For adults in low- and middle-income countries living with common mental disorders, perinatal depression, or post-traumatic stress disorder, what are the effects of primary health care worker (PHCW)-led interventions?

2021 ◽  
Author(s):  
Jane Burch ◽  
Sujoy Ray
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Common Mental Disorders ◽  
Post Traumatic Stress ◽  
Middle Income ◽  
Primary Health Care Worker ◽  
Middle Income Countries ◽  
Primary Health ◽  
Post Traumatic ◽  
Care Worker

scholarly journals Psychological interventions for post-traumatic stress disorder and depression in young survivors of mass violence in low- and middle-income countries: Meta-analysis

2017 ◽  
Vol 210 (4) ◽  
pp. 247-254 ◽  
Author(s):  
Nexhmedin Morina ◽  
Mina Malek ◽  
Angela Nickerson ◽  
Richard A. Bryant
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Effect Sizes ◽  
Psychological Interventions ◽  
Post Traumatic Stress ◽  
Mass Violence ◽  
Middle Income ◽  
Middle Income Countries ◽  
Post Traumatic

BackgroundThe majority of survivors of mass violence live in low- and middle-income countries (LMICs).AimsTo synthesise empirical findings for psychological interventions for children and adolescents with post-traumatic stress disorder (PTSD) and/or depression in LMICs affected by mass violence.MethodRandomised controlled trials with children and adolescents with symptoms of PTSD and/or depression in LMICs were identified. Overall, 21812 records were found through July 2016 in the Medline, PsycINFO and PILOTS databases; 21 met the inclusion criteria and were reviewed according to recommended guidelines.ResultsTwenty-one studies were included. Active treatments for PTSD yielded large pre-treatment to post-treatment changes (g = 1.15) and a medium controlled effect size (g = 0.57). Effect sizes were similar at follow-up. Active treatments for depression produced small to medium effect sizes. Finally, after adjustment for publication bias, the imputed uncontrolled and controlled effect sizes for PTSD were medium and small respectively.ConclusionsPsychological interventions may be effective in treating paediatric PTSD in LMICs. It appears that more targeted approaches are needed for depressive responses.

scholarly journals The psychosocial impact of the COVID-19 pandemic on 4,378 UK healthcare workers and ancillary staff: initial baseline data from a cohort study collected during the first wave of the pandemic

2021 ◽  
Author(s):  
Danielle Lamb ◽  
Sam Gnanapragasam ◽  
Neil Greenberg ◽  
Rupa Bhundia ◽  
Ewan Carr ◽  
...  
Keyword(s):  
Mental Health ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Healthcare Workers ◽  
Alcohol Misuse ◽  
Common Mental Disorders ◽  
Moral Injury ◽  
List Type ◽  
Post Traumatic Stress ◽  
Post Traumatic

AbstractObjectivesThis study reports preliminary findings on the prevalence of, and factors associated with, mental health and wellbeing outcomes of healthcare workers during the early months (April-June) of the COVID-19 pandemic in the UK.MethodsPreliminary cross-sectional data were analysed from a cohort study (n=4,378). Clinical and non-clinical staff of three London-based NHS Trusts (UK), including acute and mental health Trusts, took part in an online baseline survey. The primary outcome measure used is the presence of probable common mental disorders (CMDs), measured by the General Health Questionnaire (GHQ-12). Secondary outcomes are probable anxiety (GAD-7), depression (PHQ-9), Post-Traumatic Stress Disorder (PTSD) (PCL-6), suicidal ideation (CIS-R), and alcohol use (AUDIT). Moral injury is measured using the Moray Injury Event Scale (MIES).ResultsAnalyses showed substantial levels of CMDs (58.9%, 95%CI 58.1 to 60.8), and of PTSD (30.2%, 95%CI 28.1 to 32.5) with lower levels of depression (27.3%, 95%CI 25.3 to 29.4), anxiety (23.2%, 95%CI 21.3 to 25.3), and alcohol misuse (10.5%, 95%CI, 9.2 to 11.9). Women, younger staff, and nurses tended to have poorer outcomes than other staff, except for alcohol misuse. Higher reported exposure to moral injury (distress resulting from violation of one’s moral code) was strongly associated with increased levels of CMDs, anxiety, depression, PTSD symptoms, and alcohol misuse.ConclusionsOur findings suggest that mental health support for healthcare workers should consider those demographics and occupations at highest risk. Rigorous longitudinal data are needed in order to respond to the potential long-term mental health impacts of the pandemic.HighlightsWhat is already known about this subject?Large-scale population studies report increased prevalence of depression, anxiety, and psychological distress during the COVID-19 pandemic.Evidence from previous epidemics indicates a high and persistent burden of adverse mental health outcomes among healthcare workers.What are the new findings?Substantial levels of probable common mental disorders and post-traumatic stress disorder were found among healthcare workers.Groups at increased risk of adverse mental health outcomes included women, nurses, and younger staff, as well as those who reported higher levels of moral injury.How might this impact on policy or clinical practice in the foreseeable future?The mental health offering to healthcare workers must consider the interplay of demographic, social, and occupational factors.Additional longitudinal research that emphasises methodological rigor, namely with use of standardised diagnostic interviews to establish mental health diagnoses, is necessary to better understand the mental health burden, identify those most at risk, and provide appropriate support without pathologizing ordinary distress responses.

