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BACKGROUND: The relationship between migration and mental health is complex and involves factors at different levels, as the individual history of the migrant, the collective history of their home country, the host society's and their mutual past history. Even though the migratory scenario of France and Brazil has changed over the years, both countries currently host an important number of immigrants. AIM: The main objective of the present study was to describe and analyze the impacts of the migratory experience on mental health of migrants with different migration experiences and living in two countries: France and Brazil. METHOD: Semi-structured interviews were conducted with 13 participants, six in France and seven in Brazil. A thematic qualitative analysis of the data was performed using the ATLAS.TI software. Three themes were created based on the different times of the migration experience: before migration, during migration and after migration. All codes of these three bigger themes were organized in sub-themes for the samples in France and Brazil. RESULTS: Participants in France described an important exposure to traumatic events before and during migration. In Brazil, the migration experiences were multiple, in some cases presenting a traumatic history, but in most cases migration was seen as an opportunity to have access to better life conditions. In both countries, participants reported a great level of psychological distress associated to post-migratory difficulties (e.g. unemployment, learning a new language, or facing a new cultural environment). CONCLUSIONS: Our results suggest that multidisciplinary interventions, with focus on skills development, such as language and work-related skills, and on access to basic needs may be essential for both voluntary and involuntary migrants. In addition to these interventions, some individuals may need specialized mental health intervention, focusing in past traumatic exposure and in the current acculturation process.
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Saúde Mental , Migrantes , Aculturação , Brasil , França , Humanos , Pesquisa QualitativaRESUMO
OBJECTIVES: Currently, there is little data on the mental health consequences of the COVID-19 pandemic in low- and middle-income countries (LMICs). This study aims to examine the pooled and separate prevalence and determinants of depression during the pandemic in samples from four LMICs. METHODS: Participants (N= 1267, 40.9% women) were recruited from the Democratic Republic of the Congo (DRC), Haiti, Rwanda, and Togo. They completed an online cross-sectional survey on sociodemographics, exposure and stigmatization related to COVID-19, the Hopkins Symptom Checklist depression subscale, and the Connor-Davidson Resilience Scale-2. RESULTS: The pooled prevalence for depression symptoms was 24.3% (95% CI: 22.08-26.79%), with significant differences across countries. Younger age, gender (women), and high levels of exposure and stigmatization related to COVIID-19, and resilience were associated with depression in the pooled data. There were significant variations at the country level. Stigmatization (but not exposure to COVID-19 and resilience) was a strong predictor among the four countries. CONCLUSIONS: The prevalence of depression symptoms in the LMICs are similar to those reported in China and in most high-income countries during the pandemic. The findings emphasize the need for implementing non-fear-based education programs during epidemics to reduce stigmatization.
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Ansiedade/epidemiologia , COVID-19/psicologia , Depressão/epidemiologia , SARS-CoV-2 , Estigma Social , Adulto , Ansiedade/psicologia , COVID-19/epidemiologia , Estudos Transversais , República Democrática do Congo/epidemiologia , Escolaridade , Feminino , Haiti/epidemiologia , Humanos , Renda , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pandemias , Pobreza , Prevalência , Ruanda/epidemiologia , Estereotipagem , Togo , Adulto JovemRESUMO
OBJECTIVE: Studies have documented the significant direct and indirect psychological, social, and economic consequences of the Coronavirus disease 2019 (COVID-19) in many countries but little is known on its impact in low- and middle-income countries (LMICs) already facing difficult living conditions and having vulnerable health systems that create anxiety among the affected populations. Using a multinational convenience sample from four LMICs (DR Congo, Haiti, Rwanda, and Togo), this study aims to explore the prevalence of anxiety symptoms and associated risk and protective factors during the COVID-19 pandemic. METHODS: A total of 1267 individuals (40.8% of women) completed a questionnaire assessing exposure and stigmatization related to COVID-19, anxiety, and resilience. Analyses were performed to examine the prevalence and predictors of anxiety. RESULTS: Findings showed a pooled prevalence of 24.3% (9.4%, 29.2%, 28.5%, and 16.5% respectively for Togo, Haiti, RDC, and Rwanda, x2 = 32.6, p < .0001). For the pooled data, exposure to COVID-19 (ß = 0.06, p = .005), stigmatization related to COVID-19 (ß = 0.03, p < .001), and resilience (ß = -0.06, p < .001) contributed to the prediction of anxiety scores. Stigmatization related to COVID-19 was significantly associated to anxiety symptoms in all countries (ß = 0.02, p < .00; ß = 0.05, p = .013; ß = 0.03, p = .021; ß = 0.04, p < .001, respectively for the RDC, Rwanda, Haiti, and Togo). CONCLUSIONS: The findings highlight the need for health education programs in LMICs to decrease stigmatization and the related fears and anxieties, and increase observance of health instructions. Strength-based mental health programs based on cultural and contextual factors need to be developed to reinforce both individual and community resilience and to address the complexities of local eco-systems.
