Browsing by Author "Chandradasa, M."

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Acceptability of a web-based character strengths module for early adolescent school children
(Postgraduate Institute of Medicine University of Colombo, 2023) Chandradasa, M.; Williams, S.; Sumanasiri, S.; Selliah, S.; Gunarathne, P.; Paric, A.; Ravindran, N.; Kuruppuarachchi, K.A.L.A; Ravindran, A.
BACKGROUND: Frequent socio-political conflicts in the past decades have adversely affected the well-being of youth in Sri Lanka. There is a need to support youth development, mitigate past trauma, and promote social harmony. School-based interventions to improve character development, emotional regulation, and tolerance have good evidence and may benefit adolescents in Sri Lanka. Our objective was to develop a novel character strength program in Sinhala to promote Leadership, Empathy, Altruism, Personal Growth, and Social Responsibility (LEAPS). This program consists of ten web-based modules and is facilitated by teachers. This initial evaluation focuses on the first module and its acceptability among students and teachers. METHOD: Program modules were developed by a child and adolescent psychiatrist with the support of mental health and educational experts. The first module was piloted among grade 8 students (12-14 years) and teachers of two schools in the Gampaha District. It was designed to be interactive and contains various cultural activities and questions. On completion, participants gave feedback online via Likert scales. Ethical approval for the study was obtained from the Faculty of Medicine, University of Kelaniya. RESULTS: A total of 115 students and 66 teachers participated. Overall, more than 95% of students and teachers found the module appropriate and suitable. The students had more favourable ratings for the module compared to the teachers on aspects of understanding the content (p<0.001), ability to complete by self (p<0.001), suitability to age (p<0.001), shorter time for completion (p<0.001) and suitability of the design (p<0.001). Both groups suggested that the pictures and activities be increased. CONCLUSIONS: Teaching character strengths using a web-based intervention was well accepted by adolescent students and teachers in Sri Lanka.
Afghanistan: Decades of collective trauma, ongoing humanitarian crises, Taliban rulers, and mental health of the displaced population
(Elsevier, 2021) Mohd Saleem, S.; Shoib, S.; Dazhamyar, A.R.; Chandradasa, M.
ABSTRACT: More than half of the Afghan population suffers from depression, anxiety, and post-traumatic stress disorder, including many survivors of conflict-related violence, yet only about 10 percent receive effective psychosocial therapy from the government. As a result of decades of bloodshed, many Afghans have sustained serious psychological traumas. Due to unfair social standards, women and girls confront additional challenges, and millions of Afghans have suffered psychologically as a result of 41 years of conflict. While effective mental health investment is vital, funds must be spent judiciously to ensure access to adequate assessment while also adhering to human rights standards. The global mental health crises caused by the lengthy political struggle, as well as the COVID-19 pandemic, have collided in Afghanistan, worsening a complex humanitarian disaster and adding to the country's mounting mental health burden. Mental health is an issue that, at least in Afghanistan's current socio-political setting, requires immediate attention. While effective mental health investment is vital, funds must be spent judiciously to ensure access to adequate assessment. KEYWORDS: Conflict; Humanitarian crises; Psychological well-being; Social well-being; Trauma; War.
The alarming development of online gambling in Iranian women during the COVID-19 pandemic
(Routledge, 2023) Saeed, F.; Chandradasa, M.; Tajik Esmaeeli, S.; Shoib, S.
No abstract available
Armed assault of Russia on Ukraine and looming danger on regional mental health: a call for action by psychiatrists in conflict settings
(Cambridge University Press, 2022) Shoib, S.; Armiya'u, A.Y.; Chandradasa, M.; Zharkova, A.; Kolesnyk, P.; Swed, S.; Lucero-Prisno 3rd D.E.
No Abstract Available
Asian Journal of Psychiatry and Psychiatry in Asia: Time to reconsider human resources to represent cultural diversity in Asia
(Elsevier, 2021) Shoib, S.; Gupta, A.K.; Kar, S.K.; Chandradasa, M.; Menon, V.; Ullah, I.; Thuzar, M.; Arafat, S.M.Y.
No abstract available
Aspects of moral character, civic purpose and social identity in relevance to the psychological well-being of adolescents in Sri Lanka.
(Journal of the Postgraduate Institute of Medicine, 2019) Chandradasa, M.; Rathnayake, L.C.
