An adapted collaborative care model to manage co-morbidities of depression and chronic non-communicable diseases in Rwanda

Background The World Health Organization has recommended the implementation of the Collaborative Care Model in all countries to manage the comorbidities of depression and chronic non-communicable diseases. In Rwanda depression is major problem not only among patients with chronic illnesses but also in general population considering the unique history of war and genocide in Rwanda. Purpose The purpose of this paper is to describe the process of adaptation and testing of the Collaborative Care Model in the Rwandan healthcare context. Methods The larger study used the Action Research design with mixed method ­sequential explanatory design. A research-practice partnership method and an iterative process was used to adapt and test the Collaborative Care Model. Qualitative content analysis was used to analyse the data. Results Four structural components to the model were adapted including the addition of a registered nurse to the team, relocation of the model to the district level, consultation with a psychiatrist every 3 months and involvement of community health workers. The evaluation indicated that the model was applicable and acceptable. Conclusions Initial evaluation of the Adapted Collaborative Care Model shows promise in Rwanda. Implementation of this model in other Rwandan districts is warranted.

COVID-19 pandemic and factors influencing depression in residents of the Democratic Republic of Congo

Background: The COVID-19 outbreak caused the border closure, martial law declaration, and lockdown to prevent the spread of the disease. These policies caused reduced interaction among people,social isolation, and higher levels of anxiety and depression. Objectives: This study aimed to examine changes in depressive symptoms of residents of the Democratic Republic of Congo (DRC) that may have arisen due to the COVID-19 and lockdown measures and to identify relevant influencing factors. Methods: This cross-sectional study involved 300 residents of the DRC. An online survey tool investigated general and public health characteristics and included the Patient Health Questionnaire-9 for measuring depressive symptoms. The study was conducted from April 7­30, 2020. Results: The average depression score was low at 2.74±3.33. Factors influencing depression were the number of family members, probability of death due to COVID-19, knowledge of COVID-19, and time at home. The factor that most significantly influenced depression and these variables accounted for 26.9% of the influence of COVID-19 on depression (F= 9.936, p<.001). Conclusion: This study investigated the influence of COVID-19 outbreak on depression in DRC. Levels of depression increased for individuals who were living alone, had low levels of knowledge of COVID-19 and awareness of the disease severity, and spent a long time at home.

The impacts of COVID-19 pandemic on mental health: A scoping review

Background: This scoping review assessed the COVID-19 impacts on mental health and associated risk factors. Methods: A literature search for relevant articles published between March 2020 and July 2022, was conducted in the APA PsychInfo, JBI Evidence Synthesis, Epistemonikos, PubMed, and Cochrane databases. Results: The article inclusion criteria were met by 72 studies. The commonly used mental health assessment tools were the Patient Health Questionnaire (41.7%), Generalized Anxiety Disorder Scale (36%), 21-item Depression, Anxiety, and Stress (13.9%), Impact of Event Scale (12.5%), Pittsburgh Sleep Quality Index (9.7%), Symptom Checklist and the General Health Questionnaire (6.9% each). The prevalence rate of depression ranged from 5-76.5%, 5.6-80.5% for anxiety, 9.1- 65% for Post-Traumatic Stress Disorder, 8.3-61.7% for sleep disorders, 4.9-70.1% for stress, 7-71.5% for psychological distress, and 21.4-69.3% for general mental health conditions. The risks included female gender, healthcare related/frontline jobs, isolation/quarantine, poverty, lower education, COVID-19 risk, age, commodities, mental illness history, negative psychology, and higher social media exposure. The incidence of mental disorders increased along with the increasing cases of COVID-19 and the corresponding government restrictions. Conclusion: Standard mental health assessment tools were used in these studies conducted during COVID-19. Mental health disorders like depression, anxiety, and stress increased during the COVID-19 pandemic and lockdowns. Various factors impacted the prevalence of mental health disorders. Policymakers need to provide social protective measures to improve coping in critical health events. Further studies should investigate the effectiveness of interventions for reducing the prevalence and risk factors for mental health conditions during a public health emergency.

