In Canada, ensuring public safety, and the safety and well-being of accused individuals under the jurisdiction of the provincial review board are very important. While previous studies have reported ...a significant risk of self-harming behaviors (non-suicidal self-injury and suicide attempt) in forensic psychiatric settings, no large population study has assessed any relationship between forensic system-related factors and self-harming behaviors. A better understanding of these factors can help clinicians implement protective measures to mitigate self-harming behaviors or actions.
Using the Ontario Review Board (ORB) database covering 2014-2015 period (n = 1211, mean age = 42.5 ± 13.37 years, males = 86.1%), we analyzed the prevalence and factors associated with self-harming behaviors, emphasizing the characterization of the forensic system-related factors (ORB status, legal status, type of offense, previous criminal history, and victim relationship). The relationships between the forensic system-related factors and self-harming behaviors were explored using five separate logistic regression models, controlling for clinical and sociodemographic characteristics.
Approximately 4% of the individuals in the forensic system over the study period engaged in self-harming behaviors Among the studied patients, individuals determined to be unfit to stand trial and inpatients were significantly more likely to have self-harming behaviors. There was no significant relationship between the type of offence, victim relationship, and previous criminal history with self-harming behavior.
Forensic psychiatry inpatients should have close observation, screening, monitoring, and individual tailored management strategies for self-harming behaviors. The findings of this study indicate that forensic system-related factors, especially those that pertain to the status of individuals in the forensic system (i.e., unfit to stand trial and being an inpatient) are more responsible for self-harming behaviors among forensic patients in Ontario.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Breathe is a student-led literary and arts magazine whose goal is to provide a platform for creative expression about mental health issues and promote mental wellness among trainee healthcare ...professionals using student-submitted art and written pieces. Select pieces were published to improve readers’ understanding of and self-reflection on mental health. Common themes among the submissions include life outside of healthcare, imposter syndrome and coping with stress. This novel project had high satisfaction reported by 87.5% of surveyed readers. We advocate for improved mental health awareness and increased use of artistic expression as a coping strategy against stressors in healthcare education worldwide.
Purpose
Bipolar affective disorder (BAD) and schizophrenia are two severe psychotic conditions that are associated with disability. The present study was designed to compare the pattern of disability ...between clinically stable individuals with BAD and schizophrenia in a sub-Saharan mental health facility.
Methods
A total of 200 consecutive participants (made up of 100 each among clinically stable individuals with BAD and schizophrenia) were recruited. All participants had their diagnoses confirmed using Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID), after which the designed questionnaire and the 36-item World Health Organisation Disability Assessment Schedule interview (WHODAS II) were administered to them.
Results
In this study, the level of disability among participants with BAD was better compared to those with schizophrenia as determined by mean WHODAS score of 24.93 and 27.02, respectively. Similarly, there was a significant difference between participants with BAD and schizophrenia with respect to four domains of the WHODAS-II, viz, self-care (
p
< 0.001), getting along with others (
p
< 0.001), life activities (
p
< 0.001) and participation in the society (
p
< 0.001). The factors that were significantly associated with disability in the two groups (BAD and schizophrenia) were: unemployment status (
p
< 0.001) and remittance source of income (
p
< 0.001), while those that spent not more than ₦2,000 (13 dollars) per month on treatment (
p
= 0.004) were observed to be less disabled.
