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      Mental disorders in Bangladesh: a systematic review

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          Abstract

          Background

          Mental disorders constitute a major public health problem globally with higher burden in low and middle-income countries. In Bangladesh, systematically-collected data on mental disorders are scarce and this leaves the extent of the problem not so well defined. We reviewed the literature on mental health disorders in Bangladesh to summarize the available data and identify evidence gaps.

          Methods

          We identified relevant literature on mental disorders within Bangladesh published between 1975 and October, 2013 through a systematic and comprehensive search. Relevant information from the selected articles was extracted and presented in tables.

          Results

          We identified 32 articles which met our pre-defined eligibility criteria. The reported prevalence of mental disorders varied from 6.5 to 31.0% among adults and from 13.4 to 22.9% among children. Some awareness regarding mental health disorders exists at community level. There is a negative attitude towards treatment of those affected and treatment is not a priority in health care delivery. Mental health services are concentrated around tertiary care hospitals in big cities and absent in primary care.

          Conclusions

          The burden of mental disorders is high in Bangladesh, yet a largely unrecognized and under-researched area. To improve the mental health services in Bangladesh, further well-designed epidemiological and clinical research are needed.

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          The prevalence of comorbid depression in adults with diabetes: a meta-analysis.

          Judy Anderson, P Lustman, Melvin E. Clouse … (2001)
          To estimate the odds and prevalence of clinically relevant depression in adults with type 1 or type 2 diabetes. Depression is associated with hyperglycemia and an increased risk for diabetic complications; relief of depression is associated with improved glycemic control. A more accurate estimate of depression prevalence than what is currently available is needed to gauge the potential impact of depression management in diabetes. MEDLINE and PsycINFO databases and published references were used to identify studies that reported the prevalence of depression in diabetes. Prevalence was calculated as an aggregate mean weighted by the combined number of subjects in the included studies. We used chi(2) statistics and odds ratios (ORs) to assess the rate and likelihood of depression as a function of type of diabetes, sex, subject source, depression assessment method, and study design. A total of 42 eligible studies were identified; 20 (48%) included a nondiabetic comparison group. In the controlled studies, the odds of depression in the diabetic group were twice that of the nondiabetic comparison group (OR = 2.0, 95% CI 1.8-2.2) and did not differ by sex, type of diabetes, subject source, or assessment method. The prevalence of comorbid depression was significantly higher in diabetic women (28%) than in diabetic men (18%), in uncontrolled (30%) than in controlled studies (21%), in clinical (32%) than in community (20%) samples, and when assessed by self-report questionnaires (31%) than by standardized diagnostic interviews (11%). The presence of diabetes doubles the odds of comorbid depression. Prevalence estimates are affected by several clinical and methodological variables that do not affect the stability of the ORs.
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            Depression and poor glycemic control: a meta-analytic review of the literature.

            P Lustman, Paul Carney, Melvin E. Clouse … (2000)
            Depression is common among patients with diabetes, but its relationship to glycemic control has not been systematically reviewed. Our objective was to determine whether depression is associated with poor glycemic control. Medline and PsycINFO databases and published reference lists were used to identify studies that measured the association of depression with glycemic control. Meta-analytic procedures were used to convert the findings to a common metric, calculate effect sizes (ESs), and statistically analyze the collective data. A total of 24 studies satisfied the inclusion and exclusion criteria for the meta-analysis. Depression was significantly associated with hyperglycemia (Z = 5.4, P < 0.0001). The standardized ES was in the small-to-moderate range (0.17) and was consistent, as the 95% CI was narrow (0.13-0.21). The ES was similar in studies of either type 1 or type 2 diabetes (ES 0.19 vs. 0.16) and larger when standardized interviews and diagnostic criteria rather than self-report questionnaires were used to assess depression (ES 0.28 vs. 0.15). Depression is associated with hyperglycemia in patients with type 1 or type 2 diabetes. Additional studies are needed to establish the directional nature of this relationship and to determine the effects of depression treatment on glycemic control and the long-term course of diabetes.
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              Congruencies in Increased Mortality Rates, Years of Potential Life Lost, and Causes of Death Among Public Mental Health Clients in Eight States

              Craig W Colton, Ronald W. Manderscheid (2006)
              Introduction Mortality rates are used as global measures of a population's health status and as indicators for public health efforts and medical treatments. Elevated mortality rates among individuals with mental illness have been reported in various studies, but very little focus has been placed on interstate comparisons and congruency of mortality and causes of death among public mental health clients. Methods Using age-adjusted death rates, standardized mortality ratios, and years of potential life lost, we compared the mortality of public mental health clients in eight states with the mortality of their state general populations. The data used in our study were submitted by public mental health agencies in eight states (Arizona, Missouri, Oklahoma, Rhode Island, Texas, Utah, Vermont, and Virginia) for 1997 through 2000 during the Sixteen-State Study on Mental Health Performance Measures, a multistate study federally funded by the Center for Mental Health Services in collaboration with the National Association of State Mental Health Program Directors. Results In all eight states, we found that public mental health clients had a higher relative risk of death than the general populations of their states. Deceased public mental health clients had died at much younger ages and lost decades of potential life when compared with their living cohorts nationwide. Clients with major mental illness diagnoses died at younger ages and lost more years of life than people with non-major mental illness diagnoses. Most mental health clients died of natural causes similar to the leading causes of death found nationwide, including heart disease, cancer, and cerebrovascular, respiratory, and lung diseases. Conclusion Mental health and physical health are intertwined; both types of care should be provided and linked together within health care delivery systems. Research to track mortality and primary care should be increased to provide information for additional action, treatment modification, diagnosis-specific risk, and evidence-based practices.
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                Author and article information

                Contributors
                Mohammad Didar Hossain: ddrhossain@yahoo.com
                Helal Uddin Ahmed: soton73@gmail.com
                Waziul Alam Chowdhury: bap@agni.com
                Louis Wilhelmus Niessen: lniessen@liverpool.ac.uk
                Dewan Shamsul Alam: dsalam@icddrb.org
                Journal
                Journal ID (nlm-ta): BMC Psychiatry
                Journal ID (iso-abbrev): BMC Psychiatry
                Title: BMC Psychiatry
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-244X
                Publication date (Electronic): 30 July 2014
                Publication date PMC-release: 30 July 2014
                Publication date Collection: 2014
                Volume: 14
                Issue: 1
                Electronic Location Identifier: 216
                Affiliations
                [ ]Centre for Control of Chronic Diseases (CCCD), International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
                [ ]National Institute of Mental Health (NIMH), Sher-E-Bangla Nagar, Dhaka, 1207 Bangladesh
                [ ]Liverpool School of Tropical Medicine, Pembroke Pl, Liverpool, Merseyside L3 5QA UK
                [ ]Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
                Article
                Publisher ID: 216
                DOI: 10.1186/s12888-014-0216-9
                PMC ID: 4149198
                PubMed ID: 25073970
                SO-VID: e3a24c82-c396-4069-8200-807545ca5ecc
                Copyright © © Hossain et al., licensee BioMed Central Ltd. 2014
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 18 November 2013
                Date accepted : 18 July 2014
                Categories
                Subject: Research Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2014

                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: mental disorders,depression,systematic review,prevalence,comorbidity,service delivery,management,treatment,bangladesh
                Data availability:
                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: mental disorders, depression, systematic review, prevalence, comorbidity, service delivery, management, treatment, bangladesh

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