Prevention of: self harm in British South Asian women: study protocol of an exploratory RCT of culturally adapted manual assisted Problem Solving Training (C- MAP)

<p>Abstract</p> <p>Background</p> <p>Suicide is a major public health problem worldwide. In the UK suicide is the second most common cause of death in people aged 15-24 years. Self harm is one of the commonest reasons for medical admission in the UK. In the year following a suicide attempt the risk of a repeat attempt or death by suicide may be up to 100 times greater than in people who have never attempted suicide.</p> <p>Research evidence shows increased risk of suicide and attempted suicide among British South Asian women. There are concerns about the current service provision and its appropriateness for this community due to the low numbers that get involved with the services. Both problem solving and interpersonal forms of psychotherapy are beneficial in the treatment of patients who self harm and could potentially be helpful in this ethnic group.</p> <p>The paper describes the trial protocol of adapting and evaluating a culturally appropriate psychological treatment for the adult British South Asian women who self harm.</p> <p>Methods</p> <p>We plan to test a culturally adapted Problem Solving Therapy (C- MAP) in British South Asian women who self harm. Eight sessions of problem solving each lasting approximately 50 minutes will be delivered over 3 months. The intervention will be assessed using a prospective rater blind randomized controlled design comparing with treatment as usual (TAU). Outcome assessments will be carried out at 3 and 6 months. A sub group of the participants will be invited for qualitative interviews.</p> <p>Discussion</p> <p>This study will test the feasibility and acceptability of the C- MAP in British South Asian women. We will be informed on whether a culturally adapted brief psychological intervention compared with treatment as usual for self-harm results in decreased hopelessness and suicidal ideation. This will also enable us to collect necessary information on recruitment, effect size, the optimal delivery method and acceptability of the intervention in preparation for a definitive RCT using repetition of self harm and cost effectiveness as primary outcome measures.</p> <p>Trial Registration</p> <p>Current Controlled Trials 08/H1013/6</p

Constraint Based Hybrid Approach to Parsing Indian Languages

PACLIC 23 / City University of Hong Kong / 3-5 December 200

Social stress and perinatal depression in British Pakistani women

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Social stress and depression during pregnancy and in the postnatal period in British Pakistani mothers:A cohort study

AbstractBackgroundDepressive disorders are common and disabling among perinatal women. The rates are high in ethnic minority groups. The causes are not known in British Pakistani women. The aim of this study was to estimate the rates, correlates and maintaining factors of perinatal depression in a Pakistani sample in UK. The design used was a cross-sectional two phase population based survey with a prospective cohort study.MethodsAll women in 3rd trimester attending antenatal clinic were screened with the Edinburgh postnatal depression scale (EPDS). Women scoring 12 or more on EPDS and a random sample of low scorers were interviewed using the Schedules for Assessment in Neuropsychiatry (SCAN) and the Life Events and Difficulties schedule (LEDS). Social support was assessed with the Multidimensional Scale for Perceived Social Support (MSPSS). They were reassessed 6months after the delivery using the same measures.ResultsThe weighted prevalence of depression was 16.8%. Depressed mothers had more marked non health difficulties (housing, financial and marital). They had less social support and were socially isolated. Marked social isolation and marked non-health related difficulties were independent predictors of depression. Analyses of all the possible risk factors, comparing 26 persistent depressed with 27 depression resolved group showed significant differences in the MSPSS subscales between the two groups.LimitationsThe study lacked inter-rater reliability testing between the individuals carrying out diagnostic interviews. The study sample did not accurately represent the general population and information about the origins of depression in this group of mothers was limited.ConclusionDepression in British Pakistani mothers is associated with social isolation, poor social support and severe and persistent social difficulties. The findings will have implications in planning suitable services for this group

Maternal depression and the role of psychosocial intervention: Perception of community health workers in Pakistan

Low-income countries have a critical shortage of health professionals. In countries such as Pakistan, Community Health Workers (CHWs) can play an important role in improving access to healthcare services and hence improve health outcomes.To explore the efficacy of a training program; Learning Through Play Plus, a combination of Learning Through Play (LTP) and Thinking Healthy Program (THP) on knowledge and attitudes of CHW's regarding child development, maternal depression and cognitive behaviour.To use focus groups and the training programmes to increase the knowledge of CHWs method: a qualitative approach was used to explore experiences of CHWs who delivered the intervention. Three-day training was provided to 216 CHWs on LTP and THP. Trained facilitators conducted focus groups before and after the training to explore their prior knowledge and expectations. A semi-structured topic guide was developed for this. All the focus groups were audio-recorded. The data were analysed using framework analysis principles.Four key themes emerged from the focus groups; the psychosocial context these women live in (poverty, work-overload, interpersonal conflicts, lack of support from family, lack of awareness of depression and scarcity of mental health services) CHWs perception of depression (role of negative thoughts in depression), the impact of maternal depression on children and the impact of training for CHWs (improvement in CHWs knowledge related to children).Training CHWs improves their knowledge about child development and psychological therapies. This can contribute to improving access to maternal healthcare services and improving child development outcomes