OpenUCT :: Browsing by Subject "depression"

Browsing by Subject "depression"

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Open Access
Associations between ADHD symptoms and maternal and birth outcomes: An exploratory analysis in a multi-country cohort of expectant mothers
(2022) Murray, Aja Louise; Taut, Diana; Baban, Adriana; Hemady, Chad Lance; Walker, Susan; Osafo, Joseph; Sikander, Siham; Tomlinson, Mark; Du Toit, Stefani; Marlow, Marguerite; Ward, Catherine L; Fernando, Asvini; Madrid, Bernadette; Thang, Vo Van; Tuyen, Hoang Dinh; Dunne, Michael; Hughes, Claire; Fearon, Pasco; Valdebenito, Sara
ADHD symptoms can adversely impact functioning in a range of domains relevant for maternal well-being and foetal development; however, there has been almost no research examining their impact during pregnancy. We used data (n=1204) from a longitudinal birth cohort study spanning eight countries to address this gap. ADHD symptoms in the third trimester of pregnancy were associated with lower social support from family (b=-0.16, p=.031), friends (b=-0.16, p=.024), and significant others (b=-0.09 p=.001); higher stress (b=0.34, p<.001) and depressive symptoms (b=0.31, p<.001), and increased likelihood of an unwanted pregnancy (b=0.30, p=.009). Significant associations with tobacco use (b=.36, p=.023) and premature birth (b=.35, p=.007) did not survive correction for multiple comparisons and there were no significant associations with alcohol use, low birth weight, or unplanned pregnancy. Results suggest that women with ADHD symptoms could benefit from earlier, more regular screening for mental health difficulties and greater mental health support during pregnancy.
Open Access
Depression amongst caregivers of children and adolescents with perinatally acquired HIV in Cape Town, South Africa
(2022) Booysen, Gillian; Hoare, Jacqueline; Phillips, N
Background Depression remains the most commonly diagnosed mental health disorder. It adds significantly to the global burden of disease and is responsible for the most years of life lost to disability in both men and women (Rehm & Shield, 2019). The successful roll-out of antiretroviral therapy (ART) to those living with HIV has resulted in the emergence of an increasing population of children and adolescents with perinatally acquired-HIV (PHIV) requiring care. Caregivers of PHIV are at increased risk for the development of depression due to parental, child and socio-economic factors. Few studies have focused on the specific factors associated with caregiver depression in the context of caring for ART-treated and untreated PHIV. Aims and Objectives The aims of this cross-sectional study are to assess the prevalence of depression in caregivers of PHIV compared with caregivers of a HIV-seronegative matched control group (HC). In the HIV-impacted families, a comparison will be drawn between the prevalence of depression in biological and non-biological caregivers. Factors associated with depression in this vulnerable group will be assessed using various caregiver, child and socio-economic measures. Methods Caregivers of 75 PHIV and 30 HC were selected from a community healthcare setting in Cape Town. Results There was no difference found between levels of depression in PHIV caregivers (biological or non-biological) and caregivers of HC. Internalising and externalising child behaviours, poor family resources (including basic needs, money, time for self and time for family) and limited social support were associated with depression in both caregiver groups. In caregivers of HC, parental stress was associated with higher levels of depression. Conclusion Factors independent of HIV status of children may be driving depression in caregivers of children and adolescents in Cape Town, South Africa where HIV is endemic. Thus, this study could facilitate a better understanding of depression in the context of caring for PHIV and better inform interventions in these vulnerable family systems.