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Ansiedade/epidemiologia , COVID-19/epidemiologia , Países em Desenvolvimento/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Resiliência Psicológica , Estigma Social , Adulto , Ansiedade/etiologia , Congo/epidemiologia , Feminino , Haiti/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Proteção , Fatores de Risco , Ruanda/epidemiologia , Togo/epidemiologiaRESUMO
BACKGROUND: In 2010, an important earthquake devastated Haiti and caused thousands of deaths. In a social context where women are particularly vulnerable, this cross-sectional study examined the associations between sexual assaults experienced by women before the earthquake, the earthquake exposure, the traumatic consequences, and their satisfaction of social support received. METHODS: A total of 660 women aged 18 to 86 completed questionnaires assessing exposure to the earthquake, sexual assault victimization, peritraumatic distress, Posttraumatic stress disorder (PTSD), depression, and social support. A moderated moderation model was computed to examine associations between exposure to the earthquake, sexual assault, social support, and traumatic consequences. RESULTS: Results showed that 31.06% of women were victims of sexual assault before the earthquake. They presented higher prevalence of peritraumatic distress, PTSD, and depression symptoms, compared to non-victims. The moderated-moderation model showed that sexual assault and exposure to the earthquake were positively associated with traumatic consequences (respectively, B = 0.560, p < 0.001; B = 0.196, p < 0.001), while social support was negatively associated with them (B = -0.095, p < 0.05). Results showed a triple interaction: women victim of sexual assault who were satisfied with received social support are less likely to develop traumatic consequences after being exposed to the earthquake(B = -0.141, p < 0.01). CONCLUSIONS: By demonstrating the role of sexual assault in the development of mental health problems after the Haitian earthquake, this study shows the importance for clinicians to investigate interpersonal trauma experienced before or following natural disasters among survivors. Results also indicate the key role of family and communities to help survivors build resilience and coping strategies with their social support.
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Depressão/epidemiologia , Terremotos , Assédio Sexual/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Sobreviventes/psicologia , Adaptação Psicológica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Desastres , Feminino , Haiti/epidemiologia , Humanos , Pessoa de Meia-Idade , Prevalência , Apoio Social , Inquéritos e Questionários , Adulto JovemRESUMO
Not for the first time in recent history, the people of Haiti have been obliged to fall back on their resilience strategies in the aftermath of Hurricane Matthew. Following the powerful earthquake that struck the country on 12 January 2010, the entire population had to find the resources to survive in the face of extensive material damage and loss of life: over 222 000 dead, more than 300 000 injured and between 4000 and 7000 amputees (UNDP, 2010).
