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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Nature, prevalence and determinants of mental health problems experienced by adolescents in south Asia: a systematic review(Elsevier Ltd, 2025-01) Mudunna, C.; Weerasinghe, M.; Tran, T.; Antoniades, J.; Romero, L.; Chandradasa, M.; Fisher, J.BACKGROUND Adolescence is a sensitive phase of human development where individuals, aged 10-19 years, are particularly vulnerable to developing mental health problems (MHPs). South Asia, home to 24% of the world's population, is mostly comprised of low- and middle-income countries (LMIC). Most of the world's young people live in LMICs. This systematic review aims to assess the available evidence on the nature, prevalence and determinants of MHPs experienced by adolescents in south Asia. METHODS Following PRISMA guidelines, searches were conducted in four online databases (Ovid Medline, Ovid EMBASE, Ovid Global Health, Ovid PsycInfo), titles, abstracts, and full-texts were screened, data extracted and quality assessed. Extracted data were categorised into school-based studies (SBS) and non-school-based studies (NSBS). Data were further stratified according to country, MHPs and narratively synthesised. FINDINGS Of the 5847 records identified in the searches, 117 met inclusion criteria. Most (n = 87) were SBS. Key MHPs reported across countries include anxiety disorders and depression. Wide ranges of prevalence rates were reported for anxiety in Indian SBS (1.5-81.6%) and NSBS (1.8-88.1%), and for depression, Pakistani SBS (21-79%) and Indian NSBS (0.4-98.5%). Determinants include individual characteristics; violent victimisation; poor family/home/school environment/peer relationships; already experiencing MHPs and substance use/abuse. Increased physical activity, adequate nutrition, safe/positive homes/family environment, being unmarried females, higher maternal education, peer support/friendship, higher education level and engaging in extra-curricular activities were protective of mental well-being. INTERPRETATION Prevalence of MHPs among south Asian adolescents appears high. Determinants include social, cultural, environmental and socioeconomic factors often beyond individual control. Mental health policies and programs and research appropriate to the cultural context, that address social determinants of MHPs and evidence gaps, are needed to tackle the significant mental health burden among south Asian adolescents. FUNDING Authors CM and MW are supported by a Monash University Research Training Program Scholarship. JF is supported by the Finkel Professorial Fellowship funded by the Finkel Family Foundation.Item 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.Item 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 availableItem Religion, spirituality, and coping among the psychiatric population: a narrative review(Academy Publisher, 2024) Shoib, S.; Das, S.; Gupta, A.K.; Ullah, I.; Javed, S.; Nocera, A.; Kar, S.K.; Chandradasa, M.; de Filippis, R.BACKGROUND AND AIMS: The impact of religiosity and spirituality on mental health is still far to be adequately explored. Evidence-based data gathering papers that bring together various perspectives and facets of religion in the mentally ill population is needed. Therefore, we conducted this review to summarise evidence on the subject and raise awareness. METHODS: We searched the literature using generic terms for ‘mental health and psychiatry’, ‘beliefs’, ‘religion’, ‘religious involvement’, ‘religiosity’, ‘spiritual aspects’, and ‘spirituality’, finally summarising all appropriate references. However, for this narrative revision, we collected papers addressing various perspectives, data, and facets of religion in the mentally ill population, a subject with theoretical and practical implications in mental health. RESULTS: The initial literature search found 21,723 total results: 1,723 from PubMed/Medline and Scopus, and up to 20,000 from Google Scholar, Science Direct, and Web of Science. After removing repetitions and applying inclusion and exclusion criteria, only six studies were included in this review on religion as an adaptive resource, and nine studies on religion, spirituality, and mental health. CONCLUSIONS: Evidence-based studies on the topic are still challenging to develop while maintaining a high scientific value. Notwithstanding this, religion and spirituality can have positive/negative clinical implications depending on how they are managed. Indeed, it can reduce suicidal risk, relieve depressive and anxious symptoms, and improve patients’ and caregivers’ coping and resilience. Nevertheless, it can enhance guilt, worsen/ generate obsessions, and compulsions in the obsessive-compulsive disorder and determine or associate with mystical-religious delusions in the maniacal