Browsing by Author "Williams, Petal Petersen"

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    Prevalence and Factors Associated with Depression and Anxiety among HIV-infected Pregnant Women in Kilimanjaro Region, Tanzania
    (2018) Ngocho, James Samwel; Sorsdahl, Katherine; Williams, Petal Petersen; Watt, Melissa
    Introduction: Antenatal depression and anxiety in women living with HIV are associated with a number of poor maternal and child outcomes, and undermine the world target of eliminating mother-to-child transmission (MTCT) of HIV. Despite the importance of antenatal mental health, the data on the factors associated with common mental illnesses in HIV-infected women are limited. Thus, the aim of the present study was to determine the prevalence and factors associated with depression and anxiety among pregnant women living with HIV and attending antenatal clinics in Kilimanjaro region, Tanzania. Methods: We analysed the baseline data from an ongoing cohort study of 200 pregnant women living with HIV and attending antenatal care in two districts of the Kilimanjaro region. Women were eligible for inclusion in the parent cohort study if they were HIV-infected and in their second or third trimester of pregnancy. Antenatal depression and anxiety were assessed using the Edinburgh Postnatal Depression Scale and the Brief Symptom Scale, respectively. A multivariate logistic regression model was used to assess the factors that were independently associated with anxiety, depression and comorbidity of anxiety and depression. Variables with a p-value less than 0.15 in univariate analysis were included in the final multivariate model. Results: Participants had a median (IQR) age of 30 years (26-35). About half were married (n=98, 49.0%) and knew their HIV status prior to the index pregnancy (n=105, 52.5%). When asked whether they had disclosed their status to anyone, 159 (79.5%) had disclosed to at least one person and more than half (n=119/170, 70.0%) had disclosed to their sexual partner. Fifty (25.0%) screened positive for possible depression and this was associated with being single (aOR=4.0, 95% CI=1.2–13.7), food insecurity (aOR=2.6, 95% CI=1.0–6.6), and HIV shame (aOR=1.2, 95% CI=1.1–1.3). Of the 197 women who completed the anxiety questionnaire, 47 (23.5%) screened positive for anxiety which was associated with being ashamed of having HIV (aOR=1.1, 95% CI=1.1 – 1.2). The prevalence of comorbid symptoms of depression and anxiety was 17.8% (n=35). HIV shame and lifetime experience of violence (aOR=3.4, 95% CI=1.2 – 9.6) were found to be independently associated with comorbid depression and anxiety. Conclusion: One in every four pregnant women living with HIV screened positive for anxiety and/or depression. The majority of women with depressive symptoms also had anxiety symptoms. In this population, a number of factors were associated with depression and anxiety. These factors ranged from marital status and lifetime experience of violence, food insecurity to HIV-related shame. In order to successfully engage women in HIV care and support their well- being, prevention of MTCT (PMTCT) programmesshould have strategiesto screen and support women with mental illnesses.
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    Prevalence of depression and anxiety and associated risk factors among adolescent offenders within the juvenile justice system in Bulawayo and Matabeleland North Province(s), Zimbabwe
    (2024) Marufu, Marshall Takudzwa; Sorsdahl, Katherine; Williams, Petal Petersen; Besada, Donela; Mangez, Walter
    Background The mental health of adolescents is becoming an increasing public health concern. Mental health conditions such as depression and have their onset during childhood. Research has shown that adolescents entering the juvenile justice system are particularly vulnerable to depression and anxiety. Despite the negative consequences associated with these conditions among adolescent offenders, there is a dearth of studies conducted in low and middle countries including Zimbabwe on the prevalence and factors associated with symptoms of depression and anxiety among adolescent offenders between 10-17 years within the juvenile justice system. Thus, the aim of this study is to determine the prevalence and factors associated with symptoms of depression and anxiety among adolescent offenders between 10-17 years within the juvenile justice system in Bulawayo and Matabeleland North Province, Zimbabwe. Methods In total, 130 adolescent offenders aged between 10 and 17 years were recruited in the cross- sectional study using a convenient sampling technique. The Centre for Epidemiological Studies Depression Scale (CES-D-10) and Generalized Anxiety Disorder (GAD-7) were used to measure symptoms of depression and anxiety, respectively. The Alcohol Use Disorders Identification Test (AUDIT), Drug Use Disorders Identification Test (DUDIT), Fagerstrom Test for Nicotine Dependence (FTND), Rosenberg Self-Esteem Scale, and Sexual Risk Behaviour Beliefs and Self-Efficacy Scales were used to measure individual factors associated depression and anxiety. The Juvenile Victimization Questionnaire (JVQ) was used to measure factors associated with mental health conditions at the family level, while the Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure associations at the social level. Means and proportions were used to describe socio- demographic data as well as the prevalence of potential mental health conditions (depression and anxiety). Unadjusted and adjusted associations between individual, family, and social risk factors and the presence of depression and anxiety were also explored. Only those variables that were significant in the unadjusted models were included in the final adjusted regression model. The standard cutoff level for statistical significance used in this analysis is a p-value of 0.05 or less. The findings are presented in the form of odds ratios (ORs) with 95% confidence intervals (CIs). Page | 5 Results The prevalence of