Artificial intelligence-based models for augmenting media reporting of suicide: challenges and opportunities
2021, Volume 4, Issue 2, Pages 123-129
The sensationalised and harmful content of media reporting of suicide is a modifiable risk factor for suicide and suicidal behaviour. Although the World Health Organization (WHO) has published guidelines for responsible media reporting of suicide to prevent suicide contagion, the uptake of these recommendations across media outlets remains limited due to several barriers such as the motivation of stakeholders, inadequate training of media personnel, and a lack of real-time monitoring by the government. In this report, we suggest that artificial intelligence (AI) based models, can be used to address barriers to guideline adherence and improve the quality of media reporting. It is our understanding that the development and implementation of AI-based models or tools can assist in improving adherence to suicide reporting guidelines. We propose a hybrid model that incorporates steps that can be taken at different levels of the media news communication cycle. The algorithmic approach can help in simultaneously processing large amounts of data while also facilitating the design of article structures and placement of key information recommended by media reporting guidelines. The potential benefits of the AI-based model to the various stakeholders and the challenges in implementation are discussed. Given the positioning of responsible media reporting of suicide as a key population-level suicide prevention strategy, efforts should be made to develop and evaluate AI-based models for improving the quality of media reporting in different national or international settings.
2021, Volume 4, Issue 2, Pages 130-154
Objective: Body dysmorphic disorder (BDD) is an underdiagnosed condition among the general population with significant associated morbidity and mortality. Symptoms of BDD include worrying excessively about a particular part of the body, repeatedly checking oneself in the mirror and attempting to cover up particular areas of the body.
Aim: To determine the prevalence of BDD within the global population. To perform a further subgroup analysis to identify groups that have a higher prevalence than the general population. To assess the modalities of diagnosis BDD and its relative abundance.
Methods: A systematic review using the PubMed database using the search criteria ‘BDD’ or ‘body dysmorphic disorder’ and ‘prevalence’ or ‘incidence’ from 1 January 1990 to 1 January 2020. 591studies were found, 81 of which were eligible and included in the study. Prevalence was calculated for the global population and subgroups, student, dermatology, surgical and psychiatric patients.
Results: The ranges of prevalence within studies were as follows; within the general population, the prevalence of BDD ranged from 0.5-3.2% (n=8). It was 1.3-5.8% (n=8) in student cohorts, 4.9- 21.1% (n=12) in general dermatology cohorts, 1.3%-5.8% (n=8) in a student population, 0-54.3% (28) in psychiatric cohorts and 2.9- 57% (n=15) in cosmetic surgery cohorts.
Conclusion: Studies found had low heterogenicity. However, there was variation in diagnostic criteria and methods of data collection. This study shows that a significant number of people suffer from BDD. Due to the fact that people with BDD often don’t seek help, this number is likely an underestimation. This study identified subgroups of the population that have a higher prevalence of BDD. Targeted screening of individuals in high-risk cohorts, as well as further clinician education, may be of benefit to help aid early recognition and diagnosis. Additionally, structured clinical interviews for DSM (the Diagnostic and Statistical Manual of Mental Disorders), also known as SCID, were the most common and appear to be more effective than normal interviews at identifying individuals with BDD.
Association of perceived isolation and resilience with self-rated mental health among undergraduate medical students in Nepal during the COVID-19 pandemic
2021, Volume 4, Issue 2, Pages 155-164
Background: The COVID-19 pandemic has devastatingly affected the entire world and destroyed the equilibrium of every sphere of life. Like other groups of people, medical students of Nepal have been facing the conditions of lockdown and social isolation that have arisen because of the pandemic.
Objective: We aimed to see the relationship of perceived isolation and resilience with self-rated mental health among undergraduate medical students in Nepal.
Materials and methods: A web-based online survey was carried out in July 2020 using a semi-structured questionnaire in Google form. Data analysis was performed in SPSS vs 20. Ordered logistic regression analysis was performed to examine the effects of perceived isolation, resilience and background characteristics on self-rated mental health.
