Majnūn or Mental Disorders: Between Cultural Traditions and Western Psychology in Jordan

Mental disorders or altered psychological states are prevalent in all populations, regardless of race or ethnic origin, while at the same time, culture also shapes the conceptions of mental disorders. Religion is deeply rooted in the daily life of the Muslim-majority countries, while Arab countries are affected by an ongoing modernization. Thus, how does the traditional religious conception of mental disorders interact with Western psychological conceptions in contemporary Arab-Muslim society? This study explores the conceptions of mental disorders and their causes among Muslims in contemporary Jordan. By employing cognitive anthropological method (free listing), forty participants were asked to provide three lists of (a) typical names of mental disorders, (b) causes of mental disorders and (c) determining features of mental disorders. Collected qualitative data have been quantitatively analysed and interpreted in the context of relevant ethnographic and interview data. While Western terms of mental disorders are well known among young and educated Jordanians, the study demonstrates that Jordanians employ cultural and religious notions alongside. This co-existence of different conceptions confirms an importance of Islamic notion in the modern rendering of mental health. As a result, despite rapid modernization, mental health is still highly stigmatized.

Effect of an Anti-Stigma Program on Self-Stigma for Chinese Individuals With Schizophrenia: A Pilot Study With a Quasi-Experimental Design

The current study explored the effectiveness of an anti-stigma group program for people with schizophrenia. Thirty-four participants recruited from a psychiatric day hospital were allocated to the experimental group (EG) or control group (CG). The Internalized Stigma of Mental Illness Scale (ISMIS), Perceived Psychiatric Stigma Scale (PPSS), and Beck Depression Inventory-II (BDI-II) were used to measure outcomes, which were evaluated at baseline, immediately post program, and 3-month follow up. Generalized estimating equations showed that the EG attained a greater reduction in the stigma resistance subscale of the ISMIS than the CG at posttest and 3-month follow up. Scores on the self-deprecation subscales (p = 0.025) and concerns about marital preclusion (p = 0.037) on the PPSS and BDI-II (p = 0.027) in the EG showed significant improvement over those of the CG at 3-month follow up. The anti-stigma group program seems to be effective in reducing self-stigma and depressive symptoms in people with schizophrenia. [Journal of Psychosocial Nursing and Mental Health Services, 62(2), 37-45.].

An evaluation of pharmacists' general attitudes, knowledge, and phobias regarding medications that include corticosteroids: a cross-sectional study

BACKGROUND

Corticosteroid-containing medications are widely accessible in various forms, including topical, injectable, and inhaled formulations. Due to uncertain safety profiles, healthcare providers, including pharmacists, often express apprehension when dispensing these drugs. This cross-sectional study assesses the knowledge, attitudes, and phobia of Jordanian pharmacists regarding corticosteroid-containing medications.

METHODS

Conducted through a self-administered online questionnaire.

RESULTS

the study reveals that dermatological conditions and respiratory disorders are the primary indications for prescribing corticosteroid-containing drugs. The most reported side effects among pharmacists' patients include increased appetite, diabetes, and skin thinning. Pharmacists generally exhibit acceptable knowledge, with a median score of 9.0 out of 11.0 (IQR = 3.0). Over two-thirds of pharmacists (69.9%) achieve a high knowledge score (Bloom's cut-off point ≥ 8.8). However, only 55.7% are aware that corticosteroids may induce mood changes. High phobia scores, particularly concerning increased blood pressure and osteoporosis risks, indicate pharmacist reservations in corticosteroid dispensing. Interestingly, pharmacists in rural areas display lower knowledge scores, while those working outside community pharmacies exhibit lower phobia scores compared to their counterparts in urban areas and community pharmacies, respectively.

CONCLUSION

Despite generally good knowledge levels, the study underscores high phobia scores among Jordanian pharmacists regarding corticosteroid dispensing, particularly due to concerns about blood pressure elevation and osteoporosis risks. This suggests a potential need for targeted educational interventions and support systems to enhance pharmacist confidence and optimize corticosteroid usage while minimizing associated risks.

Evaluation of the impact of a self-stigma reduction programme on psychosocial outcomes among people with schizophrenia spectrum disorder

Purpose

The purpose of this study is to evaluate the effectiveness of a self-stigma reduction programme on self-stigma.

Design/methodology/approach

A randomized controlled trial was conducted from November 2017 to December 2018 with 278 people diagnosed with schizophrenia (PDwS). Participants were randomly assigned to receive a self-stigma reduction programme (psychoeducation, cognitive behavioural therapy and social skills training) or treatment as usual.

Findings

PDwS in the intervention group experienced a greater reduction in the level of self-stigma (20.19 vs −0.62; p < 0.001) at post-intervention and (37.35 vs −0.66; p < 0.001) at six-month follow-up.

