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Articles by M. Prince
Total Records ( 4 ) for M. Prince
  M. A Abas , S Punpuing , T Jirapramukpitak , P Guest , K Tangchonlatip , M Leese and M. Prince
 

Background

It has been suggested that rural–urban migration will have adverse consequences for older parents left behind.

Aims

To describe correlates of outmigration and to estimate any association between outmigration of children and depression in rural-dwelling older parents.

Method

Population-based survey of 1147 parents aged 60 and over in rural Thailand. We randomly oversampled parents living without children. We defined an outmigrant child as living outside their parent’s district, and measured depression as a continuous outcome with a Thai version of the EURO–D.

Results

Outmigration of all children, compared with outmigration of some or no children, was independently associated with less depression in parents. This association remained after taking account of social support, parent characteristics, health and wealth. Parents with all children outmigrated received more economic remittances and they perceived support to be as good as that of those with children close by.

Conclusions

Outmigration of children was not associated with greater depression in older parents and, after taking account of a range of possible covariables, was actually associated with less parental depression. This could be explained by pre-existing advantages in families sending more migrants and by the economic benefits of migration.

  M Guerra , C. P Ferri , A. L Sosa , A Salas , C Gaona , V Gonzales , G. R de la Torre and M. Prince
 

Background

The proportion of the global population aged 60 and over is increasing, more so in Latin America than any other region. Depression is common among elderly people and an important cause of disability worldwide.

Aims

To estimate the prevalence and correlates of late-life depression, associated disability and access to treatment in five locations in Latin America.

Method

A one-phase cross-sectional survey of 5886 people aged 65 and over from urban and rural locations in Peru and Mexico and an urban site in Venezuela. Depression was identified according to DSM–IV and ICD–10 criteria, Geriatric Mental State–Automated Geriatric Examination for Computer Assisted Taxonomy (GMS–AGECAT) algorithm and EURO–D cut-off point. Poisson regression was used to estimate the independent associations of sociodemographic characteristics, economic circumstances and health status with ICD–10 depression.

Results

For DSM–IV major depression overall prevalence varied between 1.3% and 2.8% by site, for ICD–10 depressive episode between 4.5% and 5.1%, for GMS–AGECAT depression between 30.0% and 35.9% and for EURO–D depression between 26.1% and 31.2%; therefore, there was a considerable prevalence of clinically significant depression beyond that identified by ICD–10 and DSM–IV diagnostic criteria. Most older people with depression had never received treatment. Limiting physical impairments and a past history of depression were the two most consistent correlates of the ICD–10 depressive episode.

Conclusions

The treatment gap poses a significant challenge for Latin American health systems, with their relatively weak primary care services and reliance on private specialists; local treatment trials could establish the cost-effectiveness of mental health investment in the government sector.

  V. C. H Chen , H. K. L Tan , A. T. A Cheng , C. Y Chen , L. R Liao , R Stewart , M Dewey and M. Prince
 

Background

Repeated self-harm is relatively common and is linked with an elevated risk of eventual suicide. There has been no study of this involving a large sample from the Far East.

Aims

To estimate the risk over the medium term of non-fatal repetition of self-harm and identify predictive factors in those carrying out self-harm.

Method

A total of 970 individuals who had self-harmed were recruited from a community-based suicide behaviour register system in Nantou, Taiwan from July 2000 to February 2003. Information regarding demography and suicide methods was collected. Individuals were followed-up until December 2005 to examine the risk of repeated self-harm and independent predictive factors.

Results

Ninety cohort members had repeated self-harm during the follow-up period (accounting for 131 repeated self-harm episodes in all). The cumulative risks were 5.7% for the first year, 7.8% for the second year and 9.5% for the fourth year. The risk was highest within the first year after the self-harm event. Independent risk factors included female gender and self-cutting as well as self-poisoning with drugs. Effect of younger age was mediated through the choice of methods.

Conclusions

Individuals with self-harm have a high risk of repetition, especially within the first year. Suicide prevention strategies need to focus on intervening with this population to reduce their repetition.

  C Hanlon , G Medhin , A Alem , M Araya , A Abdulahi , M Tomlinson , M Hughes , V Patel , M Dewey and M. Prince
 

Background

Traditional perinatal practices may protect against postnatal common mental disorders (CMD) in non-Western societies.

Aims

To evaluate the association between perinatal practices and postnatal CMD in rural Ethiopia.

Method

A population-based sample of 1065 women was followed up from pregnancy until 2 months postpartum. Qualitative investigation informed the development of scales measuring attitudes towards and adherence to perinatal practices. Postnatal CMD was measured using the Self-Reporting Questionnaire.

Results

Endorsement of sociocultural perinatal practices was associated with lower odds of antenatal CMD persisting into the postnatal period (adjusted odds ratio (OR) = 0.66, 95% CI 0.45–0.95). Women who endorsed protective and celebratory perinatal practices but were unable to complete them had increased odds of incident (adjusted OR = 7.26, 95% CI 1.38–38.04) and persistent postnatal CMD (adjusted OR = 2.16, 95% CI 1.11–4.23) respectively.

Conclusions

There is evidence for an independent role of sociocultural practices in maintaining perinatal mental health in this Ethiopian community.

 
 
 
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