Open Access
Depression and HIV/AIDS: adapting and piloting group interpersonal therapy for treatment of depressive symptoms for people living with HIV/AIDS in Northwest Ethiopia
(2021) Yirdaw, Biksegn; Schneider, Marguerite; Lun, Crick; Ambaw, Fentie
Background Being diagnosed with HIV/AIDS and commencement of lifelong antiretroviral therapy (ART) with the requirement of high adherence can exacerbate or trigger depressive disorders. Prevalence of major depression is substantially higher in people living with HIV/AIDS (PLWHA) than those in the general population. More than 50% of PLWHA are likely to meet one or more criteria for depression in their lifetime. However, access to interventions for depressive disorders remains limited in Low- and Middle-Income Countries (LMICs) where more than 90% of people with depressive disorders are not receiving formal treatment. The role of evidence-based psychological treatments has been fundamental in reducing the huge treatment gap in LMICs. Although brief, flexible and effective psychological treatments are emerging, issues in relation to their acceptability, feasibility and effectiveness in HIV populations remain unexplored. Therefore, this thesis aimed to adapt and pilot group interpersonal therapy (IPT) for treatment of depressive symptoms including its acceptability and feasibility for PLWHA. This thesis has been the first that attempted to adapt and pilot group IPT for treatment of depression in the HIV population in Ethiopia. The findings of this thesis can serve as a baseline for researchers interested in adapting or developing psychological treatments in the HIV population in Ethiopia. The findings contribute information on the process used in examining acceptability and feasibility of psychological interventions which provides indications for conducting future trials to test the effectiveness of group IPT. Methods First, a systematic review and meta-analysis of randomised controlled trials was conducted to identify the most effective psychological treatments for depressive symptoms for PLWHA in LMICs. Second, a survey of major depressive disorder (MDD) was conducted among PLWHA who were attending ART follow-up appointments at the Felege-Hiwot Referral Hospital (FHRH) in Northwest Ethiopia. The survey served as a baseline to identify cases for piloting of group IPT and helped to identify areas for intervention. Third, the intervention areas were further explored among stakeholders from the ART clinic including PLWHA and this was followed by a stepwise adaptation of the group IPT manual. Furthermore, a formative qualitative study was conducted to examine explanatory models of depression and to explore acceptable contexts for implementation of group IPT. A total of three focus groups were conducted with purposively selected case managers, adherence supporters and service users 2 at the ART clinic. The qualitative data were analysed based on a framework approach using predefined thematic concepts. Fourth, a pilot study of the group IPT intervention was conducted among PLWHA to evaluate the acceptability and feasibility of peer-administered group IPT for treatment of depressive symptoms for PLWHA in Ethiopia. A single-arm, prepost, peer-administered, group IPT interventional study was conducted with 31 consecutively recruited participants. The participants were assigned to four IPT groups for the intervention. A post-intervention evaluation of depressive symptoms, perceived social support (PSS), functional disability and quality of life (QoL) was conducted using the same instruments used at the baseline. No control group was included in this pilot study. Results The findings of the systematic review and meta-analysis revealed that trials that used IPT have shown good effectiveness in treating depressive symptoms of PLWHA in LMICs. The baseline study found 32.5% prevalence of MDD among randomly selected PLWHA (N=393). MDD was positively associated with reduced adherence to ART, functional disability and negatively associated with overall QoL. Overall findings of the baseline and the qualitative study indicated that psychosocial problems are the most important factors that need intervention for depression for PLWHA. The main findings in relation to the adaptation of the WHO group IPT were: i) an IPT group that contains five to ten people was perceived to be acceptable and mixed gender groups were recommended; ii) sessions were recommended to be conducted in private rooms for 1.5 to 2 hours, and on a weekly basis. Findings of the pilot study indicated that depression scores reduced significantly between baseline and postintervention (mean difference (MD)=9.92; t=-7.82; p<0.001). The mean PSS scores (MD=0.79; t=2.84; p=0.009) and the mean QoL scores (MD=0.39, t=4.58, p<0.001) improved significantly between baseline and post-intervention. All the IPT intervention areas (life change, disagreement, grief and loneliness) were found to be applicable to and important areas associated with depression in PLWHA in Ethiopia. Most importantly, disagreement within a family and life change due to HIV/AIDS, such as sickness and separation were faced by almost all PLWHA included in the study, followed by loneliness or social isolation as result of HIV stigma, and grief due to loss of loved ones including a spouse, a child, a mother or a father. Overall evaluation of the pilot indicated that the procedures and outcomes of group based IPT were perceived as acceptable. Participants of the intervention gained benefits in resolving psychosocial problems and reported high satisfaction with counsellors and intervention setting. The eight weekly sessions that lasted around two hours were acceptable; however, 3 additional sessions were recommended by some counsellors until everyone recovers from depression. Conclusion The overall findings of this thesis suggested that group IPT was found to be acceptable and feasible for PLWHA in Ethiopia. Future studies should focus on examining its effectiveness for treating depressive disorders among PLWHA in Ethiopia.
