Browsing by Author "Kuruppuarachchi, L."

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Do fathers develop perinatal depression, anxiety, and stress? Cross-sectional findings from a study in Sri Lanka
(Elsevier, 2024-11) Hapangama, A.; Baminiwatta, A.; Kuruppuarachchi, L.
No abstract available
Measuring resilience among Sri Lankan healthcare workers: validation of the brief resilience scale in Sinhalese and Tamil languages
(Sage Publishing, 2023) Baminiwatta, A.; Fernando, R.; Gadambanathan, T.; Jiyatha, F.; Sasala, R.; Kuruppuarachchi, L.; Wickremasinghe, R.; Hapangama, A.
Resilience is the capacity for adaptation and “bouncing back” in the face of adversity.1,2 It protects against mental health problems such as depression, anxiety, and stress and improves well-being. 3 During the COVID-19 pandemic, there was a growing need for studies on protective factors in mental health, such as resilience, particularly among healthcare workers. 4 Psychometric assessment of resilience is a prerequisite for research in this area. A review of 19 resilience scales found a wide variation in their psychometric properties, with all of them posing some challenges. 5 However, the authors noted that the Resilience Scale for Adults, Brief Resilience Scale (BRS), and the Connor-Davidson Resilience Scale had the finest psychometric ratings. BRS may have an exceptional place in behavioral research because other resilience scales tend to assess resources that promote resilience rather than resilience itself. BRS is probably the only measure to assess resilience in its most basic meaning—the ability to “bounce back.” 2 Furthermore, among resilience scales, BRS is short and, therefore, would generate better response rates in research. As BRS was not available in local languages, its validation into Sinhalese and Tamil languages was needed to enable research on resilience in Sri Lanka. METHODS: Approval was obtained from the Ethics Review Committee. The procedure for questionnaire translation followed the recommendations of Beaton et al. (2000). 6 Firstly, BRS was translated into each local language (Sinhalese and Tamil) independently by two bilingual experts, and a consensus translation was prepared. The translated version was back-translated into English by two independent bilingual translators. They were compared with the original BRS for semantic, idiomatic, experiential, and conceptual equivalence by a group of experts comprising several Sinhalese- and Tamil-speaking psychiatrists, bilingual experts, and a methodologist. A few phrases in the original English version, such as “bounce back” and “snap back,” were replaced with conceptually equivalent phrases in the local languages. Face and content validity were discussed, and a consensus translation was prepared. After conducting a pre-test and cognitive debriefing with a purposive sample of 10 healthcare workers for each language, and further minor modifications, the translated scales were administered to 150 Sinhalese- and 110 Tamil-speaking healthcare workers (nurses, doctors, and other categories), after obtaining informed consent (see Table S1 for the sociodemographic profiles; the translated questionnaires are provided as supplementary files). Confirmatory factor analysis (CFA) was used to test the model fit for the one-factor structure of BRS, 2 using the following fit indices: comparative fit index (CFI), Tucker Lewis index (TLI), standardized root mean square residual (SRMR), and root mean square error of approximation (RMSEA). Depression, anxiety, and Stress Scale -21 (DASS-21) was administered to test expected inverse correlations with resilience. RESULTS: According to CFA, the six-item BRS formed a unitary construct, with satisfactory model fit for both the Sinhalese (CFI = 0.99, TLI = 0.99, RMSEA = 0.09, SRMR = 0.05) and Tamil versions (CFI = 0.98, TLI = 0.97, RMSEA = 0.14, SRMR = 0.07). Factor loadings of individual items ranged from 0.59 to 0.86 in the Sinhalese and 0.61 to 0.82 in the Tamil version (see Table S2 for item-level statistics). Cronbach alpha of the Sinhalese and Tamil BRS were 0.82 and 0.80, respectively, indicating good internal consistency. Removal of any single item did not significantly improve internal consistency. The Sinhalese BRS score had significant negative correlation with depression (r = –0.29, P = 0.002), anxiety (r = –0.27, P = 0.005), and stress (r = –0.20, P = 0.033), whereas the Tamil BRS score had significant negative correlation with anxiety (r = –0.18, P = 0.028) and stress (r = –0.25, P = 0.002) but not with depression. DISCUSSION: Our findings support the construct validity and internal reliability of the BRS as a measure of resilience. The one-factor structure proposed by the original developers 2 and replicated in subsequent studies 7 was observed in the present study. BRS has been previously translated and validated in several languages, including German, Polish, Spanish and Dutch.7–10 Similar to the observations in the original validation sample 2 and the Spanish validation, 7 resilience, as measured using BRS, showed significant inverse correlations with depression, anxiety, and stress in the present analysis. This provided further support for its construct validity through hypothesis testing. The absence of a significant inverse correlation of the Tamil BRS score with depression may be due to the comparatively small sample size available for the Tamil validation. Although our findings were based on healthcare workers, we expect the scale’s validity to extend to the general population. Thus, the Sinhalese and Tamil BRS can be used in future large-scale research on resilience in Sri Lanka. As high rates of mental health issues were reported among healthcare workers in Sri Lanka during the COVID-19 pandemic, 11 and the country is currently going through an unprecedented economic crisis, it is important to take measures to enhance resilience among Sri Lankan healthcare workers. The availability of a validated tool in both Sinhalese and Tamil languages would enable research on mental health and resilience among culturally-diverse populations in Sri Lanka, which would provide useful information to guide health policy development. Limitations of this study include the small sample sizes and the lack of test-retest reliability assessments to ascertain the temporal stability of the BRS scores.
