Conflict and mental health: a cross-sectional epidemiological study in Nepal

Luitel, Nagendra P.; Jordans, Mark J. D.; Sapkota, Ram P.; Tol, Wietse A.; Kohrt, Brandon A.; Thapa, Suraj Bahadur; Komproe, Ivan H.; Sharma, Bhogendra

doi:10.1007/s00127-012-0539-0

Cited by 139 publications

(132 citation statements)

References 27 publications

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“…Women hypertensive patients were found to experience depression at a higher rate than men in several studies. [23][24][25][26] In the present study, the prevalence of depression among female patients was significantly higher than male patients. Taking antihypertensive medications has been previously found to be significantly associated with high BDI scores.…”

Section: Discussionsupporting

confidence: 42%

“…Similar to our study, other studies have found that increasing age is a predictor of depression among hypertensive Section: Medicine patients. [24][25][26] In the other hand, In Nigeria, a study had found no significant correlation between age and incidence of depression among patients attending the hypertensive clinic. Women hypertensive patients were found to experience depression at a higher rate than men in several studies.…”

Section: Discussionmentioning

confidence: 96%

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Prevalence of Depression among Hypertensive Patients in Saudi Arabia

Alhamidah¹,

Alshammari²,

Albukhari³

et al. 2017

AIMDR

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Background: There is a growing interest in exploring the prevalence of comorbid depression in patients with hypertension, and its impact on their physical functioning, quality of life, and healthcare utilization. However, limited data is available from developing countries, particularly Saudi Arabia, on the prevalence of depression in patients with hypertension. Aim: The main objective of our study was to investigate the prevalence of depression and associated factors among hypertensive patients attending a tertiary health care clinic in Jeddah, Saudi Arabia. Methods: We conducted a cross-sectional study, with 211 hypertensive patients attending the Out-Patient Department of King Abdulaziz University Hospital in Jeddah, for a period of 1-month commencing from 15th October to 14th November 2016. Hypertensive patients were given a structured questionnaire regarding socio-demographic data, associated risk factors, and the Beck Depression Inventory-1a (BDI) scale (valid in Arabic version) to assess Depression level. Blood pressure was measured using a manual mercury column sphygmomanometer. Result: 211 hypertensive patients were studied, 127 (60.2%) patients were males and 84 (39.8%) were female. The mean BDI score for all hypertensive patients in this study was 7.35 ± 11.68. The proportion of hypertensive patients with depression (BDI score ≥20) was 20.7%. Conclusion: Depression is highly prevalent in hypertensive patients in Saudi Arabia. Further research into effective management and screening for depression in hypertensive patients is warranted.

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Section: Discussionsupporting

confidence: 42%

Section: Discussionmentioning

confidence: 96%

Prevalence of Depression among Hypertensive Patients in Saudi Arabia

Alhamidah¹,

Alshammari²,

Albukhari³

et al. 2017

AIMDR

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“…Epidemiological estimates of community prevalence of the priority MNS disorders were available for the district neighbouring Sodo in Ethiopia [24]–[27]. In Chitwan (Nepal), community prevalence estimates were available for depression and other common mental disorders [28], and similarly for the North West province in which Dr KK district (South Africa) is located [29]. For the remaining MNS disorders and in the other PRIME sites, it was necessary to rely on extrapolation from national prevalence estimates (India, South Africa) or studies conducted in other LMICs (Uganda, Nepal).…”

Section: Resultsmentioning

confidence: 99%

Challenges and Opportunities for Implementing Integrated Mental Health Care: A District Level Situation Analysis from Five Low- and Middle-Income Countries

et al. 2014

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BackgroundLittle is known about how to tailor implementation of mental health services in low- and middle-income countries (LMICs) to the diverse settings encountered within and between countries. In this paper we compare the baseline context, challenges and opportunities in districts in five LMICs (Ethiopia, India, Nepal, South Africa and Uganda) participating in the PRogramme for Improving Mental health carE (PRIME). The purpose was to inform development and implementation of a comprehensive district plan to integrate mental health into primary care.MethodsA situation analysis tool was developed for the study, drawing on existing tools and expert consensus. Cross-sectional information obtained was largely in the public domain in all five districts.ResultsThe PRIME study districts face substantial contextual and health system challenges many of which are common across sites. Reliable information on existing treatment coverage for mental disorders was unavailable. Particularly in the low-income countries, many health service organisational requirements for mental health care were absent, including specialist mental health professionals to support the service and reliable supplies of medication. Across all sites, community mental health literacy was low and there were no models of multi-sectoral working or collaborations with traditional or religious healers. Nonetheless health system opportunities were apparent. In each district there was potential to apply existing models of care for tuberculosis and HIV or non-communicable disorders, which have established mechanisms for detection of drop-out from care, outreach and adherence support. The extensive networks of community-based health workers and volunteers in most districts provide further opportunities to expand mental health care.ConclusionsThe low level of baseline health system preparedness across sites underlines that interventions at the levels of health care organisation, health facility and community will all be essential for sustainable delivery of quality mental health care integrated into primary care.

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“…This includes an environment where people are at increased risk of depression, anxiety and post-traumatic stress disorder [4]. Poverty, female gender discrimination and caste inequality are also causal factors that contribute to mental health problems such as depression [5].…”

Section: Introductionmentioning

confidence: 99%

Demand and access to mental health services: a qualitative formative study in Nepal

Brenman

Luitel

Jordans

2014

BMC Int Health Hum Rights

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BackgroundNepal is experiencing a significant ‘treatment gap’ in mental health care. People with mental disorders do not always receive appropriate treatment due to a range of structural and individual issues, including stigma and poverty. The PRIME (Programme for Improving Mental Health Care) programme has developed a mental health care plan to address this issue in Nepal and four other low and middle income countries. This study aims to inform the development of this comprehensive care plan by investigating the perceptions of stakeholders at different levels of the care system in the district of Chitwan in southern Nepal: health professionals, lay workers and community members. It focuses specifically on issues of demand and access to care, and aims to identify barriers and potential solutions for reaching people with priority mental disorders.MethodsThis qualitative study consisted of key informant interviews (33) and focus group discussions (83 participants in 9 groups) at community and health facility levels. Data were analysed using a framework analysis approach.ResultsAs well as pragmatic barriers at the health facility level, mental health stigma and certain cultural norms were found to reduce access and demand for services. Respondents perceived the lack of awareness about mental health problems to be a major problem underlying this, even among those with high levels of education or status. They proposed strategies to improve awareness, such as channelling education through trusted and respected community figures, and responding to the need for openness or privacy in educational programmes, depending on the issue at hand. Adapting to local perceptions of stigmatised treatments emerged as another key strategy to improve demand.ConclusionsThis study identifies barriers to accessing care in Nepal that reach beyond the health facility and into the social fabric of the community. Stakeholders in PRIME’s integrated care plan advocate strategic awareness raising initiatives to improve the reach of integrated services in this low-income setting.

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Conflict and mental health: a cross-sectional epidemiological study in Nepal

Cited by 139 publications

References 27 publications

Prevalence of Depression among Hypertensive Patients in Saudi Arabia

Prevalence of Depression among Hypertensive Patients in Saudi Arabia

Challenges and Opportunities for Implementing Integrated Mental Health Care: A District Level Situation Analysis from Five Low- and Middle-Income Countries

Demand and access to mental health services: a qualitative formative study in Nepal

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