BACKGROUND: The gender-specific characteristics of individuals at an increased risk of developing depression currently remain unclear despite a higher prevalence of depression in women than in men. This study clarified socioeconomic and lifestyle factors associated with an increased risk of subclinical depression in general Japanese men and women. METHODS: Study participants were residents not receiving psychiatric treatments in 300 sites throughout Japan in 2010 (1152 men, 1529 women). Multivariable-adjusted odds ratios (OR) and 95% confidence intervals (95%CIs) for socioeconomic factors and lifestyle factors were calculated using a logistic regression analysis. RESULTS: Risk of depressive tendencies was significantly higher in men who were single and living alone (OR, 3.27; 95% CI, 1.56-6.88) than those married. The risk was significantly lower in women who were not working and aged ≥ 60 years (OR, 0.39; 95% CI, 0.22-0.68) and higher in men who were not working and aged < 60 years (OR, 3.57; 95%CI, 1.31-9.72) compared with those who were working. Current smoking was also associated with a significantly increased risk of depressive tendencies in women (OR, 2.96; 95% CI, 1.68-5.22) but not in men. CONCLUSIONS Socioeconomic and lifestyle factors were associated with an increased risk of depressive tendencies in general Japanese. Related factors were different by sex.
Adult ; Aged ; Community Psychiatry ; statistics & numerical data ; trends ; Depression ; epidemiology ; Female ; Health Surveys ; Humans ; Japan ; epidemiology ; Life Style ; Male ; Middle Aged ; Odds Ratio ; Prevalence ; Risk Factors ; Socioeconomic Factors

INTRODUCTION: Prevalence of mental disorders is high worldwide. In Low-and-Lower-Middle-income countries (LALMICs) mental illnesses are already the second cause of burden in DALYs. As psychiatrists are extremely rare in LALMICs, addressing this issue calls for shifting mental health to primary care and consequently, training first line health care providers would be the next challenge. Via the FAST program, the World Asssociation of Social Psychiatry (WASP), Sanofi, Ministries of Health, academics, patients/families association and NGOs have joined forces to improve access to mental health care in LALMICs. The program is based on 3 pillars: (1) Mental health literacy, (2) health care professionals (HCP) training and (3) affordable quality medicines.
OBJECTIVE: This study aims to develop a training curriculum and a set of materials to train HCP that is easily adaptable to the singularity of the local environment.
METHODOLOGY: (1) A master-2 public health student conducted the project; (2) two domains were selected in priority: schizophrenia and unipolar mood disorders; (3) two main targets were identified: general practitioners and nurses / community healthcare workers; (4) professional's needs were assessed through a phone questionnaire; (5) WASP experts were in charge of drafting slides kits and other technical documents (6) to avoid any risk of conflict of interest, it was decided that training on medications will be based on the WHO mhGAP guide.
RESULTS: For each disease and each category of HCP (1) a training of trainers manual; (2) a training curriculum; (3) a slide kit; (4) a training brochure; (5) videos of patients; (6) role-play scenarios; (7) clinical cases (8) pre and post assessment questionnaires, were made available.
CONCLUSION: First feed-back indicated that these tools were of great added value for countries with limited human resources, even though, as anticipated, they will have to be adapted locally, especially role-play scenarios, clinical cases and patient's videos.

Mental Health ; General Practitioners ; Health Literacy ; Prevalence ; Students, Public Health ; Mood Disorders ; Community Psychiatry ; Primary Health Care ; Community Health Services ; Curriculum ; Schizophrenia

INTRODUCTION: According to WHO about 80% of people living with a severe mental disorder in Low-and-Middle-income countries (LAMICs) do not have access to appropriate healthcare. Low literacy regarding mental disorders is one of the main barriers that prevent access to mental healthcare, which leads to stigma, socio economic exclusion, suffering of people with mental disorders and forces families to hide their relatives rather than to direct them to the community healthcare centre. To address this issue mental health, stakeholders from more than 20 countries joined forces with the World Association of Social Psychiatry and Sanofi in the FAST program, based on 3 pillars: (1) Mental health literacy, (2) health care professionals training and (3) affordable quality medicines.
OBJECTIVE: This research aimed or develop Information-Education-Communication materials to improve mental health literacy in LAMICs.
METHODOLOGY: Workshops with participants from different sectors (public, academic, associative, private) were set up to develop generic documentsbased on the experienced derived from malaria awareness programs. Then, for each country, documents were revised and adapted by a local working group.
RESULTS: A flip chart, an educational comic book, a leaflet, a poster and a brochure on schizophrenia were made available with versions adapted to the local specificities of (a) Sub - Saharan Africa (b) North Africa (c) Eastern Europe and (d) Latin America. The main message of the educational materials was that: mental disorders are like any other disease i.e. they can be treated and people with mental disorders are like any other person. The following specific topics where covered: frequency of mental disorders, symptoms recognition, cause of disease, where to seek help, stigma. Recommendations on how to use these materials were also available.
CONCLUSION: Improving mental health literacy in developing countries calls for relevant materials. A rigorous evaluation of the impact of the FAST documents is now required.

