Faculty of Social Sciences

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Evaluation of the effects of vocational choice and practical training on students’ employability
(Journal of European Industrial Training, 2007-07-31) Kagaari, R.K. James.
Purpose – The purpose of this article is to demonstrate the need for Kyambogo to pay special attention to students’ vocational choices, university based training and employability. Design/methodology/approach – The sample of 46 final year students, 90 graduates and 50 supervisors using cross sectional survey design was used to collect data. Findings – The paper reveals that factors such as government policies and regulations, people we interact and relate with for instance, parents, teachers, peers and other factors like our aspirations, interests, subjects studied at school have a significant bearing on our vocational choices. Practical training, curriculum followed in teaching and industrial training are relevant for electrical graduates in their preparation for employment challenges. Practical implications – This paper calls for involvement of stakeholders in design, implementation and evaluation of the university curriculum. That there should be vigorous and rigorous regular evaluation of training of electrical engineers to meet the ever-changing needs of employers. Originality/value – This paper presents a new approach to critical thinking young adulthood vocational choices, university based-training and employability of electrical engineering graduates.
Engineering lecturers' competencies and organisational citizenship behaviour (OCB) at Kyambogo University
(Journal of European Industrial Training, 2007-11-06) Kagaari, James.R K.; Munene, John C.
Purpose – The purpose of this paper is to establish the relevant competencies possessed by engineering lecturers and the relationship between those competencies and the exhibited organisational citizenship behaviours (OCB). Design/methodology/approach – The study was carried out in two phases. Phase one was qualitative using a competency interview guide that was administered to ten engineering lecturers, selected using a purposive sampling design. From this interview, seven key result areas, competencies and critical outputs were obtained. Phase two was quantitative following the development of a questionnaire from the established competencies, key result areas and critical outputs. The questionnaire was administered to 110 engineering lecturers. Findings – The study revealed that those lecturers who have the relevant competencies do exhibit discretionary behaviours at work. The model could be useful in deriving employee competencies and critical outputs. Research limitations/implications – A cross-sectional study using a small sample in a single institution could not warrant generalisability of the findings. Practical implications – Competency-based recruitment and selection has the potential to improve the ways in which universities could manage engineering lecturers. Originality/value – The paper presents a new approach to competency profiling, the need for competent engineering lecturers.
Positive psychology : The Case of Uganda
(Journal of Psychology in Africa, 2008) Regis, Chireshe; Paul, Ojwang; Edward, Ntare Rutondoki; Gastone, Byamugisha
The application of positive psychology concepts in professional psychology in Uganda is in its infancy. Both undergraduate and postgraduate psychology programmes in Ugandan universities have very limited emphasis on positive psychology concepts. Some applications are apparent in HIV/AIDS and disability counseling issues. Other practice areas with use of positive psychology concepts include the counseling of war victims, orphans and street children. There is potential for a greater infusion of positive psychology concepts in professional psychology in Uganda.
Performance management practices, information and communication technology (ICT) adoption and managed performance
(Quality Assurance in Education, 2010-04-27) Kagaari, R.K. James.; Munene, John C.; Ntayi, Joseph Mpeera.
Purpose – The purpose of this paper is to demonstrate the need for managers of public universities to pay attention to performance management practices and information communication technology (ICT) adoption in order to achieve successful managed performance. Design/methodology/approach – Using a disproportionate stratified purposive approach, a sample of 900 employees was drawn from four public universities in Uganda. Findings – The results revealed that performance management practices that are vested in agency relations and goal setting with ICT adoption are necessary in the achievement of managed performance in public universities. Practical implications – Building a positive employer-employee relationship and involving employees in setting goals and targets is crucial for successful management of organisations. ICT adoption will further facilitate service quality, service delivery and cost reduction. Originality/value – This paper calls for a new approach to managing employees in public universities in developing countries and Uganda in particular
Performance management practices, employee attitudes and managed performance
(International Journal of Educational Management : Emerald., 2010-08-17) Kagaari, James.
