A cross-sectional analysis of mental health disorders in a mental health services-seeking population of children, adolescents, and young adults in the context of ongoing violence and displacement in northern Cameroon

Validation of the Edinburgh postnatal depression scale and prevalence of depression among adolescent mothers in a Cameroonian context

The Edinburgh Postnatal Depression Scale (EPDS) is the screening tool for perinatal depression, and its cut-off score varies according to context and population. In Cameroon, no study has yet defined a cut-off score or the prevalence of perinatal depression in adolescent mothers. Our aim is to determine the cut-off for teenage mothers in Cameroon. The study is cross-sectional and analytical in nature. The EPDS was used to screen for symptoms of depression and an interview based on the DSM-5 criteria for depression was conducted to diagnose the depressive syndrome. The data were processed with Epidata 3.1 and was analysed with SPSS 25. Positive and negative predictive values (PPV, NVP) were calculated. The optimal EPDS score was determined by taking into account the importance of false-negative and false-positive test results. 1633 adolescent mothers were recruited. The prevalence of perinatal depression was 60.8% (95% CI = 58.5, 63.2). The cut-off score for this population was ≥ 11. Sensitivity was 92.6% (95% CI = 0.913, 0.939) specificity 53.2% (95% CI = 0.508, 0.556), PPV 75.5% and NPV 80.2%. This score of ≥ 11 is retained because false-negative results have important adverse consequences. This study on the validation of the EPDS and the prevalence of perinatal depression in a population of teenage mothers is new in Cameroon and central Africa.

Perinatal mental disorders and suicidal risk among adolescent mothers living in urban areas of Cameroon

Background

In sub-Saharan Africa the birth rate among teenage mothers is the highest in the world. In 2021, there would be 6,114,000 births for 15-19-year-olds in this part of the world. In Cameroon, the fertility rate among adolescents aged 15-19 is 24%. However, there is a significant lack of data on the mental health of teenage mothers. Given the biopsychosocial conditions of the perinatal period and adolescence, we hypothesise that the prevalence of mental disorders and the risk of suicide is very high in Cameroon. The aim is therefore to determine the prevalence of perinatal mental disorders and suicide risk among adolescent mothers in urban areas of Cameroon.

Methods

Following ethical approval of the submitted protocol, we recruited adolescent mothers and data were collected using diagnostic interviews based on the DSM-5, PDM-2 and MINI guidelines. The types of sampling used were typical and incidental. Data were tabulated with Epidata 3.1 and processed with SPSS 25.

Results

66.4% of adolescent mothers were diagnosed with a mental disorder and 27.4% with suicidal risk. It was found that there was a link between mental disorders and suicidal risk (p<0.001), with mothers at suicidal risk having an 8.4 times greater risk of having a mental disorder (OR=8.423). Linear regression confirmed the statistically significant relationship between perinatal mental disorders and suicidal risk. 31.1% of the total variance in suicidal risk was explained by mental disorders. The regression coefficients for mental disorders with a p<0.05 value is: perinatal depression (-0.279), post-partum psychosis (-0.133), trauma disorder (-0.034), generalised anxiety disorder (-0.008) and conduct disorder (-0.020).

Conclusions

Our hypothesis is confirmed, because the prevalence of 66.4% of mental disorders and 27.4% of suicidal risk are significantly high in Cameroon. In some way, the disorders predict suicidal risk, because the less an adolescent mother has one of these pathologies during the perinatal period, the less she will be at risk of suicide. More research of this kind is needed to contribute in providing more data, including solutions to address the morbidity and mortality problems associated with the mental health of teenage mothers.

Prevalence, risk factors and management of common mental health disorders in Cameroon: a systematic review

Objectives

This review aimed to synthesise evidence on (1) the prevalence of common mental health disorders (MHDs) in Cameroon; (2) the effectiveness of mental health management interventions; (3) the risk factors for common MHDs in Cameroon and (4) map the state of research on common mental disorders in Cameroon.

Design

A systematic review.

Data sources

We performed a comprehensive search for articles in major public health databases including PubMed, Scopus, Medline, CINAHL, PsycINFO, Web of Science, Embase, CINAHL from inception of each database to June 2022.

Eligibility criteria

Published articles on the prevalence, risk factors or intervention for management of common MHDs in Cameroon met the inclusion criteria for this systematic review.

Data extraction and synthesis

The abstract and full-text screening, and data extraction were performed independently by at least two researchers. The results have been reported based on a narrative synthesis.

