Pathways to care of patients with mental health problems in Bangladesh

Nuri, Nazmun Nahar; Sarker, Malabika; Ahmed, Helal Uddin; Hossain, Mohammad Didar; Beiersmann, Claudia; Jahn, Albrecht

doi:10.1186/s13033-018-0218-y

Cited by 53 publications

(50 citation statements)

References 13 publications

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“…Few tertiary pediatric hospitals in Bangladesh provide psychiatric care services. This might be due to lack of detection of the patients’ conditions or the lack of importance given to their symptoms by family members (21). A German study among 7-17 year old children and adolescents reported that about half of the patients did not receive treatment, despite resource availability (22).…”

Section: Discussionmentioning

confidence: 99%

Overall Care-Seeking Pattern and Gender Disparity at a Specialized Mental Hospital in Bangladesh

Nuri¹,

Sarker²,

Ahmed³

et al. 2019

Mater Sociomed

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Introduction: The National Institute of Mental Health (NIMH) is the only national level mental health institution in Bangladesh, with both academic and clinical functions, thus playing a crucial role in delivering specialized mental health care for the entire population. Aim: This study examined the overall pattern of mental health care seeking, age and sex distribution of patients and mental health problems diagnosed in the facility. Methods: Using a facility-based cross-sectional study design, secondary data was collected from various hospital records and reports from April 2001 to June 2016, and quantitatively analyzed. Results: There has been a steady increase in the number of patients at NIMH over the years. Typically, female patients were about half in number compared to male patients and fewer in each age group and all disease categories except inpatients with neurotic, stress-related and somatoform disorders. The highest number of inpatients and outpatients were 15-30 years old and those with schizophrenia, schizotypal and delusional disorders. Conclusion: Minors and females seeking care at NIMH were underrepresented, thus highlighting the need for interventions to improve access for these patients.

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Section: Discussionmentioning

confidence: 99%

Overall Care-Seeking Pattern and Gender Disparity at a Specialized Mental Hospital in Bangladesh

Nuri¹,

Sarker²,

Ahmed³

et al. 2019

Mater Sociomed

Self Cite

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“…As access to mental health services might vary across age groups and gender [20], we recruited two male and two female patients as well as two adult and two minor patients for each of the ICD 10 categories where possible. Since this was not possible for all ICD 10 categories, we ultimately recruited 23 male and 17 female patients including 23 adult and 17 minor patients [21].…”

Section: Methodsmentioning

confidence: 99%

“…spouse, parent, sibling) were interviewed at the end. The inclusion criteria were: a patient/his or her attendant who had had a consultation with a doctor at the NIMH OPD at least once and who agreed to participate in this study [21].…”

Section: Methodsmentioning

confidence: 99%

“…Both were developed in English and then translated into Bengali by the first author, who is a native Bengali speaker. One native Bangladeshi mental health expert and two Bangladeshi public health experts reviewed the translated tools [21]. The focus of the in-depth interviews was to learn in detail about the experience and perception of the respondents regarding care services at NIMH.…”

Section: Methodsmentioning

confidence: 99%

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Experience and perceived quality of care of patients and their attendants in a specialized mental hospital in Bangladesh