Open Access
Developing a manualised task-sharing counselling intervention for perinatal common mental disorders in the South African context
(2022) Boisits, Sonet; Kaminer, Debra; Lund, Crick
Background: Symptoms of depression and anxiety are highly prevalent amongst perinatal women in low-resource settings of South Africa, but there is no access to standardised counselling support for these conditions in public health facilities. The aim of this study was to report on the development of a maternal mental health counselling intervention for routine treatment of mild to moderate symptoms of depression and anxiety for primary healthcare in South Africa, as part of the Health Systems Strengthening in sub-Saharan Africa (ASSET) study. Methods: A four-phase study process informed the counselling intervention and training manual designed to train lay health workers. We first conducted a review of manuals from seven counselling interventions for depression and anxiety in low- and middle-income countries and two local health system training programmes to gather information on common counselling components used across maternal mental health and other evidence-based task-sharing interventions. Thereafter, semi-structured interviews were conducted with 20 health workers and 37 pregnant women from four Midwife Obstetric Units in Cape Town to explore mental health views and needs. In the third stage, multi-sector stakeholder engagements further informed the choice of intervention design and service provider. In the final phase, a four-day pre implementation pilot training with community-based health workers refined the counselling content and training material. Results: The manual review identified problem-solving, psychoeducation, basic counselling skills and behavioural activation as common counselling components across interventions. The interviews found that participants mostly identified symptoms of depression and anxiety in behavioural terms and lay health workers and pregnant women demonstrated their understanding through a range of contextual terms. Perceived causes of symptoms related to interpersonal conflict and challenging social circumstances. Stakeholder engagements identified a three session counselling model as most feasible for delivery as part of existing health care practices and community health workers in ward-based outreach teams as the best placed delivery agents. Pilot training of a three-session intervention with community-based health workers resulted in minor adaptations of the counselling assessment method. Conclusion: The study demonstrates how common therapeutic elements can be adapted to a local context and developed into an evidence-based manualised therapeutic programme while remaining sensitive to a health system's needs. While a problem-solving counselling approach, delivered in a structured format, was best suited for training lay health workers, input from health workers and perinatal mothers informed the manualised counselling content. The latter was a critical supplement to align the programme with contextual needs. Stakeholder engagements helped to align the intervention design to health system requirements and guidelines. Structured training practices and ongoing supervision of mental health workers are vital to develop counselling skills over time and to enhance personal support.
Open Access
A Psychosocial handbook: A tool for consultation
(2019) Backwell, David
This handbook was designed to be a tool for preclinical medical students during their beginnings in patient interactions and counselling. It is intended to be used in a consultation, giving step-wise approaches to some problems, and tools to use with the patients. It is by no means comprehensive, but a basic field guide to psychosocial issues common in South Africa. The handbook can be used on a tablet or smartphone, and if printed, lamination would allow repeated use of the pages that may be written on (such as the scales).
Open Access
Risk factors for substance use in pregnant women in South Africa
(2012) Vythilingum, Bavanisha; Roos, Annerine; Faure, Sheila C; Geerts, Lut; Stein, Dan J
Objectives. To study the prevalence of alcohol and substance use in a South African antenatal population and its correlates with socio-demographic factors, depression and perceived stress. Methods. A prospective self-report study on all women presenting for their first antenatal visit who consented to the study at a midwife obstetric unit (MOU) in the East Metropole district, Cape Town, using the Alcohol Use Disorders Identification Test (AUDIT), Drug Use Disorders Identification Test (DUDIT), Edinburgh Depression Scale (EDS) and Perceived Stress Scale (PSS). Statistical analyses using the chi-square test, separate one-way analyses of variance (ANOVA) and logistic regression analyses were performed as appropriate. Outcome measures were depression, alcohol use and substance use. Results. The questionnaire was completed by 323 women. During pregnancy 36.8% of women smoked, 20.2% used alcohol and 4% used substances. Using EDS cut-off scores of 12 and 15, respectively, 48.9% and 33.6% of the sample had scores consistent with major depression. An EDS cut-off score of 12 was significantly associated with both alcohol use (25.9% v. 15.2%, p=0.019) and risky drinking (76.9% v. 36.8%, p=0.04), while an EDS cut-off score of 15 was significantly associated with substance use (8.2% v. 1.4%, p=0.004) as well as alcohol dependence (23.1% v. 3.1%). Conclusions. We found high rates of both alcohol abuse and antenatal depression, and a significant association between depression, substance use and alcohol abuse; EDS scores greater than 12 could be used to identify women at risk of alcohol dependence and/or substance abuse.
Open Access
Scapulo-Thoracic Depression Grades I-IV
(2019) Kim Buchholtz, Theresa Burgess; Buchholtz K
This video demonstrates scapulothoracic depression Maitland mobilisation treatment technique. This technique may be used for treatment of both pain and stiffness.