Results

After the screening stages, 32 articles met the inclusion criteria and were included in this study. A high prevalence of common MHDs among different groups, including teenage mothers, students and people living with HIV, was observed. We identified important risk factors for these conditions in the general population and among high-risk groups. We also identified two interventions which show promising results for the management of depression among individuals with HIV in Cameroon.

Conclusion

Our review recorded a high prevalence of common MHDs and identified important risk factors for MHDs among different groups. Increased priority and participatory action with all stakeholders including individuals, communities/policy holders and in research where a huge gap remains to be filled, is crucial in reducing the burden of MHDs in Cameroon.

PROSPERO registration number

CRD42022348427.

Post-traumatic stress disorder and associated factors among internally displaced persons in Africa: A systematic review and meta-analysis

BACKGROUND

Internally displaced people (IDPs), uprooted by conflict, violence, or disaster, struggle with the trauma of violence, loss, and displacement, making them significantly more vulnerable to post-traumatic stress disorder (PTSD). Therefore, we conducted a systematic review and meta-analysis to assess the prevalence and associated factors of PTSD among IDPs in Africa.

METHODS

A comprehensive search of electronic databases was conducted to identify relevant studies published between 2008 and 2023. The search included electronic databases such as PubMed, CABI, EMBASE, SCOPUS, CINHAL, and AJOL, as well as other search sources. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Data were extracted using Microsoft Excel, and analysis was performed using STATA 17 software. The quality of the included studies was assessed using the JBI quality appraisal tool. A random-effects model was used to estimate the pooled prevalence of PTSD and its associated factors. The funnel plot and Egger's regression test were used to assess publication bias, and I2 test statistics was used to assess heterogeneity. The protocol for this review has been registered with PROSPERO (ID: CRD42023428027).

RESULTS

A total of 14 studies with a total of 7,590 participants met the inclusion criteria. The pooled prevalence of PTSD among IDPs in Africa was 51% (95% CI: 38.-64). Female gender (OR = 1.99, 95% CI: 1.65-2.32), no longer married (OR = 1.93, 95% CI: 1.43-2.43), unemployment (OR = 1.92, 95% CI: 1.17-2.67), being injured (OR = 1.94, 95% CI: 1.50-1.50), number of traumatic events experienced [4-7(OR = 2.09, 95% CI: 1.16-3.01), 8-11 (OR = 2.09, 95% CI: 2.18-4.12), 12-16 (OR = 5.37, 95% CI: 2.61-8.12)], illness without medical care (OR = 1.92, 95% CI: 1.41-2.29), being depressed (OR = 2.97, 95% CI: 2.07-3.86), and frequency of displacement more than once (OR = 2.13, 95% CI: 1.41-2.85) were significantly associated with an increased risk of PTSD.

CONCLUSIONS

The findings of this systematic review and meta-analysis highlight the alarming prevalence of PTSD among IDPs in Africa. Female gender, marital status, number of traumatic events, ill health without medical care, depression, and frequency of displacement were identified as significant risk factors for PTSD. Effective interventions and the development of tailored mental health programs are needed to prevent PTSD among IDPs, focusing on the identified risk factors.

Accessibility and Perceived Impact of a Group Psychosocial Intervention for Women in Ecuador: A Comparative Analysis by Migration Status

There is increasing guidance promoting the provision of mental health and psychosocial support programs to both migrant and host community members in humanitarian settings. However, there is a lack of information on the respective experiences and benefits for migrant and host community members who are participating in mental health and psychosocial support programming. We evaluated a community-based psychosocial program for migrant and host community women, Entre Nosotras, which was implemented with an international non-governmental organization in Ecuador in 2021. Data on participant characteristics and psychosocial wellbeing were collected via pre/post surveys with 143 participants, and qualitative interviews were conducted with a subset (n = 61) of participants. All quantitative analyses were conducted in STATA, and qualitative analysis was done in NVivo. Attendance was higher for host community members. Specifically, 71.4% of host community members attended 4-5 sessions, whereas only 37.4% of migrants attended 4-5 sessions (p = 0.004). Qualitative analysis shows that the intervention was less accessible for migrants due to a variety of structural barriers. However, this analysis also demonstrated that both groups of women felt a greater sense of social connectedness after participating in the program and expressed gratitude for the bonds they formed with other women. Some migrant women described negative experiences with the host community because they felt as though they could not confide in host community women and speak freely in front of them. These results underscore how the migratory context influences the implementation of mental health and psychosocial support (MHPSS) programs. As humanitarian guidelines continue to emphasize the integration of host community members and displaced persons, it is critical to account for how the same intervention may impact these populations differently.

