Psychiatry Journal
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A Qualitative Exploration of Causes of Depression among Persons Living with HIV Receiving Antiretroviral Therapy in Uganda: Implications for Policy

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Psychiatry Journal publishes studies in all areas of psychiatric research and practice. The journal serves professionals with an interest in mental health, including psychiatrists, psychologists, psychotherapists, and psychiatric nurses.

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Research Article

Common Mental Disorder and Its Associated Factors among Prisoners in North Wollo Zone Correctional Institutions, Northeastern Ethiopia

Background. Globally, about 450 million people suffer from mental disorders of which about 11% are assumed to be prisoners. The presence of mental illness among prisoners contributes to an increase in the risk of suicide, violence, morbidity, and mortality. In Ethiopia, there is a paucity of data particularly from resource-limited areas to assist policy maker’s efforts in reforming mental health care. Objective. This study is aimed at assessing common mental disorders and its associated factors among prisoners in North Wollo zone correctional institutions, Northeastern Ethiopia. Method. Institution-based cross-sectional study was conducted on 401 study participants from January–February 2021. A simple random sampling technique was employed to enroll the study participants. Structured interviewer-administered Self Reporting Questionnaires-20 (SRQ-20) developed by the World Health Organization was used to collect the data. Data were checked for completeness, coded and entered into Epi data version 4.2, and transferred to SPSS version 23.0 for final analysis. Binary logistic regression analysis was carried out to identify factors associated with common mental disorders. Statistical significance was declared at values < 0.05 in the final model. Results. The prevalence of common mental disorders was found to be 63.6% (95% CI 58.9, 68.3). After adjusting for confounding factors using multiple logistic regression, having children (, 95% CI: 1.93, 7.36), poor social support (, 95% CI: 2.93, 14.93), history of mental illness (, 95% CI: 1.78, 24.3), one- to five-year prison stay (, 95% CI: 1.38, 5.04), greater than five-year prison stay (, 95% CI: 2.05, 16.27), experiencing one stressful life event (, 95% CI: 1.83, 15.01), experiencing two or more stressful life events (, 95% CI: 2.98, 17.9), unavailability of reading materials (, 95% CI: 1.63, 11.43), and greater than or equal to eleven years of sentences (, 95 CI: 1.82, 10.70) were factors significantly associated with common mental disorders. Conclusion. Common mental disorders are highly prevalent among prisoners in this study area. The result of this study suggests the importance of screening and providing psychiatric counseling to this highly vulnerable population.

Research Article

Suicidal Ideation and Its Associated Factors in Medical, Dental, and Pharmacy Students: A Cross-Sectional Study during COVID-19 Pandemic

Objectives. This study is aimed at comparing the prevalence of suicidal ideation among Iranian medical, dental, and pharmacy students and determining the demographic and basic characteristics and mental and psychological issues associated with suicidal ideation in these students. Methods. This cross-sectional online survey was conducted during the 2020-2021 academic year on medical, dental, and pharmacy students studying at the Tehran University of Medical Sciences (TUMS). The questionnaire consisted of six sections: Beck Hopelessness Scale (BHS), General Health Questionnaire (GHQ), Perceived Stress Scale (PSS), UCLA loneliness scale, Maslach Burnout Inventory-Student Survey (MBI-SS), and a questionnaire that was designed to evaluate students’ family history, current psychological status, and basic and demographic characteristics. Results. In total, 419 students participated in our study, with 133 (31.7%) being medical students, 85 (20.3%) being pharmacy students, and 201 (48%) being dental students. In our study, the prevalence of suicidal ideation was 32%. Family history of psychological issues (, P =0.012), current or past smoking (, ), parents not living together (, ), and satisfaction with the current field (, ) were all independently associated with the presence of suicidal ideation. Also, higher scores in BHS (, ), PSS (, ), and UCLA loneliness scale (, ) were independently associated with a higher risk of suicidal ideation. Conclusion. The prevalence of suicidal ideation among Iranian medical, dental, and pharmacy students is relatively high and has increased during recent years, which needs emergent action.

Research Article

Attention-Deficit Hyperactivity Disorder and Comorbid Mental Health Conditions Associated with Increased Risk of Injury

Background. To describe the influence of attention-deficit hyperactivity disorder (ADHD) and comorbid mental health conditions on the risk of selected injuries. Methods. A retrospective cohort study design was employed using medical claim data from the Deseret Mutual Benefit Administrators (DMBA). Mental health conditions, injury, medication, and demographic data were extracted from claim files for ages 4-64, years 2016-2020. Results. Approximately 51.8% of individuals with ADHD had one or more comorbid mental health conditions (anxiety [37.0%], depression [29.9%], autism spectrum disorder (ASD) [3.6%], bipolar disorder [4.7%], obsessive compulsive disorder (OCD) [2.4%], schizophrenia [0.9%], and manic disorder [0.2%]). The rate of injury was 1.33 (95% CI 1.27–1.39) for ADHD only versus no ADHD and 1.62 (95% CI 1.56–1.68) for ADHD and comorbid mental health conditions versus no ADHD, after adjusting for age, sex, salary, and year. Cases with ADHD but no comorbid mental health conditions versus no ADHD were at increased risk of each of 12 types of injury. The increased risk was noticeably more pronounced for ADHD cases with one or more comorbid mental health conditions versus no ADHD. The greatest increased risk of injury was among ADHD cases with comorbid schizophrenia, followed by bipolar disorder and OCD. Comorbid autism disorder does not increase the risk of injury, but lowers it. Finally, the number of comorbid mental health conditions among ADHD cases was positively associated with increased injury rates (6% for one, 30% for two, 65% for three, and 129% for four). Conclusions. ADHD is positively associated with an increased risk of injury. Comorbid mental health conditions further increase the risk of injury among those with ADHD.