Purpose – The purpose of this paper is to establish the relationship between performance management practices, employee attitudes and managed performance. Design/methodology/approach – Using a disproportionate stratified purposive approach, a sample of 900 employees was drawn from four public universities in Uganda. Findings – The paper reveals that performance management practices and employee attitudes are crucial for achievement of managed performance in public universities. Research limitations/implications – This was a cross-sectional study that inherently has common method biases. Such biases could be minimised with replication of the study using a longitudinal study approach that would also unearth all salient issues that could have remained untouched. Practical implications – The paper emphasises the need for public universities to institutionalise result-oriented relationships and adapt in the external hyper changing environment. Originality/value – The paper calls for a new approach to managing employees in public universities with increasing demand for university education and stakeholder interests in delivery of cost-effective quality services.
Interface of culture, insecurity and HIV and AIDS: lessons from displaced communities in Pader district, northern Uganda
(Springer Nature: Conflict and Health., 2010-11-22) Rujumba, Joseph; Kwiringira, Japheth
Northern Uganda unlike other rural regions has registered high HIV prevalence rates comparable to those of urbanized Kampala and the central region. This could be due to the linkages of culture, insecurity and HIV. We explored community perceptions of HIV and AIDS as a problem and its inter-linkage with culture and insecurity in Pader District. Methods: A cross sectional qualitative study was conducted in four sub-counties of Pader District, Uganda between May and June 2008. Data for the study were collected through 12 focus group discussions (FGDs) held separately; 2 FGDs with men, 6 FGDs with women, and 4 FGDs with the youth (2 for each sex). In addition we conducted 15 key informant interviews with; 3 health workers, 4 community leaders at village and parish levels, 3 persons living with HIV and 5 district officials. Data were analysed using the content thematic approach. This process involved identification of the study themes and sub-themes following multiple reading of interview and discussion transcripts. Relevant quotations per thematic area were identified and have been used in the presentation of study findings. Results: The struggles to meet the basic and survival needs by individuals and households overshadowed HIV as a major community problem. Conflict and risky sexual related cultural practices were perceived by communities as major drivers of HIV and AIDS in the district. Insecurity had led to congestion in the camps leading to moral decadence, rape and defilement, prostitution and poverty which increased vulnerability to HIV infection. The cultural drivers of HIV and AIDS were; widow inheritance, polygamy, early marriages, family expectations, silence about sex and alcoholism. Conclusions: Development partners including civil society organisations, central government, district administration, religious and cultural leaders as well as other stakeholders should mainstream HIV in all community development and livelihood interventions in the post conflict Pader district to curtail the likely escalation of the HIV epidemic. A comprehensive behaviour change communication strategy is urgently needed to address the negative cultural practices. Real progress in the region lies in advocacy and negotiation to realise lasting peace.
Performance management practices and managed performance: moderating influence of organisational culture and climate in public universities in Uganda
(Emerald: Measuring Business Excellence, 2011-11) Kagaari, James R.K.
The purpose of this article is to explore and explain the existence and implementation of performance management practices in four public universities in Uganda. Design/methodology/approach A mixed‐method study approach (qualitative and quantitative) was adopted. A sample of 900 employees was drawn using a disproportionate stratified purposive sampling approach that yielded a 53 per cent response rate. Of the participants, 12 were purposively selected from top management members and interviewed using a semi‐structured interview guide. Using Nvivo software and Miles and Huberman approaches, interview data were managed and analysed. Findings Qualitative data results revealed that employees in public universities built relationships, utilised available resources, adapted to external environment, set goals and targets. This was made possible through planning, mobilising resources, problem solving, evaluating performance and adopting ICT to deliver cost‐effective quality services/products. The hypotheses were tested and revealed a significant positive relationship between performance management practices and managed performance (r=0.25, p<0.001). A moderating influence of organisational culture and climate on performance management practices and managed performance was also established and confirmed (ΔR2=0.012) significantly above zero (p =0.015). Research limitations/implications Cross‐sectional studies by their nature are subject to common method variances; further refinement of the instrument and a replication of the study using a longitudinal approach are recommended. Also, the additional studies should be supplemented with in‐depth interviews or case studies where possible to tap salient issues from the respondents. Practical implications Public universities should have visionary managers who should manage strategic barriers, attract and retain thinkers, and also create result‐oriented relationships to make a dynamic contribution to the development process of Uganda. Originality/value Mass university education in Uganda today calls for new approaches to managing employees in order to balance cost, quality and education access.