Psychosocial impact of the implementation of COVID-19 protocols

BACKGROUND: The COVID-19 pandemic has spread globally since the first case was diagnosed in Wuhan, China in December 2019 and we are now experiencing the fourth wave. Several measures are being taken to care for the infected and to curtail the spread of this novel infectious virus. The psychosocial impact of these measures on patients, relatives, caregivers, and medical personnel also needs to be assessed and catered for. METHODS: This is a review article on the psychosocial impact of the implementation of COVID-19 protocols. The literature search was done using Google Scholar, PubMed, and Medline. DISCUSSION: Modalities of transportation of the patient to isolation and quarantine centres have led to stigma and negative attitudes towards such individuals. When diagnosed with the infection, fear of dying from COVID-19, fear of infecting family members and close associates, fear of stigmatization, and loneliness are common among COVID-19 patients. Isolation and quarantine procedures also cause loneliness and depression, and the person is at risk of post-traumatic stress disorder. Caregivers are continually stressed out and have the constant fear of contracting SARS-CoV-2. Despite clear guidelines to help with closure for family members of people dying from COVID-19, inadequate resources make this unrealistic. CONCLUSION: Mental and emotional distress resulting from fear of SARS-Cov-2 infection, the mode of transmission, and consequences have a tremendous negative impact on the psychosocial well-being of those affected, their caregivers, and relatives. There is a need for the government, health institutions, and NGOs to establish platforms to cater to these concerns

Psychological impact of the COVID-19 pandemic on anaesthetists in an academic institution in South Africa

Background: Anaesthesiology is considered to be a medical speciality that can result in high levels of stress. The COVID-19 pandemic required anaesthetists to rapidly adopt additional challenging roles. This study describes the psychological impact of the pandemic on anaesthetists and identified and compared factors associated with depression, anxiety, stress, and post-traumatic stress disorder (PTSD). Methods: A cross-sectional study design was used. An anonymous questionnaire was used to collect data utilising convenience sampling and results were reported using descriptive statistics and logistic regression analysis. The order of importance for the sources of stress and organisational support was determined by calculating the median rank. Results: The majority of the participants were between ages 31­40 (62.6%), male (59.8%), registrars (47.6%), had no comorbidities (73.8%), and had no known mental illness (79.9%). Having a previous diagnosis of a mental health illness was linked with greater levels of depression (OR [95% CI] = 4.50 [2.02­10.24], p < 0.001), anxiety(OR [95% CI] = 3.9 [1.7­9.0], p = 0.001), stress (OR [95% CI] = 3.8 [1.6­9.2], p = 0.002), and PTSD (OR [95% CI] = 5.4 [2.2­13.5], p < 0.001). Sources of stress identified included: insecure access to appropriate personal protective equipment, being exposed to COVID-19 at work, and taking the infection home to family. Conclusion: Participants with a history of mental illness were predisposed to developing negative psychological symptoms as a result of the pandemic. The main source of stress identified was insecure access to appropriate personal protective equipment.

Contextualizing migration and mental health in the post-COVID era

Background: The population of migrants all over the world is progressively rising. The major reasons for migration include the desire for self-actualization, moving to a place with more opportunities, tourism, and education, and escaping hardship and political unrest in the home country. In recent times climate change, insecurity, and economic hardship are top of the list. The global economy has suffered a major blow from the multiple waves of the lingering COVID-19 pandemic. To lessen the scourge of inflation and to restore economic stability, several countries are being forced to liberalize their immigration policies and therefore immigrants are welcomed in these nations. This review attempts to investigate how migration in the post-pandemic era affects migrants' mental health. Main Text: Migration and the COVID-19 epidemic both have beneficial and durable effects on the mental health of migrants and immigration laws have a direct impact on several health-related issues. Mental health disorders may develop at any point from the pre-migration phase to the post-migration settlement in the host nations. Factors such as host community, racism, marginalization, political climate, poor support, loss of social status, language barriers, undocumented status, climate change, mode of dressing in the host country, and several others may lead to mental health disorders among migrants. Unfortunately, there is limited access to care, and the services provided may not be culturally sensitive. Conclusion: Despite the benefits gotten from migration like financial benefits and economic development of the native country and the left behind family members, migration has enormous psychological complications which have to be attended to. Access to specialists who are trained to provide culturally sensitive interventions and implement outreach programs to introduce the services to the migrants' community should be encouraged.

