Utilization of massage chairs for promoting overall health and wellness: A rapid scoping review

OBJECTIVE

To investigate the potential benefits of using massage chairs for improving health.

DATA SOURCES

A rapid scoping review was conducted using PubMed, Embase, Cochrane Library, and Google Scholar from inception to November 1, 2022.

STUDY SELECTION

Using the keyword strategy ("massage chair*" OR "massage-chair*"), only studies in English were selected. Two reviewers independently screened the studies, and conflicts were resolved by consensus. Studies involving physical massage therapy were excluded.

DATA EXTRACTION

A total of 59 articles were identified, and 18 were included in the final analysis. Quality assessment was performed, following STROBE, CONSORT and CASP guidelines. The following data were extracted: authors, year, country, study design, study objective, age, gender, participants, measures, and main findings.

DATA SYNTHESIS

The results of the present review indication that the utilization of massage chairs may positively affect both physical and mental health concerns. This review especially found a more significant number of studies showing benefits in mental health. However, two case reports indicated complications when using massage chairs.

CONCLUSIONS

The use of massage chairs could have benefits on cognitive function improvement, stress reduction and mental fatigue decline, muscle stiffness improvement, pain reduction, and potential benefits for quality of life.

'Chugging along, plugging in and out of it': Understanding a place-based approach for community-based support of mental health recovery

Community-based Mental Health (MH) organisations in the United Kingdom (UK) are facing challenges for sustaining in-person service delivery. Without empirical evidence that demonstrates the value of a place-based approach for MH recovery, and the types of resources needed to build nurturing spaces for peer support, community-based MH organisations will struggle to maintain their physical spaces. We present empirical insights from a case study involving interviews with 20 students accessing peer support services at the Recovery College Collective, a community-based MH organisation located in the North East of England. The interview study aims to evidence how a place-based approach can afford MH recovery. We draw from discourses on place-making and interpret our interview findings through an established framework that highlights four mechanisms through which place impacts recovery: place for doing, being, becoming and belonging. We use this framework to structure our findings and highlight key qualities of place for establishing and maintaining MH recovery. Our contribution is two-fold: we address a gap in the literature by providing empirical understandings of how place influences MH recovery, whilst extending previous research by considering the role that place plays in community-based organisations. This is timely because of the challenges faced in securing in-person service delivery post-pandemic, and a shift towards remote service provision models. We highlight key implications: (i) Accessing a physical place dedicated to MH support is vital for people who do not have anywhere else to go and are socially isolated due to their health conditions; (ii) Connecting through peer-to-peer interaction is an integral part of the recovery process, and learning from people with lived experience can inform a place-based approach that best suit their needs; and (iii) Recognising the value of place for MH support, and the resources needed for peer support delivery in the community, will help secure places that our research participants described as lifesaving.

"As I Grew Older, My Life Got Better": Conceptions of Successful Aging among Older Women Living with or at Risk of HIV

Successful aging (SA) is an important target for HIV care. However, we have insufficient understanding of how older women living with HIV (OWLH) in the US define SA. We explored conceptions of SA by OWLH and older women at risk of HIV and examined whether SA conceptions differed by (1) HIV serostatus, and (2) participation in the Women's Interagency HIV Study (WIHS). These analyses were part of a larger mixed-methods study with a sequential design. Participants were recruited at two clinical WIHS sites. We enrolled both WIHS participants and non-WIHS clinic patients. Our sample was 84% Black and included 29 OWLH and 15 older women at risk of HIV. We conducted 21 semi-structured interviews and four focus groups. The dataset was analyzed using descriptive, comparative, and relational analysis. We found four interlinked themes: life course perspective, accepting and celebrating aging, taking care of yourself, and looking good. The life course perspective was a core theme: participants assessed their aging in comparison to their earlier life hardships. These themes were similarly present among OWLH and older women at risk of HIV, although OWLH emphasized taking care of HIV. SA conceptualizations by OWLH did not differ whether or not they participated in the WIHS. Women living with or at risk of HIV may experience severe hardships throughout their lives. Overcoming these hardships may be linked to SA. Assessing the needs and connecting women to resources and programs are critical for SA promotion.

