Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Prevalence and associated factors of depression in Sri Lanka: a systematic review and meta-analysis(Springer International, 2024) Alwis, I.; Baminiwatta, A.; Chandradasa, M.PURPOSE: Epidemiological data on depression are required to inform policies and service planning in mental health in Sri Lanka. This review aimed to synthesise data from existing studies to calculate the pooled prevalence of depression in Sri Lanka, assess its variability across subgroups, and identify associated factors within each subgroup. METHODS: PubMed, Embase, PsycINFO, Science Direct, Google Scholar and local journals were searched to identify peer-reviewed studies reporting the prevalence of depression among non-clinical adult, young, older, and maternal populations in Sri Lanka. A meta-analysis was performed using a random-effects model to calculate pooled prevalence estimates. Subgroup, sensitivity and moderator analyses were performed. A qualitative synthesis of factors associated with depression was conducted. RESULTS: A total of 33 studies representing a total of 52,778 participants were included. Overall, the pooled prevalence of depression was 19.4% [14.44-25.54%]. Among subpopulations, the highest prevalence was reported among young persons (39%); the rates in adults, older persons and maternal populations were 8.7%, 18.4% and 16.9%, respectively. Prevalence estimates were higher when based on screening instruments (21.2%) compared to diagnostic interviews (4.3%). A high degree of heterogeneity (I2 = 99.2) was observed. A qualitative synthesis of factors associated with depression, including individual attributes and behaviours, socio-economic circumstances and broader environmental factors, is reported for each age group. CONCLUSION: Approximately one-fifth of the population was detected to have depression. Notable variations in prevalence were observed across age groups. The heterogeneity of studies limits the inferences drawn from this review.Item Self-harm in children and adolescents who presented at emergency units during the COVID-19 pandemic: An international retrospective cohort study(Elsevier, 2023) Wong, B.H.; Cross, S.; Zavaleta-Ramírez, P.; Bauda, I.; Hoffman, P.; Ibeziako, P.; Nussbaum, L.; Berger, G.E.; Hassanian-Moghaddam, H.; Kapornai, K.; Mehdi, T.; Tolmac, J.; Barrett, E.; Romaniuk, L.; Davico, C.; Moghraby, O.S.; Ostrauskaite, G.; Chakrabarti, S.; Carucci, S.; Sofi, G.; Hussain, H.; Lloyd, A.S.K.; McNicholas, F.; Meadowcroft, B.; Rao, M.; Csábi, G.; Gatica-Bahamonde, G.; Öğütlü, H.; Skouta, E.; Elvins, R.; Boege, I.; Dahanayake, D.M.A.; Anderluh, M.; Chandradasa, M.; Girela-Serrano, B.M.; Uccella, S.; Stevanovic, D.; Lamberti, M.; Piercey, A.; Nagy, P.; Mehta, V.S.; Rohanachandra, Y.; Li, J.; Tufan, A.E.; Mirza, H.; Rozali, F.; Baig, B.J.; Noor, I.M.; Fujita, S.; Gholami, N.; Hangül, Z.; Vasileva, A.; Salucci, K.; Bilaç, Ö.; Yektaş, Ç.; Cansız, M.A.; Aksu, G.G.; Babatunde, S.; Youssef, F.; Al-Huseini, S.; Kılıçaslan, F.; Kutuk, M.O.; Pilecka, I.; Bakolis, I.; Ougrin, D.OBJECTIVE: To compare psychiatric emergencies and self-harm at emergency departments (EDs) 1 year into the pandemic, to early pandemic and pre-pandemic, and to examine the changes in the characteristics of self-harm presentations. METHOD: This retrospective cohort study expanded on the Pandemic-Related Emergency Psychiatric Presentations (PREP-kids) study. Routine record data in March to April of 2019, 2020, and 2021 from 62 EDs in 25 countries were included. ED presentations made by children and adolescents for any mental health reasons were analyzed. RESULTS: Altogether, 8,174 psychiatric presentations were recorded (63.5% female; mean [SD] age, 14.3 [2.6] years), 3,742 of which were self-harm presentations. Rate of psychiatric ED presentations in March to April 2021 was twice as high as in March to April 2020 (incidence rate ratio [IRR], 1.93; 95% CI, 1.60-2.33), and 50% higher than in March to April 2019 (IRR, 1.51; 95% CI, 1.25-1.81). Rate of self-harm presentations doubled between March to April 2020 and March to April 2021 (IRR, 1.98; 95% CI, 1.68-2.34), and was overall 1.7 times higher than in March to April 2019 (IRR, 1.70; 95% CI, 1.44-2.00). Comparing self-harm characteristics in March to April 2021 with March to April 2019, self-harm contributed to a higher proportion of all psychiatric presentations (odds ratio [OR], 1.30; 95% CI, 1.05-1.62), whereas female representation in self-harm presentations doubled (OR, 1.98; 95% CI, 1.45-2.72) and follow-up appointments were offered 4 times as often (OR, 4.46; 95% CI, 2.32-8.58). CONCLUSION: Increased pediatric ED visits for both self-harm and psychiatric reasons were observed, suggesting potential deterioration in child mental health. Self-harm in girls possibly increased and needs to be prioritized. Clinical services should continue using follow-up appointments to support discharge from EDs. DIVERSITY & INCLUSION STATEMENT: One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.