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In Haiti, as in several developing countries, the phenomenon of street children has become a major public health issue. These children are often victims of traumas and adverse life events. This article aimed to investigate traumas experienced by street children and their coping and resilience strategies used to deal with adversities in a logic of survival, relying on a mixed method approach. A group of 176 street children, aged 7-18 (nâ¯=â¯21 girls), recruited in Port-au-Prince, completed measures assessing PTSD, social support and resilience. Semi-structured interviews were conducted to document traumatic experiences, factors related to resilience and coping strategies. After performing statistical analyses to evaluate prevalence and predictors associated with PTSD, and level of social support satisfaction and resilience, qualitative analysis using a grounded theory approach was conducted. Results showed that street children experienced multiple traumas such as neglect, maltreatment, psychological, physical and sexual abuse. However, they also showed self-efficacy to face their traumatic experiences and few of them (less than 15%) obtained scores reaching clinical rates of PTSD, while a large majority presented a level of resilience between moderate to very high. A socio-ecological model of multiple traumas and a model of coping, survival and resilience strategies are conceptualized. Data provide a better understanding of the traumas experienced by street children, their coping and resilience strategies. Results underscore ways to develop practices to offer psychological support, social and vocational integration based on the real needs of these children, in a perspective of social justice.
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Jovens em Situação de Rua/psicologia , Traumatismo Múltiplo/psicologia , Resiliência Psicológica , Adaptação Psicológica , Adolescente , Criança , Maus-Tratos Infantis/mortalidade , Maus-Tratos Infantis/psicologia , Feminino , Haiti/epidemiologia , Humanos , Masculino , Traumatismo Múltiplo/mortalidade , Satisfação Pessoal , Prevalência , Autoeficácia , Apoio SocialAssuntos
Adaptação Psicológica , Desastres , Terremotos , Resiliência Psicológica , Adolescente , Haiti , Pessoal de Saúde/psicologia , Humanos , MasculinoRESUMO
Working with street children and adolescents who lived through the 2010 earthquake in Port-au-Prince, this paper aims to assess the prevalence of symptoms of PTSD, anxiety and depression in relation to peritraumatic distress, and age, and to explore other risk factors and socio-demographic characteristics, four years after the events. Between March and June 2014, with a sample of 128 children and adolescents (120 boys and 8 girls) aged between 7 and 18, of an average age of 13.88 (SD=2.15), all living on the streets of Port-au-Prince, we used the following scales: the Trauma Exposure (TE), the Life Events Subscale of the CAPS; the Peritraumatic Distress Inventory (PDI); the Children's Revised Impact of Event Scale (CRIES-13) and the Children Depression Inventory (CDI); (BAI). Our study reveals a high prevalence of PTSD, depression and anxiety among street children. It also demonstrates that this prevalence is lower than that of several other groups of children who were also victims of the 2010 earthquake in Port-au-Prince. Children living in the streets for economic reasons presented a lower prevalence of symptoms of PTSD, anxiety and depression than those who were on the streets as a result of psychological or physical abuse within their own families, in adoptive families or in children's homes. This study demonstrates the importance of care provision for these children in terms of helping them develop coping and resilience strategies. It also stresses the importance of providing them with nonviolent living environments and opportunities to facilitate their return to normality.
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Transtorno Depressivo/fisiopatologia , Desastres , Terremotos , Jovens em Situação de Rua/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Sobreviventes/psicologia , Adaptação Psicológica , Adolescente , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/fisiopatologia , Criança , Transtorno Depressivo/epidemiologia , Feminino , Haiti/epidemiologia , Humanos , Masculino , Prevalência , Transtornos de Estresse Pós-Traumáticos/psicologiaRESUMO
BACKGROUND: Resilience is defined as the ability of people to cope with disasters and significant life adversities. The present paper aims to investigate the underlying structure of the Creole version of the Resilience Scale and its psychometric properties using a sample of adult survivors of the 2010 earthquake. METHODS: A parallel analysis was conducted to determine the number of factors to extract and confirmatory factor analysis was performed using a sample of 1355 adult survivors of the 2010 earthquake from people of specific places where earthquake occurred with an average age of 31.57 (SD=14.42). All participants completed the Creole version of Resilience Scale (RS), the Impact of Event Scale Revised (IES-R), the Beck Depression Inventory (BDI) and the Social Support Questionnaire (SQQ-6). To facilitate exploratory (EFA) and confirmatory factor analysis (CFA), the sample was divided into two subsamples (subsample 1 for EFA and subsample 2 for CFA). RESULTS: Parallel analysis and confirmatory factor analysis results showed a good-fit 3-factor structure. The Cronbach α coefficient was .79, .74 and .72 respectively for the factor 1, 2 and 3 and correlated to each other. Construct validity of the Resilience scale was provided by significant correlation with measures of depression and social support satisfaction, but no correlation was found with posttraumatic stress disorder measure, except for factor 2. CONCLUSIONS: The results reveal a different factorial structure including 25 items of the RS. However, the Haitian Creole version of RS is a valid and reliable measure for assessing resilience for adults in Haiti.
