• A critical view of the Journal – Letter to the Editor A. Chakraborty 1 – 2
  • Telepsychiatry pilot-project in Denmark Videoconference by distance by ethnic specialists to immigrants/refugees – Original Paper D. Mucic 3 – 9
    A telepsychiatry service, using broadband (sHDSL), was established in order to provide psychiatric assessments and/or treatment of immigrants/refugees. Mental health care of immigrants/refugees in Denmark is concentrated to specialized centres where treatment is provided via translators. Limited access to clinicians that speak immigrants/refugees` language and understand their background can have influence on speed and accuracy of diagnosis and treatment. Clinicians involved in the project have ethnic background (including the language abilities) which enable providing mental health care on patients` own language, without translators. The main part of the work in the first year of this 3-years project consisted of diagnostic assessment and/or treatment conducted by videoconference in real time. All participants reported a high level of acceptance and satisfaction with telepsychiatry regardless their ethnicity, educational level or mental health state. Clinicians employed in specialized centres reported their attitudes toward the project and telepsychiatry in generally, through semi-structured interview. They express reluctance toward the aim of the project and would prefer to use translators.
  • Life events and depression in the context of the changing African family. The case of Uganda – Original Paper W. Muhwezi, H. Ågren, S. Neema, S. Musisi, A. Maganda 10 – 26
    Introduction: Traditionally, the African extended family gave psychosocial support to all members, which cushioned any illness effects including depression. Recent changes in the African family, notably urbanization and market economies, have changed that structure. Changes, especially roles of the family and its relationship to life events and depression, have not received much research attention. Aim: To compare depressed and non-depressed patients in terms of their demographics, family structure, life events and depression. Methods: We compared quantitative data from 85 DSM-IV depressed patients that sought care at three Primary Health Care (PHC) centres with 170 unmatched non-depressed patients. To each group, we administered three questionnaires covering socio-demographics, family structure and an adapted Interview For Recent Life Events (IRLE). Results: Of the depressed patients, over 70% were females giving a M:F ratio of 2.3:1; 71.8% were aged < 39 years and 50.6% were married; the single were 14.1% and 73.9% belonged to male-headed households. Depressed patients significantly differed from the non-depressed in having less post-primary education (p=0.02), fewer singles (0.04), fewer had regular incomes (p=0.01), more were single parents (p=0.02) and separated (p=0.01). Family structure in the two groups never significantly differed. For life events, depressed patients had more deaths of close family members and poor harvests (p=0.003), deaths of children and funeral rites (p=0.014) and sexual health problems (p=0.002). Positive exciting events were more common among non-depressed patients from extended families (p=0.047) while saddening and bereavement events were more common among depressed patients from extended families. Sexual problems were more common among depressed patients and from nuclear families (p= 0.001 & 0.006 respectively). Being a regular income earner was protective against depression [OR=0.45 (95% CI: 0.23-0.85)]. Conclusion: Depressed patients were often single, separated and had children signifying family break ups. They had less income, lower education and had experienced more negative life events, highlighting the weakened family ties in times of modern adversities. This calls for training of more mental health workers and informal helpers for vigorous family therapy interventions in modern Africa, in the face of the weakening extended family.
  • External influences on indigenous cultures – Short Paper A. Chakraborty 32 – 36
  • Transcultural psychiatry: Specific problems related to gender – Short Paper M. Kastrup 37 – 40