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Background/Aims: The prevalence of perinatal mental health issues is significantly higher among South Asian women in the UK. However, little attention has been given to examine the views and opinions of sub-groups of South Asians in the UK. Although the prevalence of perinatal mental health issues is much higher in Sri Lanka, so far, no studies have focused on Sri Lankan women in the UK. This study's aim was to examine the views and opinions of Sri Lankan women living in the UK about perinatal mental health. Methods: A convergent mixed-method online survey was administered in English and Sinhalese. A total of 34 Sri Lankan women living in the UK, from their baby's conception to 24 months postpartum, were recruited. Qualitative responses were interpreted using thematic analysis, supported by quantitative data. Results: The participants reported that they maintained good perinatal mental health with the support of their partner and family. Midwives were most involved in inquiring about and providing information on perinatal mental health. Social stigma was a dominant barrier to accessing support. Conclusions: Midwives need to ensure that perinatal mental health is discussed sensitively with Sri Lankan women. Future quantitative research needs to examine if existing tools are culturally sensitive and qualitative research should include women's partners and families to explore how best to care for this population. [ABSTRACT FROM AUTHOR]

This article introduces Walking Corpse Syndrome, a common idiom of distress in Tamil Sri Lanka that is characterized by a variety of cognitive difficulties, feelings that an individual is functioning reflexively or impulsively, and acute attacks of dissociation that are accompanied with the sensation of empty-headedness. Walking Corpse Syndrome demonstrates some overlap with Western nosology, although it appears to be its own unique illness category, most likely of Ayurvedic provenance. The article comprises two studies. One is a secondary interview analysis of community members that aimed to identify the key symptoms of Walking Corpse Syndrome, allowing us to determine the local ethnopsychology of the syndrome and to elicit illustrative vignettes. The other study is a survey of Sri Lankan Tamil psychiatrists that aimed to investigate their understanding and experience of the disorder. This article outlines how, in certain cultural contexts, such syndromes emphasise the loss of attentional capacity and forgetfulness; it highlights the importance of "thinking a lot" as an idiom across cultures; and it details the many ways that Walking Corpse Syndrome is a key idiom of distress to assess in order to give adequate mental healthcare to Sri Lankan Tamil populations. [ABSTRACT FROM AUTHOR]

Preventing burnout and promoting positive mental health among medical students is important. Relevant research is lacking on positive mental health in medical students, particularly in low- and middle-income countries. We conducted a cross-sectional survey of Sri Lankan students enrolled in a five-year medical program. Measures included the Mental Health Continuum-Short Form, Kessler 10 Psychological Distress Scale, and Oldenburg Burnout Inventory. We investigated relationships between year in program, mental health indicators, and academic performance. Three hundred twenty-seven students participated (35% response rate). Most students had moderate positive mental health (64.8%) and severe psychological distress (40.4%). Final year students reported more psychological distress and burnout than first year students. Female students had higher burnout scores than males. In multivariable models, fourth and fifth year students evidenced lower positive mental health than first year students. Mental health indicators were unassociated with academic performance. Overall, distress rates were higher than those reported among students in other countries. Higher burnout and distress may be driven by increased responsibilities in the final clinical years of training. Bolstering positive mental health through positive emotions, meaning, and social connection may minimize burnout and distress, although extracurricular activities require time. Interventions to reduce medical student distress in Sri Lanka are needed. [ABSTRACT FROM AUTHOR]

Recent research conducted in high-income countries suggests psychotic experiences are common in the general population, but evidence from low- and middle-income countries (LMIC) remains limited. Sri Lanka is a LMIC affected by three decades of civil conflict and, in 2004, a devastating tsunami. This study aimed to investigate the prevalence of psychotic experiences in a general population sample in Sri Lanka and associations with conflict- and tsunami-related trauma. This is a first National Mental Health Survey conducted in Sri Lanka. A cross-sectional, multi-stage, cluster sampling design was used to estimate the prevalence of psychotic symptoms. Data on socio-demographic characteristics, conflict- and tsunami-related trauma, and psychotic experiences were collected using culturally validated measures in a sample of 5927 participants. The weighted prevalence of psychotic symptoms was 9.7%. Exposure to one or more conflict-related events (adj. OR 1.79, 95% CI 1.40-2.31, p<0.001) and loss or injury of a family member or friend through conflict (adj. OR, 1.83, 95% CI 1.42-2.37, p<0.001) were associated with increased odds of reporting psychotic experiences. Psychotic experiences were more common in individuals directly exposed to tsunami disaster (adj. OR, 1.68, 95% CI 1.04-2.73, P=0.035) and in those who had a family member who died or was injured as result of tsunami (adj. OR, 1.42, 95% CI 1.04-1.94, p=0.029). Our findings suggest that psychotic experiences are common in the Sri Lankan population. Exposure to traumatic events in armed conflicts and natural disasters may be important socio-environmental factors in the development of psychotic experiences. [ABSTRACT FROM AUTHOR]