ABSTRACT: Moral character is defined as the complex constellation of psychological characteristics that motivate and enable persons to function as moral agents competently. Character is composed of various character strengths, and these are trainable personal characteristics. Purpose is the long-term, progressive intention to accomplish specific aims that are meaningful to self and the broader world. Character strengths and purpose in adolescence is associated with academic achievement and long-term mental and physical well-being. Identity crisis in adolescence is associated with moral character formation, developing a purpose and psychological well-being. Sri Lanka leads human development indices (HDI) in the region. Retention in secondary schooling is high, but higher education enrolment is less than 20% and below the average for lower-middle income countries. Therefore, more than 80% of adolescents exit the educational system without entering a standard tertiary education course. After leaving school, they do not have opportunities in a structured environment to promote desirable character strengths. Despite laws against child cruelty, corporal punishment and psychological aggression are highly prevalent in Sri Lankan schools. There is sound research evidence that this method is counterproductive to long-term mental well-being and character development. Psychiatry is, at times, criticised for only focusing on psychopathology and not on overall positive mental health. Child and adolescent mental health expertise are limited in the country, and psychiatrists need to look beyond diagnostic categories to facilitate and support the character development of young Sri Lankans. Considering this context, there is a need for school-based, culturally relevant character development programmes for Sri Lankan adolescents. These programmes need to be developed recognising moral, ethical, social and cultural values, employing multi-sectoral collaboration. There has been a rising interest world over on character development in adolescents and its relevance to the mental well-being and future workforce of a country. Even though there have been several publications from the West, we could not access any publications on adolescent character development’s relevance to psychological well-being from Sri Lanka. This article discusses recent and relevant literature on character development in adolescence and the potential application of this evidence to the well-being of Sri Lankan adolescents.
Assessment of mental health problems among adolescents in Sri Lanka: Findings from the cross-sectional global school-based health survey
(John Wiley and Sons, 2022) Rasalingam, G.; Rajalingam, A.; Chandradasa, M.; Nath, M.
Background and aims: Mental health condition among adolescents is a leading cause of health-related disability in Sri Lanka. The study aims to estimate the prevalence and evaluate the associated risk factors in three major mental health domains-loneliness, anxiety and suicidal ideation-among Sri Lankan adolescents. Methods: We conducted a secondary analysis of cross-sectional data of 3262 adolescents from the Global School-based Health Survey (GSHS) conducted by the WHO in 2016. We modeled the binary outcome variables using multivariable logistic regression models with exposures representing demography, food habits, personal hygiene, behavior, substance abuse, parental and social engagement of the respondents. Results: We estimated the prevalence of loneliness, anxiety and suicidal ideation as 30.8% (95% CI: 29.3, 32.5), 20.2% (95% CI: 18.8, 21.6) and 3.7% (95% CI: 3.1, 4.4), respectively, and the overall prevalence as 40.3% (95% CI: 38.6, 42.0). Mental health problems were more prevalent among females than males. Engagement with parents and close friends, adequate nutritional intake and physically active lifestyles reduced the risk of common mental health problems. Exposure variables like food insecurity, truancy, second-hand smoking, physical fight, and being bullied increased adolescents' risk of reported psychological problems. Conclusions: We conclude that the prevalence of mental health problems in the Sri Lankan adolescent population was higher than the global average. Results suggest that future policy decisions to mitigate mental health problems among Sri Lankan adolescents should incorporate an integrated approach involving the individual, family and community to promote positive home and school environments combined with an active and healthy lifestyle.
Association between loneliness and suicidal behaviour: A scoping review
(Ankara:Türkiye Sinir ve Ruh Sağliği Derneği, 2023) Shoib, S.; Amanda, T.W.; Saeed, F.; Ransing, R.; Bhandari, S.S.; Armiya'u, A.Y.; Gürcan, A.; Chandradasa, M.
OBJECTIVE: Suicide is a public health issue, and there are several factors leading to suicide, like mental illness and psychosocial stressors. Actual loneliness (living alone) and subjective loneliness (feeling of being alone) and different suicidal behaviors have been reported to have some link. This scoping review aimed to assess the association between loneliness and suicidal behaviour by exploring the existing literature. METHODS: A scoping review was conducted implementing the appropriate framework and in accord with the PRISMA-ScR extension. A PubMed database search was made using a combination of terms to find publications in English from 2011 to 2021. Studies were included if they reported quantitative outcomes of the association between loneliness and suicidal experiences, including suicidal thoughts, plans, and/or attempts. Screening and data charting of the published literature was conducted by a panel of authors. The accuracy and clarity of extracted data was checked by three reviewers. RESULTS: Among 421 articles found, 31 full texts were evaluated based on exclusion and inclusion criteria, out of which, 18 papers that reported quantitative outcomes of the association between loneliness and suicidal experiences were included. We found that association between loneliness and suicidal behaviour is determined by individual, social and cultural factors. Co-existing mental illness, substance use disorder and economic hardship play an important role for the completion of suicide. CONCLUSION: Loneliness is correlated with suicide, and the knowledge about this association could assist in the identification of suicidal individuals or those at elevated risk of suicidal behaviour. Future studies should focus on loneliness and its relation to suicidal ideation in individuals with different mental health disorders and personalities.