Research Article

The Effects of Citalopram and Thalamic Dopamine D2/3 Receptor Availability on Decision-Making and Loss Aversion in Alcohol Dependence

Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for patients who misuse alcohol, especially in the context of comorbid depressive symptoms. Deficits in impulse control and decision-making are linked to routine alcohol consumption and alcohol dependence. The goal of this study was to determine the effects of a single dose of citalopram on measures of impulsivity, decision-making, and/or brain dopamine receptor availability in alcohol-dependent individuals. A double-blind, placebo-controlled, within-subject, outpatient study was conducted with active alcohol-dependent (DSM-IV-TR criteria) participants () and matched healthy controls (). Serial doses of both citalopram (40 mg) and saline were administered intravenously before laboratory tests of decision-making (Balloon Analogue Risk Task, delay discounting task, and Loss Aversion Gambling Task) and positron emission tomography with [18F]-fallypride to measure dopamine D2/3 receptor availability, separated by at least one week. Alcohol-dependent participants demonstrated greater loss aversion than healthy controls, but there were no group differences in risk taking on the Balloon Analogue Risk Task. Citalopram increased delay discounting across groups, with no group difference in the effect. There were no effects of citalopram on risk taking on the Balloon Analogue Risk Task. PET showed a negative correlation between thalamic dopamine D2/3 receptor availability and loss aversion across groups. The effect of citalopram to decrease the valuation of monetary reward as a function of delay raises the possibility that SSRIs can influence risky decision-making in clinical populations. In addition, these results suggest that altered thalamic dopamine signaling may play an important role in disproportionately valuing losses in patients with Alcohol Use Disorder. This trial is registered under ClinicalTrials.gov registration NCT01657760.

Research Article

Quality of Media Reporting of Suicide in Nepal

Objectives. Suicide is a major public health concern. Sensible media reporting of suicide is one of the important prevention strategies. There has been no report assessing the quality of media reporting of suicide in Nepal. We aimed to assess the quality of newspaper reporting of suicide in Nepal against the World Health Organization (WHO) reporting guidelines. Methods. We undertook a content analysis study of articles from the online archives on reporting of suicide deaths in six English language (daily or weekly) newspapers published in Nepal over the two-year duration from a period between January 1, 2019, and December 31, 2020. Also, we compared them with the World Health Organization (WHO) guidelines. Results. A total of 165 English newspaper articles reporting on suicide were analyzed. 163 (98.8%) of news were published in the main section of the newspaper, and the mean length was 17.6 sentences. The name and age of the person who died of suicide were mentioned in about 69.1% () and 53.3% () articles, respectively. The most common method of suicide reported in the news articles was hanging (45.5%, ), followed by poisoning (11.5%, ). About 97.6% () of news articles violated the recommendation provided in the WHO guidelines. Conclusions. The adherence to the WHO guidelines for media reporting of suicide in Nepal was found to be poor, with a large majority of news reports having at least one potentially harmful media characteristic. Only a small minority of news reports included potentially helpful information to prevent suicide.

Research Article

Prevalence, Risk Factors, and Negative Outcomes of Anxiety and Depressive Disorders among HIV-Infected Children and Adolescents in Uganda: CHAKA Study 2014-2017

Background. Children and adolescents infected with HIV/AIDS (CA-HIV) experience a considerable burden of depressive and anxiety disorders that have a tendency to persist into adulthood. The aim of this study was to determine the prevalence of anxiety, depression, and their clinical correlates among children and adolescents with HIV/AIDS (CA-HIV) in Uganda. Methods. A random sample of 1339 CA-HIV (ages 5-18 years) and their caregivers completed a standardized DSM-5-referenced psychiatric rating scale, the Child and Adolescent Symptom Inventory-5 (CASI-5). The prevalence of “anxiety and depression” was estimated at 95% confidence intervals. Logistic and ordinal regression models were fitted for the clinical correlates and clinical outcomes. Results. The overall prevalence of “any anxiety and depressive disorders” was 13.7% at 95% CI (based upon the symptom count criteria); 4.0% (95% CI) met the clinical psychiatric disorder criteria (both symptom count and functional impairment criteria). Anxiety disorder was more prevalent (9%, 95% CI) than depression (6.4%, 95% CI). Correlates of “anxiety and depressive disorders” included age of the child, caregiver’ psychological distress, caregivers’ age, child-caregiver relationship, and child’s current CD4 count (aOR1.00, 95% CI 1.02–1.05; ). Anxiety disorders (aOR 2.58, 95% CI 1.16-5.42; ) and depressive disorders (aOR 2.47, 95% CI 1.93–6.52; ) were also associated with hospital admissions. Limitations. Analyses were cross-sectional; we cannot comment on the causal directions. The results are entirely based upon caregiver’ reports. Conclusions. There is an urgent need to integrate mental health services into routine HIV care for CA-HIV in sub-Saharan Africa.

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