https://yorkspace.library.yorku.ca/xmlui/bitstream/handle/10315/2553/Antenatal%20risk%20factors%20for%20postpartum%20depression.pdf

Antenatal risk factors for postpartum depression: a synthesis of recent literature

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(07)61239-2.pdf

Resources for mental health: scarcity, inequity, and inefficiency

Background The excess mortality of schizophrenia is well recognised, but its precise causes are not well understood.

Aims To measure the standardised mortality ratio (SMR) and examine the reasons for any excess mortality in a community cohort with schizophrenia.

Method We carried out a 13-year follow-up of 370 patients with schizophrenia, identifying those who died and their circumstances.

Results Ninety-six per cent of the cohort was traced. There were 79 deaths. The SMRs for all causes (298), for natural (232) and for unnatural causes (1273), were significantly higher than those to be expected in the general population, as were the SMRs for disease of the circulatory, digestive, endocrine, nervous and respiratory systems, suicide and undetermined death. Smoking-related fatal disease was more prominent than in the general population.

Conclusions Some of the excess mortality of schizophrenia could be lessened by reducing patients'smoking and exposure to other environmental risk factors and by improving the management of medical disease, mood disturbance and psychosis.

/pdf/causes-of-the-excess-mortality-of-schizophrenia-504av5fii0.pdf

Causes of the excess mortality of schizophrenia.

Poverty and common mental disorders in low and middle income countries: A systematic review

Adult Psychiatric Morbidity in England, 2007: Results of a Household Survey

Women, poverty and common mental disorders in four restructuring societies

BACKGROUND Little is known about the outcome of common mental disorders (CMD) in primary care attenders in low income countries.

METHOD Two and 12 month (T1 and T2) follow-up of a cohort of cases of CMD (n = 199) recruited from primary health, traditional medical practitioner, and general practitioner clinics in Harare, Zimbabwe. The Shona Symptom Questionnaire (SSQ) was the measure of caseness.

RESULTS The persistence of case level morbidity was recorded in 41% of subjects at 12 months. Of the 134 subjects interviewed at both follow-up points, 49% had recovered by T1 and remained well at T2 while 28% were persistent cases at both T1 and T2. Higher SSQ scores, a psychological illness model, bereavement and disability predicted a poor outcome at both times. Poorer outcome at T1 only was associated with a causal model of witch-craft and an unhappy childhood. Caseness at follow-up was associated with disability and economic deprivation.

CONCLUSIONS A quarter of cases of CMD were likely to be ill throughout the 12 month follow-up period. Targeting risk groups for poor outcome for interventions and policy interventions to reduce the impact of economic deprivation may provide a way of tackling CMD in primary care in low income countries.

Outcome of common mental disorders in Harare, Zimbabwe.

BACKGROUND This study aimed to investigate the associations for common mental disorders (CMD) among primary care attenders in Harare.

METHOD This was an unmatched case-control study of attenders at primary health clinics, general practitioner surgeries and traditional medical practitioner clinics; 199 cases with CMD as identified by an indigenously developed case-finding questionnaire, and 197 controls (non-cases), were interviewed using measures of sociodemographic data, disability, care-giver diagnoses and treatment, explanatory models, life events and alcohol use.

RESULTS CMD was associated with female gender (P = 0.04) and older age (P = 0.02). After adjustment for age, gender and site of recruitment, CMD was significantly associated with chronicity of illness; number of presenting complaints; beliefs in "thinking too much" and witchcraft as a causal model; economic impoverishment; infertility; recent unemployment; an unhappy childhood for females; disability; and consultations with traditional medical practitioners and religious priests.

CONCLUSIONS Mental disorders are associated with female gender, disability, economic deprivation, and indigenous labels of distress states.

Common mental disorders in primary care in Harare, Zimbabwe: associations and risk factors.

Background. This study aimed to investigate the onset and predictors of common mental disorders (CMD) in primary-care attenders in Harare, Zimbabwe. Method. Two (Tl) and 12-month (T2) follow-up of a cohort of primary-care attenders without a common mental disorder (N = 197) as defined by the Shona Symposium Questionnaire (SSQ), recruited from primary health care clinics, traditional medical practitioner clinics and general practitioner surgeries. Outcome measure was caseness as determined by scores on the SSQ at follow-up. Results. Follow-up rate was 86 % at 2 months and 75 % at 12 months. Onset of CMD was recorded in 16% at Tl and T2. Higher psychological morbidity scores at recruitment, death of a first-degree relative and disability predicted the presence of a CMD at both follow-up points. While female gender and economic difficulties predicted onset only in the short-term, belief in supernatural causation was strongly predictive of CMD at T2. Caseness at both follow-up points was associated with economic problems and disability at those follow-up points. Conclusions. Policy initiatives to reduce economic deprivation and targeting interventions to primary-care attenders who are subclinical cases and those who have been bereaved or who are disabled may reduce the onset of new cases of CMD. Closer collaboration between biomedical and traditional medical practitioners may provide avenues for developing methods of intervention for persons with supernatural illness models.

C Todd

Papers

Women, poverty and common mental disorders in four restructuring societies

Outcome of common mental disorders in Harare, Zimbabwe.

Common mental disorders in primary care in Harare, Zimbabwe: associations and risk factors.

The onset of common mental disorders in primary care attenders in Harare, Zimbabwe.

The validity of the shona version of the self‐report questionnaire (srq) and the development of the srq-8