Pipetting Samples and Test Tube

Theme 4:
Mental Health and NDD

List of Abstracts

  1. Nutritional Status and Its Association With Cognitive Level in Children With Autism in Bangladesh

  2. Primary Developmental Findings of Cerebral Palsy Children at First Visit

  3. Oral Motor Skills And Speech Intelligibility In Bangla Speaking Children With Cerebral Palsy

  4. The Gender Inequality of Suicide: Why Are Men at Such High Risk?

  5. Assessment of The Cognitive Impairment Among Older Adults Living in Some Old Home in Dhaka District

  6. Depressive and Anxiety Disorders Among Single Mothers in Dhaka City

  7. Psychiatric Morbidity Among Rural and Slum Female Population: A Study Conducted in Bangladesh

  8. Environmental Noise Exposure and Learning Performance of Secondary School Students

  9. Perinatal Factors Among Children Neurodevelopmental Disorders in Outpatient Department Of Psychiatry

  10. Depression Literacy Status in Bangladesh: A Cross-Sectional Comparative Observation

  11. Psychometric Properties of Bangla Young Mania Rating Scale

  12. The Pattern Of Help-Seeking Behavior Among Patients With Sexual Dysfunctions Attending In Psychiatry Outpatient Department In A Tertiary Care Hospital Of Bangladesh

  13. Psychological Implications of Unemployment Among Bangladesh Civil Service Job Seekers

  14. A Cross Sectional Study on Relationship Between Loneliness And Depression Among Elderly in Dhaka  Bangladesh

  15. Mental Health Problem Among Adolescents and Youth in Bangladesh

  16. Impact of Psychosocial Intervention on Depression Among Mothers of Children With Autism Spectrum Disorder in Bangladesh

  17. Feasibility of Psychosocial Supports Can Improve Quality of Life Among The Mothers of Children With Autism Spectrum Disorder in Bangladesh


Nutritional Status and Its Association With Cognitive Level in Children With Autism in Bangladesh

Jannatara Shefa


Institute of Paediatric Neurodisorder and Autism, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

Background: Autism is a Neuro-developmental disorder which has symptoms of restricted and repetitive behavior with impaired social interaction and communication with others. The prevalence of autism spectrum disorder (ASD) is increasing day by day. A 2016 Institute of Paediatric Neuro-disorder and Autism (IPNA) rural survey reported a figure of 7.5 per 10,000 (1 in 1,333) rural children aged 18-36 months. Method: A cross-sectional study was conducted which aimed to describe the nutritional, economic and IQ levels of the autistic children in selected centers of Bangladesh, in order to identify possible associations. A total of 384 children with autism aged1-12 years were enrolled in this study. Nutritional status was assessed by means of nutritional data, anthropometric data and providing a questionnaire to parents. The parents were asked to complete a questionnaire regarding the socio-demographic status.IQ assessment was done with Bayley Scales of Infant Development, Independent Behavior Assessment Scale or the Wechsler Intelligence Scale for Children-Revised. Data analysis was done by SPSS version 20. ANOVA and t-tests were used to analyze the data. Result: Children with autism exhibited several abnormalities in terms of eating behavior. According to the anthropometric data, nutritional status of the ASD children is almost normal but malnutrition was also present in some ASD children and association between malnutrition and low IQ level was observed in the study. Conclusion: In this study, various aspects of nutritional deficiencies were observed in autistic children in our country. They also exhibited several abnormal eating behaviors. According to the anthropometric data, 23% of autistic children had low nutritional status. There was an association between poor nutritional status and low IQ levels among autistic children.