Comorbid anxiety and depression among women receiving care for breast cancer: analysis of prevalence and associated factors

Background: Living with breast cancer has been associated with increased risk for common mental health problems including depression and anxiety. However, the prevalence of comorbid anxiety and depression (CAD) and their associated factors have received little attention especially in low- and middle-income countries (LMICs) including Ghana. Objectives: This study examined the prevalence of CAD and its correlates in the context of breast cancer. Methods: Participants were 205 women receiving care for breast cancer at a Tertiary Hospital in Ghana. The Hospital Anxiety and Depression Scale (HADS) and socio-demographic questionnaires were administered to the participants. Results: Findings from the study showed that the prevalence of CAD, anxiety and depression was 29.4%, 48.5% and 37.3% respectively. CAD was significantly predicted by patients' English language reading ability, shared decision making and good doctor-patient relationship. Anxiety was significantly predicted by shared decision making and good doctor-patient relationship whereas depression was significantly predicted educational status, patients' English language reading ability, shared decision making and good doctor-patient relationship. Conclusion: The findings suggest relatively high prevalence of comorbid anxiety and depression which could negatively impact breast cancer treatment outcomes and therefore, improved interpersonal relationships between doctors and their patients as well as literacy skills are warranted

Prevalence and correlates of depression and substance use disorders in emergency department populations: A cross-sectional study at East Africa's largest public hospital

Introduction There are persistent gaps in screening, identification, and access to care for common mental disorders in Low- and Middle-Income Countries. An initial step towards reducing this gap is identifying the prevalence, co-morbidities, and context of these disorders in different clinical settings and exploring opportunities for intervention. This study evaluates the prevalence and correlates of depression and substance use disorders among adults presenting to the Emergency Department (ED) of a major national hospital in East Africa. Methods This study utilized the World Health Organization's STEPwise Approach to Surveillance (WHO-STEPS) tool and the Patient Health Questionnaire (PHQ-9) to conduct a cross-sectional survey capturing socio-demographic data, tobacco, and alcohol use and rates of depression in a sample of adults presenting to the ED. Bivariate and multivariate analyses were conducted for each outcome of interest and socio-demographics. Results Of 734 respondents, 298 (40.6%) had a PHQ-9 score in the "moderate" to "severe" range indicative of major depressive disorder. About 17% of respondents endorsed current tobacco use while about 30% reported being daily alcohol users. Those with high PHQ-9 score had higher odds of reporting current tobacco use ("severe range" = adjusted odds ratio (aOR) 1.85, 95% CI 1.05, 3.26). Those with a "severe" PHQ-9 scores were 9 times (aOR 2.3-35.3) more likely to be daily drinkers. Conclusions Screening and identification of people with depression and substance use disorders in the ED of a large national hospital in Kenya is feasible. This offers an opportunity for brief intervention and referral to further treatment

Prevalence and risk factors of depression among undergraduate medical students in a Nigerian university