Originality/value

The first RCT examines the problem and implements intervention in middle east country. Also, the authors have conducted high-quality RCT.

Relationship of stigmatization and social support with depression and anxiety among cognitively intact older adults

Aims and objectives

This study aimed to assess depression and anxiety symptoms among older adult residents of long-term care facilities (LTCFs) in Jordan and to examine the relationships between stigmatization and social support with depression and anxiety.

Methods

Data was collected between December 2019 and March 2020 using a cross-sectional design. A total of 90 LTCF residents responded to measures of cognition, anxiety, depression, stigmatization, and social support. Descriptive statistics and multiple regression analyses were used in this study.

Results

The average scores of depression and anxiety were high among the participants, with 81.1% of the participants found to be at risk of developing clinical depression. Stigmatization was positively correlated with depression and anxiety, whereas social support was negatively correlated with depression. Stigmatization was a significant predictor of both anxiety and depression scores (β = .19, p = .03; β = .32, p = .001, respectively).

Conclusions

Older adults residing in LTCFs in Jordan suffer from many psychological distress symptoms, which place them at risk of serious mental problems. Reducing stigmatization would improve the psychological well-being of LTCF residents.

Relevance to clinical practice

Caregivers working at LTCFs should be aware that with the longer stay, older adult residents are expected to complain of psychological distress symptoms. Thus, frequent assessment of the residents is highly recommended. In addition, caregivers should provide the residents with appropriate social support to mitigate the negative impact of a lengthy stay.

Evaluation of the impact of a self-stigma reduction programme on psychosocial outcomes among people with schizophrenia spectrum disorder

BACKGROUND

Self stigma is assumed to be more prominent in Jordanian society than in Western countries, reflecting a poor understanding of mental illness, collectivistic culture, and delay in accessing psychiatric care.

AIM

The purpose of the study is to evaluate the effectiveness of a self-stigma reduction programme on self-stigma.

METHODS

A randomized controlled trial was conducted from November 2017 to December 2018 with 278 people diagnosed with schizophrenia (PDwS). Participants were randomly assigned to receive a self-stigma reduction programme (psychoeducation, cognitive behavioural therapy and social skills training), or treatment as usual (TAU).

RESULTS

PDwS in the intervention group experienced a greater reduction in the level of self-stigma (20.19 vs -0.62; p < 0.001) at post-intervention and (37.35 vs -0.66; p < 0.001) at six-month follow-up.

CONCLUSIONS

The findings suggest that the self-stigma reduction programme has the potential to reduce self-stigma levels.

TRIAL REGISTRATION

NCT04087954.

Exploring the experience of relatives living with individuals diagnosed with schizophrenia in Oman: A qualitative study

WHAT IS KNOWN ON THE SUBJECT?: Relatives of individuals diagnosed with schizophrenia experience financial, social, emotional and physical burden. There is a lack of studies on the experience and needs of caregivers of individuals diagnosed with schizophrenia in the Arab world. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This is the first qualitative study to reflect the voice of parents, siblings and spouses living with schizophrenia in the Arab world. The study explored the needs of relatives of hospitalized patients. This study revealed some positive elements of caregiving experience, especially among siblings. The concept of stigma resistance may guide the establishment of stigma reduction programmes. Violence towards the relatives or vice versa is a sensitive issue that needs to be addressed and reported. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses should address parents, spouses and siblings' specific needs and challenges to include them in their relatives' treatment plan. Understanding the experience, feelings and needs of relatives living with schizophrenia would enable mental health nurses to provide a range of interventions to help reduce caregivers' burden and promote the positive gains from the caregiving experience. The study emphasizes the need for culturally adapted family interventions to effectively assist relatives in providing care and adjusting to the caregiving role. ABSTRACT: Introduction Relatives of individuals diagnosed with schizophrenia often experience positive and negative impacts. Much of the literature on family experience with schizophrenia comes from western culture, and less is known about Arabic speaking countries. There has been no previous attempt to qualitatively investigate the lived experience of relatives of hospitalized patients with schizophrenia in the Arab world. Aim To explore the experience and needs of Omani relatives of hospitalized patients diagnosed with schizophrenia. Method Qualitative semi-structured interviews with twenty relatives of hospitalized patients from Oman. The interviews were analysed using framework analysis. Results Parents, spouses and siblings were confronted with a burden specific to the demand of different life situations, and their needs differ accordingly. The findings showed four themes: burden, stigma, violence and needs. Discussion This study provides insight into the experience of Omani relatives living with schizophrenia. Although the caregiving experience appears negative, some positive elements of caregiving experience were prominent among siblings. Furthermore, the violence phenomenon among individuals with schizophrenia needs to be addressed as a priority. Implications for practice Understanding the experience, feelings and needs of relatives living with schizophrenia would enable mental health nurses to provide a range of interventions to help reduce caregivers' burden and promote the positive gains from the caregiving experience. The concept of stigma resistance in the Arab world may guide the establishment of stigma reduction programmes.

