Browsing by Subject "Suicidality"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Open Access
    Population level mental distress in rural Ethiopia
    (BioMed Central Ltd, 2014) Fekadu, Abebaw; Medhin, Girmay; Selamu, Medhin; Hailemariam, Maji; Alem, Atalay; Giorgis, Tedla; Breuer, Erica; Lund, Crick; Prince, Martin; Hanlon, Charlotte
    BACKGROUND:As part of a situational analysis for a research programme on the integration of mental health care into primary care (Programme for Improving Mental Health Care-PRIME), we conducted a baseline study aimed at determining the broad indicators of the population level of psychosocial distress in a predominantly rural community in Ethiopia. METHODS: The study was a population-based cross-sectional survey of 1497 adults selected through a multi-stage random sampling process. Population level psychosocial distress was evaluated by estimating the magnitude of common mental disorder symptoms (CMD; depressive, anxiety and somatic symptoms reaching the level of probable clinical significance), harmful use of alcohol, suicidality and psychosocial stressors experienced by the population. RESULTS: The one-month prevalence of CMD at the mild, moderate and severe threshold levels was 13.8%, 9.0% and 5.1% respectively. The respective one-month prevalence of any suicidal ideation, persistent suicidal ideation and suicide attempt was 13.5%, 3.8% and 1.8%. Hazardous use of alcohol was identified in 22.4%, significantly higher among men (33.4%) compared to women (11.3%). Stressful life events were widespread, with 41.4% reporting at least one threatening life event in the preceding six months. A similar proportion reported poor social support (40.8%). Stressful life events, increasing age, marital loss and hazardous use of alcohol were associated with CMD while stressful life events, marital loss and lower educational status, and CMD were associated with suicidality. CMD was the strongest factor associated with suicidality [e.g., OR (95% CI) for severe CMD=60.91 (28.01, 132.48)] and the strength of association increased with increase in the severity of the CMD. CONCLUSION: Indicators of psychosocial distress are prevalent in this rural community. Contrary to former assumptions in the literature, social support systems seem relatively weak and stressful life events common. Interventions geared towards modifying general risk factors and broader strategies to promote mental wellbeing are required.
  • No Thumbnail Available
    Item
    Open Access
    The effects of sexual trauma, intimate partner violence (IPV) and mental health on early versus late antiretroviral therapy (ART) initiation amongst women in South Africa
    (2024) Crookes, Charles; Joska, John
    OBJECTIVES This study had two objectives. Firstly, to determine the prevalence of physical and sexual IPV, sexual trauma and mental health symptoms in a sample of women initiating ART at two primary healthcare facilities in Khayelitsha, Cape Town. Secondly, to investigate associations between socio-demographics, sexual trauma and mental health variables on ART initiation times. METHODS This study used data from participants screening into a larger RCT of an intervention for 16 sexual trauma in women living with HIV (WLWH). This study incorporated a cross-sectional data analytic design. Electronically administered surveys collected data on demographics (age and pregnancy status), sexual trauma, physical and sexual IPV, mental health symptoms (depression, PTSD and suicidality). The outcome of interest included firstly the intention to determine the prevalence of trauma experiences and mental health symptoms in this sample of women initiating ART at two primary health care facilities in Khayelitsha. Secondly, to investigate for associations of significance between the demographic, trauma and mental health variables on ART initiation times. Early initiation was defined as ART commencement within 21 days from HIV diagnosis and late was after 21 days from diagnosis. RESULTS In total, 170 participants were included in this study. The mean age of participants was 30.65 (SD = 8.7). Most of the participants (80%) were initiated on ART early. Lifetime sexual trauma was reported by 38,2 % (n = 65). More than half the participants reported physical and or sexual IPV (57%; n = 97), more than a third reported depressive symptoms (39,4%; n = 67), half reported PTSD symptoms (50%; n = 85) and acute, high risk, suicidality was noted in (4,7%; n = 9) of the participants. In both univariate and multivariate analysis, no associations between demographic, mental health variables and most notably sexual trauma with ART initiation time were found. Logistic regression also found no association with the variables when compared with early versus late ART initiation. CONCLUSION Despite the high prevalence of sexual trauma and lifetime physical and sexual IPV, no 17 association with delays to ART initiation were found. This study could have been limited by its small sample size and we recommend future studies explore the effects of the variables in broader samples and in other areas of South Africa