Objectives: This study assessed the prevalence and risk factors of depression among undergraduate medical students at the University of Benin, Benin City, Nigeria. Design: This was a cross-sectional study. Setting: This study was carried out at the University of Benin. Participants: Three hundred medical students were recruited for this study. Methods: The Patient Health Questionnaire 9 (PHQ-9) and a structured pre-tested self-administered questionnaire were used to assess the prevalence and risk factors of depression, respectively. Results: The students' age ranged from 15 ­ 34 years, with a mean age of 21.8 ± 3.3 years. Many risk factors which could predispose students to depression were identified. Overall, 96 (32.0%) students were found to have depression. Of these, 59 (19.0%) had mild depression, 4 (1.3%) had severe depression, 53 (39.3%) were pre-clinical students, and 43 (26.1%) were clinical students. Emotional problems (OR 2.205, 95% CI 1.122 ­ 3.749, p = 0.020), financial challenges (OR 3.971, 95% CI 2.170 ­ 7.269, p < 0.001) and smoking (OR 6.877, 95% CI 1.731 ­ 27.327, p = 0.006) were the significant independent predictors of depression. Conclusion: The prevalence of depression was high among medical students. There is a need to include screening for risk factors of depression in the routine medical examinations for new students admitted into medical schools

Consequences of COVID-19 on access and delivery of mental health care in two rural Ethiopian districts. A mixed method study

Introduction: The impact of COVID-19 on people with Severe Mental Health Conditions (SMHCs) has been neglected. We aimed to describe the effect and explore the consequences of COVID-19 on people with SMHCs and mental health services in rural districts of Ethiopia. Methods: We conducted a mixed-method study nested within well-characterized population cohorts in Butajira and Sodo districts. We sampled 336 people (168 people with SMHCs, 168 comparisons) in a cross-sectional survey. We conducted qualitative key informant interviews with psychiatric nurses (n=3), primary health care workers (n=3), service users (n=4), family members (n=6) and community members (n=2). We assessed wellbeing (WHO wellbeing index), social support (Oslo social support scale; OSS) and food security quantitatively and used thematic analysis to explore impacts. Results: People with SMHCs reported significantly lower wellbeing (WHO wellbeing score 52 vs. 72; p<0.001), less social support (OSS score 8.68 vs. 9.29; p<0.001), worse living standards (47.0% vs. 29.0%; p<0.001) and increased food insecurity (26.0% vs. 12.5%; p<0.001). Household economic status worsened for over one-third of participants. Participants reported increased relapse, exacerbated stigma due to perceived susceptibility of people with SMHCs to COVID-19, and increased restraint. In mental healthcare settings, there was decreased patient flow but an increase in new cases. Innovations included flexible dispensing of medicines, longer appointment intervals and establishing new treatment centers. Conclusions: COVID-19 had negative consequences on people with SMHCs and mental health services, which must be anticipated and prevented in any future humanitarian crisis. Adaptive responses used during COVID may increase health system resilience

Prévalence et facteurs associés au diabète chez les conducteurs de taxi-motos de la ville de Parakou (Bénin) en 2021 / Prevalence and associated factors with diabetes among motorcycle taxi drivers in the city of Parakou (Benin) in 2021

Introduction : le diabète est un véritable fléau mondial par sa prévalence en croissance. Les objectifs de la présente étude étaient de déterminer la prévalence du diabète et d'identifier les facteurs associés au diabète chez les conducteurs de taximotos de la ville de Parakou en 2021. Méthodes : il s'agissait d'une étude transversale, descriptive et analytique concernant les conducteurs de taxi-motos de la ville de Parakou et réalisée du 08 février au 31 mars 2021. Résultats : au total 422 conducteurs de taxi-motos enquêtés. L'âge moyen était de 36,45±10 ans ; 85,8% avaient un revenu mensuel d'au moins 40000 FCFA, 9,7% avaient une hypertension artérielle. L'anxiété et la dépression étaient présentes respectivement chez 5,5% et 15,9 % des sujets enquêtés. La prévalence du diabète était de 2,84%. Les facteurs qui étaient significativement associés sont l'âge de 30 ans et plus (p=0,001), le tour de taille élevé (p=0,03) et la durée de sommeil journalier anormale (p=0,03). Conclusion : la prévalence du diabète est faible chez les conducteurs de taxi-motos et les facteurs associés sont l'âge de 30 ans et plus, le tour de taille élevé et la durée de sommeil journalier anormale. Il est important de communiquer pour un changement de comportement afin que les conducteurs de taximotos adoptent une hygiène de vie saine.