Is it time to discard the Diagnostic and Statistical Manual of Mental Disorders (DSM) in psycho-oncology?

The conceptual basis of psychopathology within cancer survivorship is critical, as the chosen conceptualisation informs assessment and explanatory models, as well as interventions and supportive care approaches. The validity of a chosen conceptualisation of psychopathology is therefore paramount for ensuring cancer survivors receive high-quality and efficacious care and support that can be iteratively improved via coordinated research efforts. In this paper, we discuss the traditional diagnostic approach to conceptualising psychopathology within cancer care, including the diagnostic system the 'Diagnostic and Statistical Manual of Mental Disorders' (DSM) [1], and the significant issues it presents within cancer survivorship. We detail and discuss how an alternate conceptualisation of psychopathology may enhance both research and practice within psycho-oncology. We ultimately pose, and provide our perspective, on the question "Is it Time to Discard the DSM in Psycho-Oncology?"

Youth Incarceration in Adult Facilities and Mental Health in Early Adulthood

PURPOSE

To examine the relationship between youth incarceration in adult correctional facilities and mental health in early adulthood.

METHODS

We analyzed nationally representative data from 1997 through 2019 (N = 8,961) using the National Longitudinal Survey of Youth 1997. An ordinary least squares regression model using inverse probability weights was used to assess the influence of youth incarceration in an adult facility on average mental health scores from age 18 to 37.

RESULTS

Respondents incarcerated in an adult facility as a youth had poorer average mental health than those not held in adult prisons or jails over the course of the study period. Those incarcerated for longer in adult facilities also exhibited more mental health symptoms.

DISCUSSION

Young people incarcerated in adult correctional facilities experience poorer long-term mental health related to depression and anxiety in early adulthood.

Disrupted family reunification: Mental health, race, and state-level factors

The children's mental health landscape is rapidly changing, and youth with mental health conditions (MHCs) are overrepresented in the child welfare system. Mental health is the largest unmet health need in child welfare, so MHCs may affect the likelihood of system reentry. Concerns regarding mental health contribute to calls for expanded supports, yet systems contact can also generate risk of continued child welfare involvement via surveillance. Still, we know little about how expanded supports at the state-level shape child welfare outcomes. Using the Adoption and Foster Care Analysis Reporting System (AFCARS), we examine the association between MHCs and system reentry within 36 months among youth who reunified with their families in 2016 (N = 41,860). We further examine whether this association varies across states and White, Black, and Latinx racial and ethnic groups via two- and three-way interactions. Results from multilevel models show that, net of individual and state-level factors, MHCs are associated with higher odds of reentry. This relationship is stronger for youth in states that expanded Medicaid by 2016 and with higher Medicaid/CHIP child participation rates. The results also show evidence of the moderating role of state-level factors, specifically student-to-school counselor ratio, diverging across racial and ethnic groups. Our results suggest a need for systems of care to better support youth mental health and counteract potential surveillance.

Newest Updates to Health Providers on the Hazards of Ultra-Processed Foods and Proposed Solutions

At present, the United States has the lowest life expectancy of all 12 large, rich countries in the world. While overweight and obesity, as well as lack of regular physical activity, are well recognized, another less well-known plausible hypothesis to explain this observation is the unprecedented consumption of ultra-processed food in the United States. Whether ultra-processed food contributes to our currently rising rates of morbidity and mortality from noncommunicable diseases requires direct testing in analytic studies designed a priori to do so. At present, ultra-processed foods are likely to play major roles in a myriad of diseases such as diabetes, coronary heart disease, stroke, a variety of cancers, and even mental health disorders. As was the case with cigarettes, we find ourselves needing to fight a battle where the entertainment industry, the food industry, and public policy do not align with our patients' needs. This does not mean that we should not begin to engage our patients in this vital conversation. Indeed, it makes it all the more important, and timely, that we do so.

The effect of dance on mental health and quality of life of people with Parkinson's disease: A systematic review and three-level meta-analysis

OBJECTIVES

Parkinson's disease (PD) is a neurodegenerative disease that affects millions of individuals worldwide. Dance has emerged as a comprehensive intervention for enhancing well-being in this population. This meta-analysis aimed to assess the effectiveness of dance on mental health and quality of life among individuals with PD.