Primary Developmental Findings of Cerebral Palsy Children at First Visit

Naheed Nabi


Institute Of Paediatric Neurodisorder and Autism, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh


Purpose: To find out the demographic and primary developmental findings of cerebral palsy children at Institute of Paediatric Neurodisorder and Autism (IPNA),Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Objective: The aim of this study was to find out the demographic factors of cerebral palsy children along with which type of cerebral palsy commonly found with which developmental delay and co-morbidities. Methodology: The study design was cross sectional. The sample size were 325 and Purposive sampling technique was used for sample selection who was visited first time for diagnosis and treatment at IPNA, BSMMU  in Bangladesh. Data was collected by a standard questionnaire and it was analyzed by SPSS software version 21. Result: Among 325 cerebral palsy children, most of them were under 1 to 2 years (36.7%). The age range were 2 to 130 months and male 62% (n=202) were higher than female 38% (n=124). Among them 41.4% were delivered at home. Of them Spastic Quadriplegic CP were more common (31.9%) and most common co-morbidity was epilepsy 34.4%. Home delivery was significantly associated with Spastic Quadriplegic CP and this type of CP also significantly associated with motor, cognitive and speech delay. Different types of CP also significantly associated with its co-morbidities P value in everywhere 0.00. Most of the participants were from low socio economic condition and low educational level. Conclusion: The result of the study reflected the current situation of children with cerebral palsy at the age of 2 months to 130 months and who attended at IPNA, BSMMU, Dhaka, Bangladesh.













Oral Motor Skills And Speech Intelligibility In Bangla Speaking Children With Cerebral Palsy

Md. Ubaydullah Pathan


Child Developmental Therapist, Institute Of Paediatric Neurodisorder and Autism, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh


Background: Children with Cerebral palsy (CP) have low intelligibility due to oral motor problems and some related factors. Objectives:The present study was conducted to find out the oral motor difficulties and speech intelligibility in Bangla speaking children with Cerebral palsy. Method: A cross sectional study was carried out by a structured parental questionnaire with an Intelligibility Context Scale (ICS). Among 90 children with CP comprising 55 Male and 35 Female. Result: Maximum age range was 6-14 (41.5%) where more than half (57%) comes from a single family. A greater percentage (80.0%) of children with CP had delayed speech and most of them developed one word at 2 years old. Result indicated that a high percentage of the children with DS had not good oral motor movement and about 68.9% of them had oral motor difficulties. However, there were highly significant relationship (0.000>0.05) between oral motor difficulties with lip, tongue and jaw movement, but there was not a significant relationship between gender and intelligibility scale. Highly significant relationship (P= 0.000<0.05) was found between oral motor difficulties and speech intelligibility and there is no co-relation (P= .104<0.05) initiated between age and speech intelligibility score. Conclusion: Oral motor control, speech delay and parent’s speech problem are the responsible factors to influence speech intelligibility.















The Gender Inequality of Suicide: Why Are Men at Such High Risk?

Md. Shahariar Islam


National Institute of Preventive and Social Medicine, Dhaka, Bangladesh

Suicide in men has been described as a "silent epidemic". It has a disturbingly high incidence and is a major contributor to men's mortality. epidemic because of its high incidence and substantial contribution to men's mortality, and silent because of a lack of public awareness, a paucity of explanatory research, and the reluctance of men to seek help for suicide related concerns. In British Columbia, suicide is one of the top three causes of mortality among men aged 15 and 44. Among men of all ages in Canada, suicide ranked as the seventh leading cause of death in 2007. There appears to be an overall lack of public awareness regarding the high rates of suicide among men, especially relative to other more highly publicised threats to men's health, such as HIV/AIDS, that account for far fewer premature deaths among males each year (e.g., in 2005, 45 male deaths were attributed to AIDS in Canada in contrast to 2857 male deaths from suicide). Men's general reluctance to seek help for suicide related concerns, and the stigma associated with mental health problems in general, it is no surprise that suicide among men is largely invisible. Findings from a range of intellectuals traditions and disciplines, including contributions from quantitative and qualitative research paradigms, reveal much about the consequences of male suicide to society. This study sought to validate questionnaires measuring traditional male and female gender scripts in order to test the hypothesis that scores on these questionnaires predict suicidality. These novel findings have implications for understanding and predicting suicidality in men and women, and may be valuable in the clinical context.

