Introduction: Diabetes is a real global scourge due to its growing prevalence. The objectives of this study were to determine the prevalence of diabetes and to identify the associated factors with diabetes among motorcycle cab drivers of Parakou city in 2021. Methods: This was a cross-sectional, descriptive and analytical study of motorcycle cab drivers in Parakou, city conducted from February 8 to March 31, 2021. Results: a total of 422 subjects surveyed. The average age was 36.45±10 years; 85.8% had a monthly income of at least 40,000 FCFA, 9.7% had high blood pressure. Anxiety and depression were present respectively in 5.5% and 15.9% of the subjects surveyed. The prevalence of diabetes was 2.84%. The factors that were significantly associated with diabetes were age 30 years and older (p=0.001), high waist circumference (p=0.03) and abnormal daily sleep duration (p=0.03). Conclusion: The prevalence of diabetes is low among motorcycle cab drivers and the associated factors are age 30 years and over, high waist circumference and abnormal daily sleep duration.

Perceptions and attitudes of black men in a rural district of south africa towards depression and its treatment

Depression is a major contributor to the overall global burden of disease, impacting social life, family life and occupational functioning if left untreated. Despite its high prevalence and morbidity, the evidence suggests that men are hesitant to seek help, with a large percentage remaining undiagnosed. This study aimed to determine the attitudes and perceptions related to depression and its treatment amongst black men in a rural district of South Africa.Methods: The design used was an exploratory descriptive qualitative design. Participants were selected by purposive sampling. Individual semistructured interviews were conducted, which were audio-recorded and transcribed verbatim. The data were subsequently analysed thematically to develop themes and subthemes.Results: Participants described depression as a psychological problem associated with lack of sleep, loneliness, feeling unwanted, increased stress, deep sadness, weight loss, forgetfulness, crying over small things and lack of concentration. Collectively, the interviews with participants showed a good understanding of the psychosocial determinants of depression but exposed a lack of awareness of its biological determinants. A large proportion (n = 13; 68.4%) of participants reported not having knowledge of available services in their area for people seeking treatment for depression. Barriers to help-seeking behaviours were fear of social stigma, fear of expressing their feelings, gender norms and stereotypes and lack of trust in others.Conclusion: Interventions such as support groups and mental health awareness programmes to counteract personal perceptions may help to improve and expand the effectiveness of depression treatment. The results highlight the future need to raise awareness of depressive symptoms and expand health outreach programmes.Keywords: depression; perceptions; attitudes; mental health; help-seeking; treatment; SouthAfrica.

Late-life depression and the family physician

Late-life depression (LLD) is a common disorder seen in clinical practice. Depression in this population group is often left undetected and untreated. The majority of elderly individuals who seek help present to the primary health care setting. The family physician is ideally placed to screen for symptoms of LLD, given that they often have longitudinal knowledge of the patient's history, premorbid personality, functioning and overall health status. An understanding of risk factors, differential diagnoses, appropriate opportunistic screening toolsand decision-making around management plans can assist the family physician in the early detection and treatment of these patients. In doing so, this may lead to a decrease in mortality and morbidity and enhance the patient's quality of life.Keywords: Late life; depression; older; geriatric mental health; major depressive disorder; antidepressants; cognitive impairment; dementia.

