be administered. It consists of open-ended questions, checklists and ratings on a 7-point scale addressing seven domains of interest in terms of PMH: (1) policies, guidelines and protocols; (2) PMH care practices at a national level; (3) evidence of best practice; (4) barriers to usual care; (5) resources invested; (6) benefits of investment in the policies and (7) short-term and longterm expectations of the policies. Data will be collected using Qualtrics. Descriptive statistics will be reported and differences between countries will be examined using the χ2 statistic or Student’s t-test. Ethics and dissemination Ethical approval was obtained from The Ethics Committee for Research in Life and Health Sciences of the University of Minho (Portugal) to undertake an anonymous online survey. The findings will be disseminated to professional audience through peerreview publication and presentations and shared widely with stakeholders, policy-makers and service user groups. A position paper will be developed to influence policymaking at a European level to alleviate the adversities caused by COVID-19

Panic Attack during Elective Gastrointestinal Endoscopy

Background. Esophagogastroduodenoscopy (EGD) and colonoscopy (CS) can evoke anxiety, embarrassment, and discomfort. These concerns can culminate in panic attacks, which may traumatize patients and significantly decrease their compliance to the procedure. The objective of this study was to evaluate the relationship between preendoscopic anxiety and the possibility of a panic attack during an elective gastrointestinal endoscopy (EGE). Methods. The study population comprised of 79 Greek outpatients. The examination was carried out without the use of conscious sedation. Patients' anxiety levels were assessed before the procedure using the Greek version of the Spielberger State-Trait Anxiety Inventory (STAI-Y). Results. Seventy-nine patients were enrolled: 45 EGD and 34 CS. Females had higher state and trait anxiety levels than males (48.14 ± 7.94 versus 44.17 ± 7.43, P < 0.05; and 43.68 ± 6.95 versus 39.86 ± 7.46, P < 0.05). Patients who experienced panic attack had significantly higher levels of both trait and state anxiety, compared to those who were panic-free. There was no significant relationship between panic attacks and sex or type of procedure. Conclusions. Patients who experience panic attacks during endoscopic procedures appear to have significantly higher anxiety levels before the procedure. Administering the STAI questionnaire prior to the endoscopy seems to be a useful screening method for vulnerable patients

Predictors and moderators of outcome of psychotherapeutic interventions for mental disorders in adolescents and young adults : protocol for systematic reviews

Background: Adolescence and young adulthood is a risk period for the emergence of mental disorders. There is strong evidence that psychotherapeutic interventions are effective for most mental disorders. However, very little is known about which of the different psychotherapeutic treatment modalities are effective for whom. This large systematic review aims to address this critical gap within the literature on non-specific predictors and moderators of the outcomes of psychotherapeutic interventions among adolescents and young adults with mental disorders. Methods: The protocol is being reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) Statement. PubMed and PsycINFO databases will be searched for randomized controlled and quasi-experimental/naturalistic clinical trials. Risk of bias of all included studies will be assessed by the Mixed Methods Appraisal Tool. The quality of predictor and moderator variables will be also assessed. A narrative synthesis will be conducted for all included studies. Discussion: This systematic review will strengthen the evidence base on effective mental health interventions for young people, being the first to explore predictors and moderators of outcome of psychotherapeutic interventions for a wide range of mental disorders in young people.Peer reviewe

Impact of the Covid-19 pandemic on perinatal mental health (Riseup-PPD-COVID-19): protocol for an international prospective cohort study

Corona Virus Disease 19 (COVID-19) is a new pandemic, declared a public health emergency by the World Health Organization, which could have negative consequences for pregnant and postpartum women. The scarce evidence published to date suggests that perinatal mental health has deteriorated since the COVID-19 outbreak. However, the few studies published so far have some limitations, such as a cross-sectional design and the omission of important factors for the understanding of perinatal mental health, including governmental restriction measures and healthcare practices implemented at the maternity hospitals. Within the Riseup-PPD COST Action, a study is underway to assess the impact of COVID-19 in perinatal mental health. The primary objectives are to (1) evaluate changes in perinatal mental health outcomes; and (2) determine the risk and protective factors for perinatal mental health during the COVID-19 pandemic. Additionally, we will compare the results between the countries participating in the study

Does Bed Sharing with an Infant Influence Parents’ Sexual Life? A Scoping Review in Western Countries

Bed sharing—the sharing of a sleeping surface by parents and children—is a common, yet controversial, practice. While most research has focused on the public health aspect of this practice, much less is known regarding its effect on the marital relationship. The aim of the present study was to conduct a scoping review on the impact of parent–infant bed sharing sleeping practices on the sexual and marital relationship of couples. The qualitative synthesis of six studies on this topic suggests that overall, bed sharing does not exert a significant negative impact on family functioning; when it does, it appears to be related to incongruent parental beliefs and expectations, especially when bed sharing is not an intentional choice of sleep arrangement, and there are other confounding factors such as fatigue and psychological distress. Suggestions for future studies and clinical implications are discussed

“When Grief Breaks Your Heart”: A Case Study of Interpersonal Psychotherapy Delivered in a Primary Care Setting

Depression and anxiety, the so-called common mental disorders (CMDs), are highly prevalent and disabling, yet remain largely untreated. This treatment gap is particularly true in low- and middle-income settings, where there is significant scarcity of resources (including human resources) and treatment accessibility is complicated by stigma surrounding mental illness. To address these challenges, the MANAS trial, one of the largest to date randomized, controlled trials, aimed to test the effectiveness of a stepped care intervention led by lay health counselors in primary care settings in Goa, India. Six- and 12-month follow-up outcomes suggest that MANAS was a safe, feasible, effective, and cost-effective intervention for CMDs in that context. This article demonstrates the use of culturally adapted IPT as an intervention to treat CMDs in a 54-year-old Indian primary care patient struggling with depression and heart-related problems after his wife&apos;s death. A case formulation is presented based on core IPT principles, followed by detailed delineation of treatment from beginning through termination

Effect of Yoga-Based Interventions for Anxiety Symptoms: A Meta-Analysis of Randomized Controlled Trials

Anxiety is a common and debilitating condition, which tends to follow a chronic course if left untreated. While studies have provided evidence that yoga is an effective mind-body intervention for a variety of psychological symptoms, more meta-analytic evidence supporting yoga&apos;s efficacy specifically for anxiety symptoms is needed. The aim of this study was to investigate the effect of yoga on anxiety symptoms using meta-analytic methods. A systematic search was conducted for randomized controlled trials (RCTs) on yoga and anxiety on electronic databases over key terms. Risk of bias was assessed using the Cochrane tool. Outcome data were extracted from eligible studies, and moderators were coded across studies to indicate differences in study sample, delivery method, and type of dependent variable. Effect size aggregation and omnibus analyses, as well as moderator tests, were performed. A total of 38 RCTs (N = 2.295 adults) met inclusion criteria. Yoga practice had a large and statistically significant effect on anxiety symptoms compared with control conditions (d = 0.80). In subomnibus analyses, statistically significant effects of the yoga intervention were detected on biological measures (d = 0.45), nonanxiety mental health outcomes (d = 055), physical health measures (d = 0.45), and mental and physical health outcomes combined (d = 0.65). Significant moderation was found by study location, with the largest effects appearing in Indian samples. Results suggest that yoga significantly decreases anxiety symptoms, while it appears to have an ameliorative effect on psychological symptoms more globally