scholarly journals Differentiating ICD-11 complex post-traumatic stress disorder from other common mental disorders based on levels of exposure to childhood adversities, the traumas of persecution and postmigration living difficulties among refugees from West Papua

BJPsych Open ◽  
2018 ◽  
Vol 4 (5) ◽  
pp. 361-367
Author(s):  
Derrick Silove ◽  
Susan Rees ◽  
Mohammed Mohsin ◽  
Natalino Tam ◽  
Moses Kareth ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Common Mental Disorders ◽  
Interpersonal Trauma ◽  
Post Traumatic Stress ◽  
Childhood Adversities ◽  
Cultural Validity ◽  
Post Traumatic

BackgroundFollowing years of controversy, a category of complex post-traumatic stress disorder (CPTSD) will be included in the forthcoming ICD-11.AimsTo test whether refugees with CPTSD differ from those with other common mental disorders (CMDs) in the degree of exposure to childhood adversities, adult interpersonal trauma and post-traumatic hardship.MethodSurvey of 487 West Papuan refugees (response rate 85.5%) in Papua New Guinea.ResultsRefugees with CPTSD had higher exposure to childhood adversities (CPTSD: mean 2.6, 95% CI 2.5–2.7 versus CMD: mean 1.15, 95% CI 1.10–1.20), interpersonal trauma (CPTSD: mean 9, 95% CI 8.6–9.4 versus CMD: mean 5.4, 95% CI 5.4–5.5) and postmigration living difficulties (CPTSD: mean 2.3, 95% CI 2–2.5 versus CMD mean 1.85, 95% CI 1.84–1.86), compared with those with CMDs who in turn exceeded those with no mental disorder on all these indices.ConclusionsThe findings support the cross-cultural validity of CPTSD as a reaction to high levels of exposure to recurrent interpersonal trauma and associated adversities.Declaration of interestNone.

scholarly journals IN THIS ISSUE

2006 ◽  
Vol 36 (11) ◽  
pp. 1499-1500
Author(s):  
CRAIG MORGAN
Keyword(s):  
High Risk ◽  
Personality Disorder ◽  
Mental Disorders ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Common Mental Disorders ◽  
Psychological Interventions ◽  
Post Traumatic Stress ◽  
Post Traumatic

This issue contains two reviews, one on the findings from high-risk studies of schizophrenia, and one comparing two psychological interventions for post-traumatic stress disorder (PTSD). Other sets of papers examine various aspects of PTSD, psychosis, personality disorder, and common mental disorders, and four individual papers examine a variety of topics.

scholarly journals Trauma, post-traumatic stress disorder and psychiatric disorders in a middle-income setting: prevalence and comorbidity

2014 ◽  
Vol 205 (5) ◽  
pp. 383-389 ◽  
Author(s):  
Sarah Dorrington ◽  
Helena Zavos ◽  
Harriet Ball ◽  
Peter McGuffin ◽  
Fruhling Rijsdijk ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Sexual Trauma ◽  
Stress Disorder ◽  
Traumatic Events ◽  
Post Traumatic Stress ◽  
Middle Income ◽  
Post Traumatic ◽  
Exposure To Trauma

BackgroundMost studies of post-traumatic stress disorder (PTSD) in low- and middle-income countries (LMICs) have focused on ‘high-risk’ populations defined by exposure to trauma.AimsTo estimate the prevalence of post-traumatic stress disorder (PTSD) in a LMIC, the conditional probability of PTSD given a traumatic event and the strength of associations between traumatic events and other psychiatric disorders.MethodOur sample contained a mix of 3995 twins and 2019 non-twins. We asked participants about nine different traumatic exposures, including the category ‘other’, but excluding sexual trauma.ResultsTraumatic events were reported by 36.3% of participants and lifetime PTSD was present in 2.0%. Prevalence of non-PTSD lifetime diagnosis was 19.1%. Of people who had experienced three or more traumatic events, 13.3% had lifetime PTSD and 40.4% had a non-PTSD psychiatric diagnosis.ConclusionsDespite high rates of exposure to trauma, this population had lower rates of PTSD than high-income populations, although the prevalence might have been slightly affected by the exclusion of sexual trauma. There are high rates of non-PTSD diagnoses associated with trauma exposure that could be considered in interventions for trauma-exposed populations. Our findings suggest that there is no unique relationship between traumatic experiences and the specific symptomatology of PTSD.Copyright and usage© Royal College of Psychiatrists 2014. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence.

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