Performance management practices and managed performance: the moderating influence of organisational culture and climate in public universities in Uganda
(Measuring Business Excellence, 2011-11-15) Kagaari, R.K. James.
Purpose – The purpose of this article is to explore and explain the existence and implementation of performance management practices in four public universities in Uganda. Design/methodology/approach – A mixed-method study approach (qualitative and quantitative) was adopted. A sample of 900 employees was drawn using a disproportionate stratified purposive sampling approach that yielded a 53 per cent response rate. Of the participants, 12 were purposively selected from top management members and interviewed using a semi-structured interview guide. Using Nvivo software and Miles and Huberman approaches, interview data were managed and analysed. Findings – Qualitative data results revealed that employees in public universities built relationships, utilised available resources, adapted to external environment, set goals and targets. This was made possible through planning, mobilising resources, problem solving, evaluating performance and adopting ICT to deliver cost-effective quality services/products. The hypotheses were tested and revealed a significant positive relationship between performance management practices and managed performance (r ¼ 0.25, p , 0.001). A moderating influence of organisational culture and climate on performance management practices and managed performance was also established and confirmed (DR 2 ¼ 0:012) significantly above zero (p ¼0.015). Research limitations/implications – Cross-sectional studies by their nature are subject to common method variances; further refinement of the instrument and a replication of the study using a longitudinal approach are recommended. Also, the additional studies should be supplemented with in-depth interviews or case studies where possible to tap salient issues from the respondents. Practical implications – Public universities should have visionary managers who should manage strategic barriers, attract and retain thinkers, and also create result-oriented relationships to make a dynamic contribution to the development process of Uganda. Originality/value – Mass university education in Uganda today calls for new approaches to managing employees in order to balance cost, quality and education access.
Descending the sanitation ladder in urban Uganda: evidence from Kampala slums
(Springer Nature: BMC Public Health volume ., 2014) Kwiringira, Japheth; Atekyereza, Peter; Niwagaba, Charles; Günther, Isabel
While the sanitation ladder is useful in analysing progressive improvements in sanitation, studies in Uganda have not indicated the sanitation barriers faced by the urban poor. There are various challenges in shared latrine use, cleaning and maintenance. Results from Kampala city indicate that, failure to clean and maintain sanitation infrastructure can lead to a reversal of the potential benefits that come with various sanitation facilities. Methods: A cross sectional qualitative study was conducted between March and May 2013. Data were collected through 18 focus group discussions (FGDs) held separately; one with women, men and youth respectively. We also used pictorial methods; in addition, 16 key informant interviews were conducted. Data were analysed using content thematic approach. Relevant quotations per thematic area were identified and have been used in the presentation of the results. Results: Whether a shared sanitation facility was improved or not, it was abandoned once it was not properly used and cleaned. The problem of using shared latrines began with the lack of proper latrine training when people do not know how to squat on the latrine hole. The constrained access and security concerns, obscure paths that were filthy especially at night, lack of light in the latrine cubicle, raised latrines sometimes up to two metres above the ground, coupled with lack of cleaning and emptying the shared facilities only made a bad situation worse. In this way, open defecation gradually substituted use of the available sanitation facilities. This paper argues that, filthy latrines have the same net effect as crude open defection. Conclusion: Whereas most sanitation campaigns are geared towards provision of improved sanitation infrastructure, these findings show that mere provision of infrastructure (improved or not) without adequate emphasis on proper use, cleaning and maintenance triggers an involuntary descent off the sanitation ladder. Understanding this reversal movement is critical in sustainable sanitation services and should be a concern for all actors.