Results: Out of 515 participants, 44.9% were male.31.4% reported having fair/poor mental health status and 21.9% reported feeling stressed often due to the COVID-19 pandemic. An increment of 1SD in perceived isolation is associated with about a 5% reduction in the odds of having better mental health (exp (−0.048) = 0.95; p=0.026). Similarly, an increment of 1SD in resilience is associated with about 13% lower odds of having better mental health (exp (−0.149) = 0.862 ; p<0.001).
Conclusion: This study is an early step towards the assessment of perceived isolation and mental health among undergraduate medical students amid the COVID-19 pandemic in Nepal. There is a need to conduct regular counselling sessions and strengthen the coping skills of medical students duringthe pandemic.
Association of executive function, craving and precipitants of relapse in alcohol use disorder: A cross-sectional study
2021, Volume 4, Issue 2, Pages 165-172
Objective: Alcohol use disorder (AUD) is a global health concern. Patients with AUDs often relapse. Various psychosocial factors, as well as cognitive factors, determine relapse. Failure of response inhibition is often associated with relapse. This study aimed to evaluate the association of craving and relapse precipitants with executive function in AUD.
Materials and methods: The study was conducted in the outpatient setting of a tertiary care hospital in North India (between September 2017 to August 2018) on patients with AUD, who presented with a recent relapse.
A total of 46 adult patients with AUD, who relapsed after a quit attempt were enroled in the study. Cross-sectional assessment of relapse precipitants (by using relapse precipitant inventory), craving (by using the obsessive-compulsive drinking scale (OCDS)), and executive function (EF) (by using the Wisconsin Card Sorting Test (WCST)) was done along with various socio-demographic and clinical variables.
Results: The mean age of onset of alcohol use was 21.48±4.25years and the mean duration of alcohol use was 15.13±7.70 years. The average number of relapses in the study population was 3.59±2.06. There is a significant positive correlation between a negative mood state (as a relapse precipitant) and total relapse score with craving. There is a significant association of relapse and craving with deficits of EF (perseverative and non-perseverative errors). Similarly, lessened cognitive vigilance also significantly correlate with EF deficits resulting in a relapse of AUD.
Conclusion: There is a close association of craving, and relapse with deficits of EF, in AUD. Craving and relapse in AUD may be the result of deficits in EF. Future research addressing the cognitive deficits may help in the prevention of craving and relapse.
2021, Volume 4, Issue 2, Pages 173-179
Background: Suicide is a major public health issue that has been under-researched in Iraq, particularly during the COVID-19 pandemic.
Aim: The study aimed to assess the characteristics, methods, and risk factors of suicidal behavior in Iraq during the COVID-19 pandemic.
Methods: We searched the news reports between April and May 2021 on Google using the term “suicide news in Iraq. We included online newspaper reports of suicidal behavior in Iraq that were published from January 2020 to April 2021.
Results: A total of 156 reports was studied. The majority of reports were published in the Arabic language (59%). Among the newspapers, the majority of the reports were published in the Nalia Radio and Television (NRT) and the shafaqnews (11.5% each). The mean age of the suicidal attempts was 27.69 (±13.78) years ranging from 10-65 years. The majority were male (57.7%), married (18%), student (9.6%), and urban habitant (64.74%). Hanging (31.4%), firearms (22.4%), and fall from height were the leading methods of suicide and familial disharmony (12.8%), mental disorder (9.6%), financial constraints (5.1%), marital discord (3.2%), COVID-19 related factors [like being infected, quarantined] (3.2%) were the leading cause of proximally related factors of suicidal attempts.
Conclusion: The present study suggests that of all suicides during the COVID-19 pandemic in Iraq, the majority are that of young, married, employed males. Furthermore, interpersonal and financial stressors are possible risk factors for suicide in this period.
Association of social stigma of COVID-19 with work satisfaction, burnout and fatigue among health care workers in Nepal
2021, Volume 4, Issue 2, Pages 180-190
Background: Stigma towards the patient of coronavirus disease (COVID-19) has been reported in various media reports, including negative behaviour among health care workers (HCWs) towards COVID-19 patients. Moreover, the negative behaviour of HCWs towards COVID-19 patients could affect the professional quality of life of these HCWs.