phase of bipolar disorder.Item Factors behind suicides in Muslim countries: a global ecological study(Taylor and Francis Group, 2024) Shoib, S.; Tayyeb, M.; Armiya’u, A.Y.; Raaj, S.; Elmahi, O.K.O.; Swed, S.; Saeed, F.; Nahidi, M.; Bashir, A.; Chandradasa, M.This study examines the relationship between suicide rates and social, political, and economic factors in Muslim-majority countries, considering the influence of Islam and unique socio-cultural factors. Conducted from January to December 2022, it covered 46 countries, collecting data on suicide rates, income, Human Development Index (HDI), poverty rate, life expectancy, literacy rate, and political system. Suicide rates in Muslim-majority countries could be predicted based on HDI, poverty rates, life expectancy, and literacy rates. Frequency of suicide rates varied across continents, with the highest rates in Africa. Culturally sensitive suicide prevention programs are crucial for Muslim-majority countries.Item 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.Item Relationship between childhood sexual abuse and suicidal behaviour in South Asian countries: A scoping review(Elsevier, 2022) Shoib, S.; Amanda, T.W.; Saeed, F.; Armiya’u, A.Y.; Patel, V.; Chandradasa, M.; de Berardis, D.Background: Sexual abuse is a global issue and happens in every culture and country. It is a risk factor for developing several mental disorders and suicide. While there are many studies on the relationship between childhood sexual abuse (CSA) and suicide, there are no reviews on this association from South Asia. Aims: A scoping review to explore the association between CSA and suicidal behaviour in South Asian countries. Method: A literature search was conducted with Databases PubMed/Medline, Google Scholar, and Scopus from January 1, 2001 to December 31, 2020 for articles related to child sexual abuse and suicidal behaviour. Studies from Afghanistan, Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka were included in the search. Results: Among 356 articles found, 45 publications were further evaluated based on exclusion and inclusion criteria, and 12 papers that reported quantitative outcomes of the association between CSA and suicidal experiences were included in the review. There were no eligible studies from Afghanistan, Pakistan, Nepal, and the Maldives. Due to the limited number of publications and the heterogeneity of the studies, a meta-analysis was not conducted. Most studies indicated that CSA is a risk factor for suicidal behaviour or suicide later in life. Further, cultural barriers prevent the disclosure of CSA in Asian communities. Conclusions: There is an association between CSA and suicidal behaviour in South Asian countries. Future studies should target socio-cultural aspects to develop preventive programs for CSA and later suicide.Item Academic psychiatry journals in South Asian countries: most from India, none from Afghanistan, Bhutan and the Maldives(Global Psychiatric Association, 2022) Arafat, S.M.Y.; Ali, S.A.Z.; Saleem, T.; Banerjee, D.; Singh, R.; Baminiwatta, A.; Shoib, S.Objective: As journals play a crucial role in the dissemination of knowledge, reviewing the psychiatry journals would illustrate the current status of mental health research. Aims: We aimed to identify and assess the academic journals within South Asia that focus on psychiatry. Methods: We searched on Google to identify the currently functioning psychiatry journals from South Asian countries. We used “psychiatry journals in South Asia” and “mental health journals in South Asia” as search terms. We also searched by individual country names (Afghanistan, Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan and Sri Lanka). Results: A total of 20 psychiatry journals were identified and reviewed from five countries; one each from Bangladesh, Nepal, Pakistan and Sri Lanka, while 16 journals were from India. Only three journals (15%) are indexed in PubMed, four journals (20%) in Scopus, and one in Web of Science inclusively. Major indexation was only found in the journals from India. The Indian Journal of Psychiatry appears to be the oldest and currently leading mental health journal in the region. Conclusion: The review revealed that South Asia has a noticeable deficit in a high-quality academic research publishing system in psychiatry despite the region holding about a quarter of the global population.Item International collaboration to address the inevitable mental health burden in Sri Lanka in the context of the economic crisis(Elsevier, 2022) Shoib, S.; Rathnayake, L.; Badawy, M.M.; Swed, S.; Saeed, F.; Chandradasa, M.No abstract availableItem Mental health services in Syria: Challenges and opportunities(Elsevier, 2022) Shoib, S.; Swed, S.; Alibrahim, H.; Ezzdean, W.; Almoshantaf, M.B.; Siddiqui, M.F.; Chandradasa, M.No abstract available