Open Access
The effects of socio-demographic factors on depression and perceived health status among a cohort of young people (15-24) in South Africa: evidence from the National Income Dynamics Study (NIDS) waves 1-5
(2020) Nkhoma, Nelly Ruth; Towriss, Catriona
Introduction: The prevalence of bad perceived health status and depression, their sociodemographic determinants (education level, employment status, relative household income, race, age and gender) and the modifying effect of depression on PHS have been investigated among a cohort of young adults using data from the South African National Income Dynamics Study (NIDS) waves 1-5. South Africa is a middle-income country, with very high levels of socioeconomic inequality and a history of apartheid. Both depression and PHS tend to be affected by socio-demographic and environmental factors. Methods: Depression was measured using the CES-D-10 scale and PHS was measured on a 5- point likert scale ranging from excellent to poor. A binary version of PHS was generated which groups the categories excellent, very good and good into good and the categories poor and fair into bad PHS. Descriptive analysis and Mixed Effects Regression analysis were conducted. MER is appropriate for unbalanced panels as this method is robust to irregularly spaced measurements. Results: A high prevalence of depression was found in the study with about 13%-20% of the cohort being depressed at each wave. Surprisingly, a low level of bad PHS has been found in the cohort with less than 5% of the young adults having bad PHS at all waves. Completion of secondary and tertiary education and being employed have been found to significantly lower the odds of being depressed and increase the chances of having good PHS. Africans were significantly more likely to be depressed, as compared to other racial groups. Finally, being depressed was found to reduce the likelihood of good PHS. Discussion: Education level completed and being employed have been found to significantly protect individuals from being depressed and to increase the likelihood of good PHS. In post-apartheid South Africa, the effects of inequalities arising from apartheid social and economic policies are still present with Africans being found more likely to be depressed.
Open Access
Violence, alcohol and symptoms of depression and in Cape Town's poorest communities: results of a community survey
(2018-04-20) Cassidy, Tali; Lloyd, Sam; Bowman, Brett; Myers, J E; Parry, Charles; Makanga, Tatenda; Corrigall, Joanne; Thompson, Mary Lou; Matzopoulos, Richard
Introduction This paper summarises key findings from the first of three household surveys conducted in three high-violence areas in the Cape Town, investigating community members’ experiences of alcohol use, their built environment, violence and symptoms of depression, together with their views on alcohol and other interventions. Methods A stratified random sample of 1500 dwellings, 1200 in Khayelitsha and 300 in Gugulethu and Nyanga (“Gunya”) was selected using GIS address data for formal areas and aerial photography for informal areas. Fieldwork took place from July to November 2013. Responses to questions were summarized by area, gender, age and formal vs. informal settlement type. Results After substitution and data cleaning, 1213 Khayelitsha households and 286 Gunya households were included. In Gunya, 29% of respondents reported that they or their family members had been affected by at least one violent crime (murder, assault, domestic violence, rape) in the past year, compared with 12% in Khayelitsha. Using a CES-D-10 cut-off of 10, 44% of respondents were classified as depressed. More than half the respondents reported having experienced some form of alcohol nuisance. Respondents were supportive of alcohol interventions such as increased taxes and police regulation of outlets, particularly in Gunya (87%) and amongst female respondents (76%). Satisfaction with infrastructure such as street lighting and drainage was generally low. Conclusions The results describe the co-occurring burdens of alcohol and drug use, violence, depression and deprivation in our study populations.
Open Access
Why Depression Feels Bad
(John Benjamins Publishing Company, 2010-01-01) Solms, Mark; Panksepp, Jaak; Dr Elaine K Perry
We believe that conscious mental phenomena (such as feelings) are not epiphenomenal to the workings of the brain. Feelings evolved for good biological reasons; they make specific, concrete contributions to brain functioning. Notwithstanding all the philosophical complexities, therefore, the non-conscious/conscious interactions that are the focus of this book are, in our view, causal interactions. To marginalize consciousness in relation to what is ultimately a dualistic scientific understanding of how the brain works is likely to lead us badly astray. We illustrate this view by trying to address the question: why does depression feel bad? This is the postscript of a book chapter. The final version has been published in: "New Horizons in the Neuroscience of Consciousness" by Prof. Dr. Elaine K. Perry et al. (2010). Published by John Benjamins Publishing Company Amsterdam / Philadelphia.

Browsing by Subject "depression"

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