Richard Mpango - Academia.edu (original) (raw)
Papers by Richard Mpango
BackgroundRecovery Colleges (RCs) support the recovery of individuals who have mental health issu... more BackgroundRecovery Colleges (RCs) support the recovery of individuals who have mental health issues, using the principles of coproduction and adult learning. There has been little international research on RCs and none investigating costs, staffing, or fidelity to these and other principles. We aimed to characterise RCs internationally. MethodsWe conducted an observational study integrating two equivalent cross-sectional surveys, one conducted within England in 2021 and one in all other countries in 2022. We included all RCs meeting recovery orientation, coproduction and adult learning criteria. Managers completed a survey capturing organisational and student characteristics, fidelity and budget. RCs were grouped by country and continent to allow for regression models exploring continental differences in fidelity.OutcomesWe identified 221 RCs operating across 28 countries, spanning five continents. Overall, 174 (79%) RCs participated in the survey. Most scored high on fidelity. Comp...
AIDS Care, 2020
This article sets out to investigate alcohol and substance use (ASU) among adolescents living wit... more This article sets out to investigate alcohol and substance use (ASU) among adolescents living with HIV (ALWH) in the sub-Saharan African setting of Uganda. A cross-sectional analysis of the records of 479 adolescents (aged between 12and 17 years) attending the study, "Mental health among HIV infected CHildren and Adolescents in KAmpala and Masaka, Uganda (the CHAKA study)" was undertaken. ASU was assessed through both youth self-report and caregiver report using the Diagnostic and Statistical Manual of Mental Disorders-5 referenced instruments, the Youth Inventory-4R and the Child and Adolescent Symptom Inventory-5 (CASI-5). Rates and association with potential risk and outcome factors were investigated using logistic regression models. The rate of ASU was 29/484 (5.9%) with the most frequently reported ASU being alcohol 22/484 (4.3%) and marijuana 10/484 (2.1%). Functional impairment secondary to ASU was reported by 10/484 (2.1%) of the youth. ASU was significantly associated with urban residence, caregiver psychological distress and the psychiatric diagnosis of post-traumatic stress disorder. On associations with negative outcomes, ASU was significantly associated with only "ever had sex". Health care for ALWH in sub-Saharan Africa should include ASU prevention and management strategies.
Frontiers in Public Health
PurposeThis study established the prevalence of physical and sexual victimization, associated fac... more PurposeThis study established the prevalence of physical and sexual victimization, associated factors and psychosocial consequences of victimization among 1,201 out-patients with severe mental illness at Butabika and Masaka hospitals in Uganda.MethodsParticipants completed structured, standardized and locally translated instruments. Physical and sexual victimization was assessed using the modified adverse life events module of the European Para-suicide Interview Schedule. We used logistic regression to determine the association between victimization, the associated factors and psychosocial consequences.ResultsThe prevalence of physical abuse was 34.1% and that of sexual victimization was 21.9%. The age group of > = 50 years (aOR 1.02;95% CI 0.62–1.66; p = 0.048) was more likely to have suffered physical victimization, while living in a rural area was protective against physical (aOR 0.59; 95% CI 0.46–0.76; p = <0.001) and sexual (aOR 0.48, 95% CI 0.35–0.65; p < 0.001) victi...
Psychiatry Journal
Background. Children and adolescents infected with HIV/AIDS (CA-HIV) experience a considerable bu... more Background. Children and adolescents infected with HIV/AIDS (CA-HIV) experience a considerable burden of depressive and anxiety disorders that have a tendency to persist into adulthood. The aim of this study was to determine the prevalence of anxiety, depression, and their clinical correlates among children and adolescents with HIV/AIDS (CA-HIV) in Uganda. Methods. A random sample of 1339 CA-HIV (ages 5-18 years) and their caregivers completed a standardized DSM-5-referenced psychiatric rating scale, the Child and Adolescent Symptom Inventory-5 (CASI-5). The prevalence of “anxiety and depression” was estimated at 95% confidence intervals. Logistic and ordinal regression models were fitted for the clinical correlates and clinical outcomes. Results. The overall prevalence of “any anxiety and depressive disorders” was 13.7% at 95% CI (based upon the symptom count criteria); 4.0% (95% CI) met the clinical psychiatric disorder criteria (both symptom count and functional impairment criter...