Background: Nearly one-in-ten Sri Lankans are employed abroad as International migrant workers (IMW). Very little is known about the mental health of adult members in families left-behind. This study aimed to explore the impact of economic migration on mental health (common mental disorders) of left-behind families in Sri Lanka. Methods: A cross-sectional survey using multistage sampling was conducted in six districts (representing 62% of outbound IMW population) of Sri Lanka. Spouses and non-spouse caregivers (those providing substantial care for children) from families of economic migrants were recruited. Adult mental health was measured using the Patient Health Questionnaire. Demographic, socio-economic, migration-specific and health utilization information were gathered. Results: A total of 410 IMW families were recruited (response rate: 95.1%). Both spouse and a non-spouse caregiver were recruited for 55 families with a total of 277 spouses and 188 caregivers included. Poor general health, current diagnosed illness and healthcare visit frequency was higher in the non-spouse caregiver group. Overall prevalence of common mental disorder (CMD; Depression, somatoform disorder, anxiety) was 20.7% (95%CI 16.9-24.3) with 14.4% (95%CI 10.3-18.6) among spouses and 29.8% (95%CI 23.2-36.4) among non-spouse caregivers. Prevalence of depression (25.5%; 95%CI 19.2-31.8) and somatoform disorder 11.7% (95%CI 7.0-16.3) was higher in non-spouse caregiver group. When adjusted for age and gender, non-returning IMW in family, primary education and low in-bound remittance frequency was associated with CMD for spouses while no education, poor general health and increased healthcare visits was significantly associated in the non-spouse caregiver group. Conclusions: To our knowledge, this is one of the first studies to explore specific mental health outcomes among adult left-behind family members of IMW through standardized diagnostic instruments in Sri Lanka and in South Asian region. Negative impact of economic migration is highlighted by the considerably high prevalence of CMD among adults in left-behind families. A policy framework that enables health protection whilst promoting migration for development remains a key challenge for labour-sending nations. [ABSTRACT FROM AUTHOR]

Purpose - Sri Lanka was subject to a civil war of almost 30 years' duration which was won militarily by the Sri Lankan army in May 2009. Sri Lanka was also seriously affected by the Asian tsunami in December 2004 which affected three-quarters of the country's coastline and caused considerable damage. In addition, in January 2011, the east of the country suffered from serious flooding. Many Sri Lankans have therefore lived through extremely difficult times. This paper seeks to briefly discuss some of the work undertaken by the UK: Sri Lanka Trauma Group (UKSLTG) over approximately 14 years.Design/methodology/approach - The author of this paper views well-being as multi-faceted, and sees psychological health as influenced by familial, community, spiritual, cultural, socio-political, and other factors. How an individual construes all these factors is likely to be important, particularly in the context of a civil war, a subsequent military victory by one side, and a recent return to peace. The ensuing legacy may be multi-layered, and affect individuals, families, groups, and the multiple communities that people are part of in any number of ways. The lessons learned by the UKSLTG through work in a range of contexts and with a variety of groups are discussed.Findings - The applicability of the knowledge and ideas generated through the work of the UKSLTG and their possible transferability to other contexts will also be briefly considered. The authors are not attempting to provide a definitive account of possible work but a description of what has been learned working in a war and post war situation.Originality/value - The paper highlights the importance of working in real partnership, of community engagement, and of the need to be flexible and prepared to discount original plans and to be open to doing things differently as circumstances dictate. [ABSTRACT FROM AUTHOR]

Objectives: To explore the salience of pre- and postmigration stresses as risk factors for posttraumatic stress disorder (PTSD) and to identify resilience factors and explore their mental health salience. Methods: We conducted a mental health survey of 1603 Sri Lankan Tamils in Toronto, incorporating the World Health Organization Composite International Diagnostic Interview for PTSD. Results: According to the International Classification of Diseases, 10th Revision, criteria, lifetime prevalence for PTSD was 12%; according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria it was 5.8%. Female sex and the number of stresses of passage increased the probability of PTSD, whereas satisfaction with life and the availability of nonfamily social relations reduced it. Conclusions: Consideration of pre- and postmigration stresses of passage and of the nature of resilience contributes to an improved understanding of PTSD among refugees. [ABSTRACT FROM AUTHOR]

The article presents a study which determines the daily stressors that affect the youth in eastern Sri Lanka using mixed methods approach. The study uses the Children's Daily Stressor Scale (CDSS) to assess the relative contribution of the daily stressors, disaster exposure and war to the psychosocial and mental health of the youth. The result of the study shows that the direct exposure to stress and disaster are not the most crucial determinant of mental health.

This article presents the case of a Sri Lankan woman who tells of an early life fraught with suffering and problematic dissociation. After a 30-year career as a priestess during which she became renowned for deep possession trances, firewalking, and blood sacrifices, she no longer participates in these activities. The analysis of this case argues that problematic dissociation outside a ritual context can be used in and transformed by involvement in culturally available possession rituals to promote healing. This counters Melford Spiro and others who have viewed possession experiences as necessarily abnormal, psychotic, and symptomatic of mental disorder. It supports Gananath Obeyesekere's assertion that engagement with these symbolic systems can lead to “progressive transformations.” Parallels between this priestess' lifestory and Western psychotherapy extend Obeyesekere's conception of “the work of culture” beyond the domain of meaning and symbol to include roles for embodied practice and interpersonal relationships. [spirit possession, Sri Lanka, dissociation, healing, mental health] [ABSTRACT FROM AUTHOR]

Abstract: This study investigated direct and indirect influences of Tsunami exposure on mothers'' PTSD and depressive symptoms using survey data from 325 Tsunami-affected families living in two villages in southern Sri Lanka. Findings generally support the hypothesized model in that life and property destruction contributed to the PTSD and depressive symptoms of mothers. Detrimental influences of Tsunami exposure also operated through the generation of more proximal secondary Tsunami risks such as post-Tsunami family problems. In addition, religious participation, familism, number of children, intact family status, and community support reduced mothers'' depressive symptoms. Finally, intact family status and high religious participation moderated the detrimental influence of Tsunami exposure on mothers'' PTSD symptoms. These findings can contribute directly to improving ongoing recovery and reconstruction programs and help to formulate future programs for families affected by the Tsunami and other natural disasters. [Copyright &y& Elsevier]