scholarly journals The association between a free medicine program and functioning in people with schizophrenia: a cross-sectional study in Liuyang, China

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8929
Author(s):  
Wenjie Gong ◽  
Chao Zhang ◽  
Dong (Roman) Xu ◽  
Shuiyuan Xiao ◽  
Yu Yu ◽  
...  

Background Persons with schizophrenia frequently discontinue or avoid medications. Under a national community-based mental health program many places in China have started to provide free medications to people with severe mental health disorders in their communities. In the free medication program (FMP) in Liuyang, China, peripatetic psychiatrists prescribed and dispensed antipsychotic medications free of charge at regular intervals and places convenient for all patients through the primary health care system since 2006. Our study aims to test whether adherence to this FMP improves the functioning of people with schizophrenia. Methods The research was conducted in Liuyang, a rural county in central China. Data were obtained from three sources: an ad-hoc survey and the program’s management system in 2013 and in-home interviews in 2014 in Liuyang. We conducted a cross-sectional propensity-score based analysis of the “dose” effect of FMP participation on their level of functioning, using medication refill adherence as a proxy for the participatory intensity in the program. Results Only 50.9% of 2,332 participants came for all refills in 2012. Higher refill adherence was associated with slightly worse functional outcomes. The main reasons for refill non-adherence were “unwilling to take medication or only took medication when unwell” (23.6%), “forgot or missed the appointment” (20.6%) and “hospitalized” (20.1%). Conclusions The FMP program in Liuyang seemed to have successfully removed barriers in cost and access. However, better refill adherence was not associated with better functional outcomes in this study, which might have been the result of reverse causation. To improve the effectiveness of the FMP, patient-centered measures should be considered.

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Trang Nguyen ◽  
Thach Tran ◽  
Sally Green ◽  
Arthur Hsueh ◽  
Tuan Tran ◽  
...  

Abstract Background People with severe mental illness (SMI) living in low and middle-income countries can experience extended delays to diagnosis, which hinder access to medical treatment. The aims of this study were to describe the interval to diagnosis among these people in rural Vietnam and its associated factors. Methods A population-based cross-sectional study was conducted among people with SMI in two provinces in Vietnam. The delay to diagnosis was defined as the time between the first abnormal behaviour being observed by family members and the formal diagnosis of psychosis. A multilevel linear regression was used to examine the factors associated with the delay to diagnosis. Results Among 404 people with SMI from 370 households, the median delay to diagnosis was 11.5 months (IQR 0–168.0). Overall, 53.7% had a delay to diagnosis of less than one year (95% CI: 48.81–58.54). The financial burden of these people on their families was nearly USD 470/year. After adjusting for other factors at individual and household levels, living in a Northern province; older age, and having psychotic diagnosis before the implementation of the National Community Mental Health program (2003) were associated with a delay of more than twelve months to diagnosis. Conclusions These data indicate that the implementation of a national policy for community-based care has been effective in reducing the delay to diagnosis in rural Vietnam. Therefore, there is a need for strengthening the program and mental health policies, focusing on public communication to improve mental health literacy and reduce stigma against SMI.


2021 ◽  
Vol 9 (2) ◽  
pp. 102
Author(s):  
Joel Rey U. Acob ◽  
Hidayat Arifin ◽  
Yulis Setiya Dewi

Background: COVID-19 considered as a global health crisis poses mental health problems among individual and specifics to students.Purpose: This study aimed to determine the depression, anxiety, and stress levels among students amidst COVID-19 pandemic in Philippines.Methods: A cross-sectional study was undertaken in Region 8, Eastern Visayas Philippines. A total of 311 tertiary respondents randomly selected both private and government owned higher education institutions. The data compilation was done using online questionnaires through Google Forms with validated version of the Stress, Anxiety and Depression Scales 21 (DASS21) is used to calculate students' level of stress, anxiety and, depression with their socio-demographic featuresResults: We revealed that depression, anxiety and stress are instituted in 18.6 %, 35.1 % and 2.85% of students, respectively, amidst the COVID – 19 pandemics. The symptoms of disorders were moderate to extremely severe in 6.1%, 23.5%, and 0.6% of the study sample, respectively. Age, gender, marital status and family history of illness are significantly different with age group 20 and below, females, singles, and families with no history of illness displaying high level of anxiety. Results also established an association between anxiety and family’s monthly income and history of illness. The higher the monthly income and no presence of illness of families, the more anxious the person.Conclusion: Finally, the variables used, explained only 1.5% depression, 3.4% anxiety and 1.4% stress in this time of COVID-19 outbreak. It is therefore recommended to essentially develop community-based mental health program for preventive purposes.