Psychiatry Journal
Introduction. Depression is the fourth leading cause of the global disease burden and worsens the... more Introduction. Depression is the fourth leading cause of the global disease burden and worsens the outcome of comorbidities including HIV/AIDS. Depression is particularly problematic among persons living with HIV in sub-Saharan Africa where scarcity of cost-effective interventions is compounded by inadequate understanding of the disease. We examine risk factors for depression among persons living with HIV undergoing antiretroviral treatment in Uganda and discuss policy implications. Methods. A qualitative study using a narrative approach was conducted, the formative phase of a large study to develop a model for integrating depression management into routine HIV care in Uganda. Participants were purposively sampled at four public health facilities in Mpigi District. In-depth interviews were conducted with four clinicians, three supervisors, and 11 persons living with HIV and suffering from depression, as were three focus group discussions with lay health workers. Exit interviews were ...
European Archives of Psychiatry and Clinical Neuroscience
Correlates of neurological disorders. (DOCX 41 kb)
Characteristics of study participants. (DOCX 15 kb)
Additional file 2. Sensitivity Analysis for Primary Outcomes.
Data collection tools for the study. (DOCX 39 kb)
Clinical correlates of ADHD. (DOCX 14Â kb)
Characteristics of study participants. (DOC 47Â kb)
The dataset contains sociodemographic information, health and neurocognitive and psychiatric outc... more The dataset contains sociodemographic information, health and neurocognitive and psychiatric outcomes of 322 school children who participated in the neurocognitive sub-study that was nested within the SONA project. It is supported by two questionnaires that were used to collect these data, and consent and assent forms that were used in the study.
ERJ Open Research, 2021
The reasons for the positive association between anxiety disorders and asthma are unknown. We inv... more The reasons for the positive association between anxiety disorders and asthma are unknown. We investigated the possible role of shared exposures in early life. We conducted a case–control study among adolescents (age 12–17 years) with and without asthma in urban Uganda, as part of a larger asthma case–control study. Anxiety disorders were diagnosed by psychiatric clinical officers. We focused on generalised anxiety disorder (GAD), panic disorder and social anxiety disorder. Asthma was doctor-diagnosed by study clinicians. We used questionnaires to collect data on early-life exposures. The data were analysed using multiple logistic regression. We enrolled 162 adolescents; 73 of them had asthma. Adolescents with asthma were more likely to have any of the three anxiety disorders studied (46.6%) than adolescents without asthma (21.4%) (adjusted OR (aOR) 2.68, 95% CI 1.30–5.53). The association was strong for GAD (aOR 4.49, 95% CI 1.48–13.56) and panic disorder (aOR 5.43, 95% CI 2.11–14....
![Research paper thumbnail of Prevalence and correlates of neurocognitive impairment and psychiatric disorders among schoolchildren in Wakiso District, Uganda: a cross-sectional study [version 1; peer review: 1 approved with reservations]](https://attachments.academia-assets.com/81621313/thumbnails/1.jpg)
](Background: There is limited data on the burden of mental disorders among ‘healthy’ children in A... more Background: There is limited data on the burden of mental disorders among ‘healthy’ children in Africa. We examined the prevalence and correlates of neurocognitive and psychiatric disorders among schoolchildren in Uganda. Methods: This cross-sectional study enrolled 322 schoolchildren aged 5-17years in Wakiso, Uganda. We assessed for neurocognitive impairment using the Kaufmann-Assessment-Battery, and psychiatric disorders (major-depressive-disorder (MDD), attention-deficithyperactivity-disorder (ADHD), generalised-anxiety-disorder (GAD), and substance-use-disorder (SUD)) using the parent version of the Child and Adolescent Symptom Inventory-5, and Youth Inventory-4R Self Report. Prevalence and risk factors were determined using percentages and logistic regression. Results: Twenty-five participants (8%) had neurocognitive impairment. Nineteen (5.9%) participants had MDD, nine (2.8%) had ADHD, seven (2.2%) had GAD, 14 (8.6%) had SUD; and 30 (9.3%) had any psychiatric disorder. None o...
