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Perceived discrimination is associated with worse mental health. Few studies have assessed whether perceived discrimination (i) is associated with the risk of psychotic disorders and (ii) contributes to an increased risk among minority ethnic groups relative to the ethnic majority.
We used data from the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions Work Package 2, a population-based case−control study of incident psychotic disorders in 17 catchment sites across six countries. We calculated odds ratios (OR) and 95% confidence intervals (95% CI) for the associations between perceived discrimination and psychosis using mixed-effects logistic regression models. We used stratified and mediation analyses to explore differences for minority ethnic groups.
Reporting any perceived experience of major discrimination (e.g. unfair treatment by police, not getting hired) was higher in cases than controls (41.8% v. 34.2%). Pervasive experiences of discrimination (≥3 types) were also higher in cases than controls (11.3% v. 5.5%). In fully adjusted models, the odds of psychosis were 1.20 (95% CI 0.91–1.59) for any discrimination and 1.79 (95% CI 1.19–1.59) for pervasive discrimination compared with no discrimination. In stratified analyses, the magnitude of association for pervasive experiences of discrimination appeared stronger for minority ethnic groups (OR = 1.73, 95% CI 1.12–2.68) than the ethnic majority (OR = 1.42, 95% CI 0.65–3.10). In exploratory mediation analysis, pervasive discrimination minimally explained excess risk among minority ethnic groups (5.1%).
Pervasive experiences of discrimination are associated with slightly increased odds of psychotic disorders and may minimally help explain excess risk for minority ethnic groups.
The coronavirus disease (COVID-19) pandemic is a disaster of unprecedented proportions with global repercussions. Psychological preparedness, the primed cognitive awareness and anticipation of dealing with emotional responses in an adverse situation, has assumed a compelling relevance during a health disaster of this magnitude.
An anonymized eSurvey was conducted in India to assess psychological preparedness toward the ongoing pandemic with a focus on knowledge, management of own and others’ emotional response, and anticipatory coping mechanisms among the survey population. An adapted version of the qualitative Psychological Preparedness for Natural Disaster Scale validated by the World Health Organization was widely circulated over the Internet and various social media platforms for assessment. Results are expressed as median ± standard deviation. Descriptive statistics were used and figures downloaded from surveymonkey.com.
Of the 1120 respondents (M:F 1.7:1, age 35 years ±14.1), most expressed a high level of perceived knowledge and confidence of managing COVID-19, such as awareness of the symptoms of the illness (95.1%), actions needed (94.4%), hospital to report to (88.9%), and emergency contact number (89.1%). A majority (95%) monitored regularly the news bulletins and scientific journals regarding COVID-19. However, nearly one-third (29.2%) could not assess their likelihood of developing COVID-19, and 17.5% were unaware of the difference between a mild and severe infection. Twenty-three percent (23.3%) were unfamiliar with the materials needed in an acute illness situation.
Psychological disaster preparedness is reasonable, although lacking in specific domains. Timely but focused interventions can be a cost-efficient administrative exercise, which federal agencies may prioritize working on.
The term ‘global mental health’ came to the fore in 2007, when the Lancet published a series by that name.
To review all peer-reviewed articles using the term ‘global mental health’ and determine the implicit priorities of scientific literature that self-identifies with this term.
We conducted a systematic review to quantify all peer-reviewed articles using the English term ‘global mental health’ in their text published between 1 January 2007 and 31 December 2016, including by geographic regions and by mental health conditions.
A total of 467 articles met criteria. Use of the term ‘global mental health’ increased from 12 articles in 2007 to 114 articles in 2016. For the 111 empirical studies (23.8% of articles), the majority (78.4%) took place in low- and middle-income countries (LMICs), with the most in Sub-Saharan Africa (28.4%) and South Asia (25.5%) and none from Central Asia. The most commonly studied mental health conditions were depression (29.7%), psychoses (12.6%) and conditions specifically related to stress (12.6%), with fewer studies on epilepsy (2.7%), self-harm and suicide (1.8%) and dementia (0.9%). The majority of studies lacked contextual information, including specific region(s) within countries where studies took place (20.7% missing), specific language(s) in which studies were conducted (36.9% missing), and details on ethnic identities such as ethnicity, caste and/or tribe (79.6% missing) and on socioeconomic status (85.4% missing).
Research identifying itself as ‘global mental health’ has focused predominantly on depression in LMICs and lacked contextual and sociodemographic data that limit interpretation and application of findings.
Declaration of interest
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