A comparison of traumatic experiences and human rights violations of persons with mental health conditions or psychosocial disabilities and persons with other disabilities.

This study compares the traumatic and human rights violation experiences of persons with mental health conditions or psychosocial disabilities and those of persons with other disabilities in the Philippines. Additionally, the role of gender in exposure to traumatic experience and human rights protection levels is explored. Of those registered as persons with disabilities in the city of Muntinlupa, 3000 subjects were randomly selected and 1,024 among them (Male = 510, Female = 512, Others = 2) agreed to participate in this study. This comparative study adopts a cross-sectional design. The survey was conducted using a structured questionnaire. The researchers mobilized health workers, officially recruited by the city, to visit the target participants' houses and to distribute the questionnaires to collect data. The questionnaire comprises items related to the participants' socio-demographic characteristics, exposure to traumatic experiences, and human rights-based well-being. Regarding the frequency of exposure to traumatic experiences, a little difference was found in physical domestic violence (abuse) between the two groups (Frequency = 20 (9.66), 44 (5.39%), χ2 = 5.154, p < 0.05). Regarding human rights-based well-being, no significant difference was found between persons with mental health conditions or psychosocial disabilities and persons with other disabilities. However, the human rights-based well-being of women with mental health conditions or psychosocial disabilities was significantly worse than that of women with other types of disabilities. Concrete and day-to-day human rights challenges in several areas in addition to inaccessibility to various services may have contributed to the human rights challenges encountered by women with mental health conditions or psychosocial disabilities. De-stigmatization of women with mental health conditions or psychosocial disabilities, the implementation of awareness-raising campaigns on various levels, and developing capacity of women with mental health conditions or psychosocial disabilities on how to protect their own rights may help improve the status quo.

Effect of Diversity Education on Young Adolescents in Japan: Toward the "Do No Harm" Principle.

This study evaluated the impact of a semi-structured diversity education program on young adolescents, which included five 45-min sessions facilitated by schoolteachers using an instructors' manual. The study compared changes in knowledge and attitude related to diversity, self-esteem, and mental health among participants before and after the program. The participants were 776 junior high school students. Self-esteem and mental health conditions were assessed with the Rosenberg Self-Esteem Scale (RSES) and Kessler 6-Item Psychological Distress Scale (K6). The ratio of those who answered the knowledge and attitude questions correctly increased significantly for most questions, while the ratio decreased significantly for two questions. The RSES scores improved significantly after the program, but the difference was very small. Mental health, as measured by K6, became significantly worse after the program. A logistic regression analysis indicated that lower K6 scores before the program and worse academic grades had significantly higher odds ratios; being a girl, not having a disability, and having close friends were associated with worse K6 scores after the program. Further, this indicates the importance of developing processes based on evidence and the "nothing about us without us" principle.

Effectiveness of Psychological First Aid e-Orientation among the General Population in Muntinlupa, the Philippines.

This present study examined the effectiveness of the Psychological First Aid (PFA) e-orientation as well as face-to-face PFA orientation among the general population in Muntinlupa City, the Philippines. The e-orientation group consisted of 150 participants who received a two-hour PFA e-orientation (male: 47, female: 97, others: 6, mean age: 33.4 (SD = 12.1)), the face-to-face (F2F) group consisted of 139 participants who received a two-hour face-to-face PFA orientation (male: 41, female: 95, others: 3, mean age: 35.0 (SD = 13.8)), and the control group consisted of 117 participants who received a two-hour face-to-face health promotion orientation for obesity (male: 48, female: 65, others: 4, mean age: 34.2 (SD = 13.8)). In order to see the effect of these interventions, the confidence to provide PFAs was compared between the pre- and post-interventions in each group with paired t-tests. Further, the number of correct answers regarding the knowledge on PFA was also compared between the pre- and post-interventions utilizing a McNemar test. The results demonstrated that the mean scores on the confidence increased significantly in the e-orientation (pre: 25.1 (SD = 4.7), post: 26.1 (SD = 5.3), p = 0.02) and F2F (pre: 26.2 (SD = 6.0), post: 29.6 (SD = 6.9), p < 0.01) groups. Regarding knowledge on PFA, in the e-orientation group, the number of those who answered correctly increased significantly in a question (pre: 10, post: 24, p = 0.01), and there was a trend for improvement in another question (pre: 63, post: 76, p = 0.06). In the F2F group, the number of those who answered correctly increased significantly in two questions (pre: 21, post: 38, p < 0.01, and pre: 5, post: 14, p = 0.05), and there were trends for improvement in two questions (pre: 69, post: 82, p = 0.06, and pre: 17, post: 27, p = 0.09), while in the control group, there were no significant differences in any of the questions between pre- and post-intervention. The results suggest that both the PFA e-orientation and face-to-face orientation are effective for the general population in terms of increasing confidence and knowledge related to PFA.