Assessment of The Cognitive Impairment Among Older Adults Living in Some Old Home in Dhaka District

Nasrin Akter, Lubna Yesmin, Bilkis Banu, Sarder Mahmud Hossain

Northern University Bangladesh


Introduction: Like other developing countries, Bangladesh is presently witnessing a great burden of rapid aging and loosing the social values of older adults due to age related cognitive impairment as well as neurodegenerative dementia. This study was designed to assess the cognitive impairment as well as depression among older adults in relation to their socio-demographic condition. Method: A cross-sectional survey was conducted among purposively selected 200 older adults aged between 60-80 years residing in some old home in Dhaka district, Bangladesh. Data were collected by face-to-face interview while Cognitive function and level of depression was assessed by applying standardized Mini-Mental State Examination (MMSE) of Folstein and Geriatric Depression Scale (GDS). Result: Among the respondents majority (81.5%) were staying in old home for 1-5 years. To observe the functional disabilities mostly (91.0%) had difficulty with vision, 40.7% had difficulty with hearing and 19.6% had difficulty in moving around. MMSE test revealed almost half (43%) had moderate cognitive impairment, 36% had mild and 19.5% were may be normal while more than half (43%) of the respondents had severe depression. A strong statistical association was found between educational status and level of depression (p=<0.001) where it was clear that higher educated respondents had more severe depression. Another significant association was found between level of cognitive impairment and level of depression of the older adults (p=<0.001) and the association revealed that more depressed respondents had more cognitive impairment. Conclusion: An alarming proportion of cognitive impairment as well as depression were found associated with higher educational status among the older adults living in old home for a significant period. Therefore, adequate nutritional and psychological support needed for elderly people.










Depressive and Anxiety Disorders Among Single Mothers in Dhaka City

Jhunu Shamsun Nahar


Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh


Background: Recent researches and media reports say that the number of single mothers in urban area of Dhaka city is increasing day by day. Single mothers are widow, divorcee women and unmarried mothers.  According to the records of the two city corporations women seeking divorce in the capital city has been slowly increasing. In 2013, the two city corporations receive 8,191 divorce petitions; 6,880 from wives and 1,311 from husbands. Objective: The purpose the present study was to find out the prevalence of Depressive and Anxiety Disorders among single mothers in Dhaka city as well as their variations in respect of demographical distribution. Apart from that stress on single mothers was also measured by DASS 21. Method: This was a descriptive cross sectional study, conducted under the supervision of the Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka. Total 156 Single mothers from three social strata such as from lower, middle and upper class group were included using purposive sampling technique from August 2016 to July 2017. Data was collected through face to face interview using semi-structured questionnaire, SCID-I CV and validated Bangla version of Depression Anxiety Stress Scale 21 (DASS-21). Data was analyzed with SPSS version 17. Conclusion: The study concluded that the overall psychiatric disorder among single mother was 54.5%. This study provided us a sound background knowledge regarding psychiatric disorders among single mothers. The data also suggested the need for early psychological assessment of the single mothers as well as early intervention like psychological, familial and social support to improve the quality of life.










Psychiatric Morbidity Among Rural and Slum Female Population: A Study Conducted in Bangladesh