Objective: We aimed to assess stigma related to COVID-19 patients among HCWs and explore its impact on their professional quality of life during COVID-19 pandemic in Nepal.
Methods: An online cross-sectional study was carried out among 421 HCWs (health assistants 35.6%, nurses 33%, doctors 23.3% and paramedics 8.1%), 52.7% female, working in health facilities in Nepal. The measures included background characteristics, stigma in terms of - discrimination towards COVID-19 patients, acceptance of COVID-19 patients and fear of COVID-19, and professional quality of life in terms of - work satisfaction, burnout and fatigue. Descriptive and inferential statistics were utilised to analyze the data in SPSSvs20.
Results: While around two-third of the study participants showed discriminating attitude towards COVID-19, a half showed negative attitude towards acceptance of COVID-19 patients, and a fifth reported attitude of fear of COVID-19.
Multivariable regression analysis indicated that while presence of fear of COVID-19 was associated with low satisfaction, low burnout, and low fatigue; attitude of acceptance of COVID-19 patients was associated with low burnout and low fatigue; and attitude of discrimination towards COVID-19 patients was associated with only low satisfaction.
Conclusion: Strategies directed towards - reducing fear and discrimination towards COVID-19 patients, and enhancing positive attitude of acceptance towards COVID-19 patients among HCWs, and thus, creating enabling environment for reducing their burnout and fatigue, and increasing work satisfaction are recommended.
The socioeconomic burden and disability linked with mental illnesses: findings from the National Mental Health Survey of India 2015-16 in Uttar Pradesh
2021, Volume 4, Issue 2, Pages 191-200
BACKGROUND: Mental health problems can lead to a substantial disability, financial loss, and a caregiver burden globally. The national mental health survey of India (NMHS) 2015-16 attempted to estimate the disability and socio-economic impact of mental morbidities in India and the representative state level. This paper reports the socio-economic impact and disability due to mental morbidity in Uttar Pradesh, India, by NMHS-2015-16, which will help the policymakers address the mental healthcare needs of the community.
METHODS: This was a cross-sectional study done in the community setting. The investigators estimated socio-economic impact due to mental morbidities by using a structured questionnaire and applying the Sheehan Disability Scale.
RESULTS: A total of 3,508 adults were interviewed, of which 282 individuals had a lifetime prevalence of mental health problems (excluding tobacco use disorder). Disability was reported: 27.3% at work, 31.9% in family life and 28.4% in social settings. Disability due to mental health problems were more evident in those with common and severe mental illnesses. The median monthly expense for the illness was found to be about 1,000 rupees INR (10 GBP). The individuals with mental health issues found in this study had 10 days of absentism from work and 20 days of reduced efficiency in work in the past 30 days.
Conclusion: Disabilities related to mental health illness are having significant socio-economic impact across India. There is a need for early intervention and more adequate addressing of these issues across the national mental health policy and programming arena.
2021, Volume 4, Issue 2, Pages 201-207
BACKGROUND: Stigma related to coronavirus disease 2019 (COVID-19) can be a potential barrier in the prevention of the disease. The current study aimed to measure COVID-19-related stigma among the people of India.
METHODS: A cross-sectional online survey was conducted using a semi-structured questionnaire regarding the socio-demographic background and perceived stigma towards COVID-19, using a convenient sampling technique.
RESULTS: A total of 405 responses were received. The respondents’ mean age was 25.6 ±8 years with an age range of 18-76 years, and 52.5% were male. Among the respondents: 60 believed that they would be judged negatively by other people if they disclose their COVID status; 59% believed that if the COVID-19 status of a person is reported to their employer, they are likely to lose their jobs;70% reported that they would feel uncomfortable with patients with COVID-19 infection; 67% thought that developing COVID-19 can make them isolated from society.
