Following Hawley's point of view regarding the definition and inclusiveness of human ecology, ecological data must include both a population and its characteristics and some measurements of the environment of this population. Following Hawley, an ecological investigation must select from available data and examine at least some of the relationships that may exist among these measurable population and environmental characteristics, in an effort to find and isolate the causes of mental disorders, particularly of those now called "functional."

Thesis (M Med(Psychiatry))--University of Limpopo (Medunsa Campus) ,2009. / Profiling of mental disorders in tertiary institutions is relatively an understudied subject .The aim of the study was to delineate the types, age and gender distribution of psychiatric disorders in Dr. George Mukhari hospital .This is a tertiary psychiatric unit which caters for mental health care users in Garankuwa , Soshanguve , Mabopane region. The study is retrospective and caters for a period January 2006 to December 2006. Dr George Mukhari being a tertiary institution ,the types of mental disorders seen are the emergency ones i.e. aggressive ,life threatening or complex in nature . Schizophrenia was the most common disorder , affecting more males than females in adults , whereas mental retardation was more common in children affecting more males than females. . This underlay the devastating nature of neuoro-developmental problems in psychiatry. Most of the mental health care users seen were single and un-employed(most on disability grants)

The purpose of this study is to get a deeper understanding of staff who are exposed to threat and violence in the work with people with mental disabilities. Focus is aimed at the staff´s experience of that in their daily work can be exposed to threat and violence. The first question for the study is what definition the staff gives to threat and violence in the daily work with people with mental disabilities and the second one is what determines the decision in making/or not making a report in threat and violence in the daily work with people with mental disorders. To collect empirical data the study is based on seven individual semistructured interviews with staff working with people with mental disabilities. The theory used to analyse is the normalisationprocess. The analyse is based on the interview-participants views on how they define threat and violence, their view on the client and themselves and also reporting threat and violence. The result is that the staff is affected by different aspects and a conflict is made between context and individual. This conflict contributes to the decision in reporting and definition of threat and violence.

Nearly 46 million Americans meet the criteria for a mental disorder. Anxiety impacts 30% of these individuals in the United States. A mounting focus on mental health has prompted a growing response in both research and clinical contexts. Despite this increased attention, Asian Americans still face significant mental health disparities. Furthermore, the broad use of the term Asian Americans makes it difficult for researchers and clinicians to encapsulate the needs in this diverse group. Asian American adolescents are an at risk population due to the significant developmental and cultural stressors they face. Consequently, knowledge pertaining to this population’s mental health resource utilization becomes an important tool in providing care. A socioecological approach was used to investigate determinants relevant to anxiety and mental health resource utilization in Asian American adolescents. Current public health models do not adequately represent the interactions between the analyzed determinants. As such, a socioecological model was proposed which depicts the dynamic relationships surrounding Asian American adolescent mental health resource utilization. A dearth in current research makes it difficult to generalize this model for the whole population. Nevertheless, this model provides an important first step to understanding the unique situation that Asian American adolescents face.