Author(s):  
Nguyen Toan Tran ◽  
Jessica Franzen ◽  
Françoise Jermann ◽  
Serge Rudaz ◽  
Guido Bondolfi ◽  
...  

Background University students’ psychological health is linked to their academic satisfaction. This study aimed to investigate students’ psychological health and academic satisfaction in the context of COVID-19 and academic year-end stress. Methods Standardized self-filled scales for anxiety, depression, stress, psychological well-being, and an ad-hoc COVID-19 stress scale were used in this cross-sectional study. Participants were first- to third-year students of eight different health-related tracks in Geneva, Switzerland. Descriptive statistics and hierarchical regression analyses were applied. Results In June 2020, out of 2835 invited students, 433 (15%) completed the survey. Academic satisfaction was a stronger mental health predictor than COVID-19, which mainly predicted stress and anxiety. Lower academic satisfaction scores were significantly associated with stress (β = -.53, p < .001), depression (β = -.26, p < .001), anxiety (β = -.20, p < .001), while higher scores with psychological well-being (β = .48, p < .001). Being female was strongly associated with anxiety and stress but not with depression or psychological well-being. Lower age was associated with stress only. The nature of the academic training had a lesser impact on mental health and the academic year none. Compared to students starting the academic year, year-end students reported significantly lower academic satisfaction, higher depression, and particularly higher anxiety and stress. There was, however, no difference in psychological well-being. Conclusion Students suffer more from anxiety, stress, depression, and lower satisfaction with studies at the end of the academic year than at the beginning. Academic satisfaction plays a more substantial role than COVID-19 in predicting students’ overall mental health status. Training institutions should address the underlying factors that can enhance students’ academic satisfaction, especially during the COVID-19 period, in addition to ensuring that they have a continuous and adequate learning experience, as well as access to psychosocial services that help them cope with mental distress and enhance their psychological well-being.


Author(s):  
Erika Viktória Miszory ◽  
Melinda Járomi ◽  
Annamária Pakai

Abstract Aim The number of Hungarian polio patients can be estimated at approximately 3000. Polio infection is currently affecting people 56–65 years of age. The aim of the study was to reveal the quality of life of patients living with polio virus in Hungary. Subject and methods The quantitative cross-sectional study was conducted in January–April 2017 among polyomyelitis patients living in Hungary. In the non-random, targeted, expert sample selection, the target group was composed of patients infected with poliovirus (N = 268). We have excluded those who refused to sign the consent statement. Our data collection method was an SF-36 questionnaire. Using the IBM SPSS Statistics Version 22 program, descriptive and mathematical statistics (χ2-test) were calculated (p < 0.05). Results The mean age of the members of the examined population is 63.5 years; 68.1% were women and 31.90% were men. The majority of the respondents were infected by the polyovirus in 1956 (11.9%), 1957 (24.3%), and 1959 (19.5%). Polio patients, with the exception of two dimensions (mental health, social operation), on the scale of 100 do not reach the “average” quality of life (physical functioning 23 points, functional role 36 points, emotional role 47 points, body pain 48 points, general health 42 points, vitality 50 points, health change 31 points). Conclusion The quality of life of polio patients is far below the dimensions of physical function, while the difference in mental health compared to healthy people is minimal. It would be important to educate health professionals about the existing disease, to develop an effective rehabilitation method.