Quality of life among people who use drugs living in poor urban communities in the Philippines.

BACKGROUND: The quality of life (QOL) and mental health of people who use drugs (PWUD) in the Philippines, especially those living in poor urban communities, are highly concerning due to the situations surrounding drug use and the ongoing hard-line antidrug policy. This study aimed to investigate the QOL and mental health status of PWUD, compare them with a comparison group with no history of drug use, and identify factors associated with QOL among Filipino PWUD. METHODS: A cross-sectional study was conducted with recruitment from a community-based rehabilitation programme and poor urban communities in Muntinlupa in 2018. QOL was measured using the WHOQOL-BREF, while psychological distress and posttraumatic stress disorder (PTSD) were measured using the Kessler Psychological Distress Scale (K-6) and the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), respectively. Multivariable linear regressions with each WHOQOL-BREF domain as a dependent factor were conducted to establish three predictions: age- and gender-adjusted QOL means, factors associated with QOL among PWUD, and interaction of lifetime drug use with each covariate. RESULTS: In total, 272 PWUD and 402 comparison participants were recruited. Most PWUD were current drug users (53%), primarily of methamphetamine (70%). Among PWUD, the prevalence of moderate to severe psychological distress was 70%, and probable PTSD was 28%-both rates higher than those among the comparison group. All four QOL domain scores (physical, psychological, social, and environmental) of PWUD were lower than those of the comparison group. Multivariable regressions showed that psychological distress, current drug use, selling drugs, experiencing discrimination, and being never-married were associated with lower QOL. Higher individual income, household resources, social activity participation, and service use for drug use problems were associated with higher QOL among PWUD. Stratified and interaction analyses revealed that the QOL of PWUD was more sensitive to changes in individual income relative to the QOL of comparison group. CONCLUSION: A comprehensive intervention addressing psychological distress reduction, economic empowerment, and social inclusion-complementary to abstinence-oriented programmes-may improve the well-being of Filipino PWUD.

Postoperative Pain Management in Patients With Ulcerative Colitis.

Inflammatory bowel disease (IBD) is a group of chronic inflammatory disorders of the gastrointestinal tract including ulcerative colitis (UC) and Crohn's disease. Pain management can be challenging in patients with IBD because there are limitations on the use of analgesics. Use of nonsteroidal anti-inflammatory drugs is not recommended in patients with IBD because there is risk of relapse of IBD and an overall increase in disease activity. Opioids, although frequently used for treating severe acute pain, can have additional risks and complications in patients with IBD such as ileus, toxic megacolon, and narcotic bowel syndrome. Furthermore, little information is available in the literature on pain management in these patients undergoing noncolorectal surgery. This report describes 2 patients with UC in whom postoperative pain following oral and maxillofacial surgery was managed by intravenous patient-controlled analgesia with pentazocine. Apart from the development of acute dystonia in 1 case that was likely due to the use of droperidol for prevention of postoperative nausea and vomiting, postoperative pain was well controlled by pentazocine in both patients without any complications or UC exacerbations.

Comprehensive SDG goal and targets for non-communicable diseases and mental health.

The negotiations on the SDG goals and targets, leading to the sustainable development Declaration in September 2015, are now in the final stages. Ensuring that people with mental disorders are not left behind in the global development program from 2015 to 2030 will require specific and explicit commitments and targets against which progress in mental health can be measured and reported. The arguments for inclusion of explicit mental health targets in the SDGs are compelling. The final negotiations on the SDG goals and targets will now determine whether people with mental illness and psychosocial disabilities will continue to be neglected or will benefit equitably from inclusion in the post-2015 development program.