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Desastres , Terremotos , Escalas de Graduação Psiquiátrica/normas , Resiliência Psicológica , Sobreviventes/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Depressão/diagnóstico , Depressão/etnologia , Depressão/psicologia , Feminino , Haiti/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Apoio Social , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/etnologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários/normas , Adulto JovemAssuntos
Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Países em Desenvolvimento , Desastres , Terremotos , Rituais Fúnebres , Pesar , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Simbolismo , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/psicologia , Estudos Transversais , Haiti , HumanosRESUMO
BACKGROUND: More than 500 studies were conducted in Haiti following the January 12 of 2010 earthquake, yet few of them assessed mental health of the population. To our knowledge, none targeted the effectiveness of various methods used to treat survivors, whether adults or children METHOD: Our study aimed to assess one year after the disaster, the effect of a specific psycho-social support offered to relocated children in Port-au-Prince compared with a control group. RESULTS: The two groups were homogeneous in the intensity of the peritraumatic distress they experienced. We were unable to show a significant difference between both in the average scores for PTSD, nor for depression, nor in three out of the four sub-scales of the Child Behavior Check-List. In case children, 68% and 40.9%, respectively, and 50% and 20.5% of the control group, reported severe levels of the symptoms of PTSD and depression. These surprising results can be explained by the absence of equivalence in the two groups from a socio-demographic point of view and because subjects were not randomly selected in the recruitment process. CONCLUSION: This study has not made it possible to indicate the effectiveness of a specific psycho-social support offered to children in the aftermath of the disaster. On the other hand, the sample illustrates the high prevalence (more than 50% for PTSD) of severe post-traumatic stress in this group of school-age children, one year after the earthquake. These results indicate that serious attention should be paid to the mental health aspects in reconstruction program for the country.
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Depressão/epidemiologia , Terremotos , Apoio Social , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Sobreviventes/psicologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Haiti/epidemiologia , Humanos , Masculino , PrevalênciaRESUMO
BACKGROUND: We examined the prevalence and predictive factors of PTSD and depression in relation with peritraumatic distress, trauma exposure, and sociodemographic characteristics among children and adolescent who survived the 2010 Haiti's earthquake. METHODS: We analyzed data collected between June and July 2012 from a sample of 872 participants aged 7 to 17 in 12 schools, door-to-door canvassing and two centers for street children at Port-au-Prince. Participants completed the Impact of Event Scale Revised (IES-R), Peritraumatic Distress Inventory, Child Depression Inventory 2 (CDI), and sociodemographic and traumatic exposure questionnaires. RESULTS: Of 872 participants, respectively 322 (36.93%); and 403 (46.21%) reported a clinically significant symptoms of PTSD and depression, which were significantly higher among girls. The best predictive variables are peritraumatic distress for PTSD (ß=0.53,P<.0001) a traumatic exposure for depression (ß=0.23,P<.0001). The comorbidity between PTSD and depression symptoms is 22.25%. CONCLUSIONS: This first study in children on the prevalence of PTSD and depression resulting from the 2010 Haiti earthquake demonstrates a need for improvement in treatment aimed at reducing PTSD and depression. Such treatment should be geared primarily toward girls, adolescents between the ages of 14 and 17 and those children and adolescents who have lost a family member in the earthquake.
