Prevalence of externalizing behavior problems in Sri Lankan preschool children: birth,childhood, and sociodemographic risk factors

Purpose  

There is dearth of epidemiological data on externalizing behavior problems among preschool children in many developing countries. The aim of this study was to examine the prevalence and associated birth, childhood, and sociodemographic factors of externalizing behavior problems among a community sample of preschool children in Sri Lanka.     

Mapping mental health finances in Ghana, Uganda, Sri Lanka, India and Lao PDR

Background  

Limited evidence about mental health finances in low and middle-income countries is a key challenge to mental health care policy initiatives. This study aimed to map mental health finances in Ghana, Uganda, India (Kerala state), Sri Lanka and Lao PDR focusing on how much money is available for mental health, how it is spent, and how this impacts mental health services.     

The prevalence of previous self-harm amongst self-poisoning patients in Sri Lanka

Background  

One of the most important components of suicide prevention strategies is to target people who repeat self-harm as they are a high risk group. However, there is some evidence that the incidence of repeat self-harm is lower in Asia than in the West. The objective of this study was to investigate the prevalence of previous self-harm among a consecutive series of self-harm patients presenting to hospitals in rural Sri Lanka.     

The Child Behaviour Assessment Instrument: development and validation of a measure to screen for externalising child behavioural problems in community setting

Background  

In Sri Lanka, behavioural problems have grown to epidemic proportions accounting second highest category of mental health problems among children. Early identification of behavioural problems in children is an important pre-requisite of the implementation of interventions to prevent long term psychiatric outcomes. The objectives of the study were to develop and validate a screening instrument for use in the community setting to identify behavioural problems in children aged 4-6 years.     

Collective trauma in the Vanni- a qualitative inquiry into the mental health of the internally displaced due to the civil war in Sri Lanka

Background  

From January to May, 2009, a population of 300,000 in the Vanni, northern Sri Lanka underwent multiple displacements, deaths, injuries, deprivation of water, food, medical care and other basic needs caught between the shelling and bombings of the state forces and the LTTE which forcefully recruited men, women and children to fight on the frontlines and held the rest hostage. This study explores the long term psychosocial and mental health consequences of exposure to massive, existential trauma.     

Immigrants’ utilization of specialist mental healthcare according to age,country of origin,and migration history: a nation-wide register study in Norway

Purpose

As the immigrant population rises in Norway, it becomes ever more important to consider the responsiveness of health services to the specific needs of these immigrants. It has been questioned whether access to mental healthcare is adequate among all groups of immigrants. This study aims to examine the use of specialist mental healthcare services among ethnic Norwegians and specific immigrants groups.

Methods

Register data were used from the Norwegian Patient Registry and Statistics Norway. The sample (age 0–59) consisted of 3.3 million ethnic Norwegians and 200,000 immigrants from 11 countries. Poisson regression models were applied to examine variations in the use of specialist mental healthcare during 2008–2011 according to country of origin, age group, reason for immigration, and length of stay.

Results

Immigrant children and adolescents had overall significantly lower use of specialist mental healthcare than ethnic Norwegians of the same age. A distinct exception was the high utilization rate among children and youth from Iran. Among adult immigrants, utilization rates were generally lower than among ethnic Norwegians, particularly those from Poland, Somalia, Sri Lanka, and Vietnam. Adult immigrants from Iraq and Iran, however, had high utilization rates. Refugees had high utilization rates of specialist mental healthcare, while labour immigrants had low use.

Conclusion

Utilization rates of specialist mental healthcare are lower among immigrants than Norwegians. Immigrants from Poland, Somalia, Sri Lanka, and Vietnam, had generally quite low rates, while immigrants from Iran had high utilization rates. The findings suggest that specialist mental healthcare in Norway is underutilized among considerable parts of the immigrant population.

     

Caregiver strain and symptoms of depression among principal caregivers of patients with schizophrenia and bipolar affective disorder in Sri Lanka

Introduction

Data on caregiver strain and depression of principal caregivers of patients with mental illnesses are few in developing countries. Findings from developed countries cannot be applied directly to developing countries as culture specific factors may influence the outcome.

Methods

A prospective study was carried out in the University Psychiatry Unit of the National Hospital of Sri Lanka (NHSL) to identify symptoms of depression, caregiver strain and dissatisfaction with life in caregivers of patients with schizophrenia and bipolar affective disorder. Participants were assessed using the Center for Epidemiological Studies – Depression Scale, Satisfaction with Life Scale and the Modified Caregiver Strain Index.

Results and discussion

Eighty caregivers were interviewed (males; 36, 45%). Symptoms of depression were significant in 37.5%, while 48.8% had unsatisfactory scores on the Satisfaction with Life Scale. Depression and higher caregiver strain were associated with spending more time with the patient, interruption to work, disputes with relations, being assaulted by patient and self admission of needing professional help to overcome mental stress.

Conclusion

This study identified several associations for depression and increased caregiver strain among caregivers in a subset of patients with mental disorder in Sri Lanka. These can be used as markers to screen and increase pretest probability to identify caregivers needing help rather than applying the cumbersome questionnaires to all.     

