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Gabarrell-Pascuet A, García-Mieres H, Giné-Vázquez I, Moneta MV, Koyanagi A, Haro JM, Domènech-Abella J. The Association of Social Support and Loneliness with Symptoms of Depression, Anxiety, and Posttraumatic Stress during the COVID-19 Pandemic: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2765. [PMID: 36833463 PMCID: PMC9957328 DOI: 10.3390/ijerph20042765] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Research suggests that changes in social support and loneliness have affected mental disorder symptoms during the COVID-19 pandemic. However, there are a lack of studies comparing the robustness of these associations. AIMS The aims were to estimate the strength of the associations of loneliness and social support with symptoms of depression, anxiety, and posttraumatic stress during the COVID-19 pandemic (2020-2022) in the general population. METHOD The method entailed a systematic review and random-effects meta-analysis of quantitative studies. RESULTS Seventy-three studies were included in the meta-analysis. The pooled correlations of the effect size of the association of loneliness with symptoms of depression, anxiety, and posttraumatic stress were 0.49, 0.40, and 0.38, respectively. The corresponding figures for social support were 0.29, 0.19, and 0.18, respectively. Subgroup analyses revealed that the strength of some associations could be influenced by the sociodemographic characteristics of the study samples, such as age, gender, region, and COVID-19 stringency index, and by methodological moderators, such as sample size, collection date, methodological quality, and the measurement scales. CONCLUSIONS Social support had a weak association with mental disorder symptoms during the COVID-19 pandemic while the association with loneliness was moderate. Strategies to address loneliness could be highly effective in reducing the impact of the pandemic on social relationships and mental health.
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Affiliation(s)
- Aina Gabarrell-Pascuet
- Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, 08950 Esplugues de Llobregat, Spain
- Research, Teaching, and Innovation Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Medicine, Universitat de Barcelona, 08007 Barcelona, Spain
| | - Helena García-Mieres
- Health Services Research Unit, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Iago Giné-Vázquez
- Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, 08950 Esplugues de Llobregat, Spain
- Research, Teaching, and Innovation Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Maria Victoria Moneta
- Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, 08950 Esplugues de Llobregat, Spain
- Research, Teaching, and Innovation Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Ai Koyanagi
- Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, 08950 Esplugues de Llobregat, Spain
- Research, Teaching, and Innovation Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), 08010 Barcelona, Spain
| | - Josep Maria Haro
- Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, 08950 Esplugues de Llobregat, Spain
- Research, Teaching, and Innovation Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Medicine, Universitat de Barcelona, 08007 Barcelona, Spain
| | - Joan Domènech-Abella
- Epidemiology of Mental Health Disorders and Ageing Research Group, Sant Joan de Déu Research Institute, 08950 Esplugues de Llobregat, Spain
- Research, Teaching, and Innovation Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Venturo-Conerly KE, Eisenman D, Wasil AR, Singla DR, Weisz JR. Meta-analysis: The Effectiveness of Youth Psychotherapy Interventions in Low- and Middle-Income Countries. J Am Acad Child Adolesc Psychiatry 2022:S0890-8567(22)01980-3. [PMID: 36563875 DOI: 10.1016/j.jaac.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 07/20/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Because most youth psychotherapies are developed and tested in high-income countries, relatively little is known about their effectiveness or moderators in low- and middle-income countries (LMICs). To address this gap, we conducted a meta-analysis of randomized controlled trials (RCTs) testing psychotherapies for youth with multiple psychiatric conditions in LMICs, and we tested candidate moderators. METHOD We searched 9 international databases for RCTs of youth psychotherapies in LMICs published through January 2021. The RCTs targeted elevated symptoms of youth anxiety (including post-traumatic stress disorder [PTSD] and obsessive-compulsive disorder), depression, conduct problems, and attention problems. Using robust variance estimation, we estimated the pooled effect sizes (Hedges g) at post treatment and follow-up for intervention vs control conditions. RESULTS Of 5,145 articles identified, 34 articles (with 43 treatment-control comparisons and 4,176 participants) met methodological standards and were included. The overall pooled g with winsorized outliers was 1.01 (95% CI = 0.72-1.29, p < .001) at post treatment and 0.68 (95% CI = 0.29-1.07, p = .003) at follow-up. Interventions delivered by professional clinicians significantly outperformed those delivered by lay providers (g = 1.59 vs 0.53), but all interventions for conduct problems were delivered by professionals, and the difference for interventions targeting internalizing problems (g = 1.33 vs .53) was not significant. Interventions developed non-locally were more effective if they were not adapted to local contexts than if they were adapted locally (g = 2.31 vs 0.66), highlighting a need for further research on effective adaptations. Significant risk of bias was identified. CONCLUSION Overall, pooled effects of youth psychotherapies in LMICs were markedly larger than those in recent comparable non-LMIC meta-analyses, which have shown small-to-medium effects for youth psychotherapies. Findings highlight the potential benefits of youth psychotherapies in LMICs, as well as a need for more RCTs and improved study quality.