METHODS

Three databases were searched in December 2022. Research papers comparing the effects of dance with a non-dance control on the quality of life or mental health of individuals with PD were included. Two authors independently screened the studies, extracted data, and assessed methodological quality of eligible studies. To address the interdependence of effect sizes within studies, the three-level meta-analysis approach was employed to analyze the data.

RESULTS

Thirteen trials involving a total of 496 participants were included, with 11 being subjected to statistical analysis. The results indicated that dance had a positive impact on mental health (g = 0.43, 95 % CI = [0.11, 0.75]) and quality of life (g = 0.46, 95 % CI = [-0.04, 0.95]) when compared to passive control groups. Moderator analyses revealed that non-partnered dance and dance interventions with lower total dosages were particularly beneficial for mental health.

CONCLUSION

Dance interventions are an effective lifestyle activity for enhancing mental health and quality of life in individuals with PD. A theoretical framework is proposed to explain the impact of dance on well-being from neurological, social, physical, and psychological perspectives.

Association between retirement age and depressive symptoms among Korean retirees: Results from Korean Retirement and Income Panel Study

BACKGROUND

The effective age of retirement in South Korea is higher than the average of Organization for Economic Co-operation and Development (OECD) countries. Early retirement in Asia may affect mental health differently compared to western countries. Thus, we examined the association between retirement age and depressive symptoms among South Korean retirees.

METHODS

We used data from the 2011, 2013, 2015, 2017, and 2019 Korean Retirement and Income Panel Study, including a total of 2998, 3152, 3203, 3154, and 3055 participants, respectively. We excluded those younger than 50 years, non-retirees, those without information on the Center for Epidemiological Studies-Depression (CES-D) scale, and those with other missing values. We used a generalized estimating equation model to identify the association between retirement age and depressive symptoms measured using the CES-D.

RESULTS

Participants who retired at age < 50 years had significantly higher CES-D scores (β = 1.764, P = 0.0003) compared to those who retired at age ≥ 70 years. The negative effects of early retirement on depressive symptoms were greater among male participants, heads of households, young involuntary retirees, those who retired within the past 20 years, and those who had no difficulties in activities of daily living.

LIMITATIONS

Since we evaluated the association between retirement age and depressive symptoms in one direction, there is a possibility of reverse causality.

CONCLUSION

Our findings highlight the importance of managing depressive symptoms in early retirees, especially young involuntary retirees and those burdened with family care.

What do clinicians mean by epidemics' preparedness

BACKGROUND

Infectious disease pandemics and epidemics pose significant global threats, and the risk of emerging infectious diseases has increased because of factors such as international connections, travel, and population density. Despite investments in global health surveillance, much of the world remains unprepared to manage infectious disease threats.

OBJECTIVES

This review article discusses the general considerations and lessons learned from the COVID-19 pandemic in terms of epidemic preparedness.

SOURCES

Non-systematic search on PubMed, scientific society websites, and scientific newspapers (performed in April 2023).

CONTENT

Key factors for preparedness include robust public health infrastructure, adequate allocation of resources, and effective communication between stakeholders. This narrative review emphasizes the need for timely and accurate dissemination of medical knowledge, as well as addressing the challenges of misinformation and infodemics. It also highlights the importance of quick availability of diagnostic tests and vaccines, ensuring equitable access to these technologies. The role of scientific coordination in developing treatment strategies and the safety and mental well-being of healthcare workers are discussed. Lastly, it should be emphasized the need for medical training, multidisciplinary teams, new technologies and artificial intelligence, and the active role of infectious disease physicians in epidemic preparedness efforts.

IMPLICATIONS

From clinicians' perspective, healthcare authorities play a crucial role in epidemic preparedness even by providing resource management plans, ensuring availability of essential supplies and training, facilitating communication, and improving safe infection management.

A cross-sectional study of the relationship between frequency of cannabis use and psychiatric symptoms among people seeking mental health and addiction services in Nova Scotia (2019-21)

BACKGROUND

Cannabis use may be a modifiable risk factor for mental health problems; however, the role of cannabis use frequency in population seeking mental health and addiction services remains unclear. This study aimed to: 1) compare the prevalence and functional impact of psychiatric symptoms among frequent, infrequent, and non-users of cannabis; and 2) evaluate the associations between cannabis use frequency and functional impact of psychiatric symptoms in help-seeking individuals.