Risky sexual behaviors, mental health, and history of childhood abuse among adolescents.

Although it seems evident that attention should be paid to risky sexual behaviors and their association with mental health among young people, this topic has not been thoroughly investigated. The present study aims to explore the relationship between sexual risk behaviors and mental health among adolescents. The participants were 251 adolescents in a juvenile detention facility (221 males and 31 females) as the "delinquent" group and 367 high school students (167 males and 200 females) as the "non-delinquent" group. A questionnaire including the Kessler 10, the Impact of Event Scale-Revised, and the Adolescent Dissociative Experience Scale was employed to measure mental health status as well as sexual risk behaviors, suicidal ideation/attempts, and abuse history. Having a history of sexual abuse or of physical abuse was associated with age when one first had sex among males with delinquent behaviors, while same tendency was observed among males without delinquent behaviors. Among the female with delinquent behaviors group, past abuse history was significantly associated with higher number of sex partners. In the non-delinquent group, better mental health among males and, contrarily, worse mental health among females were associated with having more sex partners. The results highlight the importance of addressing abuse history among females and males. Given that poor mental health status in the adolescents was associated with risky sexual behaviors, adolescents are a vulnerable group that requires attention in terms of sexual and reproductive health that integrates mental health and psychosocial components.

Persistent distress after psychological exposure to the Nagasaki atomic bomb explosion.

BACKGROUND: Although there is speculation that individuals living in the vicinity of nuclear disasters have persistent mental health deterioration due to psychological stress, few attempts have been made to examine this issue. AIMS: To determine whether having been in the vicinity of the Nagasaki atomic bomb explosion in the absence of substantial exposure to radiation affected the mental health of local inhabitants more than half a century later. METHOD: Participants were randomly recruited from individuals who lived in the vicinity of the atomic bomb explosion in uncontaminated suburbs of Nagasaki. This sample (n = 347) was stratified by gender, age, perception of the explosion and current district of residence. Controls (n = 288) were recruited from among individuals who had moved into the area from outside Nagasaki 5-15 years after the bombing, matched for gender, age and district of residence. The primary outcome measure was the proportion of those at high risk of mental disorder based on the 28-item version of the General Health Questionnaire, with a cut-off point of 5/6. Other parameters related to individual perception of the explosion, health status, life events and habits were also assessed. RESULTS: Having been in the vicinity of the explosion was the most significant factor (OR = 5.26, 95% CI 2.56-11.11) contributing to poorer mental health; erroneous knowledge of radiological hazard showed a mild association. In the sample group, anxiety after learning of the potential radiological hazard was significantly correlated with poor mental health (P<0.05), whereas anxiety about the explosion, or the degree of perception of it, was not; 74.5% of the sample group believed erroneously that the flash of the explosion was synonymous with radiation. CONCLUSIONS: Having been in the vicinity of the atomic bomb explosion without radiological exposure continued to be associated with poorer mental health more than half a century after the event. Fear on learning about the potential radiological hazard and lack of knowledge about radiological risk are responsible for this association.

The Ha Noi Expert Statement: recognition of maternal mental health in resource-constrained settings is essential for achieving the Millennium Development Goals.