Prevalence and correlates of depression in patients with epilepsy in Sri Lanka
(The Sri Lanka Medical Association, 2021) de Silva, S.; Isuru, A.; Rodrigo, A.; Kuruppuarachchi, L.
Background: Depression is one of the most common psychiatric disorder in patients with epilepsy and it is often associated with poor quality of life, increased risk of suicide and poor seizure control, yet remains underdiagnosed and undertreated. The prevalence and associations for depression in patients with epilepsy vary between studies reflecting regional and cultural influences. Therefore, it is important to identify unique attributes within a community on this phenomenon This is the first study from Sri Lanka on the prevalence and correlates of depression in patients with epilepsy. Method: We conducted this cross-sectional study at the Epilepsy clinic, Colombo North Teaching Hospital, Ragama. All consenting patients with a diagnosis of epilepsy followed up at the clinic, during study period, were enrolled. Symptoms of depression were screened with Beck Depression Inventory II and diagnosis was confirmed with a clinical assessment by psychiatrist. Results: Of 150 participants, majority were female 63.3%. (95) and 36.7% (55) of the sample were between 26-45 years. The prevalence of depressive disorder was 22% (33). The prevalence of depression was significantly associated with the recent diagnosis of epilepsy, use of multiple antiepileptic medications and duration of seizure free period (p<0.05). There is a statistically significant association between prevalence of depression with the use of carbamazepine, topiramate, clobazam and phenobarbitone. Regression analysis revealed higher the duration individuals suffering from epilepsy were at lower odds of having depression compared with that of individuals suffering from lower duration of epilepsy. For each year in increase of duration of epilepsy, the odds of depression decreased by 2% (95% CI 0.3% to 5.1%) Conclusion: The prevalence of depression is high in patients with epilepsy. Risk of having depression is higher during the early phase of the illness. Therefore, it is important to screen patients with epilepsy for depressive disorder during the early course of the illness.
A Randomized, double-blind, placebo-controlled trial on the role of preemptive analgesia with acetaminophen [paracetamol] in reducing headache following electroconvulsive therapy [ECT]
(BioMed Central, 2017) Isuru, A.; Rodrigo, A.; Wijesinghe, C.; Ediriweera, D.; Premadasa, S.; Wijesekera, C.; Kuruppuarachchi, L.
BACKGROUND: Electroconvulsive therapy (ECT) is a safe and efficient treatment for several severe psychiatric disorders, but its use is limited by side effects. Post-ECT headache is one of the commonest side effects. Preemptive analgesia is effective in post-surgical pain management. The most commonly used analgesic is acetaminophen (paracetamol). However, acetaminophen as a preemptive analgesic for post-ECT headache has not been studied adequately. This study was conducted to compare the incidence and severity of post-ECT headache in patients who were administered acetaminophen pre-ECT with a placebo group. METHODS: This study was a randomised, double-blind, placebo-controlled trial. Sixty-three patients received 1 g acetaminophen and 63 patients received a placebo identical to acetaminophen. The incidence and severity of headache 2 h before and after ECT were compared between placebo and acetaminophen groups. The severity was measured using a visual analog scale. Generalised linear models were used to evaluate variables associated with post ECT headache. RESULTS: Demographic and clinical variables of placebo and acetaminophen groups were comparable except for the energy level used to induce a seizure. Higher proportion of the placebo group (71.4%) experienced post-ECT headache when compared to the acetaminophen group (p < 0.001). The median pain score for headache was 0 (Inter quartile range: 0-2) in acetaminophen group whereas the score was 2 (IQR: 0-4) in placebo group (P < 0.001). Model fitting showed that the administration of acetaminophen is associated with less post-ECT headache (odds ratio = 0.23, 95% CI: 0.11-0.48, P < 0.001). CONCLUSION: A significant reduction was seen in both the incidence and severity of post-ECT headache with preemptive analgesia with acetaminophen.