METHODS

Data from the Mental Health and Addictions (MHA) Central Intake system in Nova Scotia, Canada was used. Participants aged 19-64 who received MHA Intake assessments from September 2019 to December 2021 with complete information about substance use were included (N = 20,611). Cannabis use frequency over past 30 days was categorized into frequent (>4 times a month), infrequent (≤4 times a month), and non-use. Psychiatric symptomatology consists of five domains: mood, anxiety, psychosis, cognition, and externalizing behaviors. Multivariate ordinal logistic regression was used to examine the associations between cannabis use frequency and functional impact of psychiatric symptoms.

RESULTS

Frequent and infrequent cannabis users had a higher prevalence of psychiatric symptoms in each domain than non-users, while no significant differences were found between frequent and infrequent users. Frequent cannabis use was associated with greater functional impact of psychiatric symptoms in each domain compared to non-users, while infrequent use was only associated with greater functional impact of externalizing behaviors.

CONCLUSION

Frequent cannabis use is associated with increased prevalence and functional impact of psychiatric symptoms among adults seeking mental health services.

Debate: Involuntary treatment and detention are a necessary part of mental health care for children and young people - a perspective from an Independent Advocate in England, United Kingdom

This is a perspective from an Independent Advocate in England, United Kingdom on the importance of equality in the involuntary treatment of children and young people (CYP). The article highlights the need for safeguards when CYP require detention as part of their mental health care. The paper raises concern that CYP and their families who are less empowered to advocate for optimal care plans may be at risk of less satisfactory outcomes from mental health detention. It notes that CYP in the care system may be particularly vulnerable to such outcomes due to their lower levels empowerment. To mitigate this risk, services need to be proactive in reducing inequity arising from differential levels of empowerment among service users. This could be achieved by adopting strong participation and coproduction activities and ensuring access to Advocacy services for all CYP.

Adherence to the ultra-processed dietary pattern and risk of depressive outcomes: Findings from the NutriNet Brasil cohort study and an updated systematic review and meta-analysis

BACKGROUND & AIMS

We aimed to analyze the prospective association between adherence to the ultra-processed dietary pattern and risk of depressive outcomes using original data from the NutriNet Brasil cohort and via a systematic review and meta-analysis of observational studies that have investigated the same association.

METHODS

In our original research analysis, we used data from 15,960 adults (≥18 y) participating in the NutriNet Brasil cohort study, free of depression or depressive symptoms during the baseline (77.5% women, 45.8 ± 13.0 y). The mean dietary share of ultra-processed foods (%Kcal/d), calculated from two baseline 24-h dietary recalls, was used to measure the adherence to the ultra-processed dietary pattern. New cases of depressive symptoms were assessed using the Patient Health Questionnaire-9 over the follow-up period (mean: 18.3 months). Cox proportional hazards models were used for the main analyses. In our systematic review and meta-analysis, we incorporated effect estimates from six prospective cohort studies that have examined the same association, including ours.

RESULTS

In the adjusted model, each 10% increase in the dietary share of ultra-processed foods was associated with a 10% increase in the hazard of incident cases of depressive symptoms (HR:1.10; 95%CI: 1.07-1.14). This association was slightly attenuated in the models including potential mediators. In our meta-analysis of six prospective studies, high versus low exposure to ultra-processed foods was associated with a summary hazard ratio of depressive outcomes of 1.32; 95%CI: 1.19-1.46; I2: 71%.

CONCLUSION

A higher adherence to the ultra-processed dietary pattern was associated with a higher risk of developing depressive outcomes in the NutriNet Brasil cohort and in the meta-analysis.

Mental Health for LGBTQIA+ Older Adults

LGBTQIA+ older adults share a unique set of risk factors that impact mental health. This article provides an overview of the minority stress and allostatic load models and how they can lead to worse physical and mental health outcomes. The article also describes unique epidemiologic and psychosocial context for various aspects of mental health among LGBTQIA+ older adults. Within each section are suggestions for health care providers when addressing these mental health issues and caring for LGBTQIA+ older adults in all settings.

