Global Mental Health


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Global mental health research in the Department of Psychiatry and Behavioral Sciences is experiencing an exciting period of growth. Significantly driven by junior faculty and fellows/residents, several new projects are underway. The topics and geographic areas studied reflect the diversity of Duke researchers and range from clinical research to large population based studies, from South Africa to South Asia.

Psychiatry researchers are also active in cross-disciplinary and cross-campus collaborations, with strong ties to both the Duke Global Health Institute and the Center for Health Policy & Inequalities Research, among others.

Global Mental Health Investigators

Julie Adams, MD, Clinical Associate

Select publication:

Adams J, Almond M, Ringo E, Shangali W, Sikkema K. Feasibility of nurse-led antidepressant medication management of depression in an HIV clinic in Tanzania. International Journal of Psychiatry in Medicine. In Press, 2012.

Lauren Franz, MB ChB, PHD, PGY V
Dr. Franz is spending three months conducting mentored research on a cultural adaptation of the Autism Diagnostic Observation Schedule, the gold standard autism diagnostic instrument, for Zulu children in KwaZulu-Natal. In addition to the cultural adaptation and translation of the ADOS she hopes to facilitate ongoing collaboration between the research group she will be working with in South Africa and the Center for Developmental Epidemiology at Duke. This project aims to compare and contrast the relationships between child cognitive, mental, and physical health and caregiver mental health, substance use, and family functioning in 918, 2-5 year old children and their caregivers in North Carolina USA; and 2000, 5-6 year old children and their caregivers in KwaZulu-Natal, South Africa.

Brandon Kohrt, MD, PhD, Assistant Professor
Dr. Kohrt was appointed assistant professor in the Duke Global Health Institute and the Department of Psychiatry and Behavioral Sciences July 1, 2013 to expand on our existing expertise in global mental health. Dr. Kohrt conducts global mental health research focusing on populations affected by war-related trauma and chronic stressors of poverty, discrimination, and lack of access to healthcare and education. He has worked in Nepal for 16 years using a biocultural developmental perspective integrating epidemiology, cultural anthropology, ethnopsychology, and neuroendocrinology. Since 2000, he has conducted a prospective study of adults in rural Nepal examining the effects of political trauma, ethnic discrimination, gender-based violence, and poverty on mental health. With Transcultural Psychosocial Organization (TPO) Nepal, he designed and evaluated psychosocial reintegration packages for child soldiers in Nepal. He currently works with The Carter Center Mental Health Liberia Program developing anti-stigma campaigns and family psychoeducation programs. He co-founded the Atlanta Asylum Network for Torture Survivors, for which he was recognized by Physicians for Human Rights with the Navin Narayan Health and Human Rights Leadership Award. In 2009, he started a mental health clinic for Bhutanese refugees.

Joanna “Asia” Maselko, DSc, Assistant Professor
Dr. Maselko is the PI of the Sri Lanka Healthy Minds Study, which examines the relationship between family characteristics, caregiver depression symptoms, and elder health in multi-generational households. This NIH funded study is being conducted in collaboration with the University of Ruhuna in Galle, Sri Lanka. The goal is to better understand successful models of family based care, which is not only very prevalent in lower and middle income countries but is expected to become more prevalent in high income countries like the US as well. Another study based in Karnataka, India, examines the influence of family structure and social support with maternal mental health and child developmental outcomes.

Select publications:

Mohanan M., Maselko J. Mind after Matter: Quasi-Experimental evidence on the causal effects of physical health shocks on mental health. International Journal of Epidemiology. 2010 39(2):487-93

Maselko J., Patel, V. Why women attempt suicide: The contribution of socioeconomic adversity, physical ill-health and psychiatric disorder in a population based longitudinal study in India. Journal of Epidemiology and Community Health. 2008 62:817-822

Rahman, A., Patel, V., Maselko, J., Kirkwood, B. The neglected ‘m’ in MCH programmes – why mental health of mothers is important for child nutrition. Tropical Medicine and International Health. 2008 13(4):579-83

Prince, M., Patel, V., Saxena, S., Maj, M., Maselko J., Phillips, M., and Rahman, A. No health without mental health – a slogan with substance. The Lancet. 2007 370:859-877

Bates L., Maselko J., Schuler, S. Does women’s education influence the timing of marriage and childbearing in the next generation? Evidence from Bangladesh. Studies in Family Planning, 2007 38(2): 101-112.

Christina Meade, PhD, Assistant Professor

Select publications:

Meade, C.S., Watt, M.H., Sikkema, K.J., Deng, L.X., Skinner, D., Pieterse, D. & Kalichman, S.C. (in press). Methamphetamine use is associated with HIV risk among patrons of alcohol serving venues in Cape Town, South Africa. Drug and Alcohol Dependence.

Watt, M.H., Ranby, K.W., Meade, C.S., Sikkema, K.J., MacFarlane, J.C., Skinner, D., Pieterse, D., & Kalichman, S.C. (2012). PTSD symptoms mediate the relationship between traumatic experiences and drinking behavior among women attending alcohol-serving venues in a South African township. Journal of Studies on Alcohol and Drugs, 73, 549-558.

Sikkema, K.J., Watt, M.H., Meade, C.S., Ranby, K.W., Kalichman, S.C., Skinner, D., & Pieterse, D. (2011). Mental health and HIV sexual risk behavior among patrons of alcohol serving venues in Cape Town, South Africa. Journal of Acquired Immune Deficiency Syndrome, 57, 230-237. PMCID: PMC3135683.

Meade, C.S., Wang, J., Lin, X., Hao, W., & Poppen, P.J. (2010). Stress and coping in HIV-positive former plasma/blood donors in China: A test of cognitive appraisal theory. AIDS & Behavior, 14, 328-338.

Karen O'Donnell, PhD, Associate Professor

Select publications:

Whetten K., Ostermann J, Whetten R.A., Pence B.W., O’Donnell K., Messer L.C., Thielman NM, The PositiveOutcomes for Orphans (POFO) Research Team (2009.) “A Comparison of the Wellbeing of Orphans and Abandoned Children Ages 6-12 in Institutional and Community-Based Care Settings in 5 Less Wealthy Nations.” PLoS ONE. 4(12):e8169.

Whetten, K., Ostermann J., Whetten R., O’Donnell, K., Thielman, N. and the Positive Outcomes for Orphans Team. (2011). More than the loss of a parent: Potentially traumatic events among orphaned and abandoned children. Journal of Traumatic Stress 24(2):174-182.

Whetten, R., Messer, L., Ostermann, J., Whetten, K., Pence, B., Buckner, M., Thielman, N., & O’Donnell, K.(2011) Child work and labour among orphaned and abandoned children in five low and middle income countries. BMC International Health and Human Rights,11(1):1-10.

O’Donnell, K., Murphy, R., Ostermann, J., Masnick, M., Whetten, R., Madden, E., Thielman, N., Whetten, K. and the Positive Outcomes for Orphans Team. (2011). A brief assessment of learning for orphaned and abandoned children in low and middle income countries. AIDS and Behavior (2012) 16:480–490.

Kristen Shirey, MD, Clinical Associate
Dr. Shirey is conducting clinical research on the diagnosis and treatment of post-traumatic stress disorder (PTSD) and suicide in Eldoret, Kenya where she completed a global health rotation during her combined Internal Medicine/Psychiatry Residency Program at Duke. In the current project, Dr. Shirey is estimating the prevalence of PTSD, identifying primary care patients for future treatment intervention studies and training community health workers to carry out PTSD interventions.