Gender variations in access, choice to use and cleaning of shared latrines; experiences from Kampala slums, Uganda
(Springer Link: BMC Public Health., 2014-11-19) Kwiringira, Japheth; Atekyereza, Peter; Niwagaba, Charles; Günther, Isabel
Sanitation is one of the most intimate issues that affect women, especially in slums of developing countries. There are few studies that have paid attention to the gender variations in access, choice to use and cleaning of shared latrines in slums. Methods: This paper draws on qualitative data from a cross sectional study conducted between 2012 and 2013 in six slums of Kampala City, Uganda. The study involved both women and men. Data were collected from 12 Focus Group Discussions (FGDs), 15 Key informant interviews; community transects and photographs of shared latrines. Results: Location of a shared latrine facility, distance, filthy, narrow and irregular paths; the time when a facility is visited (day or night), privacy and steep inclines were gender ‘filters’ to accessing shared latrines. A full latrine pit was more likely to inhibit access to and choice of a facility for women than men. Results indicate that the available coping mechanisms turned out to be gendered, with fewer options available for women than men. On the whole, women sought for privacy, easy reach, self-respect and esteem, cleanliness and privacy than men. While men like women also wanted clean facilities for use; they (men) were not keen on cleaning these facilities. The cleaning of shared latrines was seen by both women and men as a role for women. Conclusion: The presence of sanitation facilities as the first step in the access, choice, use, and cleaning by both women and men has distinct motivations and limitations along gender lines. The study confirms that the use and cleaning of latrines is regulated by gender in daily living. Using a latrine for women was much more than relieving oneself: it involved security, intimacy and health concerns.
Uganda’s vision 2040 and human needs promotion
(Council for the Development of Social Science Research in Africa, 2015) Balyejjusa, Senkosi Moses
In 2013 the President of Uganda Yoweri Kaguta Museveni launched Uganda’s Vision 2040, a thirty-year development master plan which has received both praise and criticism from Ugandans. Although Vision 2040 has received both praise and criticism in almost equal measure, in this article I argue that Vision 2040 does not adequately promote the satisfaction of the human needs of Ugandans, yet the satisfaction of these needs is a prerequisite for achieving genuine development. Using a human needs framework in general, and Doyal and Gough’s intermediate needs in particular, I show that the Vision’s strategies adequately promote the satisfaction of only three intermediate needs of Ugandans, partially promote the satisfaction of seven intermediate needs of Ugandans, and that there is no single strategy to promote the satisfaction of one of the intermediate needs. This is because some of the Vision strategies do not adequately tackle the current and likely future challenges and bottlenecks to the satisfaction of the human needs of Ugandans. This is mainly due to the central role placed on the private capital (sector) in Vision 2040. I argue that in order for Vision 2040 to adequately promote the satisfaction of the human needs of Ugandans, all and not just some of the needs must be adequately satisfied since human needs are interrelated and interdependent. In addition, Vision 2040 should also be in position to satisfy the human needs of all Ugandans and not just some.
The testimony of neoliberal contradiction in education choice and privatisation in a poor country: the case of a private, undocumented rural primary school in Uganda
(Ethnography and Education, 2015-07) Nathaniel, Mayengo; Jane, Namusoke; Barbara, Dennis
With international momentum to achieve ‘Education for All’ by 2015, global attention is being paid to those parts of the world where mass formal primary schooling is relatively new. Uganda is such a place. In the context of ethnographic fieldwork at a poor, undocumented, private primary school in rural Uganda, parents were inter- viewed in order to better understand their conceptualisations of education during this ‘massification’ era. The interviews reveal interesting contradictions between the espoused neoliberal principles and the nuances with which they describe education. In the absence of a robust public schooling system, privatisation has emerged to fill the gaps in educational provision as the country finds itself caught between the international mandate for free primary education and the lack of capital.