War in the midst of a pandemic: the synergy accelerating mental health disorders

War and displacement can have long-term and disastrous repercussions on people's mental, emotional, and physical health. Bombardments, invasions, occupation desertion, and being forced to flee diminish people's sense of security. The risk of being hurt or maimed as a result of conflict causes acute dread, which sets in motion other cascades of mental illnesses such as depression, anxiety, and post-traumatic stress disorder. These mental and emotional impacts are exacerbated by a co-existing pandemic, as migration and populations forced into cramped, dangerous situations are likely to contribute significantly to disease spread, particularly given the current surge of the highly transmissible omicron variant of COVID-19. This threat to life and livelihood eventually leaves some survivors with mental health disorders.

Contemporary prevalence and predictors of anxiety among patients living with HIVAIDS in Ghana

Objectives: To identify the prevalence and associated factors of anxiety in people living with HIV/AIDS in a tertiary centre in Ghana. Design: The study employed a cross-sectional design. Setting: The study was conducted in the outpatient HIV clinic of a tertiary hospital. Participants: Participants were adult PLWHA receiving OPD care, including those established on combined antiretroviral therapy (cART) and newer patients who were not on cART. Four hundred ninety-five participants aged ≥30 years were consecutively enrolled on the study. Interventions: Demographic and clinical data were collected using standard questionnaires and patient files. Anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS). Multivariate logistic regression analysis was done to identify associated factors. Main outcome measure: Proportion of PLWHA who had HADS score of ≥8 Results: Overall prevalence of anxiety was 61.0% (95%CI: 56.6 ­ 65.3), with no significant difference between recently diagnosed (≤ 6 months, 64.3%) and those with established diagnoses (>6 months, 59.1%). Urban residence (aOR: 1.67, 95%CI: 1.12 ­ 2.51), alcohol use (aOR: 1.64, 95%CI: 1.13 ­ 2.38) and depression (aOR: 13.62, 95%CI: 7.91 ­ 23.45) were independently associated with anxiety. Conclusion: In this sample, 6 in 10 Ghanaian PLWHA had evidence of anxiety. Liaison with the national mental health service for more comprehensive and integrated care and further research into the mental health of PLWHA is recommended to reduce this high burden of anxiety

The prevalence and correlates of anxiety and depression amongst essential workers during the COVID-19 lockdown in Ekiti State, Nigeria

Background: Essential workers are imperative in the fight against the coronavirus disease (COVID-19) pandemic. Aim: To assess the prevalence and factors associated with anxiety and depression among essential workers during the COVID-19 pandemic and lockdown. Setting: This study was set in Ekiti State, Nigeria. Method: This was a cross-sectional study involving essential workers in Ekiti State Nigeria, during the COVID-19 pandemic and lockdown. A total of 588 essential workers were sampled. Online socio-demographic variables and the Hospital Anxiety and Depression Scale, a 14 item self-reported questionnaire were used. Results: The prevalence of anxiety and depression among the respondents was 93.4% (CI = 91.2­95.2) and 64.3% (CI = 60.4­68.4) respectively. Among the health workers, the prevalence of anxiety and depression were 96.5% (CI =94.8­98.1) and 66.5% (CI = 60.5­69.8) respectively while the prevalence of anxiety and depressive symptoms among non- health workers were 84.6% (CI = 78.7­90.1) and 61.5% (CI = 54.2­69.4) respectively. The odds ratio (OR) of depressive symptoms was increased among, respondents who were not satisfied with the support they received from the government during the pandemic (AOR = 2.071, CI = 1.350­2.213), respondents that were 35 years and younger (AOR = 1.512, CI = 1.033­2.213) and reduced amongst Christians (AOR = 0.501, CI = 0.286­0.879). The odd of anxiety was increased among health workers compared to non-health workers (AOR = 3.700, CI = 1.744­7.851) and the odds of anxiety was reduced among respondents with previous history of mental illness (AOR = 0.215, CI = 0.049­0.943). Conclusion: Anxiety and depressive symptoms were common mental illness among essential workers working during the COVID-19 lockdown, therefore their mental health should be adequately considered to sustain the fight against the virus.