Author(s):  
Sofia Pappa ◽  
Joshua Barnett ◽  
Ines Berges ◽  
Nikolaos Sakkas

The burden of the COVID-19 pandemic on health systems and the physical and mental health of healthcare workers (HCWs) has been substantial. This cross-sectional study aims to assess the effects of COVID-19 on the psychological wellbeing of mental health workers who provide care to a vulnerable patient population that have been particularly affected during this crisis. A total of 387 HCWs from across a large urban mental health service completed a self-administered questionnaire consisting of socio-demographic, lifestyle and work-based information and validated psychometric scales. Depression and anxiety were measured using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7), respectively; sleep problems with the Athens Insomnia Scale (AIS); burnout with the Maslach Burnout Inventory (MBI); and resilience with the Resilience Scale-14 (RS-14). Multivariable logistic regression analysis was performed to determine potential mediating factors. Prevalence of burnout was notable, with 52% recording moderate/severe in Emotional Exhaustion, 19.5% moderate/severe in Depersonalisation, and 55.5% low/moderate Personal Accomplishment. Over half of all respondents (52%) experienced sleep problems; the presence of depressive symptoms was a significant predictor of insomnia. An increase in potentially harmful lifestyle changes, such as smoking, alcohol consumption and overeating was also observed. However, high Resilience was reported by 70% of the samples and the importance of this is highlighted. Female gender was associated with increased levels of depression and emotional exhaustion while those with a history of mental health conditions were most at risk of affective symptoms, insomnia, and burnout. Overall, our study revealed considerable levels of psychological distress and maladaptive coping strategies but also resilience and satisfaction with organizational support provided. Findings can inform tailored interventions in order to mitigate vulnerability and prevent long-term psychological sequelae.


Author(s):  
Alfonso Urzúa ◽  
Alejandra Caqueo-Urízar ◽  
Diego Henríquez ◽  
David R. Williams

There is not much evidence on the effects of south–south migration and its consequences on physical and mental health. Our objective was to examine the mediating role of Acculturative Stress in the association between ethnic discrimination and racial discrimination with physical and mental health. This research is a non-experimental, analytical, cross-sectional study. A total of 976 adult Colombian migrants living in Chile were interviewed. We used the Everyday Discrimination Scale, the acculturative stress scale, and the Medical Outcomes Study Short Form (SF-12) for health status; we found that racial and ethnic discrimination had a negative effect on physical and mental health. In the simultaneous presence of both types of discrimination, racial discrimination was completely absorbed by ethnic discrimination, the latter becoming a total mediator of the effect of racial discrimination on mental and physical health. Our findings are consistent with the literature, which suggests that there are various types of discrimination which, individually or in their intersectionality, can have negative effects on health.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah L. McKune ◽  
Daniel Acosta ◽  
Nick Diaz ◽  
Kaitlin Brittain ◽  
Diana Joyce- Beaulieu ◽  
...  

Abstract Background Given the emerging literature regarding the impacts of lockdown measures on mental health, this study aims to describe the psychosocial health of school-aged children and adolescents during the COVID-19 Safer-at-Home School mandates. Methods A cross-sectional study was conducted in April 2020 (n = 280) among K-12 students at a research school in North Central Florida. Bivariate analysis and logistic and multinomial logistic regression models were used to examine socio-demographic and knowledge, attitude, and practice (KAP) predictors of indicators of anxiety-related, depressive, and obsessive-compulsive disorder(OCD)-related symptoms. Outcomes (anxiety, OCD, and depressive related symptoms) were measured by indices generated based on reported symptoms associated with each psychosocial outcome. Results Loss of household income was associated with increased risk for all three index-based outcomes: depressive symptoms [aOR = 3.130, 95% CI = (1.41–6.97)], anxiety-related symptoms [aOR = 2.531, 95%CI = (1.154–5.551)], and OCD-related symptoms [aOR = 2.90, 95%CI = (1.32–6.36)]. Being female was associated with being at higher risk for depressive symptoms [aOR = 1.72, 95% CI = (1.02–2.93)], anxiety-related symptoms [aOR = 1.75, 95% CI = (1.04–2.97)], and OCD-related symptoms [aOR = 1.764, 95%CI = (1.027–3.028)]. Parental practices protective against COVID-19 were associated with children being at higher risk of depressive symptoms [aOR = 1.55, 95% CI = (1.04–2.31)]. Lower school level was associated with children being at higher risk of anxiety-related and OCD-related symptoms. Conclusions As the COVID-19 pandemic continues, schools should prioritize mental health interventions that target younger, female students, and children of families with income loss. Limiting the spread of COVID-19 through school closure may exacerbate negative psychosocial health outcomes in children, thus school administrators should move quickly to target those at greatest risk.


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