Human ; Health Literacy ; Mental Health ; Developing Countries ; Social Stigma ; Community Psychiatry ; Schizophrenia ; Community Health Services ; Malaria

INTRODUCTION: Prevalence of mental disorders is high worldwide. In Low-and-Lower-Middle-income countries (LALMICs) mental illnesses are already the second cause of burden in DALYs. As psychiatrists are extremely rare in LALMICs, addressing this issue calls for shifting mental health to primary care and consequently, training first line health care providers would be the next challenge. Via the FAST program, the World Asssociation of Social Psychiatry (WASP), Sanofi, Ministries of Health, academics, patients/families association and NGOs have joined forces to improve access to mental health care in LALMICs. The program is based on 3 pillars: (1) Mental health literacy, (2) health care professionals (HCP) training and (3) affordable quality medicines.
OBJECTIVE: This study aims to develop a training curriculum and a set of materials to train HCP that is easily adaptable to the singularity of the local environment.
METHODOLOGY: (1) A master-2 public health student conducted the project; (2) two domains were selected in priority: schizophrenia and unipolar mood disorders; (3) two main targets were identified: general practitioners and nurses / community healthcare workers; (4) professional's needs were assessed through a phone questionnaire; (5) WASP experts were in charge of drafting slides kits and other technical documents (6) to avoid any risk of conflict of interest, it was decided that training on medications will be based on the WHO mhGAP guide.
RESULTS: For each disease and each category of HCP (1) a training of trainers manual; (2) a training curriculum; (3) a slide kit; (4) a training brochure; (5) videos of patients; (6) role-play scenarios; (7) clinical cases (8) pre and post assessment questionnaires, were made available.
CONCLUSION: First feed-back indicated that these tools were of great added value for countries with limited human resources, even though, as anticipated, they will have to be adapted locally, especially role-play scenarios, clinical cases and patient's videos.

Mental Health ; General Practitioners ; Health Literacy ; Prevalence ; Students, Public Health ; Mood Disorders ; Community Psychiatry ; Primary Health Care ; Community Health Services ; Curriculum ; Schizophrenia

INTRODUCTION: According to WHO about 80% of people living with a severe mental disorder in Low-and-Middle-income countries (LAMICs) do not have access to appropriate healthcare. Low literacy regarding mental disorders is one of the main barriers that prevent access to mental healthcare, which leads to stigma, socio economic exclusion, suffering of people with mental disorders and forces families to hide their relatives rather than to direct them to the community healthcare centre. To address this issue mental health, stakeholders from more than 20 countries joined forces with the World Association of Social Psychiatry and Sanofi in the FAST program, based on 3 pillars: (1) Mental health literacy, (2) health care professionals training and (3) affordable quality medicines.
OBJECTIVE: This research aimed or develop Information-Education-Communication materials to improve mental health literacy in LAMICs.
METHODOLOGY: Workshops with participants from different sectors (public, academic, associative, private) were set up to develop generic documentsbased on the experienced derived from malaria awareness programs. Then, for each country, documents were revised and adapted by a local working group.
RESULTS: A flip chart, an educational comic book, a leaflet, a poster and a brochure on schizophrenia were made available with versions adapted to the local specificities of (a) Sub - Saharan Africa (b) North Africa (c) Eastern Europe and (d) Latin America. The main message of the educational materials was that: mental disorders are like any other disease i.e. they can be treated and people with mental disorders are like any other person. The following specific topics where covered: frequency of mental disorders, symptoms recognition, cause of disease, where to seek help, stigma. Recommendations on how to use these materials were also available.
CONCLUSION: Improving mental health literacy in developing countries calls for relevant materials. A rigorous evaluation of the impact of the FAST documents is now required.

Human ; Health Literacy ; Mental Health ; Developing Countries ; Social Stigma ; Community Psychiatry ; Schizophrenia ; Community Health Services ; Malaria

PURPOSE: The purpose of this study was to explore the utility of autism spectrum disorder (ASD) screening tools using community network of home childcare center visiting nurses. METHODS: The design of this study is multilevel survey to find the ASD using modified checklist for autism in toddlers (M-CHAT) for first screening by childcare teachers, checklist for autism in toddlers (CHAT) for secondary screening by nurses, Autism diagnostic observation schedule (ADOS) and Autism diagnostic interview revised (ADI-R) for final diagnosis by pediatric psychiatrists. RESULTS: In first screening by using M-CHAT, 61 subjects(0.56%) were detected among 8,926 subjects. Among the first screened 61 subjects, 13 subjects were exempted for normal finding in CHAT. 24 subjects consented participation for final diagnosis and 23 of them were diagnosed ASD. CONCLUSION: In conclusion, M-CHAT and CHAT were verified their utility as screening tools for ASD in the community and the community health networks as a childcare visiting nurses can be useful network in early detection and referral of ASD.
Appointments and Schedules ; Autistic Disorder* ; Checklist ; Child ; Autism Spectrum Disorder* ; Community Networks ; Diagnosis ; Mass Screening* ; Nurses, Community Health* ; Psychiatry ; Referral and Consultation