Nuri

Sarker

Ahmed

et al. 2019

Int J Ment Health Syst

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Background A person’s perception of health service quality depends on his or her expectations and priorities. If the perception of care is good, then it eventually enhances future health service utilization, adherence to treatment and desired outcomes. Understanding a patient’s perspective is key for delivering a better quality patient-centred health care service. This study explored experience and perception of patients and their attendants of mental health care services at the National Institute of Mental Health (NIMH) which is the only national level mental health institute in Bangladesh. NIMH is located in the capital city and provides specialized mental health care services for the whole population. Methods A facility-based cross-sectional study was conducted using a mixed-method design at the NIMH. A total of 40 respondents (patients, or their attendants if the patient was minor or unable to respond due to lack of mental stability) visiting the outpatient department (OPD) of NIMH were selected by purposive sampling. For each of the ten ICD 10 categories (10th revision of International Classification of Diseases by the World Health Organization [WHO]) for mental disorders, four patients were chosen. Finally, 13 patients and 27 attendants (on behalf of 17 minor patients and 10 adult patients unable to respond) participated in the interview. Results The respondents rated 34 short statements clustered around four dimensions of care (accessibility, interpersonal communications, condition of the waiting and consultation rooms, and general quality of OPD services) and we interpreted those scores as follows: 7.6–10 very satisfied/very good quality, 5.1–7.5 satisfied/good quality, 2.6–5.0 dissatisfied/poor quality and 1.0–2.5 completely dissatisfied/very poor quality. For accessibility and interpersonal communications, the patients perceived care as very good (average scores on a Likert scale of 1–10 were 8.3 and 7.6, respectively). The respondents considered the condition of the waiting and consultation rooms and general quality of OPD care as good (average scores 5.8 and 7.1, respectively). NIMH had serious lack of resources in terms of functional medical equipment and physicians appointed, which negatively impacted on the service quality. Conclusions Patients receiving services from the NIMH OPD had a positive perception of the quality of care in general. But, at an individual level, some respondents expressed dissatisfaction. Our findings are informative for quality improvement and client-oriented care service planning at NIMH, Bangladesh.

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“…Among all of these, schizophrenia (SCZ) is one of the most prevalent neuropsychiatric disorders all over the world. SCZ is a typical type of mental disease with an incidence of 1% and a high socio-economic impact in Bangladesh [ 3 , 4 ]. SCZ and associated problems are quite heritable but cannot be defined by way of presently acknowledged genetic threat elements.…”

Section: Introductionmentioning

confidence: 99%

Association of DRD2 gene polymorphisms with schizophrenia in the young Bangladeshi population: A pilot study

Hussain

Siddiqui

Mondal

et al. 2020

Heliyon

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Purpose DRD2 gene is considered one of the most important candidate genes for the schizophrenia (SCZ) development due to its role in dopamine signaling and no genetic association study has been conducted yet on the Bangladeshi SCZ patients. The objective of the present study was to investigate the association of DRD2 genetic polymorphisms (rs4648317, rs4936270, and rs7131056) with SCZ in the Bangladeshi population. Patients and methods This case-control study consisted of 101 SCZ patients and 101 controls. Genotyping was performed by the polymerase chain reaction and restriction fragment length polymorphism (PCR–RFLP) method. Results The average ages were 22.15 and 22.09 years in patients and controls, respectively (p > 0.05). CT genotype of rs4936270 showed a significantly higher risk for the development of SCZ compared to CC genotype (OR = 2.0, p = 0.023), whereas no association was found for TT genotype. For the dominant model and T allele, rs4936270 showed a higher risk for the development of SCZ (OR = 2.01, p = 0.020; OR = 1.76, p = 0.021, respectively), while the recessive model had no association with SCZ. A statistically significant (OR = 2.70, p = 0.036) higher risk was found for the AA genotype, but no association was found for GA genotype of rs4648317 SNP compared to GG genotype. In case of dominant and recessive models, rs4648317 showed no association with SCZ. ‘A’ allele of rs4648317 SNP was found to be significantly associated with the elevated risk of SCZ (OR = 1.50, p = 0.044). No association with SCZ of rs7131056 SNP was found for AC, CC genotypes, dominant, recessive, and allele models. Furthermore, from the haplotyping analysis, we found that CAA and TAA haplotypes of rs4936270, rs7131056 and rs4648317 SNPs are associated with SCZ (χ2 = 8.26, p = 0.004; χ2 = 5.31, p = 0.021, respectively). After Bonferroni correction, the association of SCZ did not withstand with any genotype, allele and haplotype (p < 0.017) except CAA haplotype. Conclusion Our results suggest that DRD2 gene polymorphisms may be associated with the susceptibility of SCZ in the young Bangladeshi population.

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Pathways to care of patients with mental health problems in Bangladesh

Cited by 53 publications

References 13 publications

Overall Care-Seeking Pattern and Gender Disparity at a Specialized Mental Hospital in Bangladesh

Overall Care-Seeking Pattern and Gender Disparity at a Specialized Mental Hospital in Bangladesh

Experience and perceived quality of care of patients and their attendants in a specialized mental hospital in Bangladesh

Association of DRD2 gene polymorphisms with schizophrenia in the young Bangladeshi population: A pilot study

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