Individual-level socioeconomic status and contact or familiarity with people with mental illness: a cross-sectional study in Wuhou District, Chengdu, Southwest China

Background

People with mental illness (PWMI) often suffer from public stigma, which can make them unwilling to seek help and reduce access to early treatment. The aims of this study were to determine attitudes towards PWMI among the general public in a Chinese sample and to explore the relationships with sociodemographic characteristics.

Methods

A community-based, cross-sectional study was conducted from March to June 2019. The participants’ attitudes towards PWMI were evaluated by the Chinese version of the Social Distance Scale (SDSC). An independent-sample T-test and one-way ANOVA were used to determine the association of categorical variables with the outcome variable. Multiple linear regression and Spearman correlations were computed to explore the correlation between SDSC scores and individual-level socioeconomic status (SES).

Results

A total of 1437 participants were recruited, and their total SDSC score was 12.53 (SD: 3.11). Univariate analysis results showed that age, education level, educational attainment, and individual-level SES as well as whether they were caregivers/family members of PWMI were correlated with SDSC scores. The results of regression analysis showed a significant effect caused by contact or familiarity with PWMI (B = -1.134, β = -.190, P < 0.001), as well as for individual-level SES (B = -.339, β = -.110, P < 0.001). Spearman correlation results showed that SDSC scores were negatively correlated with individual-level SES (r = -.078, p < 0.01) and contact or familiarity with PWMI (r = -.168, p < 0.001).

Conclusion

This study reveals that public stigma towards PWMI is common in Southwest China. Individuals who are not a family member or a caregiver of PWMI or have low education level or low individual-level SES need to be provided more anti-stigma interventions. Contacting with PWMI is also a potentially beneficial measure to reduce social distance.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12875-021-01422-y.

Voicing Jordanian Adolescents' Suicide

BACKGROUND

Studies focusing on adolescent suicide in Arab countries are particularly scarce, with the few available undertaken from within an epidemiological paradigm.

OBJECTIVE

This study aimed to understand Jordanian adolescents' perceptions, beliefs, and attitudes toward suicide.

METHODS

A qualitative design using 12 dual-moderator focus group discussions was conducted in public schools. Participants were selected from the three main regions of the country (rural southern, urban central, and suburban northern). Participants included Jordanian adolescent boys and girls, aged 14-17 years, who reported experiencing mild to moderate depressive symptoms. A relational content analysis approach was used for coding data, and a content analysis was used to identify salient thematic categories. Data were analyzed using NVivo software.

RESULTS

Four themes emerged, including perceived risk factors, perceived protective factors, active and passive suicidal ideations, and e-games and Internet influences. Main risk factors were depression; anxiety; stigma, shame, and isolation; family issues; life pressures; and guilt. Conversely, religiosity, perceived positive family functioning, and availability of long-term goals seemed to confer resilience to adolescents' suicidal ideation and behavior. Passive suicidality (having death wishes without any plans to complete suicide) was noticed most among participants who feared jeopardizing the family's reputation if they committed suicide. Several boys with active suicidal ideations used the Blue Whale Challenge e-game to learn how to complete suicide and relinquish their problems.

DISCUSSION

Suicide is a multifactorial problem requiring multimodal strategies. Evidence from this research suggests that those most passionate about the outcome of interest are encouraged to redouble efforts to reduce modifiable risk factors, enrich protective factors, target the underlying psychiatric illness that informs suicidal ideations and behavior, and research the effect of social media and Internet activity more deeply. Parents are advised to monitor the online activities of their children and familiarize themselves with the digital applications they use.

Internalized stigma and its correlates among family caregivers of patients diagnosed with schizophrenia in Changsha, Hunan, China