Jhunu Shamsun Nahar


Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh


Objective: To find out the prevalence of psychiatric disorders. To compare among the rural and slum female population. To find out the influence of socio-demographic factors on psychiatric disorders. Method: This is a community based, cross sectional and descriptive study. 366 randomly selected respondents was taken (206 from rural and 104 from slum). Two-staged screening procedure was done. First, screening was by Self Reporting Questionnaire (SRQ) to divide the sample into screen positive and screen negative. In second stage, assessment of mixture of all screen positive and 25% screen negativewas done by structured clinical interview for diagnosis (SCID- NP). Later exact clinical diagnosis was assigned by DSM-5. Data collection of rural area was done in a village with 647 households and 2000 voters (population approximately 3500). Slum area data collection was done in Ward no. 47 of Dhaka City Corporation with 800 households (slum rooms) with approximate population 4000 to 4500. Socio-demographic data and other important variables were obtained by a questionnaire. Stress was scored according to Presumptive Stressful Life Events Scale (PSLE). Result: Higher prevalence was found among rural sample (22.8%) than slum (10.90%) population. Among rural population, Depressive Disorders (46.7%), Somatoform Disorder (18.3%), Generalized Anxiety Disorder (16.7%)  and among slum respondents PTSD (54.5%), Depressive Disorders (45.5%), Generalized Anxiety Disorders and Substance Misuse (18.1%) showed higher prevalence rate respectively. Mean stress score was also higher among rural (90.6 ± 17) respondents than slum (46.5±12.1) ones. . Poverty, loss of crops, household animals, multiple marriages of husbands, dowry demands, child rearing etc. were main stress factors for rural women. Conclusion: Due attention needed to be given to the female population especially in rural areas regarding management of mental disorders.









Environmental Noise Exposure and Learning Performance of Secondary School Students

Samiha Kaisar


National Institution of Preventive and Social Medicine, Department of Occupational and Environmental Health, Dhaka, Bangladesh


Introduction: Noise, inappropriate temperature, insufficient light, overcrowded classes, misplaced boards and inappropriate classroom layout all could be confounding variables distracting students in class. This cross sectional study emphasizes on the effects of classroom noise on student's learning performance, students perception on noise and internal and external noise levels. Method: To assess any relationship between environmental noise level and learning performance of secondary school students, evaluation of various noise descriptors such as L10, L50, L90, Leq, and NC was measured with smart phone using calibrated sound level meter app. The population of the study included students from class seven to class ten of the academic year 2017-2018 in Dhaka, of whom 580 students from three schools were selected by systematic random sampling as the participants. Data collection technique included informed assent form, student perception on noise questionnaire and reading comprehension test and observation checklist to examine the physical parameters of noise in educational institutions. Equivalent noise levels (Leq) were measured in selected classrooms; after identifying the noisiest classrooms attended by secondary school students. Result: From the study it is found that students seemed to be very sensitive of noise during their learning activities like doing tests or exams and reading. The scores of the reading test were significantly associated with socio-demographic factors like age, mothers educational attainments and family income. Multiple Linear regression analysis reveals that there is a moderate negative correlation between classroom noise level and learning performance (r= -0.343, β= -0.853, p<0.0001); as identified by poor reading score due to high level of noise. Conclusion: Further studies are required to gather more precise insights considering the underlying reasons about the effects of noise on learning performance.












Perinatal Factors Among Children Neurodevelopmental Disorders in Outpatient Department Of Psychiatry

Fatima Zohra


National Institute of Mental Health, Dhaka, Bangladesh


Introduction:  Neurodevelopmental disorders are major public health problem. Perinatal factors like maternal age, stress, maternal physical illnesses, birth complications, prerterm, low birth weight and neonatal infections are the important risk factors for NDD. Objective:  The present study aimed at  determining the  proportion of perinatal factors among children with neurodevelopmental disorders attending children outpatient in dhaka. Method:  This was a cross sectional study conducted among 115 children with NDD age between 0-17 years by convenient sampling from OPD of NIMH and IPNA, BSMMU from March 2016 to September 2018. Total 115 samples were taken ensuring all confidentiality a face to face interview was taken with a semi structured questionnaire including socio-demographic and perinatal factors. Data were analyzed using SPSS, version 20.0.  Result:  It is evident from the study that majority of the respondents  were 5-8 yrs  (29.6%) with male  predominance (78.3%) Among 115 respondents proportion of ID (32%) was predominant followed by ADHD (27.8%), ASD (16.5%), Communication disorders (13.9%). Most of the mother had physical illness (66.1 % ) , 47% mother took medications ,  51.3%  mothers had  no frequent check up, 53.9 % mother did not get adequate sleep or nutrition during pregnancy, 68.7% mother suffering from stress, 50.4% did not get adequate weight  gain had birth complication (82.6%). Most of the respondents was deliverd by normal vaginal delivery  (62.6%),  foetal complications ( 56.5%),  birth asphyxia (61.7%), head injury (40.9%). The most of the children were preterm  (80%) born before 37 weeks , low birth weight  (46.1% ), neonatal illness (69.6%)  were found within 1 month mostly  pneumonia (30.0 %)   followed by neonatal Jaundice ( 20% ). Conclusion: Early identification of possible perinatal factors and providing safe perinatal period can give a positive impact in prevention of   neurodevelopmental disorder in children.










