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To investigate the effectiveness of community-based mental health interventions by professionally trained, lay counsellors in low- and middle-income countries. We searched PubMed®, Cochrane Central Register of Controlled Trials, PROSPERO and EBSCO databases and professional section publications of the United States National Center for PTSD for randomized controlled trials of mental health interventions by professionally trained, lay counsellors in low- and middle-income countries published between 2000 and 2019. Studies of interventions by professional mental health workers, medical professionals or community health workers were excluded because there are shortages of these personnel in the study countries. Additional data were obtained from study authors. The primary outcomes were measures of post-traumatic stress disorder, depression, anxiety and alcohol use. To estimate effect size, we used a random-effects meta-analysis model. We identified 1072 studies, of which 19 (involving 20 trials and 5612 participants in total) met the inclusion criteria. Hedges' for the aggregate effect size of the interventions by professionally trained, lay counsellors compared with mostly either no intervention or usual care was -0.616 (95% confidence interval: -0.866 to -0.366). This result indicates a significant, medium-sized effect. There was no evidence of publication bias or any other form of bias across the studies and there were no extreme outliers among the study results. The use of professionally trained, lay counsellors to provide mental health interventions in low- and middle-income countries was associated with significant improvements in mental health symptoms across a range of settings.

Breastfeeding is one of the most important public health interventions that supports infant and young child survival in humanitarian crises. Yet, breastfeeding in these settings is often difficult and challenges are not always easy to address. The purpose of this study was to understand breastfeeding decisions and experiences among a population of internally displaced Yazidi women living in IDP camps across the Kurdistan Region of Iraq. This mixed-methods, multi-sited study was designed to document Yazidi women’s breastfeeding experiences while living in an IDP camp in the KRI. Qualitative and quantitative data were collected November 2018-December 2019 in five IDP camps throughout Sulaymaniya Province to which Yazidi families had been resettled. Mental Health screening data were collected with 30 pregnant and postpartum women. Semi-structured interviews were conducted with these same 30 women as well as some spouses ( n  = 7) and aid workers ( n  = 5). Thematic narrative analysis was used to analyze the data and develop themes and interpretations. Breastfeeding decisions and practices are strongly circumscribed by living conditions in the camp, pregnancy and birth experiences, poverty, lack of mental health care, social support, and cultural beliefs regarding the importance of breastfeeding. There is a critical need for increased investment in delivering mental health support in camps, specifically for people experiencing pregnancy, childbirth, and breastfeeding and those who are supporting these populations, with an emphasis on culturally sensitive, trauma-informed care. Doing so has the potential to promote more humane, holistic, and human-rights-based approaches to perinatal and postpartum care for Yazidis and for IYCF-E programs globally.

Background Yazidi survivors of a 2014 genocidal attack by the self-proclaimed Islamic State of Iraq and Syria (ISIS) have complex medical and mental health needs in the perinatal and postpartum period. Few studies have assessed perinatal mental health needs for this population of women who are living in camps for Internally Displaced Persons (IDP) in the Kurdistan Region of Iraq (KRI). Methods The specific aim of this formative cross-sectional study was to assess the prevalence of perinatal depressive symptoms, specifically the risk of perinatal depression symptoms, among a purposive sample of Yazidi women living in camps for internally displaced persons in the Kurdistan region of Iraq. One hundred twenty-two pregnant and recently postpartum (<1 year) Yazidi women completed a Kurdish-language version of the Edinburgh Postnatal Depression Scale (EPDS) questionnaire. Pregnant and postpartum participants’ responses were analyzed together, in order to assess an overall combined risk of perinatal mental health issues for the study population. Logistic regression analyses were used to measure the association of participant characteristics with an elevated risk of perinatal depressive symptoms. Results Participants were 17-45 years of age (mean 32 years, SD 7.63) Among the 122 women, 67.2% (n=82) were pregnant and 32.8% (n=40) were <1 year postpartum. Overall, 78% (n=95) of participants were at an elevated risk of depression (EPDS >10), and 53% (n=65) of all participants were at risk of moderate to severe depression (EPDS >12). Thoughts of self-harm (EPDS item 10) were reported among 97% (n=118) of participants. Logistic regression analysis indicated that increased risk of perinatal depressive symptoms was significantly associated with reports of health problems during pregnancy (OR=3.22, 95% [CI]:1.08-9.61) and marital status (OR=16.00; 95% [CI]: 0.42-0.50). Age (OR= 0.84; 95% [CI]: 0.75–0.94) and level of education (OR=0.15; 95% [CI]: 0.42-0.50) had protective effects. Conclusions Rates of perinatal depressive symptoms risk among internally displaced Yazid pregnant and postpartum women are higher than the general Kurdish-speaking population in Iraq (28.4%). Culturally responsive trauma informed perinatal and postpartum care services, which include both community-based and clinical strategies for perinatal depressive symptoms and suicide prevention for this population, are critically needed.