WHAT IS KNOWN ON THE SUBJECT?: Schizophrenia is a severe and highly stigmatized mental illness. High internalized stigma affects FGs' quality of life and caregiving capacity. Worldwide studies aimed at internalized stigma among patients diagnosed with mental illness or their FGs have reported significant stigma and some correlates, but studies involving FGs that focus on a specific mental illness (e.g. schizophrenia) and report the impact of potential psychosocial variables (e.g. coping and hope) on internalized stigma are limited. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: Internalized stigma was common among Chinese FGs of patients diagnosed with schizophrenia and half of them presented at a mild level. Internalized stigma was negatively associated with hope and positively associated with passive coping. FGs, who live with patients, have difficulty supervising medication, or care for a male relative has higher internalized stigma. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Regarding informative support, interventions (e.g. enhancing mental health literacy programs and cognitive therapies) to provide knowledge about schizophrenia, the skills to manage patients' adherence to medications, the benefits of treatment and the possibilities of rehabilitation are necessary for FGs. Regarding psychosocial processes, effective interventions (e.g. group psychoeducation and group social skills training) aimed to enhance hope, social support and coping styles towards internalized stigma should be implemented among FGs. Both informative support and psychosocial interventions used to decrease FGs' internalized stigma can be delivered by healthcare providers or by peer caregivers. ABSTRACT: Introduction Internalized stigma is prevalent among patients diagnosed with schizophrenia. Their family caregivers (FGs) also suffer from internalized stigma, but limited studies have addressed the issue. Aim The aim of this study was to determine the severity of internalized stigma and its correlates among FGs of patients diagnosed with schizophrenia in Changsha, Hunan, China. Methods A consecutive sample of 299 FGs was recruited at the psychiatric outpatient department of a tertiary hospital in Changsha. This study explored the relationships between internalized stigma and potential factors. Results Nearly 50% of the FGs perceived mild internalized stigma, 24% of the FGs reported moderate level, and 6% had a severe level. Internalized stigma was associated with patients' characteristics (severity of illness) and FGs' characteristics (hope, social support, passive coping, age, education background, residence with the patient, caring for a male or a young patient and difficulty in supervising medication). Discussion and implications for practice Informative and psychosocial interventions based on education and contact for FGs such as enhancing mental health literacy programs, cognitive therapies and group psychoeducation can provide FGs with a better understanding of schizophrenia and to promote hope, active coping and social support.

Stigma Among Chinese Medical Students Toward Individuals With Mental Illness

The current study aimed to examine medical students' attitudes toward individuals with mental illness. Stratified cluster sampling was used to survey 735 Chinese medical students from three medical universities in Shandong, China. Participants completed the Perceived Devaluation and Discrimination Scale (PDD). Scores on the devaluation subscale items (mean = 2.80, SD = 0.59) were lower than the midpoint score (i.e., 3) (p < 0.001), and scores on the discrimination subscale items (mean = 3.20, SD = 0.52) were higher than the midpoint score (p < 0.001). Higher scores indicated more negative attitudes toward individuals with mental illness. Significant gender differences were found in the discrimination subscale scores and total PDD scores, with lower scores in men compared with women. Compared with medical students in other years, students in their senior year of medical school had the lowest scores on the discrimination subscale. Students may benefit from increased education regarding psychology and psychiatry and by having more contact with individuals with mental illness. [Journal of Psychosocial Nursing and Mental Health Services, 58(2), 27-31.].

Knowledge and Attitudes of Young People toward Mental Illness: A Cross Sectional Study

The aim of the study was to investigate young Jordanians' knowledge and attitudes toward people who have a mental illness. A cross sectional design was utilized. A convenient sample of 858 participants aged between 15-24 years old completed a survey. Participants under 19 years were accessed through their schools and those 19 years and above were accessed through universities. Results showed that although the majority of university and school students' responses were generally consistent, they disagreed on 11 items on the survey; for example, 186 (39.3%) of university students agreed that mental illness has a biological origin compared with only 119 (30%) of school students. The majority of young people 737 (85.9%) were willing to learn and 792 (92.3%) felt that they have to help people with mental illness, which make them willing to learn. In conclusion, the findings provide insights for decision makers and researchers in Jordan about young peoples' knowledge and attitudes toward mental illness. Increasing young adults' literacy through introducing educational programs such as mental health first aid courses will enrich their knowledge; help change attitudes and reduce stigma toward people living with mental illness.

Perspectives and Experiences of Primary Caregivers of Individuals with Schizophrenia in Thailand

This study investigates primary caregiver perspectives on long-term experiences of caring for individuals with schizophrenia in Thailand. Study participants were 30 caregivers in the Bangkok Metropolitan Area (BMA). Data were collected by semi-structured qualitative interview and analyzed by thematic analysis. Participants defined psychotic symptoms as symptoms requiring prevention and good care, which caregivers must learn to live with. Caregivers were reported to have "acquired experience in controlling psychotic symptoms and recognizing frequency, timing, content, warning signs, and patient response." Schizophrenic patients experienced difficulty engaging in community activities and encountered teasing, stigma, and social isolation. These findings suggest that caregivers saw psychotic symptoms as necessarily leading to ongoing serious problems. The difficulty of dealing with such symptoms was aggravated by caregiver poverty, emotional condition, and advanced age. Innovations in psychiatric and mental health nursing intervention are needed, including psycho-educational community activities to confront the teasing, stigma, and social isolation of individuals with schizophrenia. Simulation applications on mobile phones and Internet are recommended.