Stress, anxiété, dépression et qualité de vie des patients tuberculeux pharmacorésistants à Kinshasa, République Démocratique du Congo / Stress, anxiety, depression and quality of life of drug-resistant tuberculosis patients in Kinshasa, Democratic Republic of the Congo

Contexte & objectif. La prise en charge médicale de la tuberculose pharmacorésistante connaît des progrès dans le monde. Mais, le volet psychosocial a été peu exploré en République Démocratique du Congo. La présente étude a évalué la qualité de vie des patients tuberculeux pharmacorésistants (PTP) suivis au Centre d'Excellence Damien (CEDA) à Kinshasa. Méthodes. L'échelle de stress perçu (PSS), l'Hospital Anxiety and Depression Scale (HADS) et l'Indicateur de Santé Perceptuelle de NOTTINGHAM (ISPN) ont été utilisés dans une étude transversale réalisée du 1er avril au 31 décembre 2018 sur 81 PTP hospitalisés au CEDA de Kinshasa. La méthode de régression logistique a recherché les déterminants de la qualité de vie. Résultats. Au cours de la période de l'étude, 81 PTP étaient reçus dont 62 TB multirésistants (TB MR, 76,5%) contre 19 TB ultrarésistants (TBUR, 23,5%), constituant les deux groupes d'étude. L'âge moyen des sujets était de 34,7±14,3 ans. Les hommes étaient légèrement prépondérants (53 %) avec un sex ratio H/F de 1,1. La tranche d'âge de 21 à 30 ans était plus représentée (35%). Trois-quarts des sujets étaient solitaires (75%), plus de deuxtiers avaient un niveau secondaire (69%), plus de la moitié n'avait pas d'occupation (56%), près de deux-tiers fréquentaient les Eglises indépendantes (60%). Trente-cinq pourcents des patients avaient une mauvaise qualité de vie. Celle-ci était liée à l'âge >40 ans, au type TBMR, au retard d'accompagnement psychosocial, au niveau d'étude primaire, à la présence de la co-infection tuberculose- VIH/SIDA, au stress perçu et à l'anxiété-dépression. Conclusion. Les patients tuberculeux pharmacorésistants à Kinshasa ont une qualité de vie altérée. Cette situation est favorisée par l'âge >40 ans, le type de tuberculose pharmacorésistante, le retard d'accompagnement psychosocial, le faible niveau d'étude, la présence de la coinfection tuberculose-VIH/SIDA, le stress perçu, l'anxiété et la dépression.

Context and objective. Despite many progress in the treatment of drug-resistant tuberculosis, psychosocial aspects remain poorly adressed in the Democratic Republic of Congo. This study aimed to evaluate the quality of life of drugresistant tuberculosis patients. Methods. A crosssectional survey was conducted in hospitalized drug-resistant tuberculosis patients at CEDA Kinshasa, during the period from April 1 to December 31th, 2018, through the perceived stress scale (PSS), the Hospital Anxiety and Depression Scale (HADS) and the NOTTINGHAM Health Profil (NHP) tools. Data from 62 multdrug rerestitant TB patients (MDR TB, 76,5%) were compared with 19 ultraresistant (PXDR, 23.5 %) and analyzed, using a multivariate logistic regression analysis to assess the determinants of quality of life. Results. Among a total of 81 pharmaco-resistant TB patients, average age 34.7 ± 14.3 years, with a slight man preponderance (53 %), 35% had a poor quality of life. This was linked to age > 40 years, MDRTB type, delayed psychosocial support, primary education, the presence of TBHIV co-infection, and perceived stress and anxiety-depression. Conclusion.The study reveals an impaired quality of life in Drug-resistant tuberculosis patients in Kinshasa, with some identified correlates. Targeted measures are needed to improve the management of these patients