Depression Literacy Status in Bangladesh: A Cross-Sectional Comparative Observation

S M Yasir Arafat1, Md Shahoriar Ahmed2, Md Saleh Uddin3


1Department of Psychiatry, CARe Medical College, Dhaka, Bangladesh; 2Department of Physiotherapy, Center for Rehabilitation and Paralysis, Dhaka, Bangladesh; 3Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh


Background: Depression is considered as a prime source of nonfatal disease and literacy in depression has an important role in treatment of it. Objective: We aimed to look into the depression literacy status in Bangladesh over four heterogeneous groups. Method: This cross sectional study conducted in four different study places and among 608 respondents. Respondents groups were consist of university students, depressed patients who were taking professional help, chronic physically ill patients without addressing the depression and medical graduates not working in mental health. Respondents were conveniently approached with the self-reporting D-Lit Bangla questionnaire from March 2016 to May 2017. Result: Distribution of the correct responses revealed poor correctness in psychotic symptom spectrum (Q1, Q3, Q5) and treatment aspects of depression (Q10, Q14, Q18, Q20) in all institutions but there were variations among the institutions. The mean score was found 9.19 and there 55.77% of the respondents had scores below the mean score. Conclusion: The study revealed higher literacy in medical graduates and lower literacy in depressed patients. Adequate strategies should be focused to improve the depression literacy both in general and clinical populations which will ultimately reduce the burden of depression in a country like Bangladesh.












Psychometric Properties of Bangla Young Mania Rating Scale

Hosnea Ara1, Jhunu Shamsun Nahar2, Wasima Rahman2, Srijony Ahmed3, S M Yasir Arafat4


1Department of Psychiatry, Ad-din Women’s Medical College, Dhaka, Bangladesh;  2Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh; 3Department of Psychiatry, Dhaka Community Medical College, Dhaka, Bangladesh;  4Department of Psychiatry, CARe Medical College, Dhaka, Bangladesh


Introduction: The Young Mania Rating Scale (YMRS) is widely used clinician-rated instrument which measures the symptom severity of mania and considered as gold standard. We aimed to assess the psychometric properties of Bangla YMRS. Method: Current validation study was performed from January 2015 to September 2016 among patients of mania of department of psychiatry of Bangabandhu Sheikh Mujib Medical University, Dhaka. The adaptation of YMRS to Bangla was achieved according to the standard process of forward-backward translation. Data were collected from 51 manic patients and analyzed different forms of reliability and validity by Statistical Package for the Social Science version 16.0 software. Result: The Cronbach's alpha value was 0.89 and interrater reliability was measured by Cohen kappa coefficient and ranged from 0.80 to 0.98 those signifies an acceptable reliability statistic. Face validity and content validity were assessed systematically and construct validity was assessed by factor analysis. Only 1 factor was were extracted by exploratory factor analysis with varimax rotation signifying the unidirectionality of the construct. Conclusions: Bangla YMRS can be a psychometrically reliable and valid tool to use in clinical settings, research and primary care setting to assess the symptom severity of mania as well as the relapse of episode.