OBJECTIVES: This study was to understand the characteristics of depressive symptoms among the community-dwelling elderly. METHODS: Through a community mental health mass screening program in senior society, 197 elderly were evaluated for depressive symptoms with Korean version of Short form Geriatric Depression Scale (SGDS-K). The subjects were grouped into normal or caution groups with a cut-off score of 6. The response rate and odds ratio were calculated and compared within each question. RESULTS: Although they had low total score, many subjects in normal group have the symptoms of the question 2, 13, 5, 10, 7, 4 (in order). Question 12, 6, 8, 4, 14, 3 (in order) showed higher odds ratio in caution group than normal group. Questions belonged to a factor 'general depressive mood' scored much higher odds ratio than the other. CONCLUSION: Even the elderly with low score in SGDS-K might complain of symptoms such as decreased level of energy, activities, interests, and memory. However the subjects with high score tend to report feeling more worthless, afraid, helpless, bored, hopeless, and empty. It can be helpful to know the distribution of depressive symptoms for providing careful mental health service to the elderly dwelling in the communities.
Aged* ; Community Mental Health Centers ; Depression* ; Geriatric Psychiatry ; Humans ; Mass Screening ; Memory ; Mental Health ; Mental Health Services ; Odds Ratio ; Psychiatric Status Rating Scales

For improving mental health of the future unified Korea, proper preparation would be necessary in the fields of clinical, social, and cultural psychiatry. Clinically, a diagnostic and treatment system for mental illness should be re-established after Korean unification. There should also be specific preparation for suicides, trauma- or stress-related disorders, somatizations, substance abuse, and childhood psychiatric problems which are expected to rapidly increase in North Korean areas after the unification. In the field of social psychiatry, de-stigmatization and de-institutionalization of those with mental illness would be important after the unification. Education of mental health professionals in North Korean areas would also be crucial. Culturally, it would be necessary to expect the psychological change of both South and North Koreans.
Community Psychiatry ; Democratic People's Republic of Korea ; Education ; Ethnopsychology ; Korea ; Mental Health ; Substance-Related Disorders ; Suicide

OBJECTIVES: The aim of this study was to investigate how mental health professionals in Korea evaluate the burden of disease caused by psychiatric disorders and to propose future directions of the public mental health policies. METHODS: A questionnaire was mailed to 240 mental health professionals, who were composed of psychiatrists from mental hospitals and staffs who are nurses, clinical psychologists and social workers working in the community mental health centers in June, 2004. Two hundred twenty four out of two hundred forty subjects (93.3%), which were composed of 104 psychiatrists and 120 staffs, completed the questionnaire. The questionnaire included 6-item questions about the burden of disease in Korea. RESULTS: Mental health professionals reported that the five diseases with the biggest burden were malignant neoplasms, traffic accidents, schizophrenia, alcohol use disorders and cerebrovascular diseases, consecutively. The burden of alcohol use disorders, cerebrovascular diseases, traffic accidents, unipolar depressive disorder and malignant neoplasms are expected to increase over the next several years. The proportions of psychiatric disorders among all the diseases in terms of burden of disease and medical costs were estimated as 18.4% (+/-12.8) and 12.0% (+/-11.7) respectively. CONCLUSION: This study showed that many of Korean mental health professionals have under-estimated burden of psychiatric disorders, especially, unipolar depressive disorder. It would be necessary to emphasize the importance of unipolar depressive disorder in applying educational and public programs for the mental health professionals, as well as for the general population.
Accidents, Traffic ; Community Mental Health Centers ; Depressive Disorder ; Hospitals, Psychiatric ; Korea ; Mental Health ; Postal Service ; Psychiatry ; Surveys and Questionnaires ; Schizophrenia ; Social Workers

OBJECTIVES: There is a increasing need to recruit and retain more psychiatrists who can plan and implement organized programs to work with chronic mentally ill patients in community settings. The aim of study is to discover what training is currently in place to prepare psychiatrist for work in "community" or "public" settings. METHODS: Survey questionnaires were mailed to 85 residency training directors and 10 leaders of community mental health in 2005. Response rate was 75%. RESULTS: Academic seminar about community mental health were not administered to residents in 63% of training hospitals. Forty one out of 64 training hospitals had community mental health rotation programs. Community mental health center (50%) and day hospital (36%) were the most common type of programs. Few general hospital had affiliation with community mental health programs. The amount of time for clinical rotation varied from less than three months part time to 6 months fulltime, with most frequent form of one day per week for three month in second or third year of psychiatry residents. CONCLUSION: Further steps are needed to improve residency training curricula and to encourage well qualified psychiatrist to choose careers in community psychiatry.
Community Psychiatry ; Curriculum ; Hospitals, General ; Humans ; Hypogonadism ; Internship and Residency ; Mental Health ; Mentally Ill Persons ; Mitochondrial Diseases ; Ophthalmoplegia ; Postal Service ; Psychiatry ; Surveys and Questionnaires