BackgroundMental 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.MethodsWe 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.ResultsWe 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.ConclusionsThe 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.
BackgroundAutism spectrum disorders (ASD) are a group of complex neurodevelopmental disorders. The prevalence of ASD in many South Asian countries is still unknown. The aim of this study was to systematically review available epidemiological studies of ASD in this region to identify gaps in our current knowledge.MethodsWe searched, collected and evaluated articles published between January 1962 and July 2016 which reported the prevalence of ASD in eight South Asian countries. The search was conducted in line with the PRISMA guidelines.ResultsWe identified six articles from Bangladesh, India, and Sri Lanka which met our predefined inclusion criteria. The reported prevalence of ASD in South Asia ranged from 0.09% in India to 1.07% in Sri Lanka that indicates up to one in 93 children have ASD in this region. Alarmingly high prevalence (3%) was reported in Dhaka city. Study sample sizes ranged from 374 in Sri Lanka to 18,480 in India. The age range varied between 1 and 30 years. No studies were found which reported the prevalence of ASD in Pakistan, Nepal, Bhutan, Maldives and Afghanistan. This review identifies methodological differences in case definition, screening instruments and diagnostic criteria among reported three countries which make it very difficult to compare the studies.ConclusionsOur study is an attempt at understanding the scale of the problem and scarcity of information regarding ASD in the South Asia. This study will contribute to the evidence base needed to design further research and make policy decisions on addressing this issue in this region. Knowing the prevalence of ASD in South Asia is vital to ensure the effective allocation of resources and services.
Background Depression is the most common comorbid psychiatric disorder in people who die by suicide and 39% of global suicides occur in the World Health Organization (WHO) South-East Asia Region. The aim of this systematic review was to identify, for countries of this region, first the prevalence of depression among people who (i) die by, or (ii) attempt, suicide, and second, the proportion of people with depression who attempt or die by suicide. Methods PubMed, PsycINFO, EMBASE and Google Scholar were searched, together with five available national databases, for quantitative research papers published in English between 1956 and 4 September 2016 from the 11 countries of the WHO South-East Asia Region. Results The 19 articles that met the predefined eligibility criteria were from five countries: Bangladesh (1), India (12), Indonesia (1), Sri Lanka (3) and Thailand (2); no eligible papers from the remaining countries of the region were retrieved. Eight studies, from Bangladesh, India, Indonesia and Sri Lanka, reported the prevalence of depression among people who had died by suicide. The study settings varied, as did the proportion of depression recorded (6.9-51.7%), and the study sample sizes ranged from 27 to 372. Eight studies from India and one from Sri Lanka investigated depression among people who had attempted suicide. Using a range of screening and diagnostic tools, the reported prevalence of depression ranged between 22.0% and 59.7%. The study sample sizes ranged from 56 to 949. Only two articles were found, both from Thailand, that reported on suicide in people with depression. Conclusion Despite the high burden of mortality of suicide in the WHO South-East Asia Region, evidence on the relation between suicide and depression is scarce. There is a need to understand this phenomenon better, in order to inform suicide-prevention strategies in the region.
Mental health is the most neglected and stigmatized branch of medical science in Bangladesh. Attitudes towards psychiatry are an important determination for selection of the subject as career by the undergraduate medical students. The objective of this study was to determine the attitudes of undergraduate medical students towards psychiatry and related factors. It was across sectional study conducted from May 2013 to September 2013 among 1 st and 5 th year medical students of Rajshahi Medical College, Rajshashi and Shaheed Shahrawardi Medical College, Dhaka. Results showed that only 2.6% of 5 th year medical students wanted to be specialized in psychiatry and none of 1 st year medical students wanted to be specialized in psychiatry. All of them (100% and 98.7%) agreed with the statement that psychiatric research has made good strides in advancing care of major mental disorder and majority students of both groups were (96% and 86.6% respectively) with the statement that psychiatry was a rapidly expanding frontier of medicine. Around two-third of the students (79.3% and 82.7% respectively) perceived psychiatric treatment as being helpful. Fifty nine (76.6%) of 5 th year students and forty one (55.7%) of 1 st year students did not agree that psychiatrists frequently abuse their legal power to hospitalize patients against their will. Positive opinions on attitudes of undergraduate medical students towards psychiatry became strengthen further following exposure to psychiatry lectures and clerkship in psychiatry ward. Bang J Psychiatry 2014,28(2):45-49
Background: Severe mental illness like schizophrenia has far-reaching consequence for both patients and caregivers and their relatives and they also experience feeling of loss and grief. They are confronted with uncertainty and emotion of shame, guilt and anger like the patients they feel stigmatized and socially isolated. Caring for a family member with schizophrenia is an enduring stressor and causes considerable amount of burden. Objective: To assess mental health status of the caregivers of schizophrenia patients. Methodology: This descriptive cross sectional study was done among the caregivers of schizophrenia patients in outpatient and inpatient department of National Institute of Mental Health (NIMH), Dhaka, Bangladesh from September 2010 to February 2011. A semi-structured Questionnaire and General Health Questionnaire-28 (GHQ-28) were applied to the caregivers of schizophrenia patients who fulfilled the inclusion criteria. Among the respondents whose GHO-28 score were 4 or above Structured Clinical Interview for DSM-IV Axis I Non Patient (SCID-I/NP) version was applied to identify psychiatric disorders among the caregivers of schizophrenia.Results: Out of 272 respondents most of them were female (88.97%), housewife (72.42%) of 21 to 50 yrs age (80.51%). In this study 22.43% of respondents were suffering from different types of mental disorders. Among them major depressive disorder were most prevalent (11.8%). Other psychiatric disorders were found generalized anxiety disorder (4.8%), pain disorder (2.9%). Less common were panic disorder, social phobia, adjustment disorder and undifferentiated somatoform disorder (0.7% in each type).Conclusions: Significant proportions of the caregiver of schizophrenic patients were suffering from psychiatric disorders that did not get any psychiatric treatment.Journal of Current and Advance Medical Research 2015;2(1):12-17DOI: http://dx.doi.org/10.3329/jcamr.v2i1.22581
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