The Pattern Of Help-Seeking Behavior Among Patients With Sexual Dysfunctions Attending In Psychiatry Outpatient Department In A Tertiary Care Hospital Of Bangladesh

Panchanan Acharjee, M S I Mullick


Department of Psychiatry, Chattogram Medical College, Chattogram, Bangladesh; Child and adolescent Psychiatry, Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh


Introduction: Though sexual dysfunctions are common, few seek help. Identifying the pattern of help-seeking can explain the gap between care need and actual use of care. This study was aimed to know the patterns of help-seeking behavior among patients with sexual dysfunctions. Method: This was a cross-sectional, qualitative study. Diagnosed case of sexual dysfunctions were selected through purposeful sampling. Based on data saturation, 18 in-depth interviews (IDI) were done in the format of story-telling. Summary of the interview was described to the participant at the end. Interviews were audio recorded and field notes were taken. Method triangulation was done using 2 key informant interviews (KII) and one focus group discussion (FGD) with four participants. Collected data were thoroughly checked, transcribed and then analyzed manually using six steps of the thematic analysis method. Codes were peer-reviewed. Deviant cases were critically explored and explained in a separate theme. Result: The majority of the participants were male, from 20-35 years, literate and from an urban background. Premature ejaculation and female sexual interest/arousal disorder were the most common disorders among male and female respectively. Identifying the problem, most participants sought help from close and intimate relationships; except a few of the participants, who choose self-search strategy. Complementary and Alternative Medicine (CAM) approach was mostly used and traditional healers played the major role. The biomedical approach was the last to seek help and most visited the Dermatology and Venereology department. Self-help technique and internet use was found as an emerging way to seek help. Conclusion: Increasing the awareness is necessary as surrounding people were the primary source of information. Besides filling up the knowledge gap, findings of this study will help to develop proper service delivery system in the context of a developing country.










Psychological Implications of Unemployment Among Bangladesh Civil Service Job Seekers

Md. Abdur Rafi1, Mohammed A. Mamun2, Kazi Abdul Mubin3


1Rajshahi Medical College Hospital, Rajshahi, Bangladesh; 2Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh; 3Department of Pharmacy, University of Rajshahi, Rajshahi, Bangladesh


Introduction: Recent trends suggest that university graduates seeking jobs are more susceptible to common mental disorders, such as depression, anxiety, or stress. But, the mental health issues among unemployed graduates have not been explored in Bangladesh yet. This study aimed to assess for the first time the prevalence and associated risk factors of depression, anxiety and stress among the Bangladesh Civil Service (BCS) job seekers. Method: 304 graduates residing in Rajshahi, Bangladesh, who were preparing to attend the 40th Bangladesh Civil Service (BCS) examination, the most sought-after employment opportunity in the country, were surveyed. Measures included socio-demographics, field of study and career-related variables, and the Bangla Depression, Anxiety and Stress Scale (DASS-21). Chi-square test, Fisher Exact test and Binary Logistic Regression with Depression, Anxiety and Stress as the dependent variable were carried out to identify the factors associated with those. Result: Overall, the prevalence of moderate to extremely severe depression, anxiety and stress was 49.3%, 53.6%, and 28.3% respectively, with no detectable differences between genders. Insecurity related to BCS job (OR=0.41; CI=0.26-0.65, p<0.001; ref: job insecurity), family and social pressure to obtain BCS job (OR=4.58; CI=1.67-12.56, p<0.001) and stress (OR=8.33; CI=4.47-15.51, p<0.001) emerged as independent predictors for depression. In addition, having part-time job was associated with anxiety (OR=2.38; CI=1.34-4.23, p=0.003), and security in BCS job and serving the nation through this job were negatively associated with stress (OR=0.59; CI=0.35-0.98, p=0.042 versus OR=0.59; CI=0.36-1.00, p=0.05). Conclusion: The relatively high rates of depression, anxiety and stress among graduate job seekers should prompt implementation of market force initiatives that incorporate interventions related to the major risk factors uncovered herein.