Association of duration of untreated psychosis and functional level, in first episode of schizophrenia attendingan outpatient clinic in Sri Lanka
(Postgraduate Institute of Medicine, University of Colombo, 2016) Chandradasa, M.; Champika, L.; Gunathillaka, K.; Mendis, J.
Schizophrenia is a progressive disorder that affects thoughts, emotions, perceptions and psychosocial behaviour.The duration of untreated psychosis (DUP) is the time period from development of initial psychotic symptom in the patient to the beginning of adequate treatment. Studies in the west have indicated that longer DUP is associated with poorer prognosis and functional levelin schizophrenia. This study aimed to quantify the DUP retrospectively in a group of patients in their first episode of schizophrenia attending the outpatient psychiatry clinic ofNational Hospital of Sri Lanka. Their functional level was assessed using the modified general assessment of functioning scale (mGAF) prospectively over three months. The mean DUP was 35.5 months and a longer DUP was significantly associated with lower mGAF scores. This DUP is higher compared to western and Indian data, and indicates the need for early recognition and management.
Association of family history of bipolar disorder with risk of violence in inpatient mania: a cohort study
(Sri Lanka College of Psychiatrists, 2016) Chandradasa, M.; Champika, L.; Rajapakse, T. N.
BACGROUND: Evidence suggests that a positive family history of bipolar affective disorder is associated with response to lithium and the course of the illness, in people suffering from this disorder. This may indicate a subgroup of patients with unique characteristics and treatment responses. AIMS: To explore associations between a positive family history of bipolar disorder and the risk of violence, in patients hospitalized for treatment of mania. METHODS: Adults receiving inpatient treatment for a manic relapse of bipolar affective disorder, at two tertiary care hospitals in Kandy, Sri Lanka were studied as a cohort. For each participant with a positive family history of bipolar disorder, an age and gender matched adult, also suffering from a manic relapse of bipolar affective disorder but without a family history, was included as a control. A second researcher, who was blind to the participants’ family history, assessed the risk of violence among all participants, at baseline, and at weekly intervals thereafter until discharge, using the historical clinical risk management Scale 20 (HCR-20).RESULTS: A total of 148 participants were included, with 74 each in the study arm and control arm respectively. Of all participants, 57% were females. Significantly higher rates of unemployment, harmful use of alcohol and absence of confiding relationships were found in participants with a positive family history; they also had a significantly higher mean average HCR-20 scores compared to controls. CONCLUSION: A positive family history of bipolar affective disorder was associated with a higher risk of violence during hospitalization for a manic relapse, as indicated by the mean average HCR-20 scores. A positive family history may be a potential identifier of those at a higher risk of violence in bipolar mania.
Auditory and visual hallucinations in an adolescent following orthotopic liver transplantation
(Sri Lanka College of Psychiatrists, 2024-10) Chandradasa, M.; Abeyrathne, M.; Sithara, P.; Kodithuwakku, K.; Fernando, M.
No abstract available
Brain drain among Sri Lankan psychiatrists
(Sri Lanka College of Psychiatrists, 2023) Chandradasa, M.; Kuruppuarachchi, K.A.L.A
No abstract available
Bridging the gap: Policy recommendations to address suicides committed by Indigenous youth in Victoria
(AccScience Publishing, 2024-12) Shoib, S.; Das, S.; Saeed, F.; Chandradasa, M.; Zaidi, I.