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Transtorno Depressivo/epidemiologia , Terremotos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Sobreviventes/psicologia , Sobreviventes/estatística & dados numéricos , Adolescente , Criança , Comorbidade , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologia , Desastres , Feminino , Haiti/epidemiologia , Humanos , Masculino , Prevalência , Fatores Socioeconômicos , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e QuestionáriosRESUMO
BACKGROUND: On January 12, 2010, a powerful 7.0 magnitude earthquake struck the Republic of Haiti and destroyed Port-au-Prince, the capital and others cities across the country. While some studies have examined the long-term traumatic effects of the seismic event on children and adolescents victims, so far no study has examined the consequences on adults generally. As such, this study aims to investigate the traumatic consequences of the earthquake among adults related to degree of exposure, peritraumatic distress, depressive symptoms and sociodemographic factors two and a half years after. In addition, predictive factors of PTSD and depressive symptoms were also identified. METHODS: From June to July 2012, a total of 1355 adults (660 women) was assessed by means the traumatic exposure questionnaire, the Life Events Checklist subscale, the Peritraumatic Distress Inventory (PDI), the Impact of Event Scale - Revised (IES-R) and the Beck Depression Inventory (BDI), in addition to social demographic characteristics. RESULTS: The prevalence rates of PTSD and depressive symptoms were 36.75% (498 cases) and 25.98% (352 cases) respectively. The risk factors for PTSD and depressive symptoms were young and old age, female gender, unemployed status and low level of education. The bests predictives variables were peritraumatic distress for PTSD (ß=.57, p<.0001) and for depressive symptoms (ß=.21, p<.0001). The commorbidity between PTSD and depression was 13.36%. CONCLUSIONS: This study found that psychological symptoms are frequent event 30 months after the earthquake. The different mental health care providers, the public health ministry, NGOs working on the ground in Haiti should design programmes in order to aid the psychological wellbeing of the population focussing on youth, older and retired adults, females, people with low levels of education and those who do not work.
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Depressão/epidemiologia , Desastres , Terremotos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Sobreviventes/psicologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Feminino , Haiti/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Inquéritos e Questionários , Sobreviventes/estatística & dados numéricos , Adulto JovemRESUMO
In this article, we posit the hypothesis that the January 2010 earthquake in Port-au-Prince reawakened a number of traumas linked to the natural disasters that struck Gonaives in 2004 and 2008. The study set out to evaluate the PTSD and social support in the affected areas in Gonaives seven years after the disasters. The study covered a sample of 917 participants, of whom 534 (58.23%) were females, aged between 10 and 23 with an average age of 16.03 (SD = 2.65). A variety of scales were used: the Clinician Administered PTSD Scale (CAPS-1); the Traumatic Exposure Severity Scale (TESS); the PTSD Check-List Civilian version (PCL-C); the Impact of Event Scale Revised (IES-R) and the Social Support Questionnaire (SSQ). The results reveal a higher rate of PTSD among the oldest participants, a similarly higher rate of social support among Catholics than among Protestants, a more severe rate of PTSD among school going children and a positive correlation between social support and PTSD.
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Apoio Social , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Sobreviventes/psicologia , Adolescente , Adulto , Criança , Desastres , Terremotos , Feminino , Haiti/epidemiologia , Haiti/etnologia , Humanos , Masculino , Transtornos de Estresse Pós-Traumáticos/etnologia , Fatores de Tempo , Adulto JovemRESUMO
Resilience is defined as the capacity of human beings to deal with and adapt to adversity, suffering, tragedy or other traumatic event. This study aims to investigate psychometric properties and the underlying structure of the Creole version of the RS among children and adolescents survivors to the 2010 Haitian earthquake. A total of 872 children and adolescents exposed to the earthquake with an average age of 14.91 (SD=1.94) completed the Creole version of RS, the Impact Event Scale-Revised, the Children Depression Inventory and the Social Support Questionnaire-6. The current validity of RS and the internal consistency were investigated; sex, age, religion and others socio-demographic variables differences were also analysed. Cronbach's alpha coefficient for the RS was .77; the split-half coefficient was .72. The goodness-of-fit for the 5-factor model presents the best adjusted indices. The total resilience score was correlated positively with social support (r=.42, p<.01). Mean score of the RS was 131.46 (SD=21.01). No significant differences were observed about sex, age and residential municipality. The results showed that the Haitian Creole version of RS is a valid and reliable measure in assessing resilience for the children and adolescent survivors to the 2010's earthquake.