A Cross Sectional Study on Relationship Between Loneliness And Depression Among Elderly in Dhaka  Bangladesh

Naznin Sultana, Ishrat Jahan, Ahmed Hossain,


North South University, Dhaka, Bangladesh


Introduction: Loneliness has been linked with a variety of negative health outcomes and several studies found that loneliness tends to increase the risk of depression. According to WHO, it is estimated that in Bangladesh 4.1% of the population is suffering from depression and Depression is the responsible for 7.1% of the total years of life lived with disability in Bangladesh. It has been shown that elderly people in Bangladesh had a 2.79 times higher risk of depression than the middle aged person. This study aimed to find out the relationship between loneliness and depression among geriatric population in Dhaka. Method: This cross sectional study was carried out among 161 elderly people aged belong 60 to 80 by following the inclusion criteria in Dhaka, Bangladesh. Data were collected on a pretested questionnaire by face to face interview using the short version of GDS and UCLA loneliness scale along with that information on socio-demography, social support, medication and chronic diseases was also recorded. Result:  Among the 161 elderly 52.2% were male and 47.8% were female and 66.1% were married. Around 49.7% elderly had no education, and previous occupation of most of the elderly was service holder. 68.3% elderly was satisfied with their children support. Inspite that around 34.2% elderly don't have enough money to buy medicine and two third of the elderly was suffered from different chronic diseases such as diabetes, hypertension and bone diseases. The prevalence of depression and loneliness were 37.5% and 30% respectively. A positive relationship was found between geriatric depression and loneliness (p<0.002). Social factor like support from family and peer group also associated. Conclusion: Nowadays depression in elderly is increasing worldwide and Bangladesh isn't lagging behind. Social factor like family support, support from peer group and economic solvency of elderly may help to change the scenario.












Mental Health Problem Among Adolescents and Youth in Bangladesh

Syed Emdadul Haque


UChicago Research Bangladesh


Background: Childhood mental and developmental disorders have serious adverse impacts on the psychological and social well-being of children and their families. More than half of all mental disorders have an onset in childhood and adolescence with suicide being the third leading cause of death aged between 15-29 years old. Lack of attention to mental health of children and adolescents may lead to mental disorders with lifelong consequences with health regimens and reduces the capacity of societies to be safe and productive. However, adolescent and youths mental health thus needs to be considered and emphasised as an integral component of overall health and growth of young population. Thus, we reviewed available information to see the current situation of mental health and neurodevelopment problem of adolescents and youth in Bangladesh.  Method: We reviewed available reports, articles, and policy papers published during year 2010 to 2019. We used search engine Google Scholar and PubMed for this secondary analysis. Result: About 94% of primary school aged (5-10 years) children could be categorized into a psychiatric condition. Among students aged 13-17 years in Bangladesh, 4% of boys and 6% of girls consider attempting suicide (WHO, 2018) which is the results of mental health and neurodevelopment problem of Bangladesh. It is alarming that autism spectrum disorders   prevalence (3.0%) among the adolescents and youth in the Dhaka city whereas 0.09% in India and 1.07% in SriLanka. Conclusion: Mental illness refers to a wide range of mental health conditions that affect mood, thinking and behaviour. Youth with positive mental health have positive self-efficacy beliefs, are productive and able to tackle developmental challenges adequately. On the other hand, poor mental health in young age is associated with school failure, delinquency, social and peer problems, substance misuse alongside adverse outcomes in adulthood. Developed effective diagnosis manuals, conducted nationwide survey, enhance the public and professional awareness, and integrated the e-health services for the children with mental health problem are urgently need to save the nation.











Impact of Psychosocial Intervention on Depression Among Mothers of Children With Autism Spectrum Disorder in Bangladesh

Saimul Islam, Kamrun Nahar Koly, Bilkis Ara, Mir Nabila Ashraf, Aliya Naheed


Initiative for Noncommunicable Diseases, Health Systems and Population Studies Division, icddr,b, Mohakhali, Dhaka, Bangladesh