The Aboriginal population comprises 3.3% of the total Australian population, and youth represent 19% of this segment. In general, the Aboriginal inhabitants of Australia experience discrimination, limited access to education, and low socioeconomic conditions, and exhibit high mental disorder rates. The rate of suicide attempts by the Indigenous people of Victoria increased by 75% in 2021. This study examined the possible risk factors associated with suicides committed by Indigenous youth in Victoria. It focused on the health profiles of Victorian Aboriginal individuals, identified stakeholders who could help improve their mental well-being, addressed the needs and issues related to Aboriginal mental health, and examined substance abuse in this population segment. Finally, recommendations are offered to mitigate the studied problem. Rising suicide rates represent an urgent concern because they reflect the diminished mental health conditions of a society, particularly among its marginalized populations. It is crucial to develop an integrated suicide prevention act that takes into account the biological, psychological, social, cultural, and spiritual determinants of this population.
Challenges in mental health and psychosocial care in conflict-affected low- and middle-income countries.
(Elsevier Ltd, 2022) Shoib, S.; Javed, S.; Alamrawy, R.G.; Nigar, A.; Das, S.; Saeed, F.; Handuleh, J.I.M.; Shellah, D.; Dazhamyar, A.R.; Chandradasa, M.
No Abstract Available.
Child and Adolescent Mental Health Services (CAMHS) in a lower-middle income country: A survey from Sri Lanka.
(SAGE Publications, 2023) Rohanachandra, Y.M.; Chandradasa, M.; Dahanayake, D.M.A.
No abstract available
Child and youth mental health in post-war Sri Lanka
(Royal College of Psychiatrists, 2017) Chandradasa, M.; Kuruppuarachchi, K.A.L.A.
Sri Lanka's civil war and the tsunami in 2004 had enormous psychological impacts on the country's children. Tackling these issues has been difficult due to the lack of specialists in child and adolescent psychiatry. The end of the war in 2009 opened new avenues for the development of mental health services for children and youth in Sri Lanka. The year 2016 was historic in that the first board-certified child and adolescent psychiatrists assumed services in the country, after training in Australia.
Child psychiatry
(Samudra Medical Publications, 2022) Chandradasa, M.
No abstract available
The Children of Afghanistan need urgent mental health support.
(Elsevier, 2022) Shoib, S.; Essar, M.Y.; Saleem, S.M.; Legris, Z.; Chandradasa, M.
No abstract available
Children, adolescent, and youth mental health in Sri Lanka in the context of recent violence, COVID-19, and economic crisis: A call for action.
(Elsevier, 2022) Shoib, S.; Chandradasa, M.; Rathnayake, L.; Usmani, S.; Saeed, F.
No Abstract Available
Climate change and Indigenous mental health in Australia: In the aftermath of the defeat of the Voice referendum
(Sage Publishing, 2024) Shoib, S.; Das, S.; Zaidi, I.; Chandradasa, M.
INTRODUCTION: This manuscript delves into the intricate connection between climate change and Indigenous mental health in Australia, with a focus on the aftermath of the defeat of the 'Voice' referendum. Climate change, recognized for its broad impact on mental health determinants, poses heightened risks to vulnerable communities, including Indigenous populations. The defeat of 'The Voice' referendum adds complexity, highlighting concerns about the lack of meaningful rights for the First Peoples of Australia. The bushfires further underscore ecological consequences, affecting Indigenous ecosystems and intensifying existing environmental challenges. Climate change exacerbates existing health challenges for Indigenous peoples, introducing new issues like ecological sorrow and anxiety. METHODOLOGY: The manuscript advocates for prioritized research in Indigenous communities to explore the link between climate change and mental health. It emphasizes interdisciplinary and collaborative research, giving voice to those directly affected by climate change. The lack of trust between Indigenous populations and authorities, along with the implications on self-determination, is crucial research focus. RESULTS: Renewable energy emerges as a potential solution deeply ingrained in Indigenous practices. The manuscript discusses challenges in achieving eco-friendly resettlement, emphasizing collaboration difficulties between the government and remote communities. The indigenous worldview, with its interconnectedness, is crucial for sustainable strategies. DISCUSSION AND FUTURE DIRECTIONS: Indigenous perspectives on planetary health are crucial, emphasizing the importance of Indigenous knowledge in shaping effective climate policies. The manuscript stresses dialogues between policymakers and Indigenous elders for formulating respectful land laws. It calls for global attention to the role of Indigenous peoples as biodiversity caretakers and urges recognition of their knowledge in climate change. Future directions include data collection for ecosystem protection, improving mental health outcomes post-climate events, and supporting impacted communities. Mental health care approaches in remote communities and practitioner training for climate-related issues are emphasized. The manuscript calls for increased funding for interdisciplinary research to understand the long-term impact of climate change on mental health, especially among vulnerable populations.