Prevalence of suicidal ideation and attempt: associations with psychiatric disorders and HIV/AIDS in post-conflict northern Uganda
(AJOL: African Health Sciences, 2016) Mugisha, James; Muyinda, Herbert; Kagee, Ashraf; Wandiembe, Peter; Kiwuwa, Stephen M.; Vancampfort, Davy; Kinyanda, Eugene
Research on the prevalence of suicidal ideation, attempt, and cormorbid psychiatric disorders in post-conflict areas is still limited. Aim: We explored the prevalence of suicidal ideation, attempt, associated psychiatric disorders and HIV/AIDS in post-conflict Northern Uganda, an area that experienced civil strife for over two decades. Methods: A total of 2400 respondents (aged 18 and above) and randomly selected in three districts (Gulu, Amuru and Nwoya), were interviewed. Multivariable logistic regression was used to assess for associations between suicidality (suicidal ideation and attempt) and psychiatric cormorbidities. Results: The prevalence of suicidal ideation and attempt were 12.1 % and 6.2 % respectively. Suicidality was significantly (P<0.001) higher among respondents with major depressive disorder (adjusted Odds Ratio (OR) = 9.5; 95%CI= 7.4, 12.1) and post-traumatic stress disorder (adjusted OR =2.4; 95%CI= 1.6, 3.6). Men had lower odds of ideating or attempting suicide compared to women (adjusted OR = 0.55; 95%CI: 0.38, 0.82). Conclusion: The prevalence rate of suicide ideation and attempt indicate a major public health problem in post-conflict Northern Uganda. Effective public mental health programs that that target both suicidality and psychiatric co-morbodities will be vital. Special attention should be given to women in post conflict Northern Uganda.
Sedentary behavior in people living with HIV: a systematic review and meta-analysis
(Journal of Physical Activity and Health, 2016) Vancampfort, Davy; Mugisha, James; De Hert, Marc; Probst, Michel; Stubbs, Brendon
Sedentary behavior is independently associated with an increased risk of poor mental health, developing cardiovascular disease (CVD) and premature mortality. Despite the knowledge that CVD is one of the leading causes of non-AIDS related premature mortality in people living with HIV (PLWH), relatively little attention has been attributed to sedentary behavior in this population. The aims of this meta-analysis were to (a) establish the pooled mean time spent sedentary, (b) investigate predictors of sedentary levels, and (c) explore differences with age- and gender-matched healthy controls. Methods: Two independent authors searched major databases until August 2016. A random effects meta-analysis was performed. Results: Across 6 unique cross-sectional studies, including 9 sedentary levels, there were 523 (292 men) PLWH (age range = 37 to 58 years). PLWH spent 533 min/day (95% CI = 466 to 599) engaging in sedentary behavior. There was a trend (P = .07) for higher levels of sedentary behavior in self-report measures (551 min, 95% CI = 543 to 560, N = 4) than in objective sedentary behavior time (505 min, 95% CI = 498 to 512, N = 3). The time PLWH spend engaging in sedentary behavior is among the highest levels reported in the literature. Conclusions: Given that sedentary behavior is an independent predictor of CVD, future lifestyle interventions specifically targeting the prevention of sedentary behavior in PLWH are warranted.