This thesis explores mental health problems relating to war and natural disaster and suicidal behaviour in the Nicaraguan population. The more specific aims of the study were to assess the prevalence and sociodemographic correlates of mental disorder in a community-based study during time of war (Paper I), to assess the mental health impact of Hurricane Mitch in 1998 (Paper II), to assess the incidence of hospitalized parasuicide cases and groups at risk (Paper III), and to examine suicide intent among attempters relating to gender, suicide method and sociodemographic factors and identify predictors for repetition of an attempt (Paper IV). Method: Based on 4453 family food ration books for families living in an urban area of León, Subtiava, 219 families including 746 adults were selected through a systematic sampling procedure. The study was conducted in 1987 during the war. We were able to reach 584 adults for interview according to the Present State Examination for ICD-9 diagnoses and Self-Report Questionnaire (Paper I). In Paper II, 496 adult primary health care attendees were interviewed six months after Hurricane Mitch according to the Harvard Trauma Questionnaire and were diagnosed for post-traumatic stress disorder (PTSD) according to DSM-IV. In Papers III and IV, all cases from León city admitted to HEODRA Hospital for a suicide attempt over a three-year period (n=233) were interviewed regarding sociodemographic factors and method, time and place of the suicide attempt. A subgroup of 204 cases was interviewed using the Suicide Intent Scale (SIS). Out of those 106 cases were followed-up regarding repetition of attempt or completed suicide after a mean period of 1172 days. Results: In the Paper I study, the one-month prevalence of any mental disorder was 28.8% for men and 30.8% for women. Among men, alcoholism was the most common diagnosis, whereas neurosis, crisis reaction and depression were dominant among women. Alcoholism was scored as the second most severe disorder after psychosis in terms of functional level. In the Mitch study six months after the hurricane, traumatic events were common and 39% reported death or serious injury of a close relative as a result of the hurricane. The prevalence of PTSD ranged from 4.5% in the least damaged area to 9.0% in the worst damaged area. At the prolonged follow-up six months later, half of the cases still retained their diagnosis. Trauma-related symptoms were common and death of a relative, destroyed house, female sex, illiteracy and previous mental health problems were associated with a higher level of symptoms. Suicidal ideation was reported among 8.5% and was significantly associated with previous mental health problems and illiteracy. The studies regarding hospitalized parasuicides showed the highest rate among girls aged 15–19 years (302 attempts per 100 000 inhabitants and year). After drug intoxication, pesticide was the second most common method and most often used by men (23%). Half of the women had recent contact with health care services before attempting suicide. There were significant peaks regarding time of attempt in terms of seasonal and diurnal distribution. Overall scores regarding seriousness of the intent (SIS) were equal between the sexes, but the pattern of SIS items showed significant gender differences in terms of relation to background factors and method used. For women, having a child was one factor associated with higher seriousness. Factor analysis of SIS items revealed a four-factor solution, explaining 59% of the variance. Risk for fatal repetition was 3.2% after three years and for non-fatal repetition 4.8%. During follow-up, three men (11%) had completed suicide but no women. We failed to identify any predictors for repetition from background factors or SIS. Conclusion: The studies have identified different groups at risk for mental health problems relating to war and disasters. Parasuicide rates equalled those from European countries. Whereas young girls dominated, attempts among men were more severe in terms of the methods used and completed suicide at follow-up. SIS seemed to give a meaningful pattern among women but not for men. In our study, seriousness of attempt in terms of method or suicide intent did not predict repetition. Overall non-fatal repetition rate was very low as compared to other studies.

Experiences of Barriers and Facilitators for Physical Activity from People with Mental Disorders who Participated in a Physical Activity Project - An Interview Study   Purpose: To explore the experiences regarding perceived barriers and facilitators for physical activity of three participants with mental disorders who took part in the Norwegian Physical Activity Mentor project. Design and methods: Descriptive qualitative design. Individual semi-structured interviews were used for data collection. Data from the interviews was used in two separate bachelor theses, written by Swedish and Norwegian physiotherapy students. This cooperation was part of the NordPlus Higher Education Program Joint Physiotherapy Education in Bachelor Thesis Module. Qualitative content analysis was used in processing the data. Findings: Perceived barriers for physical activity were: mental disorder symptoms, antipsychotics, undertaking physical activity independently and physical experiences. Perceived facilitators for physical activity were: positive mental effects, intrinsic and extrinsic motivational factors, goal setting and routine. The experiences from the Physical Activity Mentor project, including the possibility of self-selected activities, were mainly positive. The support provided by the physical activity mentor was an important facilitator. Conclusion: Disease-related problems were perceived as barriers for physical activity. The most important perceived facilitator for physical activity was mental benefits from being physically active. External support from a physical activity mentor might facilitate physical activity for psychiatric outpatients.     Key words: mental disorder, physical activity, barriers, facilitators, mentor / NordPlus Higher Education Program Joint Physiotherapy Education in Bachelor Thesis Module

No description available.