Conclusions
Overall, participants with BAD fared better in the level of disability and most of the measured domains of disability in comparison with those with schizophrenia. Both socio-demographic and treatment-related factors seem to define the pattern disability among participants. Thus, evidence-guided preventive and rehabilitative treatment strategies directed against functional impairment using prioritized model among individuals with BAD and schizophrenia are advocated.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Evidence-based rehabilitative treatment is constrained due to limited knowledge about disability and its related factors among individuals with schizophrenia across West Africa. This study aims to ...investigate the pattern of disability, and the associated factors among individuals with schizophrenia. One hundred consecutively recruited consenting participants were subjected to designed questionnaire to inquire about their demographic and illness-related variables. This was followed by the administration of Structured Clinical Interview for DSM-IV-TR Axis I Disorders and Brief Psychiatric Rating Scale to confirm the diagnosis of schizophrenia and rate severity of symptoms respectively in them. In addition, the World Health Organisation Disability Assessment Scale II (WHODAS-II) was used to assess for disability in all participants. Different degrees of disability based on WHODAS- II mean score of 27.02±3.49 were noted among individuals with schizophrenia, and affectation of domains of disability like self care, getting along with others, life activities and participation in the society among others were observed. In addition, high level of disability was significantly associated with younger adults in the age group 18-44 years (P=0.007), unemployment status (P=0.003), remittance source of income (P=0.034) and ethnicity (P=0.017); conversely, less number of children (P=0.033), less amount spent on treatment (P<0.001) and lower BPRS score (P<0.001) correlated negatively with high level of disability. In spite of clinical stability following treatment, individuals with schizophrenia were disabled to varied degrees, and socioeconomic as well as illness-related factors constituted important correlates. Integration of rehabilitation along with social intervention into treatment design to reduce disability is implied, and further research is also warranted.
Background: The rising prevalence of alcohol use among youths in low resource settings is a major public health issue of concern, especially as alcohol use remains a leading contributor to deaths and ...disability globally. This study aimed to evaluate the effects of screening and brief intervention (SBI) on alcohol use risk among university students. Methods: In this quasi-experimental study, a total of 636 students were screened for alcohol use risk with the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test (WHO-ASSIST) version 3.1. All participants with moderate and high risk of alcohol use were administered brief intervention (BI) delivered by trained students at baseline, 1 month, and 3 months, with a final assessment in 6 months. Longitudinal data on their alcohol use risk were analyzed. Results: The mean age (standard deviation) of the participants was 21.13 (3.05) years and 44.5% were female. The prevalence of the current alcohol use based on the WHO-ASSIST was 49.2% (n = 315). Following three sessions of BI, the repeated measures ANOVA indicated that the WHO-ASSIST mean score for high-risk alcohol users (n = 44) fell from 33.23 (3.82) at baseline to 18.3 (9.84) at 6th month. This difference was statistically significant. Similarly, the mean score for moderate alcohol users fell from 19.62 (2.97) at baseline to 11.31 (5.52) at 6 months. The difference was statistically significant. There were significant group-level differences in the risk score over the study period, for the low risk, moderate risk, and high-risk users at the end of the study. Conclusion: Screening and BI showed significant benefits on alcohol use risk. Our findings suggest SBI as a feasible and effective intervention for mitigating the risk of alcohol use among young students in resource-restricted settings. Further research using a robust sample to reflect differences in setting and student characteristics is warranted.
Forensic-correctional psychiatric services are an important component of the public mental health services that provide care to offenders with mental illness in the criminal justice system and ...conduct psycho-legal assessments. Although forensic-correctional psychiatric services have evolved in Abu Dhabi, more work is needed in providing adequate mental health care for offenders.
This study provides a situational analysis of forensic-correctional psychiatric services in Abu Dhabi. We included a descriptive analysis of the data collected on service users admitted for psycho-legal assessments and treatment in the forensic-correctional units and those reviewed in the medical board units for issuing court reports. The study spanned the period between January 2019 to October 2020.
A total of 398 males were included in the study. The participants' mean age was 35.3 (SD 9.27) years and were predominantly single, unemployed and high school graduates. The most prevalent diagnosis was schizophrenia spectrum disorder, (n=129, 31.6%). The mean length of stay in the forensic-correctional unit was 11.07 days. As many as 82.4% of the participants were referred for evaluation. The most common type of crime was categorized as "abnormal behaviour" under the code of practice number 511 of the list of crimes as per the general prosecutor of the United Arab Emirates followed by violence.
Considering the level of demand for services and the limited number of forensic-correctional health professionals, there is a need for more resources to develop expertise, clinical services and infrastructures to expand the practice of forensic-correctional psychiatry. The creation of a universal database for all forensic-correctional psychiatric services is needed to better understand the unmet mental health needs. An additional investment of resources for research to inform mental health policy, laws and practice is indicated. Optimally, the lessons highlighted in this study can guide action plans for improving forensic-correctional mental health services in comparable settings.
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