Communication and institutional effectiveness: the case of Nakawa and Kawempe divisions in Kampala city
(Kyambogo University [unpublished work], 2016-01) Nampenja, Ramlah
This study examined the effect of internal communication on the effectiveness of Nakawa and Kawempe division local governments in Kampala City. The study specifically explored the relationship between horizontal and vertical communication and the contribution of internal communication on institutional effectiveness. The study was a cross-sectional, correlation survey. A total of 52 respondents, including 5 key informants and 47 employees, participated in the study. Primary data was obtained using a questionnaire and a structured interview guide. Data was analyzed using descriptive and inferential quantitative as well as qualitative methods. The findings revealed that the horizontal and vertical communication were not sufficient. However, a significant positive relationship existed between horizontal and vertical communication and institutional effectiveness. This meant that when local governments, implement good horizontal and vertical communication strategies, the performance of these institutions increases. The findings revealed though generally horizontal and vertical communication were generally insufficient in both divisions, Kawempe had the lowest level. It was revealed that employees are not given adequate opportunity to discuss best work practices, to solve departmental problems or to suggest performance improvements. This has subsequently lowered the performance of these institutions. Low performance is exhibited by failure to; achieve service goals, maintain good working environment and resources have clear performance goals. The study recommends that: Local governments are senstised about the contribution of effective internal communication on the effectiveness of their institutions. This may awaken those who do not have one to initiate it. A framework which can help improve on horizontal communication in local governments be created to act as a point of reference for better internal communication. Local governments should have a well laid out internal communication strategy and should be made a performance indicator. Local government personnel both top management and other employees need training on how to start and maintain an effective internal communication strategy.
Towards understanding governance issues in integration of mental health into primary health care in Uganda
(Springer Nature: International Journal of Mental Health Systems., 2016-03-24) Mugisha, James; Ssebunnya, Joshua; Kigozi, Fred N.
There is a growing burden of mental illness in low income countries. The situation is further worsened by the high poverty levels in these countries, resulting in difficult choices for their health sectors as regards to responding to the burden of mental health problems. In Uganda, integration of mental health into primary health care (PHC) has been adopted as the most vital strategy for ensuring mental health service delivery to the general population. Objectives: To identify governance related factors that promote/or hinder integration of mental health into PHC in Uganda. Methods: A qualitative research design was adopted at national and district level. A total of 18 Key informant interviews were conducted at both levels. Content thematic analysis was the main method of data analysis. Findings: There were positive gains in working on relevant laws and policies. However, both the mental health law and policy are still in draft form. There is also increased responsiveness/participation of key stakeholders; especially at national level in the planning and budgeting for mental health services. This however seems to be a challenge at both district and community level. In terms of efficiency, human resources, finances, medicines and technologies constitute a major drawback to the integration of mental health into PHC. Ethics, oversight, information and monitoring functions though reported to be in place, become weaker at the district level than at national level due to limited finances, human resources gaps and limited technical capacity. Other governance related issues are also reported in this study. Conclusions: There is some progress especially in the legal and policy arena to support integration of mental health into PHC in Uganda. However, adequate resources are still required to facilitate the effective functioning of all governance pillars that make integration of mental health into PHC feasible in Uganda.