Adherence to combination antiretroviral therapy is important for achieving optimal HIV-related outcomes. Epidemiologic data indicate that persons with mental disorders are disproportionately affected by HIV/AIDS, which is concerning since having a mental disorder has been associated with poor adherence to medications for treatment of chronic disease states. The purpose of this study was to examine the relationship between the presence of mental disorders and adherence to combination antiretroviral therapy. Additionally, this study examined the relationship between adherence to psychotropic medications and adherence to antiretroviral therapy. Study data were collected from the Texas Medicaid Vendor Drug Program database and Texas Medicaid enrollment files. Adherence to and persistence with antiretroviral therapy, as well as adherence to psychotropic medications when applicable, were evaluated over a 12-month period in 1,321 patients starting a new combination antiretroviral regimen. The presence of a mental disorder was defined based on prescription claims for psychotropic medications. Proportion of days covered was used to calculate adherence, while persistence was defined as the number of days persistent with all antiretrovirals in the index regimen. Logistic regression was used to evaluate the relationship between psychotropic medication use and adherence to antiretroviral therapy (90% cut-off), as well as the relationship between adherence to psychotropic medications (80% cut-off) and adherence to antiretroviral therapy. The relationship between antiretroviral persistence and psychotropic medication use was evaluated using multiple linear regression. Factorial ANOVA was used to evaluate the interactions between race/ethnicity, gender, and psychotropic medication use in their effects on adherence to and persistence with antiretroviral therapy. No significant relationship was found between the presence of a mental disorder and adherence to or persistence with combination antiretroviral therapy in this study. However, the limitations of using psychotropic medication use as a proxy for mental disorders may have affected the results. Adherence to psychotropic medications overall (n = 501; OR = 3.37, 95% CI: 1.86 – 6.10; p < 0.001) and specifically to antidepressants (n = 443; OR = 4.23, 95% CI: 2.31 – 7.75; p < 0.001) was significantly associated with adherence to antiretroviral therapy, indicating a possible relationship between effective treatment for mental disorders and combination antiretroviral therapy adherence. While additional research is needed to clarify this relationship, these data support the need for an integrated approach to treatment of mental disorders and HIV/AIDS. / text

Ce travail a été conçu comme une enquête préliminaire à l’étude de l’influence de la christianisation de l’Occident romain sur les conceptions, les traitements et les usages de la « folie » dans l’Antiquité tardive. Il examine les conceptions et les traitements de la maladie mentale proposés par les sources juridiques et médicales romaines, ainsi que les usages du thème de la « folie » dans les discours philosophique, tragique, comique et historiographique, comme dans la rhétorique judicaire et politique. Au moyen d’une approche d’inspiration fonctionnaliste, il entend rendre compte, simultanément, de l’autonomie de chacun de ces discours et de leurs points de rencontre au sujet de la « folie ». Ses principaux objectifs sont de dessiner les contours de la « folie » comme objet d’histoire et de clarifier la distribution des termes qui la désignent au sein du vaste champ sémantique dont elle est l’objet. / This work surveys conceptions and treatments of mental illness in the Roman Empire until the dawn of Late Antiquity. We investigate legal and medical sources and examine different uses of the idea of “madness” in wide ranging discourse from this period in philosophy, tragedy, comedy, history, as well as in legal or political rhetoric. The historical approach, inspired by functionalist social theories, is designed to further understand the autonomy, and/or analyze the encounters of each of these areas of discourse as they deal with madness. The underlying objective is to extricate the structure of madness concept as a matter of history and to clarify connotations and semantic references in the use of the many terms that refer to madness in Latin sources. The work also provides a preliminary investigation for the study of if, and how, the Christianizing of the western provinces of the Roman Empire influenced conceptions, treatments and uses of “madness” in Late Antiquity.

Depression is a pervasive mental health disorder worldwide. Although being diagnosed with chronic illness exacerbates susceptibility to depression, detection and subsequent treatment of comorbid depression in primary care settings remain suboptimal because patients with chronic medical disorders are not commonly screened for depression. There is a need to initiate proactive measures by implementing routine screening in primary care settings. The plan-do-study-act (PDSA) model guided an intervention to establish a depression screening practice. This study aimed to determine if the implementation of evidence-based screening for depression using the Patient Health Questionnaire-9 (PHQ-9) tool could increase diagnosis of comorbid depression among patients suffering from chronic diseases. Convenience sampling served as the method for selecting healthcare records that met the predetermined criteria. Two hundred established patients over 18 years of age were screened for depression at a primary care clinic in Maryland within a 10-week period following Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Study participants included 84 (42%) males and 116 (58%) females. Of these, 84 (42%) had minimal depression, 57 (29%) had mild depression, 23 (12%) had moderate depression, 24 (12%) had moderate-severe depression, and 12 (6%) had severe depression. The baseline report from the clinic revealed 0% depression screening practices yet the post-project chart review revealed a surprisingly high rate of depression diagnosis in 34 (17%) of 200 patients suffering from chronic illnesses. Identification of a reliable tool that would be used to screen depression among patients with chronic diseases at primary care clinics to mitigate the deleterious effects of depression and promote the well-being and health of patients and their families is important.