Post-traumatic stress disorder and its associated factors among war-affected residents in Woldia town, North East Ethiopia, 2022; community based cross-sectional study

INTRODUCTION

Post-traumatic stress disorder is marked by increased stress and anxiety following exposure to a traumatic or stressful event. Events of conflict and war-related traumas were commonly reported situations and people who have undergone through have a higher tendency to develop PTSD Woldia town had been under a serious military surge and a five-month encroachment, so the expected destruction in property, impact on physical, social and mental health of civilians was potentially high. More importantly, there is no study that investigated the significance of association between war-related traumatic events and post-traumatic stress disorder in the area. so this study aims to assess prevalence of post-traumatic stress disorder and its associated factors among war-affected residents in Woldia town, North East Ethiopia, 2022.

METHOD

A community-based cross-sectional study design was employed by using a multi-stage systematic random sampling technique from May-15 to June-15/2022. A total of 609 participants were enrolled. PTSD was measured by the post-traumatic stress disorder checklist for DSM-5 (PCL-5). Data were entered by Epi data version 4.6.0.2 and analyzed using STATA version 14. Bivariable and Multivariable logistic regression analysis was done to identify associated factors to PTSD and P-values less than 0.05 were considered statistically significant.

RESULTS

The overall prevalence of PTSD was 56.28%. Destruction/looting of property (AOR = 1.6,95%CI,1.11-2.47), murder/injury of family member (AOR = 2.1,95% CI,1.37-3.22), witness of murder of family member/others (AOR = 1.6,95% CI,1.01-2.71), unlawful imprisonment (AOR = 1.7, 95%CI, 1.06-2.74), depression (AOR = 2, 95%CI, 1.37-2.93), anxiety (AOR = 3.3, 95%CI,2.26-4.97), experience trauma on themselves (AOR = 2.0,95%CI,1.22-3.58), poor (AOR = 3.1,95%CI,1.60-6.04) and moderate (AOR = 3.0, 95%CI, 1.56-5.87) social support were statistically associated with PTSD at a p-value < 0.05.

CONCLUSION

The study reveals that the prevalence of PTSD was high in Woldia town following an armed conflict between Federal Government and Tigray forces. Destruction/looting of property, murder/injury of family, witness murder of family/others, unlawful imprisonment, depression, anxiety, experience on themselves, poor and moderate social support were statistically associated with PTSD. Hence, encourage organization working on mental health, routine patient assessment with a history of trauma, facilitating means to support affected residents is recommended.

Social integration, solidarity, and psychological health of internally displaced persons in Cameroon: Exploring the role of community satisfaction

BACKGROUND/INTRODUCTION

Conflict-induced displacement continue to be a pressing public policy concern due to the adverse effects on the well-being of internally displaced persons (IDPs). Understanding the integration process of these individuals, particularly the role of solidarity and social integration in fostering a sense of belonging and improving their community experiences and psychological well-being, remains unclear. This study investigates the role of community satisfaction in the relationship among social integration, solidarity, and psychological health of IDPs in Cameroon.

METHODS

Cross-sectional data from 428 displaced individuals in the Ntui subdivision, Cameroon, were analyzed using structural equation modeling (SEM). This technique tested four latent variables: social integration, solidarity, community satisfaction, and psychological health.

RESULTS

The results show a direct association between solidarity and both community satisfaction (β = 0.282; p < 0.001) and psychological health (β = 0.137; p < 0.01). Community satisfaction also has a direct relationship with the psychological health of the IDPs (β = 0.292; p < 0.001). An indirect effect of solidarity on psychological health through community satisfaction was observed (β = 0.084 (SE = 0.025, CI = [0.047, 0.129], p < 0.001)). However, no mediational effect of community satisfaction was found on the association between social integration and psychological health. The model accounted for 7% of the variance in community satisfaction (R2 = 0.07) and 20% of the variance in psychological health (R2 = 0.20). Conclusion: The findings indicate a strong sense of solidarity among the displaced persons in the studied communities in Cameroon, which promotes their psychological health via community satisfaction. As such, interventions should aim to foster solidarity among displaced persons to enhance their community experiences and psychological health.