Mental health problems in women during pregnancy and after childbirth and their adverse consequences for child health and development have received sustained detailed attention in high-income countries. In contrast, evidence has only been generated more recently in resource-constrained settings.In June 2007 the United Nations Population Fund, the World Health Organization, the Key Centre for Women's Health in Society, a WHO Collaborating Centre for Women's Health and the Research and Training Centre for Community Development in Vietnam convened the first international expert meeting on maternal mental health and child health and development in resource-constrained settings. It aimed to appraise the evidence about the nature, prevalence and risks for common perinatal mental disorders in women; the consequences of these for child health and development and ameliorative strategies in these contexts.The substantial disparity in rates of perinatal mental disorders between women living in high- and low-income settings, suggests social rather than biological determinants. Risks in resource-constrained contexts include: poverty; crowded living situations; limited reproductive autonomy; unintended pregnancy; lack of empathy from the intimate partner; rigid gender stereotypes about responsibility for household work and infant care; family violence; poor physical health and discrimination. Development is adversely affected if infants lack day-to-day interactions with a caregiver who can interpret their cues, and respond effectively. Women with compromised mental health are less able to provide sensitive, responsive infant care. In resource-constrained settings infants whose mothers are depressed are less likely to thrive and to receive optimal care than those whose mothers are well.The meeting outcome is the Hanoi Expert Statement (Additional file 1). It argues that the Millennium Development Goals to improve maternal health, reduce child mortality, promote gender equality and empower women, achieve universal primary education and eradicate extreme poverty and hunger cannot be attained without a specific focus on women's mental health. It was co-signed by the international expert group; relevant WHO and UNFPA departmental representatives and international authorities. They concur that social rather than medical responses are required. Improvements in maternal mental health require a cross-sectoral response addressing poverty reduction, women's rights, social protection, violence prevention, education and gender in addition to health.

Association between sexual risk behaviors and drug and alcohol use among young people with delinquent behaviors.

OBJECTIVES: This study examined the association between sexual risk behaviors and drug and alcohol use among young people in a juvenile classification home. METHODS: The subjects completed a questionnaire including demographic information, questions on sexual risk behaviors, Drug Abuse Screening Test (DAST-20), Adolescent Alcohol Involvement Scale (AAIS) and Rosenberg Self-Esteem Scale (RSE). RESULTS: Median of the lifetime number of sex partners was 2. The mean age for first engaging in sexual intercourse was 14.81. Non-school-attendance, higher DAST-20 and AAIS scores produced significant odds ratios for having a greater number of sex partners, and higher DAST-20 scores produced a significant association with an earlier sexual debut. CONCLUSION: This study indicated association between sexual risk behaviors and substance use among young men.

Comparative study of the prevalence of suicidal behavior and sexual abuse history in delinquent and non-delinquent adolescents.

The present study examined the prevalence of suicidal behavior and sexual abuse history in delinquent and non-delinquent adolescents aged 15-17 years. Results showed that delinquent adolescents, particularly girls, more frequently reported histories of suicidal behavior and sexual abuse than non-delinquent adolescents.

The relationship between past traumatic experience and sickness absence.

BACKGROUND: Past traumatic experiences have been reported to lower stress tolerance, thereby increasing job strain. However, the relationship between past traumatic experiences and employee sickness absence is poorly understood. AIMS: This study explores the relationship between sickness absence and past traumatic experience with regard to the amount of time lapsed after the experience, job strain and other mental health states such as depression and anxiety. METHODS: A total of 3238 workers were assessed for levels of traumatic stress, depressive status, anxiety and job stress. RESULTS: Odds ratios of the presence of traumatic experiences to sickness absence, adjusted for sex, age and depressive and anxiety states, were presented according to the length of time that had passed since the traumatic events. The odds ratio in the 0-1 Years Group was 1.75 (p < 0.05), and the odds ratio for the 19+ Years Group was 1.46 (p < 0.1). CONCLUSIONS: Past traumatic events are related to sickness absence. Sickness absence resulting from a past traumatic experience is important with respect to industrial health.

Mental health of female survivors of human trafficking in Nepal.

Little is known about the mental health status of trafficked women, even though international conventions require that it be considered. This study, therefore, aims at exploring the mental health status, including anxiety, depression and post-traumatic stress disorder (PTSD), of female survivors of human trafficking who are currently supported by local non-governmental organizations (NGOs) in Katmandu, the capital of Nepal, through comparison between those who were forced to work as sex workers and those who worked in other areas such as domestic and circus work (non-sex workers group). The Hopkins Symptoms Checklist-25 (HSCL-25) was administered to assess anxiety and depression, and the PTSD Checklist Civilian Version (PCL-C) was used to evaluate PTSD. Both the sex workers' and the non-sex workers' groups had a high proportion of cases with anxiety, depression, and PTSD. The sex workers group tended to have more anxiety symptoms (97.7%) than the non-sex workers group (87.5%). Regarding depression, all the constituents of the sex workers group scored over the cut-off point (100%), and the group showed a significantly higher prevalence than the non-sex workers (80.8%). The proportion of those who are above the cut-off for PTSD was higher in the sex workers group (29.6%) than in the non-sex workers group (7.5%). There was a higher rate of HIV infection in the sex workers group (29.6%) than in the non-sex workers group (0%). The findings suggest that programs to address human trafficking should include interventions (such as psychosocial support) to improve survivors' mental health status, paying attention to the category of work performed during the trafficking period. In particular, the current efforts of the United Nations and various NGOs that help survivors of human trafficking need to more explicitly focus on mental health and psychosocial support.