Journal of Acquired Immune Deficiency Syndromes, 2018
If citing, it is advised that you check and use the publisher's definitive version for pagination... more If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections.
Data collection tools for the study. (DOCX 30Â kb)
BJPsych. International
The International Health Partnership (‘the Link’) between the East London NHS Foundation Trust an... more The International Health Partnership (‘the Link’) between the East London NHS Foundation Trust and Butabika Hospital in Uganda was set up in 2005. It has facilitated staff exchanges and set up many workstreams (e.g. in child and adolescent psychiatry, nursing and psychology) and projects (e.g. a peer support worker project and a violence reduction programme). The Link has been collaborative and mutually beneficial. The authors describe benefits and challenges at individual and organisational levels. Notably, the Link has achieved a commitment to service user involvement and an increasingly central involvement of the Ugandan diaspora working in mental health in the UK.
BMC Psychiatry
Background Reducing readmissions among frequent users of psychiatric inpatient care could result ... more Background Reducing readmissions among frequent users of psychiatric inpatient care could result in substantial cost savings to under-resourced mental health systems. Studies from high-income countries indicate that formal peer support can be an effective intervention for the reduction of readmissions among frequent users. Although in recent years formal peer support programmes have been established in mental health services in a few low- and middle-income countries (LMICs), they have not been rigorously evaluated. Methods This protocol describes a quasi-experimental difference-in-differences study conducted as part of a broader evaluation of the Brain Gain II peer support programme based at Butabika National Referral Hospital in Kampala, Uganda. The primary objective is to investigate whether frequent users of psychiatric inpatient care who have access to a peer support worker (PSW+) experience a greater reduction in rehospitalisation rates and number of days spent in hospital comp...
BackgroundRecovery Colleges (RCs) support the recovery of individuals who have mental health issu... more BackgroundRecovery Colleges (RCs) support the recovery of individuals who have mental health issues, using the principles of coproduction and adult learning. There has been little international research on RCs and none investigating costs, staffing, or fidelity to these and other principles. We aimed to characterise RCs internationally. MethodsWe conducted an observational study integrating two equivalent cross-sectional surveys, one conducted within England in 2021 and one in all other countries in 2022. We included all RCs meeting recovery orientation, coproduction and adult learning criteria. Managers completed a survey capturing organisational and student characteristics, fidelity and budget. RCs were grouped by country and continent to allow for regression models exploring continental differences in fidelity.OutcomesWe identified 221 RCs operating across 28 countries, spanning five continents. Overall, 174 (79%) RCs participated in the survey. Most scored high on fidelity. Comp...
AIDS Care, 2020
This article sets out to investigate alcohol and substance use (ASU) among adolescents living wit... more This article sets out to investigate alcohol and substance use (ASU) among adolescents living with HIV (ALWH) in the sub-Saharan African setting of Uganda. A cross-sectional analysis of the records of 479 adolescents (aged between 12and 17 years) attending the study, "Mental health among HIV infected CHildren and Adolescents in KAmpala and Masaka, Uganda (the CHAKA study)" was undertaken. ASU was assessed through both youth self-report and caregiver report using the Diagnostic and Statistical Manual of Mental Disorders-5 referenced instruments, the Youth Inventory-4R and the Child and Adolescent Symptom Inventory-5 (CASI-5). Rates and association with potential risk and outcome factors were investigated using logistic regression models. The rate of ASU was 29/484 (5.9%) with the most frequently reported ASU being alcohol 22/484 (4.3%) and marijuana 10/484 (2.1%). Functional impairment secondary to ASU was reported by 10/484 (2.1%) of the youth. ASU was significantly associated with urban residence, caregiver psychological distress and the psychiatric diagnosis of post-traumatic stress disorder. On associations with negative outcomes, ASU was significantly associated with only "ever had sex". Health care for ALWH in sub-Saharan Africa should include ASU prevention and management strategies.
