Positive health is one of the main components of person centered integrative diagnosis, as it involves the understanding of the patient's clinical condition within his context. Poverty is an important contextual factor that has been related to negative aspects of mental health in many studies, but has been studied little in regard to positive health, raising the importance of integrative care in poor persons. Objective: To identify in an adult population the extent to which poverty indicators are related to positive mental health indicators. Methods: The study consisted of a face-to-face household survey of 6555 community aged 18 years and older residents in five cities of the coast of Peru, selected trough a probabilistic three-stage sample procedure. The study integrated person-centered diagnosis proposals and other positive aspects of health as part of a comprehensive assessment which included an adaptation and complementation of the International Guidelines for Diagnostic Assessment (IGDA) diagnostic suggestions through the following instruments: the MINI International Neuropsychiatric Interview ICD-10 version, the Quality of Life Index, the Mental Health Questionnaire (MHQ) elaborated in Colombia. Socioeconomic data were assessed using a question from the MHQ about the family capacity to supply essential needs with the household income. Relational statistical analyses between the different components of the diagnostic formulation and other positive aspects of health and socioeconomic condition were conducted. Results: The average age was 39 years, illiteracy rate was 3.6%; 59.2% of the sample had not worked in the last week and the poverty line measured by the family capacity to supply essential needs with the household income was 25.5%. Economic deprivation was associated with the worst indicators of positive mental health such as lower scores on quality of life measures, more selfcare functioning difficulties, lower satisfaction with personal aspects such as physical appearance, intelligence, education or work conditions, less feelings of happiness, more perceived psychosocial stressors with work, children and health and lower family integration. Conclusions: The implications of socioeconomic aspects in regard to the comprehensive diagnostic processes, treatment and research should be considered, particularly in less-developed countries. Health policies based on person-centered care programs, through the assessment of positive health, could help services to be more sensitive to more vulnerable sectors of the populations.
Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder. Worldwide, its prevalence is ~2% and its etiology is mostly unknown. Identifying biological factors contributing to OCD will elucidate underlying mechanisms and might contribute to improved treatment outcomes. Genomic studies of OCD are beginning to reveal long-sought risk loci, but >95% of the cases currently in analysis are of homogenous European ancestry. If not addressed, this Eurocentric bias will result in OCD genomic findings being more accurate for individuals of European ancestry than other ancestries, thereby contributing to health disparities in potential future applications of genomics. In this study protocol paper, we describe the Latin American Trans-ancestry INitiative for OCD genomics (LATINO, www.latinostudy.org). LATINO is a new network of investigators from across Latin America, the United States, and Canada who have begun to collect DNA and clinical data from 5,000 richly-phenotyped OCD cases of Latin American ancestry in a culturally sensitive and ethical manner. In this project, we will utilize trans-ancestry genomic analyses to accelerate the identification of OCD risk loci, fine-map putative causal variants, and improve the performance of polygenic risk scores in diverse populations. We will also capitalize on rich clinical data to examine the genetics of treatment response, biologically plausible OCD subtypes, and symptom dimensions. Additionally, LATINO will help elucidate the diversity of the clinical presentations of OCD across cultures through various trainings developed and offered in collaboration with Latin American investigators. We believe this study will advance the important goal of global mental health discovery and equity.
Background: Peru is the worst affected country by the COVID-19 pandemic showing the world highest mortality rate, thus triggering an increased mental health burden. Nevertheless, there are few population-based epidemiologic surveys of mental disorders in Peru; Therefore, nationally representative research is needed to understand the underlying population-based mental health burden and identify unmet care needs. Objective: The present study aims to estimate the prevalence and patterns of psychiatric disorders, mental health service use, and unmet mental health care needs Methods: This cross-sectional study will collect information from a multistage random sample of 19,500 households. A child, an adolescent, an adult, and an older adult will be interviewed in the household. Trained staff will conduct face-to-face diagnostic interviews via the Preschool Age Psychiatric Assessment, the Child and Adolescent Psychiatric Assessment, the WHO's Composite International Diagnostic Interview, and the Alzheimer Disease 8 Scale. In addition, descriptive and inferential analysis for complex sampling will be performed to estimate the prevalence and correlates. Ethics and dissemination: IRB will approve the research protocol before the commencement of the study. Only respondents who signed their informed consents or assents will participate in the study; The parent or guardian will sign the consent for the participation of preschool children. The research findings will be disseminated in peer-reviewed publications, scientific reports, and presentations at national, and international meetings. In addition, de-identified data and study results will be posted on the Peruvian National Institute of Mental Health (PNIMH) website to be freely available to policymakers, researchers, and the general public.
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