BackgroundThe Mental Health Country Profile is a tool that was generated by the International Mental Health Policy and Services Project to inform policy makers, professionals and other key stakeholders about important issues which need to be considered in mental health policy development. The Mental Health Country Profile contains four domains, which include the mental health context, resources, provision and outcomes. We have aimed to generate a Mental Health Country Profile for Vietnam, in order to highlight the strengths and weaknesses of the Vietnamese mental health situation, in order to inform future reform efforts and decision-making.MethodsThis study used snowball sampling to identify informants for generating a Mental Health Country Profile for Vietnam, and the data gathering was done through semi-structured interviews and collection of relevant reports and documents. The material from the interviews and documents was analysed according to qualitative content analysis.ResultsMarked strengths of the Vietnam mental health system are the aims to move toward community management and detection of mental illness, and the active involvement of several multilateral organizations and NGOs. However, there are a number of shortages still found, including the lack of treatment interventions apart from medications, the high proportion of treatments to be paid out-of-pocket, prominence of large tertiary psychiatric hospitals, and a lack of preventative measures or mental health information to the public.ConclusionsAt the end of this decade, mental health care in Vietnam is still characterised by unclear policy and poor critical mass especially within the governmental sector. This initial attempt to map the mental health situation of Vietnam suffers from a number of limitations and should be seen as a first step towards a comprehensive profile.

Clinical burnout is one of the leading causes of work absenteeism in high- and middle-income countries. There is hence a great need for the identification of effective intervention strategies to increase return-to-work (RTW) in this population. This review aimed to assess the effectiveness of tertiary interventions for individuals with clinically significant burnout on RTW and psychological symptoms of exhaustion, depression and anxiety. Four electronic databases (Ovid MEDLINE, PsychINFO, PubMed and CINAHL Plus) were searched in April 2016 for randomized and non-randomized controlled trials of tertiary interventions in clinical burnout. Article screening and data extraction were conducted independently by two reviewers. Pooled odds ratios (ORs) and hazard ratios (HRs) were estimated with random-effects meta-analyses. Eight articles met the inclusion criteria. There was some evidence of publication bias. Included trials were of variable methodological quality. A significant effect of tertiary interventions compared with treatment as usual or wait-list controls on time until RTW was found, HR = 4.5, 95% confidence interval (CI) = 2.15-9.45; however, considerable heterogeneity was detected. The effect of tertiary interventions on full RTW was not significant, OR = 1.33, 95% CI = 0.59-2.98. No significant effects on psychological symptoms of exhaustion, depression or anxiety were observed. In conclusion, tertiary interventions for individuals with clinically significant burnout may be effective in facilitating RTW. Successful interventions incorporated advice from labor experts and enabled patients to initiate a workplace dialogue with their employers.

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Abstractobjectives To examine the association of low birthweight (LBW) and prematurity with clinically significant symptoms of antenatal common mental disorders (ACMDs) during the third trimester of pregnancy in a semi-rural area in Vietnam.methods Prospective community-based cohort study. Severity of ACMD symptoms was assessed with the Edinburgh Depression Scale, low birthweight was defined as below 2500 g, and gestational age was estimated according to last menstrual period. Reproductive and socio-demographic risk factors were measured as potential confounders of the association between ACMD and the outcomes. We conducted bivariate analyses of association between ACMD and the perinatal outcomes, employing chi-square tests, crude odds ratios and 95% confidence intervals. Multiple logistic regression analysis was used to adjust for confounding.findings We found a prevalence of clinically significant symptoms of ACMDs of 37.4%, which were significantly associated with preterm birth (adjusted OR 1.98, CI 95% = 1.14-3.43) and low birthweight (adjusted OR 2.24, CI 95% = 1.02-4.95). Among the examined risk factors for the outcome measures, only maternal age was found to be statistically significant for low birthweight and preterm birth.conclusions This study confirms that clinically significant symptom levels of ACMD in Vietnam are associated with preterm birth and low birthweight. These findings highlight the importance of cost-effective public health interventions for ACMD in Vietnam and further exploration of its physiological link with preterm birth and low birthweight.keywords depression, maternal health, child health, low birthweight, premature birth, Vietnam Background

Mindfulness Based Interventions (MBIs) have recently been increasingly used in clinical settings, and research regarding their effects on health has grown rapidly. However, with regard to the physiological effects of mindfulness practices, studies have reported associations that vary in strength and direction. Therefore, in this systematic review and meta-analysis, we aimed to systematically identify, appraise, and summarize the existing data from randomized and non-randomized controlled trials that examine physiological effects of the standardized MBIs by focusing on pro-inflammatory cytokines and C-reactive protein, and commonly used heart rate variability parameters. The following electronic databases were searched: MEDLINE (via Ovid), PsychINFO (via Ovid), PubMed, Web of Science, EMBASE, CINAHL, ProQuest (Dissertations and Theses), and Centre for Reviews and Dissemination. The systematic review identified 10 studies to be included in the meta-analysis, comprising in total 607 participants. The meta-analysis ended up with mixed and inconclusive results. This was assumedly due to the small number of the original studies and, in particular, to the lack of large, rigorously conducted RCTs. Therefore, the current meta-analysis highlights the necessity of larger, more rigorously conducted RCTs on physiological outcomes with standardized MBIs being compared to various forms of active controls, and with more long-term follow-ups.