Seasonal variations and shared latrine cleaning practices in the slums of Kampala city, Uganda
(Springer Link: BMC Public Health., 2016-04-27) Kwiringira, Japheth; Atekyereza, Peter; Niwagaba, Charles; Kabumbuli, Robert; Rwabukwali, Charles; Kulabako, Robinah; Günther, Isabel
The effect of seasons on health outcomes is a reflection on the status of public health and the state of development in a given society. Evidence shows that in Sub-Saharan Africa, most infectious diseases flourish during the wet months of the year; while human activities in a context of constrained choices in life exacerbate the effects of seasons on human health. The paper argues that, the wet season and when human activities are at their peak, sanitation is most dire poor slum populations. Methods: A shared latrine cleaning observation was undertaken over a period of 6 months in the slums of Kampala city. Data was collected through facility observations, user group meetings, Focus group discussions and, key informant interviews. The photos of the observed sanitation facilities were taken and assessed for facility cleanliness or dirt. Shared latrine pictures, observations, Focus Group Discussion, community meetings and key informant interviews were analysed and subjected to an analysis over the wet, dry and human activity cycles before a facility was categorised as either ‘dirty’ or ‘clean’. Results: Human activity cycles also referred to as socio-economic seasons were, school days, holidays, weekends and market days. These have been called ‘impure’ seasons, while the ‘pure’ seasons were the wet and dry months: improved and unimproved facilities were negatively affected by the wet seasons and the peak seasons of human activity. Wet seasons were associated with, mud and stagnant water, flooding pits and a repugnant smell from the latrine cubicle which made cleaning difficult. During the dry season, latrines became relatively cleaner than during the wet season. The presence of many child(ren) users during school days as well as the influx of market goers for the roadside weekly markets compromised the cleaning outcomes for these shared sanitation facilities. Conclusion: Shared latrine cleaning in slums is impacted by seasonal variations related to weather conditions and human activity. The wet seasons made the already bad sanitation situation worse. The seasonal fluctuations in the state of shared slum sanitation relate to a wider malaise in the population and an implied capacity deficit among urban authorities. Poor sanitation in slums is part of a broader urban mismanagement conundrum pointing towards the urgent need for multiple interventions aimed at improving the general urban living conditions well beyond sanitation.
Physical activity levels and psychosis: a mediation analysis of factors influencing physical activity target achievement among 204 186 people across 46 Low- and middle-income countries
(Schizophrenia Bulletin: The Journal of Psychoses and Related Disorders., 2016-08-24) Stubbs, Brendon; Koyanagi, Ai; Schuch, Felipe; Firth, Joseph; Rosenbaum, Simon; Gaughran, Fiona; Mugisha, James; Vancampfort, Davy
Physical activity (PA) can help reduce cardiovascular disease and premature mortality in people with psychosis. However, there is a paucity of representative data on PA in people with psychosis, especially from low- and middle-income countries (LMICs). Moreover, data on subclinical psychosis and PA is absent. This study explored whether complying with PA recommendations of 150 minutes of moderate-vigorous PA per week is related to: (1) psychotic symptoms without a psychosis diagnosis (subclinical psychosis); and (2) clinical psychosis (psychosis diagnosis). A total of 204 186 participants aged 18–64 years from 46 LMICs recruited via the World Health Survey were subdivided into those with (1) no psychosis diagnosis and no psychotic symptoms in the past 12 months (controls); (2) subclinical psychosis; and (3) psychosis diagnosis. People with a psychosis diagnosis had significantly higher odds for low PA in the overall sample (OR = 1.36; 95% CI = 1.04–1.78; P = .024) and among males (OR = 2.29; 95% CI = 1.57–3.34; P < .0001) but not females (OR = 0.93; 95% CI = 0.67–1.30; P = .6712). No difference was found among those with subclinical psychosis vs controls. Mediation analyses demonstrated that mobility difficulties explained the largest amount of low PA among males (18.5%) followed by self-care difficulties (16.3%), depression (16.1%), cognition (11.8%), pain and discomfort (11.4%), interpersonal activities (8.6%), sleep and energy (7.2%), and vision (3.0%). The results from the largest dataset on PA and psychosis and first in LMICs, found that psychosis diagnosis (especially among males) but not subclinical psychosis, is associated with physical inactivity. Population level interventions seeking to increase PA among people with psychosis may help improve health outcomes.
Physical activity and depression: a large cross-sectional, population-based study across 36 low- and middle-income countries
(Wiley Online Library: Acta Psychiatrica Scandinavica, 2016-10-05) Stubbs, B.; Koyanagi, A.; Schuch, F. B.; Firth, J.; Rosenbaum, S.; Veronese, N.; Solmi, M.; Mugisha, J.; Vancampfort, D.