Frontiers in Public Health
PurposeThis study established the prevalence of physical and sexual victimization, associated fac... more PurposeThis study established the prevalence of physical and sexual victimization, associated factors and psychosocial consequences of victimization among 1,201 out-patients with severe mental illness at Butabika and Masaka hospitals in Uganda.MethodsParticipants completed structured, standardized and locally translated instruments. Physical and sexual victimization was assessed using the modified adverse life events module of the European Para-suicide Interview Schedule. We used logistic regression to determine the association between victimization, the associated factors and psychosocial consequences.ResultsThe prevalence of physical abuse was 34.1% and that of sexual victimization was 21.9%. The age group of > = 50 years (aOR 1.02;95% CI 0.62–1.66; p = 0.048) was more likely to have suffered physical victimization, while living in a rural area was protective against physical (aOR 0.59; 95% CI 0.46–0.76; p = <0.001) and sexual (aOR 0.48, 95% CI 0.35–0.65; p < 0.001) victi...
Psychiatry Journal
Background. Children and adolescents infected with HIV/AIDS (CA-HIV) experience a considerable bu... more Background. Children and adolescents infected with HIV/AIDS (CA-HIV) experience a considerable burden of depressive and anxiety disorders that have a tendency to persist into adulthood. The aim of this study was to determine the prevalence of anxiety, depression, and their clinical correlates among children and adolescents with HIV/AIDS (CA-HIV) in Uganda. Methods. A random sample of 1339 CA-HIV (ages 5-18 years) and their caregivers completed a standardized DSM-5-referenced psychiatric rating scale, the Child and Adolescent Symptom Inventory-5 (CASI-5). The prevalence of “anxiety and depression” was estimated at 95% confidence intervals. Logistic and ordinal regression models were fitted for the clinical correlates and clinical outcomes. Results. The overall prevalence of “any anxiety and depressive disorders” was 13.7% at 95% CI (based upon the symptom count criteria); 4.0% (95% CI) met the clinical psychiatric disorder criteria (both symptom count and functional impairment criter...
Psychiatry Journal
Introduction. Depression is the fourth leading cause of the global disease burden and worsens the... more Introduction. Depression is the fourth leading cause of the global disease burden and worsens the outcome of comorbidities including HIV/AIDS. Depression is particularly problematic among persons living with HIV in sub-Saharan Africa where scarcity of cost-effective interventions is compounded by inadequate understanding of the disease. We examine risk factors for depression among persons living with HIV undergoing antiretroviral treatment in Uganda and discuss policy implications. Methods. A qualitative study using a narrative approach was conducted, the formative phase of a large study to develop a model for integrating depression management into routine HIV care in Uganda. Participants were purposively sampled at four public health facilities in Mpigi District. In-depth interviews were conducted with four clinicians, three supervisors, and 11 persons living with HIV and suffering from depression, as were three focus group discussions with lay health workers. Exit interviews were ...
European Archives of Psychiatry and Clinical Neuroscience
Correlates of neurological disorders. (DOCX 41 kb)
Characteristics of study participants. (DOCX 15 kb)
Additional file 2. Sensitivity Analysis for Primary Outcomes.
Data collection tools for the study. (DOCX 39 kb)
Clinical correlates of ADHD. (DOCX 14Â kb)
Characteristics of study participants. (DOC 47Â kb)
The dataset contains sociodemographic information, health and neurocognitive and psychiatric outc... more The dataset contains sociodemographic information, health and neurocognitive and psychiatric outcomes of 322 school children who participated in the neurocognitive sub-study that was nested within the SONA project. It is supported by two questionnaires that were used to collect these data, and consent and assent forms that were used in the study.
