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- Hanlon, Charlotte, et al.
(författare)
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Between life and death : exploring the sociocultural context of antenatal mental distress in rural Ethiopia
- 2010
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Ingår i: Archives of Women's Mental Health. - : Springer Science and Business Media LLC. - 1434-1816 .- 1435-1102. ; 13:5, s. 385-393
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Tidskriftsartikel (refereegranskat)abstract
- The high prevalence of antenatal common mental disorders in sub-Saharan Africa compared to high-income countries is poorly understood. This qualitative study explored the sociocultural context of antenatal mental distress in a rural Ethiopian community. Five focus group discussions and 25 in-depth interviews were conducted with purposively sampled community stakeholders. Inductive analysis was used to develop final themes. Worry about forthcoming delivery and fears for the woman's survival were prominent concerns of all participants, but only rarely perceived to be pathological in intensity. Sociocultural practices such as continuing physical labour, dietary restriction, prayer and rituals to protect against supernatural attack were geared towards safe delivery and managing vulnerability. Despite strong cultural norms to celebrate pregnancy, participants emphasised that many pregnancies were unwanted and an additional burden on top of pre-existing economic and marital difficulties. Short birth interval and pregnancy out of wedlock were both seen as shameful and potent sources of mental distress. The notion that pregnancy in traditional societies is uniformly a time of joy and happiness is misplaced. Although antenatal mental distress may be self-limiting for many women, in those with enduring life difficulties, including poverty and abusive relationships, poor maternal mental health may persist.
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- Hanlon, Charlotte, et al.
(författare)
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Lessons learned in developing community mental health care in Africa
- 2010
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Ingår i: World Psychiatry. - 1723-8617 .- 2051-5545. ; 9:3, s. 185-189
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Tidskriftsartikel (refereegranskat)abstract
- This paper summarizes the findings for the African region of the WPA task force on steps, obstacles and mistakes to avoid in the implementation of community mental health care. We present an overview of mental health policies, plans and programmes in the African region; a summary of relevant research and studies; a critical appraisal of community mental health service components; a discussion of the key challenges, obstacles and lessons learned, and some recommendations for the development of community mental health services in the African region.
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- Ross, Joanna, et al.
(författare)
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Perinatal mental distress and infant morbidity in Ethiopia : a cohort study
- 2011
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Ingår i: Archives of Disease in Childhood. - : BMJ. - 1359-2998 .- 1468-2052. ; 96:1, s. F59-F64
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Tidskriftsartikel (refereegranskat)abstract
- Persistent perinatal CMD was associated with infant diarrhoea in this low-income country setting. The observed relationship was independent of maternal health-promoting practices. Future research should further explore the mechanisms underlying the observed association to inform intervention strategies.
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| 8. |
- Servili, Chiara, et al.
(författare)
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Maternal common mental disorders and infant development in Ethiopia : the P-MaMiE birth cohort
- 2010
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 10, s. 693-
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Tidskriftsartikel (refereegranskat)abstract
- The study supports the hypothesis that it is the accumulation of risk exposures across time rather than early exposure to maternal CMD per se that is more likely to affect child development. Further investigation of the impact of chronicity of maternal CMD upon child development in LAMICs is indicated. In the Ethiopian setting, poverty, interpersonal violence and infant undernutrition should be targets for interventions to reduce the loss of child developmental potential.
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| 9. |
- Shibre, Teshome, et al.
(författare)
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Suicide and suicide attempts in people with severe mental disorders in Butajira, Ethiopia : 10 year follow-up of a population-based cohort
- 2014
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Ingår i: BMC Psychiatry. - : BioMed Central. - 1471-244X. ; 14, s. 150-
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Tidskriftsartikel (refereegranskat)abstract
- Background: People with severe mental disorders (SMD) are at higher risk of suicide. However, research into suicide attempts and completed suicide in people with SMD in low-and middle-income countries is mostly limited to patients attending psychiatric facilities where selection bias is likely to be high. Methods: A population-based cohort of 919 people with SMD from rural Ethiopia (who received standardized clinician diagnoses of schizophrenia (n = 358) major depressive disorder (n = 216) and bipolar I disorder (n = 345)) were followed up annually for an average of 10 years. The Longitudinal Interval Follow-up Evaluation chart was administered by psychiatrists and used to evaluate systematically suicidal behavior and risk factors, which may be amenable to intervention. Results: Over the follow-up period, the cumulative risk of suicide attempt was 26.3% for major depression, 23.8% for bipolar I disorder and 13.1% for schizophrenia, (p < 0.001). The overall incidence of completed suicide was 200.2/100,000 person-years (CI = 120.6, 312.5). Hanging was the most frequent method used (71.5%) for both attempters and completers. Most people who completed suicide were successful on the first attempt (84.2%), but the case-fatality rate for suicide attempt was 9.7%. In the adjusted logistic regression model, being currently married (Adjusted OR) =2.17, 95% CI = 1.21, 3.91), and having a diagnosis of bipolar I disorder (Adjusted OR = 2.59, 95% CI = 1.57, 4.26) or major depression (Adjusted OR = 2.71, 95% CI = 1.60, 4.58) were associated significantly with increased risk of suicide attempts. Conclusion: In this sample of people with SMD from a rural setting, the rate of suicide was high. Initiatives to integrate mental health service into primary care need to focus on limiting access to suicide methods in people with SMD in addition to expanding access to mental health care.
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- Teferra, Solomon, 1979-, et al.
(författare)
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Khat-chewing in persons with severe mental illness in Ethiopia : A qualitative study exploring perspectives of patients and caregivers
- 2011
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Ingår i: Transcultural Psychiatry. - London : Sage Publications on behalf of McGill University. - 1363-4615 .- 1461-7471. ; 28:4, s. 455-472
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Tidskriftsartikel (refereegranskat)abstract
- People with severe mental illness (SMI) in Ethiopia chew khat despite advice from their physicians to desist. We wanted to better understand their reasons for khat chewing, including any benefits that they might gain. A qualitative study was conducted involving patients with SMI and their caregivers in Butajira. Reasons given by patients as well as caregivers were more or less congruent: social pressure, a means for survival by improving function, combating medication side effects, to experience pleasure and curbing appetite. These findings will be of value to health workers, caregivers and policymakers alike in improving care and understanding for this patient group. Furthermore, our study indicates a role for future research to explore potentially beneficial effects of khat in this population.
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