Medicine

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Examining depression and quality of life in patients with thalassemia in Sri Lanka
(Wolters Kluwer - Medknow, 2019) Patel, P.; Beamish, P.; da Silva, T.L.; Kaushalya, D.; Premawardhena, A.; Williams, S.; Ravindran, A.V.
BACKGROUND: With more effective treatments and improved outcomes in thalassemia, there is increasing focus on its psychological sequelae. Most published data on this topic are from high income countries and much less so from low and middle income countries, where thalassemia is more prevalent. AIM: The aim of this study was to systematically evaluate the psychiatric morbidity and quality of life in relation to demographic and illness related variables among Sri Lankan patients with thalassemia. METHODS: This cross sectional investigation was conducted at the University of Kelaniya Teaching Hospital in Sri Lanka. Patients with all forms of thalassemia, over 12 years of age, and in stable medical condition (n = 120) were recruited. Assessment tools included a general demographic questionnaire, the Beck Depression Inventory II, and the World Health Organization Quality of Life Measure–Brief. Statistical analysis was conducted using linear regressions, Chi squares, and analyses of variance. RESULTS: Lack of family support, longer duration of inpatient admission, and female gender were associated with higher depression scores and reduced quality of life. Environmental and social quality of life were positively correlated with levels of peer support in males, while increased support from religion correlated with lower depression scores and higher satisfaction with environmental and psychological quality of life in women. There was no association between the type of thalassemia and either depression or quality of life measures. CONCLUSION: Several factors may influence the psychological state and well being of patients with thalassemia in Sri Lanka. Specific service innovations (some gender specific) may help to address these factors to improve treatment outcome and well being.
Perceived functional impairment and spirituality/religiosity as predictors of depression in a Sri Lankan spinal cord injury patient population
(Houndmills, Basingstoke, Hampshire, UK : Stockton Press, 2016) Xue, S.; Arya, S.; Embuldeniya, A.; Narammalage, H.; da Silva, T.; Williams, S.; Ravindran, A.
STUDY DESIGN:Cross-sectional, questionnaire-based study.OBJECTIVES:To test the hypothesis that self-perceived functional impairment and religiosity/spirituality (S/R) predict depression among traumatic spinal cord injury (SCI) patients in Sri Lanka. SETTING: Ragama Rheumatology and Rehabilitation Hospital, Ragama, Sri Lanka. METHODS: The Spinal Cord Independence Measure, Benefit Through Spirituality/Religiosity Scale, Sheehan Disability Inventory and Beck Depression Inventory-II (BDI-II) were administered to 61 consenting in-patients with traumatic SCI between June and July 2014. A linear regression model on BDI-II score was developed to examine the impact of self-perceived functional impairment and S/R activities on psychiatric outcomes in context of various sociodemographic variables.RESULTS: Psychiatric consequences of SCI were reflected in a 41% prevalence of depression. Thirty-six percent (R2=0.36) of the variance in BDI-II scores (F(5, 55)=6.07, P<0.001) was explained by the regression model. Functional impairment (β=0.54, t(55)=4.73, P<0.001) and perceived benefit through S/R activities (β=-0.31, t(55)=-2.55, P<0.05) emerged as the strongest predictors for depression severity.CONCLUSIONS: Perceived functional impairment in work, social and family domains predicted depressive symptomatology among SCI inpatients in Sri Lanka, while perceived benefit through S/R protected against depression. The findings emphasize the need for rehabilitative programming to support patients' S/R activities and mental wellbeing, promoting reintegration into their community roles.

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