ERJ Open Research, 2021
The reasons for the positive association between anxiety disorders and asthma are unknown. We inv... more The reasons for the positive association between anxiety disorders and asthma are unknown. We investigated the possible role of shared exposures in early life. We conducted a case–control study among adolescents (age 12–17 years) with and without asthma in urban Uganda, as part of a larger asthma case–control study. Anxiety disorders were diagnosed by psychiatric clinical officers. We focused on generalised anxiety disorder (GAD), panic disorder and social anxiety disorder. Asthma was doctor-diagnosed by study clinicians. We used questionnaires to collect data on early-life exposures. The data were analysed using multiple logistic regression. We enrolled 162 adolescents; 73 of them had asthma. Adolescents with asthma were more likely to have any of the three anxiety disorders studied (46.6%) than adolescents without asthma (21.4%) (adjusted OR (aOR) 2.68, 95% CI 1.30–5.53). The association was strong for GAD (aOR 4.49, 95% CI 1.48–13.56) and panic disorder (aOR 5.43, 95% CI 2.11–14....
Background: There is limited data on the burden of mental disorders among ‘healthy’ children in A... more Background: There is limited data on the burden of mental disorders among ‘healthy’ children in Africa. We examined the prevalence and correlates of neurocognitive and psychiatric disorders among schoolchildren in Uganda. Methods: This cross-sectional study enrolled 322 schoolchildren aged 5-17years in Wakiso, Uganda. We assessed for neurocognitive impairment using the Kaufmann-Assessment-Battery, and psychiatric disorders (major-depressive-disorder (MDD), attention-deficithyperactivity-disorder (ADHD), generalised-anxiety-disorder (GAD), and substance-use-disorder (SUD)) using the parent version of the Child and Adolescent Symptom Inventory-5, and Youth Inventory-4R Self Report. Prevalence and risk factors were determined using percentages and logistic regression. Results: Twenty-five participants (8%) had neurocognitive impairment. Nineteen (5.9%) participants had MDD, nine (2.8%) had ADHD, seven (2.2%) had GAD, 14 (8.6%) had SUD; and 30 (9.3%) had any psychiatric disorder. None o...
Journal of Acquired Immune Deficiency Syndromes, 2018
If citing, it is advised that you check and use the publisher's definitive version for pagination... more If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections.
Data collection tools for the study. (DOCX 30Â kb)
BJPsych. International
The International Health Partnership (‘the Link’) between the East London NHS Foundation Trust an... more The International Health Partnership (‘the Link’) between the East London NHS Foundation Trust and Butabika Hospital in Uganda was set up in 2005. It has facilitated staff exchanges and set up many workstreams (e.g. in child and adolescent psychiatry, nursing and psychology) and projects (e.g. a peer support worker project and a violence reduction programme). The Link has been collaborative and mutually beneficial. The authors describe benefits and challenges at individual and organisational levels. Notably, the Link has achieved a commitment to service user involvement and an increasingly central involvement of the Ugandan diaspora working in mental health in the UK.
BMC Psychiatry
Background Reducing readmissions among frequent users of psychiatric inpatient care could result ... more Background Reducing readmissions among frequent users of psychiatric inpatient care could result in substantial cost savings to under-resourced mental health systems. Studies from high-income countries indicate that formal peer support can be an effective intervention for the reduction of readmissions among frequent users. Although in recent years formal peer support programmes have been established in mental health services in a few low- and middle-income countries (LMICs), they have not been rigorously evaluated. Methods This protocol describes a quasi-experimental difference-in-differences study conducted as part of a broader evaluation of the Brain Gain II peer support programme based at Butabika National Referral Hospital in Kampala, Uganda. The primary objective is to investigate whether frequent users of psychiatric inpatient care who have access to a peer support worker (PSW+) experience a greater reduction in rehospitalisation rates and number of days spent in hospital comp...