Physical activity (PA) is good for health, yet several small-scale studies have suggested that depression is associated with low PA. A paucity of nationally representative studies investigating this relationship exists, particularly in low- and middle-income countries (LMICs). This study explored the global association of PA with depression and its mediating factors. Method Participants from 36 LMICs from the World Health Survey were included. Multivariable logistic regression analyses were undertaken exploring the relationship between PA and depression. Results Across 178 867 people (mean ± SD age = 36.2 ± 13.5 years; 49.9% male), the prevalence of depression and the prevalence of low PA were 6.6% and 16.8% respectively. The prevalence of low PA was significantly higher among those with depression vs. no depression (26.0% vs. 15.8%, P < 0.0001). In the adjusted model, depression was associated with higher odds for low PA (OR = 1.42; 95% CI = 1.24–1.63). Mediation analyses demonstrated that low PA among people with depression was explained by mobility limitations (40.3%), pain and discomfort (35.8%), disruptions in sleep and energy (25.2%), cognition (19.4%) and vision (10.9%). Conclusion Individuals with depression engage in lower levels of PA in LMICs. Future longitudinal research is warranted to better understand the relationships observed.
Physical multimorbidity and psychosis: comprehensive cross sectional analysis including 242,952 people across 48 low- and middle-income countries
(BMC Medicine, 2016-11-22) Stubbs, Brendon; Koyanagi, Ai; Veronese, Nicola; Vancampfort, Davy; Solmi, Marco; Gaughran, Fiona; Carvalho, André F.; Lally, John; Mitchell, Alex J.; Mugisha, James; Correll, Christoph U.
: In people with psychosis, physical comorbidities, including cardiovascular and metabolic diseases, are highly prevalent and leading contributors to the premature mortality encountered. However, little is known about physical health multimorbidity in this population or in people with subclinical psychosis and in low- and middle-income countries (LMICs). This study explores physical health multimorbidity patterns among people with psychosis or subclinical psychosis. Methods: Overall, data from 242,952 individuals from 48 LMICs, recruited via the World Health Survey, were included in this cross-sectional study. Participants were subdivided into those (1) with a lifetime diagnosis of psychosis (“psychosis”); (2) with more than one psychotic symptom in the past 12 months, but no lifetime diagnosis of psychosis (“subclinical psychosis”); and (3) without psychotic symptoms in the past 12 months or a lifetime diagnosis of psychosis (“controls”). Nine operationalized somatic disorders were examined: arthritis, angina pectoris, asthma, diabetes, chronic back pain, visual impairment, hearing problems, edentulism, and tuberculosis. The association between psychosis and multimorbidity was assessed by multivariable logistic regression analysis. Results: The prevalence of multimorbidity (i.e., two or more physical health conditions) was: controls = 11.4% (95% CI, 11.0–11.8%); subclinical psychosis = 21.8% (95% CI, 20.6–23.0%), and psychosis = 36.0% (95% CI, 32.1–40. 2%) (P < 0.0001). After adjustment for age, sex, education, country-wise wealth, and country, subclinical psychosis and psychosis were associated with 2.20 (95% CI, 2.02–2.39) and 4.05 (95% CI, 3.25–5.04) times higher odds for multimorbidity. Moreover, multimorbidity was increased in subclinical and established psychosis in all age ranges (18–44, 45–64, ≥ 65 years). However, multimorbidity was most evident in younger age groups, with people aged 18–44 years with psychosis at greatest odds of physical health multimorbidity (OR = 4.68; 95% CI, 3.46–6.32).(Continued from previous page) Conclusions: This large multinational study demonstrates that physical health multimorbidity is increased across the psychosis-spectrum. Most notably, the association between multimorbidity and psychosis was stronger among younger adults, thus adding further impetus to the calls for the early intervention efforts to prevent the burden of physical health comorbidity at later stages. Urgent public health interventions are necessary not only for those with a psychosis diagnosis, but also for subclinical psychosis to address this considerable public health problem.

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