CONCLUSION: Perceived stigma was found in the form of fear of being negatively judged and fear of losing their job after disclosing their COVID-19 status. The study warrants an urgent need for stigma reduction strategies which are focused on education and awareness concerning COVID-19.
There is a substantial global burden of perioperative anxiety in the paediatric population – a systematic review
2021, Volume 4, Issue 2, Pages 208-217
Objective: Perioperative anxiety is described as an uncomfortable, tense or unpleasant mood at any point in the surgical journey. It can alter the way patients’ deal with the surgical experience and think about surgical treatments in the future. This systematic review aims to investigate the methods of diagnosing perioperative anxiety and assess the prevalence of the condition within the global paediatric population undergoing operations.
Materials and methods: The systematic review was conducted in accordance with the PRISMA Checklist (a 27-item checklist to address introduction, methods, results and discussion with a systematic review). Medline and Scopus databases were searched. Two independent reviewers determined which papers were suitable for inclusion. Inclusion was determined by the mention of prevalence of operative-related anxiety, in a population under 18 years old and patients that were undergoing an operation in a hospital setting. Initially, 48 papers were found and, after screening, a total of 12 eligible studies were included. Data was extracted on the method of diagnosis of anxiety, the prevalence of perioperative anxiety, the time of assessment and the age of the cohort. Cochrane bias assessment was used to assess the presence of types of bias in randomised control trials (RCTs) included and the risk of bias in non-randomised studies of interventions tool in each non-RCTs.
Results: 83% (n=10) studies used the modified Yale Preoperative Anxiety Scale (mYPAS) for diagnosis. The overall average prevalence of perioperative anxiety in each paediatric cohort undergoing surgery was 42.1% (95% CI 30.5 - 53.7). There was not sufficient evidence to support a relationship between the age of the patient groups, the time of the anxiety assessment and the prevalence of the perioperative anxiety.
Conclusion: Paediatric anxiety remains a significant factor affecting over a third of all children who undergo operations. The vast majority of papers used the mYPAS for diagnosis although there is still some debate about the most appropriate diagnostic tool. Further studies are needed to assess the factors influencing perioperative anxiety and to evaluate the impact of perioperative anxiety on the patient experience and recovery.
A Cross-sectional study of prevalence and predictors of psychological distress during COVID-19 pandemic among the Indian population
2021, Volume 4, Issue 2, Pages 218-229
Objectives: To assess the prevalence of psychological distress and identify the predictors and factors associated with the distress during the onset of COVID-19 pandemic among Indian population.
Methods: An online cross-sectional study with a semi-structured questionnaire was used to assess the psychological distress using the General Health Questionnaire (GHQ-12) among Indians. Descriptive statistics and prevalence of psychological distress were calculated. Chi-square test was done to find the association between the independent variables and psychological distress. Factors that are significantly associated with psychological distress were further analysed using multiple logistic regression analysis to identify the predictors.
Results: 846 responses were obtained with mean age 32 years (32.45 ± 11.44). 35% (n=290) had significant psychological distress with mean GHQ-12 score of 2.37. Factors associated were age (p=0.002), family members having COVID symptoms (p=0.017), lockdown distress (p=0.0001), source of health information (p=0.041), perception that information by social media increased fear (p=0.0001), likelihood of family contracting COVID-19 (p=0.022), pattern of food consumption (p=0.0001) and worry about financial burden during lockdown (p=0.0001). By logistic regression analysis, we found increased odds of developing psychological distress among the participants aged less than 40 years (OR=1.49, C.I=1-2.249,p=0.050); people who felt distressed due to the lockdown situation (OR= 2.31, C.I=1.694-3.162, p=0.0001); individuals whose fear increased due to social media information (OR=1.55, C.I= 1.144-2.113, p=0.005) and participants whose food pattern increased during the lockdown period (OR=1.41, C.I=1.035-1.923, p=0.029).
Conclusions: Nearly 1/3rd of the participants were in a state of psychological distress which transcended topographical barriers with factors such as being less than 40 years of age, accessing health information through social media, pattern of food consumption being increased and being in lockdown situation as predictors of psychological distress.