depression and anxiety among participants was 18.5% and 10.8% respectively. In total, 7.6% of participants had reported symptoms of both depression and anxiety, highlighting the co-morbidity of mental health conditions among adolescent offenders. After adjusting models, results indicate that adolescents with a known history of mental health problems were more likely to report symptoms of anxiety than those without a known history (OR=15.10, 95% CI 1.86 -122.78). The adjusted models also indicate that adolescents who report more social support are less likely to experience symptoms of anxiety (OR=0.96, 95% CI 0.92 - 0.99). Additionally, the adjusted model shows that participants with high risky sexual behaviour (OR=1.19, 95% CI 1.05-1.35), high self-esteem (OR=1.19, 95% CI 1.05-1.35) and experiencing juvenile victimization or childhood violence (OR=46.87, 95% CI 3.89-565.237) were more likely to have symptoms of depression. Finally, results show that being a first time offender (OR=0.17, 95% CI 0.04-0.80) and having a mother who is alive (OR=0.12, 95% CI 0.02-0.76) are protective factors that reduces the risk of young offenders experiencing symptoms of depression. Conclusion Results from the study show that symptoms of depression and anxiety are prevalent among adolescent offenders within the juvenile justice system and are associated with several risk factors. Selective prevention interventions are recommended for this vulnerable population.
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    The experiences of ex-offenders living with a mental disorder within three to twelve months following discharge from psychiatric prison care in Zimbabwe: a qualitative study
    (2022) Mhishi, Wellington; Sorsdahl, Katherine; Williams, Petal Petersen; Mangezi, Walter
    Background: There are significant challenges in many countries to effectively manage service needs of prisoners with a mental illness. In Zimbabwe, there is no literature on the prevalence of mental disorders among prisoners but it is likely to be as high as in other African countries. Apart from high prison populations which often under resourced, it is also reported that ex-offenders from correctional psychiatric institutions face a range of social, economic and personal challenges once released which often hamper their ability to live adaptive crime-free lifestyles. Although there is extensive literature on experiences of offenders within the criminal justice system, few studies have examined the convergence of the factors affecting those ex-offenders living with mental illness' transition from the prison environment to the community, as related to (i) their experiences upon discharge, (ii) barriers to effective community reintegration of this vulnerable population, and (iii) their service needs. The study addresses this gap. Aims & Objectives: The overall aim of the study was to explore the experiences of ex-offenders with a mental illness within a period of three to twelve months following discharge from psychiatric prison care. Specific objectives included: (1) exploring the experiences and needs of ex-offenders with severe mental illness upon discharge from psychiatric prison care; (2) exploring the key drivers and barriers to community re-integration of ex-offenders with severe mental illness after being discharged from psychiatric prison care; and explore available services and identify further service needs of ex-offenders with mental illness after being discharged from psychiatric prison care. Methods: Thirteen ex-offenders with a severe mental illness who were discharged at Chikurubi Maximum Security Prison participated in the study. There is a dedicated psychiatric facility at Chikurubi Maximum Security Prison and it was being funded externally through MSF. Key informant structured interviews were utilised. All ex-offenders were discharged within a period of three to twelve months, were over eighteen (18) years of age and they participated in the study willingly and provided informed consent. Only those based in Harare Metropolitan Province were included. The research participants were interviewed using a qualitative interview schedule which inquired about the experiences and needs of ex-offenders with severe mental illness; key drivers and barriers to community re-integration following discharge and access to mental health services. Interviews were transcribed verbatim and analysed using the framework approach to identify themes. To facilitate analysis of data, the qualitative analysis computer software NVivo 12 was utilised. Results: Findings of the study were grouped according to three main themes. Theme one highlighted how the prison infrastructure and environment negatively impacted on their mental health. This included dilapidated buildings, no running water, electricity shortages, poor ventilation in cells and overcrowding. The second theme focused on the perceived benefits of the comprehensive and integrated mental health services at Chikurubi Hospital. The third theme looked at the experiences and needs upon discharge from psychiatric prison care. Participants had mixed experiences of integration depending on the severity of the crime committed and whether or not they were integrated back into the same community where the crime was committed. Successful reintegration was challenging given the stigma and discrimination experienced as a result of committing a crime and having a mental health illness. The lack of community based services providing recovery focused interventions was also highlighted as a challenge. Conclusions: The study examined experiences of ex-offenders living with mental illness within three to twelve months following discharge from psychiatric prison care. Chikurubi Psychiatric Hospital provided comprehensive quality services through external funding. Upon discharge, community mental health services focused primarily on clinical recovery in the form of medication, impacting on the mental health of the participants as they re-integrated into the community.