The quality of life, mental health, and perceived stigma of leprosy patients in Bangladesh.

The present study aims to determine the quality of life (QOL) and general mental health of leprosy patients compared with the general population, and evaluate contributing factors such as socio-economic characteristics and perceived stigma. A total of 189 patients (160 outpatients, 29 inpatients) and 200 controls without leprosy or other chronic diseases were selected from Dhaka district, Bangladesh, using stratified random sampling. A Bangladeshi version of a structured questionnaire including socio-demographic characteristics-the Bangla version of the World Health Organization Quality of Life Assessment BREF (WHOQOL-BREF)-was used to assess QOL; a Self-Reporting Questionnaire (SRQ) was used to evaluate general mental health; the Barthel Index to control activities of daily living (ADL); and the authors' Perceived Stigma Questionnaire was used to assess perceived stigma of patients with leprosy. Medical records were examined to evaluate disability grades and impairment. QOL and general mental health scores of leprosy patients were worse than those of the general population. Multiple regression analysis revealed that factors potentially contributing to the deteriorated QOL of leprosy patients were the presence of perceived stigma, fewer years of education, the presence of deformities, and a lower annual income. Perceived stigma showed the greatest association with adverse QOL. We conclude that there is an urgent need for interventions sensitive to the effects of perceived stigma, gender, and medical conditions to improve the QOL and mental health of Bangladeshi leprosy patients.

Reliability and validity of the Bangla version of WHOQOL-BREF in an adult population in Dhaka, Bangladesh.

The aim of the present study was to evaluate the validity and reliability of the Bangla version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF) in an adult population in Bangladesh. Approximately 200 adults in the Dhaka district were interviewed using a questionnaire containing the Bangla version of the WHOQOL-BREF, as well as questions related to sociodemographic data. To assess the reliability of WHOQOL-BREF, Cronbach's alpha was calculated, and test-retest reliability was evaluated using intraclass correlation coefficient (ICC) of the first and second administrations. For comparison, approximately 200 leprosy patients were also interviewed with the questionnaire to examine the discriminant validity between groups. On the whole, sufficient validity was observed, and the Bangla version of the WHOQOL-BREF was deemed to be valid and reliable in assessing the quality of life of an adult population in Bangladesh.

Mental health, quality of life, and nutritional status of adolescents in Dhaka, Bangladesh: comparison between an urban slum and a non-slum area.

This study aims to clarify the quality of life (QOL), mental health, and nutritional status of adolescents in Dhaka city, Bangladesh by comparing non-slum areas and slums, and to find the factors associated with their mental health problems. A sample of 187 boys and 137 girls from non-slum areas, and 157 boys and 121 girls from slums, between 11-18 years old were interviewed with a questionnaire consisting of a Bangla translation of the World Health Organization Quality of Life Assessment Instrument (WHOQOL-BREF), Self Reporting Questionnaire (SRQ), Youth Self-Report (YSR) and other questions. The height and weight of the respondents were measured. All significant differences in demographic characteristics, anthropometric measures, and WHOQOL-BREF were found to reflect worse conditions in slum than in non-slum areas. Contrarily, all differences in SRQ and YSR were worse in non-slum areas for both genders, except that the "conduct problems" score for YSR was worse for slum boys. Mental states were mainly associated with school enrollment and working status. Worse physical environment and QOL were found in slums, along with gender and area specific mental health difficulties. The results suggest gender specific needs and a requirement for area sensitive countermeasures.