Background
Despite the potential benefits of parents-adolescent relationships on suicidal behaviours among adolescents, research on these topics are importantly limited by lack of comprehensiveness, difficulties in cross-country comparisons, and limited generalisability, among others. We aimed to estimate the prevalence of various aspects of parents-adolescent relationships and suicidal behaviours by sex and region, and to investigate their associations.
Methods
We used data from the Global School-based Health Survey (GSHS) from 52 countries in 2009–2015 for 120 858 adolescents (53.9% girls) aged 12–15 years. Using meta-analysis with random effects, we estimated the prevalence of parents-adolescent relationships (i.e. understanding problems, monitoring academic and leisure time activities, and respecting privacy) and suicidal behaviours (i.e. suicidal ideation, suicide planning, and suicide attempt). Multi-level mixed-effect logistic regressions were used to investigate their associations.
Findings
Overall, boys and girls reported similar levels of parental understanding of problems (35.8% vs. 36.8%), monitoring academic activities (41.8% vs. 41.1%), and respecting privacy (69.6% vs. 69.7%), whereas girls reported higher level of parental monitoring of leisure time activities than boys (44.9% vs. 40.0%). Adolescents in the Western Pacific region reported the lowest level of parental understanding of problems and monitoring activities, while those in South-East Asia region least reported that their parents respected their privacy. The overall prevalence of any suicidal behaviour was higher in girls than boys (26.2% vs. 23.0%). Suicidal behaviour was less likely in adolescents if their parents understood their problems (odds ratio, 95% confidence intervals: 0.70, 0.68–0.73), monitored their academic (0.81, 0.78–0.84) and leisure time activities (0.73, 0.71–0.75), and respected their privacy (0.83, 0.80–0.86). There was evidence of heterogeneity in those associations by sex and regions.
Interpretations
Although the prevalence of parents-adolescent relationships and adolescent suicidal behaviours varied particularly by sex and region, there were strong and independent associations among them.
The complexity and diversity of clinical manifestations of obsessive-compulsive disorder have intrigued psychiatrists for a long time. Various differences have been noted in the presentation of obsessive-compulsive disorder of different age group. It was aimed to assess the variations of presentation of symptoms in children and adults in a tertiary level hospital. This study was done in an outpatient department from May 2015 to April 2017. Four hundred patients were included in the study consecutively after considering the inclusion and exclusion criteria. Respondents were interviewed with a semi-structured questionnaire which includes demographic variables, psychiatric diagnoses (DSM-IV-TR) and Y-BOCS symptom checklist. Obsessive-compulsive disorder started before adulthood in 41.5% of patients and onset after 18 years was found to be 58.5%. In this study, cases of obsessions, dirt and contamination was seen to predominate in both early- and late-onset obsessive compulsive disorder (68.3 and 71.4% respectively) and among the cases of compulsions, cleaning variety was found to be highest in both early- and late-onset (65.8 and 73.3% respectively). Age should be taken into account when evaluating obsessive compulsive disorder patients. The results suggest that more studies are necessary to determine whether in fact, it defines a homogeneous and particular group in obsessive-compulsive disorder.
Forensic Mental Health in Bangladesh is an unattended domain of mental health services. With about 17% of the population suffering from mental disorders per year and more than 80 thousand prisoners in the country, there have not been any studies to look into forensic mental health situations. This research has given an overview of the health and legal systems through qualitative research focusing on a desk review and key informant interviews. Findings show that though there are guidelines in the law and regulatory codes in the judicial systems, implementing those guidelines is not seen in many cases. There are several areas in the health system in terms of capacity, service and resources which needs to be addressed by the government for supporting the healthcare providers, lawyers, judges and mentally ill or disabled people. Our study also portrayed the current referral mechanisms connecting both legal and health systems while addressing different cases of forensic mental health. Finally, discussing the implications of the findings, we presented recommendations from our study and other literature.
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