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Affiliation(s)
| | | | | | - Daisy R Singla
- Center of Addiction and Mental Health, Toronto, Ontario, Canada; University of Toronto, Ontario, Canada; Sinai Health, Toronto, Ontario, Canada
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Salamanca-Buentello F, Seeman MV, Daar AS, Upshur REG. The ethical, social, and cultural dimensions of screening for mental health in children and adolescents of the developing world. PLoS One 2020; 15:e0237853. [PMID: 32834012 PMCID: PMC7446846 DOI: 10.1371/journal.pone.0237853] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 08/04/2020] [Indexed: 01/14/2023] Open
Abstract
Despite their burden and high prevalence, mental health disorders of children and adolescents remain neglected in many parts of the world. In developing countries, where half of the population is younger than 18 years old, one of every five children and adolescents is estimated to suffer from a mental health disorder. It is then essential to detect these conditions through screening in a timely and accurate manner. But such screening is fraught with considerable ethical, social, and cultural challenges. This study systematically identifies, for the first time, these challenges, along with potential solutions to address them. We report on the results of an international multi- and inter-disciplinary three-round Delphi survey completed by 135 mental health experts from 37 countries. We asked these experts to identify and rank the main ethical, social, and cultural challenges of screening for child and adolescent mental health problems in developing nations, and to propose solutions for each challenge. Thirty-nine significant challenges emerged around eight themes, along with 32 potential solutions organized into seven themes. There was a high degree of consensus among the experts, but a few interesting disagreements arose between members of the panel from high-income countries and those from low- and middle-income nations. The panelists overwhelmingly supported mental health screening for children and adolescents. They recommended ensuring local acceptance and support for screening prior to program initiation, along with careful and comprehensive protection of human rights; integrating screening procedures into primary care; designing and implementing culturally appropriate screening tools, programs, and follow-up; securing long-term funding; expanding capacity building; and task-shifting screening to local non-specialists. These recommendations can serve as a guide for policy and decision-making, resource allocation, and international cooperation. They also offer a novel approach to reduce the burden of these disorders by encouraging their timely and context-sensitive prevention and management.
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Affiliation(s)
| | - Mary V. Seeman
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Abdallah S. Daar
- Departments of Clinical Public Health and Surgery, University of Toronto, Toronto, Ontario, Canada
- Stellenbosch Institute for Advanced Study, Stellenbosch, Western Cape, South Africa
| | - Ross E. G. Upshur
- Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld - Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
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Uppendahl JR, Alozkan-Sever C, Cuijpers P, de Vries R, Sijbrandij M. Psychological and Psychosocial Interventions for PTSD, Depression and Anxiety Among Children and Adolescents in Low- and Middle-Income Countries: A Meta-Analysis. Front Psychiatry 2020; 10:933. [PMID: 32132936 PMCID: PMC7040217 DOI: 10.3389/fpsyt.2019.00933] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/25/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND In low- and middle-income countries, rates of common mental health disorders are found to be very high among children and adolescents while individuals, particularly in these countries, face barriers to mental health care. In the recent years, randomized controlled trials (RCTs) have been conducted that implemented and tested different psychological and psychosocial treatment approaches to treat common mental disorders. This review aims to analyze psychological interventions among children and adolescents in low- and middle-income countries. METHODS RCTs carried out in low- and middle-income countries on psychological and psychosocial interventions for children and adolescents with symptoms of trauma- and stressor related disorders, depression or anxiety were identified in bibliographic databases. Databases were systematically searched until December 14, 2018. Effect sizes indicating differences between treatment and control groups at post-test were computed using a random-effects model. Outcomes were symptoms of depression, anxiety and posttraumatic stress disorder (PTSD). RESULTS Thirteen studies with a total of 2,626 participants aged between 5 and 18 years were included. Treatments varied between studies and number of treatment sessions ranged from 1 to 16. The pooled effect size, combining outcomes of depression, anxiety and PTSD of psychological or psychosocial intervention versus care-as-usual or a control conditions yielded a medium effect (g = 0.62; 95% CI: 0.27-0.98). Heterogeneity was very high (I2 = 94.41; 95% CI = 80-91). The beneficial effect of interventions increased after excluding outliers (g = 0.72; 95% CI: 0.37-1.07), while heterogeneity remained high (I2 = 86.12; 95% CI = 87-94). CONCLUSION High quality RCTs investigating the effect of psychological and psychosocial interventions on PTSD, depression and anxiety among children and adolescents in low- and middle-income countries are scarce. Results of the available studies may suggest that psychological and psychosocial interventions might be more effective in reducing symptoms of anxiety, depression and PTSD compared to control conditions. Due to very high heterogeneity, this evidence must be considered with caution.