Standard screening tools can facilitate the complicated issue of diagnosis. From among those tools, standard tests that are cheap, easy to implement, valid and reliable are often translated and used after being normalized. Likewise, this study aims at normalizing the Bender visual-motor test among 5-7 year-old Kurdish children of Kalar, Iraqi Kurdistan. The present study is a descriptive-analytic one. Sampling was conducted in clusters from March to May 2017, and it included 141 children (77 females and 64 males). The instrument was the Bender-Gestalt Visual-Motor Test. Protocols obtained were num-bered on the basis of the expanded Koppitz scoring system. Data were analyzed by SPSS 22 using descriptive statistics, the Chi-Squared Test and one-way ANOVA. Findings of the test-retest reliability method showed that the reliability coefficient was significant (P<0.05). The highest error rate (85%) in boys was related to card no. 7 and in girls, it was related to the same card (89%), as well. The least frequent errors for boys belonged to cards 2 and 6. Girls experienced the least amount of difficulty with card 8, i.e. rotation. The difference between 56 6 old girls and boys was significant in cards 5 and 8. For 6-7 year old children, the highest error rate was related to card A (over 84%). In girls, errors of card 8 was more common (82%). The least errors made by the boys were related to cards 1, 2, 5, 6, and 8. Females experienced the least rate of difficulty with cards 5, 6, and 8 (over 3%). The difference between boys and girls was meaningful regarding cards A, 1, 2, and 5. Despite some differences in error analysis, no significant difference was observed on the basis of gender. Hence, the Bender-Gestalt test can be safely used for any sex group. The result approved the efficiency of the Bender-Gestalt test in the population of this research.

General anxiety disorder is one of the most common anxiety disorder, especially in college students, because it usually develops in early adolescence or young adulthood. The present study aimed to investigate the prevalence of social anxiety disorder and its associated factors in students of educational science for academic year 2016-2017. This study was a cross-sectional and descriptive study. One hundred and ninety eight (107 females and 91 males) students in college of educatin , University of Garmian were randomly selected. A questionnaire in two parts (demographic and Social Phobia Inventory) was used to collect data. Data were analyzed by descriptive and analytic statistics in SPSS -22. The percentage ofparticipation in the study was 79.2%. Mean and standard deviation of students ' age were 20.53 year and 1.86. The majority of the students were female (54%). Findings showed that prevalence of social anxiety disorder was more than 80%. Intensity of social phobia was mild in 20.2%, moderate in 41.9%, and severe in 28.3% of participants. Gender was associated with social anxiety disorder (p<0.05); and social anxiety was more prevalent in freshmen and sophomores (p<0.05). It can be concluded from this research that social anxiety is a prevalent disorder in students of college of Education. It is more prevalent in females, freshmen, and sophomores. According to the findings of the research, these students need more protection.

Objectif Évaluer l'efficacité des interventions de santé mentale gérées au sein de la sphere communautaire par des conseillers non professionnels spécialement formés dans les pays a faibles et moyens revenus. Méthodes Nous avons mené nos recherches dans les bases de données de PubMed®, du Registre central Cochrane des essais contrôlés, de PROSPERO et d'EBSCO, ainsi que parmi les publications de la section professionnelle du Centre national américain du TSPT, afin d'en extraire des essais randomisés contrôlés portant sur des interventions de santé mentale gérées par des conseillers non professionnels spécialement formés dans les pays a faibles et moyens revenus, publiés entre 2000 et 2019. Les études consacrées aux interventions effectuées par des professionnels de la santé mentale, des membres du corps médical ou des agents de santé communautaires ont été écartées, car les pays observés manquent de personnel dans ce domaine. D'autres données ont été prélevées aupres des auteurs d'études. Les premiers résultats étaient des mesures relatives aux troubles de stress post-traumatique, a la dépression, a l'anxiété et a la consommation d'alcool. Nous avons employé un modele de méta-analyse a effets aléatoires pour évaluer les retombées. Résultats Nous avons identifié 1072 études; 19 d'entre elles (impliquant 20 essais et 5612 participants au total) correspondaient aux criteres d'inclusion. Le g de Hedges pour la taille de l'effet cumulé des interventions gérées par des conseillers non professionnels spécialement formés, comparé la plupart du temps avec l'absence d'intervention ou les soins habituels, s'élevait a -0,616 (intervalle de confiance de 95%: -0,866 a -0,366). Ce résultat témoigne d'un effet non négligeable, de taille moyenne. Il n'existait aucune preuve indiquant un biais de publication ou toute autre forme de biais dans les études, et les résultats ne laissaient transparaître aucune valeur extréme atypique. Conclusion Le recours a des conseillers non professionnels spécialement formés pour effectuer des interventions de santé mentale dans les pays a faibles et moyens revenus a entraíné une amélioration significative des symptômes dans de nombreuses situations.