Background: Psychosocial supports have positive impact on maternal depression. We assessed the impact of psychosocial counseling on depression among mothers of children with autism spectrum disorder (ASD) in two special educational schools in Dhaka, Bangladesh. Method: Psychosocial services were introduced for mothers of the children with ASD as routine care for six months. Depressive symptoms were assessed using patient health questionnaire-9 (PHQ-9) following a written consent, and Major depressive episode (MDE) was assessed by a psychologist using SCID-I (DSM-V non-patient version), if PHQ-9 >4 before intervention. Designated psychologist provided psychosocial counseling to those who sought the services. A psychiatrist provided necessary management when visited the centre every month. Level of depression was assessed by culturally adapted Beck Depression Inventory (BDI), and MDE was assessed before (baseline) and after intervention (end line). Result: Between May and October 2017, 188 mothers at two schools were informed about the services and 81 availed the services (43%). Mean age(±SD) of the mothers was 40 (±8) years, 84% completed a college education, and mean(±SD) duration of schooling by the children was 6.1(±4.5) years. At baseline 41 mothers had PHQ-9 score >4(50.6%), and 22 mothers had MDE (27.1%). The overall mean BDI score changed from 79.5(±23) at baseline to 60.0(±20) at end line (24.7% reduction, P=0.004). The mean BDI score changed from 97.8(±12.1) to 69.9(±22.1) (P<0.001), and from 72.7(±22.6) to 56.1(±18.1) among mothers with and without a MDE respectively leading to 20% more changes in MDE (P<0.001). Changes in BDI were not observed after adjusting for mothers’ age, education and years of schooling of the children. Conclusion: Integrating psychosocial counseling in routine ASD care reduces clinical depression among mothers of children with ASD irrespective of socio demographic status and duration of children’s enrollment in the schools. Integrating psychosocial counseling in ASD services can be a potential strategy for addressing maternal depression in Bangladesh.









Feasibility of Psychosocial Supports Can Improve Quality of Life Among The Mothers of Children With Autism Spectrum Disorder in Bangladesh

Kamrun Nahar Koly, Saimul Islam, Mir Nabila Ashraf, Aliya Naheed


Initiative for Noncommunicable Diseases, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease search, Bangladesh

Background: Parenting children with autism spectrum disorder (ASD) can negatively impact on quality of life (QoL) among mothers of children with ASD. Parental supports in ASD care are limited in developing countries. We assessed feasibility of integrating psychosocial supports (PSS) in two special schools in Dhaka city and its impact on QOL among mothers of children with ASD. Method: PSS included deployment of a psychologist who offered psychosocial counseling to mothers who volunteered to avail the services, monthly group sessions that included interactive sessions for awareness building about mental health, education on coping strategy, self care and group meditations, and a psychiatrist visit at a regular interval for management of depression and other mental health conditions. A research staff applied culturally validated EQ-5D-3L™ Tools for measuring 5 dimensions of QoL including ‘mobility’, ‘self-care’, ‘usual activities’, ‘pain/discomfort’ and ‘anxiety/depression’ at 3-levels: no problems, some problems, and extreme problems. EQ-5D also included a Visual Analogue Scale (VAS) that allowed self-rating on a 20-cm vertical scale with endpoints of ‘best imaginable health state’ set at ‘100’ and ‘worst imaginable health state’ set at ‘0’. Result: Between May and October 2017, 188 mothers were informed about PSS and 81 mothers were enrolled (43%) following consent. All mothers attended at least one psychosocial counseling session, 14 group sessions were  held where number of attendance varied from 14 to 45 per session, and 16 mothers were provided psychiatrist’s consultation in four psychiatrist’ visits. Following intervention, extreme problems reported by mothers reduced from 11.7% to 8.2% in ‘mobility’ (P=0.001), from 27.3% to 9.8% in ‘pain/ discomfort’ (P=0.004), from 28.6% to 11.5% in ‘anxiety/ depression’ (P=0.009), and mean (±SD) VAS score improved from 70.3±14.1 to 80.2±13.3 (P=0.001).  Conclusion: Integration of psychosocial supports in routine ASD care is feasible in special school settings in urban Bangladesh, and positively impacts on quality of life (QOL) among the mothers of children with ASD. Psychosocial supports should be integrated in routine ASD care in Bangladesh.

 

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