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Affiliation(s)
- Jana R. Uppendahl
- Department of Clinical, Neuro and Developmental Psychology, World Health Organization Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Cansu Alozkan-Sever
- Department of Clinical, Neuro and Developmental Psychology, World Health Organization Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, World Health Organization Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Ralph de Vries
- Medical Library, Vrije Universiteit, Amsterdam, Netherlands
| | - Marit Sijbrandij
- Department of Clinical, Neuro and Developmental Psychology, World Health Organization Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
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Dang HM, Weiss B, Trung LT. Functional impairment and mental health functioning among Vietnamese children. Soc Psychiatry Psychiatr Epidemiol 2016; 51:39-47. [PMID: 26315942 PMCID: PMC4724307 DOI: 10.1007/s00127-015-1114-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 08/12/2015] [Indexed: 01/13/2023]
Abstract
PURPOSE Functional impairment is a key indicator of need for mental health services among children and adolescents, often a stronger predictor of service usage than mental health symptoms themselves. Functional impairment may be of particular importance in low- and middle-income countries (LMIC) because of its potential to focus policy on treatment of child mental health problems which is generally given low priority in LMIC. However, few studies have assessed functional impairment in LMIC. The present study assessed rates of functional impairment among children in Vietnam, as a case example of an LMIC, as well as effects of other risk/protective factors of particular relevance to LMIC (e.g., whether the family lived in an urban or rural area; family structure variables such as grandparents living with the family). METHODS 1314 parents of children 6-16 years old from 10 Vietnamese provinces were interviewed. RESULTS The overall rate of functional impairment among Vietnamese children was 20 %, similar to rates in high-income countries such as Germany and the United States, suggesting that LMIC status may not be associated with dramatic increases in functional impairment in children. Functional impairment was significantly greater among mental health cases than non-cases, with increases of over 550 % associated with mental health caseness. A number of other risk factors (e.g., marital status) had smaller but significant effects. CONCLUSIONS Mental health problems are a major but not the sole contributor to functional impairment among Vietnamese children. The pragmatic significance of this research lies in its potential to affect public awareness and policy related to child mental health in LMIC.
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Affiliation(s)
- Hoang-Minh Dang
- Vietnam National University, 144 Xuan Thuy Road, Cau Giay District, Hanoi, Vietnam.
| | - Bahr Weiss
- Vanderbilt University, Nashville, Tennessee, USA
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Weiss B, Dang M, Trung L, Nguyen MC, Thuy NTH, Pollack A. A Nationally-Representative Epidemiological and Risk Factor Assessment of Child Mental Health in Vietnam. ACTA ACUST UNITED AC 2014; 3:139-153. [PMID: 25328817 DOI: 10.1037/ipp0000016] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
As part of the global mental health movement's focus on identifying and reducing international disparities, this study conducted the first nationally representative child mental health epidemiological survey in Vietnam. We assessed as risk/protective factors several family social structure characteristics (e.g., presence of grandparents, number of siblings in the home) of particular relevance to non-Western countries. Epidemiological data using the Child Behavior Checklist and the Strengths and Difficulties Questionnaire were collected at 60 sites in 10 of Vietnam's 63 provinces selected to provide a nationally representative sample, which included 1,314 adult informants of children 6-16 years of age, and 591 children aged 12-16. Vietnamese children's mental health functioning was reported overall to be better by approximately a third standard deviation than the international average; this international difference was particularly large for externalizing (behavior) problems as compared to internalizing (emotional) problems, suggesting that a cultural problem suppression model may be operating in Vietnam. Significant variability in mental health problems was found across provinces, emphasizing the need for nationally representative samples when conducting child mental health epidemiological surveys. Contrary to many other studies, in Vietnam higher SES was found to be a risk factor for attention/hyperactivity problems.
