Search

BackgroundIn this global study we sought to estimate the degree to which a family member might feel embarrassed when a close relative is suffering from an alcohol, drug, or mental health condition (ADMC) versus a general medical condition (GMC). To date, most studies have considered embarrassment and stigma in society and internalized by the afflicted individual but have not assessed family embarrassment in a large-scale study.MethodIn 16 sites of the World Mental Health Surveys (WMHS), standardized assessments were completed including items on family embarrassment. Site matching was used to constrain local socially shared determinants of stigma-related feelings, enabling a conditional logistic regression model that estimates the embarrassment close relatives may hold in relation to family members affected by an ADMC, a GMC, or both conditions.ResultsThere was a statistically robust association such that subgroups with an ADMC-affected relative were more likely to feel embarrassed compared to subgroups with a relative affected by a GMC (p < 0.001), even with covariate adjustments for age and sex.ConclusionsThe pattern of evidence from this research is consistent with conceptual models for interventions that target individual- and family-level stigma-related feelings of embarrassment as possible obstacles to effective early intervention and treatment for an ADMC. Macro-level interventions are under way but micro-level interventions may also be required among family members, along with care for each person with an ADMC. [ABSTRACT FROM PUBLISHER]

Al-Hamzawi A, Al-Diwan JK, Al-Hasnawi SM, Taib NI, Chatterji S, Hwang I, Kessler RC, McLaughlin KA. The prevalence and correlates of intermittent explosive disorder (IED) in Iraq. Objective: Intermittent explosive disorder is common, begins early in life, and is associated with considerable impairment in the United States. The epidemiology of IED outside the United States is unknown. We examined the prevalence and correlates of IED in Iraq, where exposure to violence has been widespread during the last three decades. Method: Data were drawn from a national survey of the Iraq population, the Iraq Mental Health Survey (IMHS), conducted in 2006-2007. The WHO Composite International Diagnostic interview was used to assess DSM-IV disorders, including IED. The response rate was 95.2%. Results: Lifetime and 12-month prevalence estimates of IED were 1.7% and 1.5%. Mean age of onset was 18.5. The mean number of lifetime attacks was 141.6 attacks, and IED-related injuries occurred 61 times per 100 lifetime cases. IED was significantly comorbid with mood and anxiety, but not substance, disorders. Conclusion: Although the prevalence of IED is lower in Iraq than in the United States, the disorder has an early age of onset, is highly persistent, and is associated with substantial comorbidity and functional impairment. Iraq lacks national policies or systematic programmes to reduce aggression, highlighting the importance of implementing violence prevention programmes to reduce the societal burden of violence in Iraq. [ABSTRACT FROM AUTHOR]