Increasing mental health capacity in a post-conflict country through effective professional volunteer partnerships: A series of case studies with government agencies,local NGOs and the diaspora community

Abstract

The focus of this paper is on working in partnership with local practitioners and communities to strengthen local capacity building in the area of mental health and well-being in Sri Lanka. This paper will examine the context, organizing concepts, organizational processes, and the development of good working relationships and partnership building behind this work. Our involvement was based on requests which came to the authors as a result of their previous work in Sri Lanka over several decades. This work had been undertaken on behalf of the UK–Sri Lanka Trauma Group (UKSLTG), a UK-based charity which was set up in 1994, and of which the authors are founding members (www.uksrilankatrauma.org.uk). In the first section of the paper, contextual issues will be discussed. The second section of the paper provides details of the training undertaken on mental health promotion among young people in Sri Lanka for the Directorate of Mental Health. The third section of the paper reviews work undertaken with a major psycho-social/mental health organization on issues relating to writing and implementing an ethical code for mental health practitioners and briefly discusses some of the dilemmas associated with this.     

Lessons from case studies of integrating mental health into primary health care in South Africa and Uganda

Background

Studies on the mental health of refugees have tended to focus upon the impact of traumatic experiences in the country of origin, and acculturation processes in exile. The effects of crises in the country of origin on refugees living in exile have been little studied. This article examines how the final stages of the civil war in Sri Lanka in 2009 influenced members of pro-LTTE Tamil NGO's in Norway.

Method

Ethnographic fieldwork methods were employed within Tamil NGO's in the two largest cities in Norway between November 2008 and June 2011.

Results

The findings suggest that collective resources became severely drained as a result of the crisis, severely disrupting the fabric of social life. Public support from the majority community remained scarce throughout the crisis.

Conclusions

The study suggests that there is a need for public support to exile groups indirectly affected by man-made crises in their country of origin.     

Sri Lankan doctors’ and medical undergraduates’ attitudes towards mental illness

Background  

Stigmatizing attitudes towards mental illness can impede help-seeking and adversely affect treatment outcomes, especially if such attitudes are endorsed by medical personnel. In order to help identify targets for anti-stigma interventions, we comprehensively examined negative attitudes towards mental illness displayed by Sri Lankan doctors and medical students and compared these with equivalent UK and other international data.     

Neurorehabilitation in Sri Lanka: an emerging sub-specialty for neurology trainees

Sri Lanka has an ageing population with an impending epidemic of stroke at hand. Stroke is the leading cause of adult disability in Sri Lanka. Sri Lanka has seen many recent advances in stroke services in the recent past providing a benchmark example for the countries in the Asia Pacific region, modeling the best care for stroke patients across the region with limited facilities they have. Three postgraduate trainees in neurology and medicine from Sri Lanka will spend a year at Western Health/ University of Melbourne, Melbourne, Australia for a period of 12 months for training in neurorehabilitation for stroke. It is timely for neurology trainees and trainees in internal medicine in Sri Lanka to be interested in neurorehabilitation. We sincerely hope the Board of study of Neurology, Post Graduate Institute of Medicine, Colombo, Sri Lanka will take the necessary steps to establish neurorehabilitation as an emerging sub-specialty for neurology trainees in Sri Lanka now.     

Intracranial aneurysms in adolescents

Purpose  

Intracranial aneurysms are extremely uncommon in adolescents. This study was undertaken to assess the clinical and radiological characteristics and clarify the choice of therapeutic strategies of intracranial aneurysms in adolescents with age range from 15 to 18 years.     

Involuntary commitment and detainment in adolescent psychiatric inpatient care

Objective  

To evaluate whether adolescents committed to psychiatric inpatient care are the most disturbed, and whether psychosocial factors other than psychiatric symptoms are associated with commitment to and detainment in psychiatric care among adolescents.     

Factors influencing primary care attendance in adolescents with high levels of depressive symptoms

Background  

Although depression is common amongst adolescents attending general practice, little is known about factors which influence consultation. This study aims to identify factors that contribute to GP attendance in adolescents with high levels of mood symptoms.     

Correlates of weapon carrying among high school students in the United States

Background  

Deaths and injuries arising from interpersonal violence among adolescents are major public health concerns in the United States. The bearing of weapons among adolescents is a critical factor in many of these deaths and injuries.     

Anxiety symptoms in rural Mexican adolescents

Background  

We investigated the contributions of individual, family, and community-level factors for explaining anxiety symptoms among rural adolescents in Mexico.     

How do ADHD children perceive their cognitive, affective, and behavioral aspects of anger expression in school setting?

Background  

Anger is an ignored research area in children and young adolescents with Attention deficit hyperactivity disorder (ADHD) in the school setting. This study compares school anger dimensions in children and young adolescents with ADHD and a control group.     

Reboxetine versus methylphenidate in treatment of children and adolescents with attention deficit-hyperactivity disorder

Background and purpose  

Attention deficit-hyperactivity disorder (ADHD) is a common psychiatric diagnosis among children and adolescents. This study has been conducted to evaluate the efficacy and tolerability of reboxetine in comparison with methylphenidate in treatment of children and adolescents with ADHD.     

Increasing self-reported suicide attempts by adolescents in Greece between 1984 and 2007

Purpose  

This study examines trends in self-reported suicide attempts by Greek adolescents.