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Steel Z, Marnane C, Iranpour C, Chey T, Jackson JW, Patel V, Silove D. The global prevalence of common mental disorders: a systematic review and meta-analysis 1980-2013. Int J Epidemiol 2014; 43:476-93. [PMID: 24648481 PMCID: PMC3997379 DOI: 10.1093/ije/dyu038] [Citation(s) in RCA: 1465] [Impact Index Per Article: 146.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Since the introduction of specified diagnostic criteria for mental disorders in the 1970s, there has been a rapid expansion in the number of large-scale mental health surveys providing population estimates of the combined prevalence of common mental disorders (most commonly involving mood, anxiety and substance use disorders). In this study we undertake a systematic review and meta-analysis of this literature. METHODS We applied an optimized search strategy across the Medline, PsycINFO, EMBASE and PubMed databases, supplemented by hand searching to identify relevant surveys. We identified 174 surveys across 63 countries providing period prevalence estimates (155 surveys) and lifetime prevalence estimates (85 surveys). Random effects meta-analysis was undertaken on logit-transformed prevalence rates to calculate pooled prevalence estimates, stratified according to methodological and substantive groupings. RESULTS Pooling across all studies, approximately 1 in 5 respondents (17.6%, 95% confidence interval:16.3-18.9%) were identified as meeting criteria for a common mental disorder during the 12-months preceding assessment; 29.2% (25.9-32.6%) of respondents were identified as having experienced a common mental disorder at some time during their lifetimes. A consistent gender effect in the prevalence of common mental disorder was evident; women having higher rates of mood (7.3%:4.0%) and anxiety (8.7%:4.3%) disorders during the previous 12 months and men having higher rates of substance use disorders (2.0%:7.5%), with a similar pattern for lifetime prevalence. There was also evidence of consistent regional variation in the prevalence of common mental disorder. Countries within North and South East Asia in particular displayed consistently lower one-year and lifetime prevalence estimates than other regions. One-year prevalence rates were also low among Sub-Saharan-Africa, whereas English speaking counties returned the highest lifetime prevalence estimates. CONCLUSIONS Despite a substantial degree of inter-survey heterogeneity in the meta-analysis, the findings confirm that common mental disorders are highly prevalent globally, affecting people across all regions of the world. This research provides an important resource for modelling population needs based on global regional estimates of mental disorder. The reasons for regional variation in mental disorder require further investigation.
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Affiliation(s)
- Zachary Steel
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, NSW, Australia, Centre for Population Mental Health Research, South West Sydney Local District Network, Sydney, NSW, Australia, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK, Centre for Mental Health, Public Health Foundation of India and Sangath, Goa, India
| | - Claire Marnane
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, NSW, Australia, Centre for Population Mental Health Research, South West Sydney Local District Network, Sydney, NSW, Australia, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK, Centre for Mental Health, Public Health Foundation of India and Sangath, Goa, India
| | - Changiz Iranpour
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, NSW, Australia, Centre for Population Mental Health Research, South West Sydney Local District Network, Sydney, NSW, Australia, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK, Centre for Mental Health, Public Health Foundation of India and Sangath, Goa, India
| | - Tien Chey
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, NSW, Australia, Centre for Population Mental Health Research, South West Sydney Local District Network, Sydney, NSW, Australia, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK, Centre for Mental Health, Public Health Foundation of India and Sangath, Goa, India
| | - John W Jackson
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, NSW, Australia, Centre for Population Mental Health Research, South West Sydney Local District Network, Sydney, NSW, Australia, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK, Centre for Mental Health, Public Health Foundation of India and Sangath, Goa, India
| | - Vikram Patel
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, NSW, Australia, Centre for Population Mental Health Research, South West Sydney Local District Network, Sydney, NSW, Australia, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK, Centre for Mental Health, Public Health Foundation of India and Sangath, Goa, India
| | - Derrick Silove
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, NSW, Australia, Centre for Population Mental Health Research, South West Sydney Local District Network, Sydney, NSW, Australia, Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK, Centre for Mental Health, Public Health Foundation of India and Sangath, Goa, India
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Rohde LA. Do we face the same dilemma on pediatric psychopharmacology in low and middle income countries? World Psychiatry 2013; 12:132-3. [PMID: 23737420 PMCID: PMC3683263 DOI: 10.1002/wps.20035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Luis Augusto Rohde
- Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul; Porto Alegre; Rio Grande do Sul; Brazil
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