Intervention on depression and insomnia symptoms during the COVID-19 pandemic

Objectives: The COVID-19 pandemic has created significant psychological challenges globally. Evidence has been mounting of greater emotional distress and possible worsening of underlying psychiatric disorders, due to repercussions of COVID-19. In addition, the pandemic has created barriers to access for help, due to social distancing and travel restrictions. Thus, creating a major need for effective interventions that can be accessed safely from home and provide coping tools which can be learned and practiced while in isolation. An App based Yoga of Immortals (YOI) program is one such strategy to help cope with stressful situations. The objective of this study was to investigate if the YOI program can provide significant benefit for depressive and insomnia symptoms. Material and Methods: Participants in this study were asked to complete two brief online but well validated mental health screening tools before intervention. This was followed by a 7-week long YOI intervention. Following the intervention, participants were once again asked to complete the online validated questionnaires. The survey questionnaires included baseline demographic data and validated scales for measuring insomnia severity Insomnia severity Index (ISI) and levels of depression symptoms patient health questionnaire-8, (PHQ-8). All statistical analysis was performed using the Statistical Package for the Social Science. Results: SY YOI intervention of 7 weeks significantly improved the ISI scores as well as PHQ-8 scores in the study population (P < 0.0001 in all comparisons). Conclusion: YOI intervention is an effective intervention strategy for decreasing insomnia and depression symptoms, even during the pandemic

Depressive symptoms disrupt leftward cradling

Objective: Leftward cradling bias is thought to facilitate optimal interaction between mother and infant. There is mixed evidence indicating this bias may be disrupted by depression. This study investigated the relationship between depressive symptoms and preferred cradling side (i.e., cradling bias) in nulliparous women.Method: Six hundred and nineteen females, aged 18 to 25 years, were asked to imagine cradling an infant to soothe it. This instruction was given on four separate occasions. Participants also completed the Beck Depression Inventory-II. All data were collected via an online survey.Results: As the number of depressive symptoms increased, leftward cradling decreased. Although this relationship was not statistically significant, a pattern emerged: As depressive symptoms increased, so too did the likelihood of cradling to the right. Furthermore, those scoring highest on depressive symptoms were more likely to cradle inconsistently to the left, consistently to the right, or show no bias, when compared to those scoring lower on depressive symptoms.Conclusions: Theory suggests that leftward cradling is facilitated by right hemisphere processes involved in relating to others. A relationship between affective symptoms such as depressive symptoms and reduced leftward cradling bias supports this argument. It is argued that leftward cradling facilitates optimal interactions between cradler and infant. Consequently, disruptions of leftward cradling have implications for child development

Adolescent mothers: a qualitative study on barriers and facilitators to mental health in a low-resource setting in Cape Town, South Africa

Background: Pregnant and postnatal adolescent women are a high-risk group for common mental disorders (CMDs); however, they have low levels of engagement and retention with mental health services. Negative consequences of CMDs have been documented for both mother and child. Aim: The study aimed to explore the barriers and facilitators to service access for adolescents in low-resource settings. Setting: We interviewed 12 adolescents, aged 15­19 years, from low-resource settings in Cape Town, South Africa. Participants had previously engaged with a mental health service, integrated into maternity care. Methods: Twelve semi-structured, individual interviews were used for this qualitative study. Interviews were recorded, transcribed and coded. A framework analysis was employed for data analysis. Results: Adolescents perceived considerable stigma around both teenage pregnancy and mental illness, which inhibited use of mental health services. Other barriers included fearing a lack of confidentiality as well as logistical and environmental obstacles. Service uptake was facilitated by support from other adults and flexible appointment times. Face-to-face individual counselling was their preferred format for a mental health intervention. Conclusion: Several key components for adolescent-friendly mental health services emerged from our findings: integrate routine mental health screening into existing obstetric services to de-stigmatise mental health problems and optimise screening coverage; coordinate obstetric and counselling appointment times to rationalise the use of limited resources; and sensitise care providers to the needs of adolescents to reduce stigma around adolescent sexual activity and mental illness. A non-judgemental, caring and confidential relationship between counsellors and clients is crucial for successful interactions