Precarious employment and mental health in the Belgian service voucher system: the role of working conditions and perceived financial strain

INTRODUCTION

Jobs in domestic cleaning are often conceived as 'precarious employment' (PE)-i.e. a multidimensional concept referring to accumulated adverse characteristics of employment due to workers' weak bargaining position. Against this background, the Belgian service voucher system (SVS) was implemented aimed at creating formal and stable, subsidized domestic services jobs.

PURPOSE

The current study assesses the relationship between PE and mental health (WHO5) in the Belgian SVS, accounting for the potential mediating role of working conditions and perceived financial strain at the household level.

METHODS

We analysed a cross-sectional sample of 1,115 Belgian SVS domestic cleaners, collected in 2019 through an online survey. A mediation model was estimated.

RESULTS

The crude effect of PE on adverse mental health was strong (ß 0.545-S.E. 0.063). However, 50% of the association between PE and mental well-being was mediated by work task characteristics (quantitative demands, physical demands, task variation and autonomy) and 25% by household-level perceived financial strain. The remaining direct effect of PE on adverse mental well-being is ß 0.066 (S.E. 0.032-25% of the total effect).

CONCLUSION

These findings are the first based on the Belgian Employment Precariousness Scale (EPRES-BE) and are consistent with earlier-made-but seldom simultaneously tested-assumptions on the mechanisms relating PE to adverse mental health-i.e. involving direct associations and indirect associations via adverse working conditions and material deprivation. Based on the results, we recommend more democratic and higher-quality management practices in the SVS, in addition to higher wages and working time reduction.

Rural Friendship Bench: A qualitative study in Zaka district, Zimbabwe

BACKGROUND

We piloted the Friendship Bench-an evidence-based, urban-area task sharing intervention for common mental disorders-in rural Zimbabwe. The intervention combines problem solving therapy with income generating activities. This study sought to understand the intervention's implementation in terms of acceptability, feasibility, and sustainability as well as local attitudes towards mental wellbeing in rural Zimbabwe.

METHODS

Using four separate semi-structured interview guides, we conducted in-depth interviews (N = 32) with patients (n = 9), village health workers (n = 12), nurses (n = 6), and community leaders (n = 5). We analyzed our data using thematic analysis with a diverse coding team using an integrative deductive-inductive approach.

RESULTS

Five themes emerged: 1) explanatory models for mental illness, 2) clinical workflow and emphasis on documentation, 3) positive feedback about the Friendship Bench, 4) accessibility, and 5) feasibility.

CONCLUSION

In its current format, our intervention was acceptable but neither feasible nor sustainable. Sociocultural context is critical in the development of rural task sharing interventions for mental health. We thus recommend a robust pilot and adaptation phase when scaling task sharing interventions in rural sub-Saharan Africa to elevate community voices, leverage existing social structures, and embed interventions as deeply into communities as possible.

The protective effects of Swedish COVID-19 pandemic strategies on adolescents' mental health: a longitudinal cohort study

AIM

The aim of this study was to investigate a cohort of Swedish eighth graders' mental health and experiences during the COVID-19 pandemic.

METHODS

Participants were 157 eighth graders recruited in junior high schools during 2020 who completed a depression questionnaire and a survey about their psychosocial health in relation to the COVID-19 pandemic, alongside a follow-up assessment in 2021. Analyses were conducted using latent change score and cross-lagged models.

RESULTS

Participants' depressive symptoms did not substantially increase during the COVID-19 pandemic. The level of depressive symptoms in 2020 was significantly associated with participants' perceptions of the pandemic in 2020 and spring 2021. Participants with higher depression scores reported worse experiences of the pandemic.

CONCLUSIONS

The stable level of depressive symptoms among this cohort of eighth graders suggested that keeping schools open during a nationwide lockdown could mitigate some mental health consequences. Adolescents in this study with higher self-assessed depressive symptoms were more likely to experience increased depression after 6 months and had worse experiences during the pandemic than others. This suggests that the pandemic may not immediately affect mental well-being, but those at risk may be affected over time.

Zuranolone: A Narrative Review of a New Oral Treatment for Postpartum Depression

PURPOSE

Postpartum depression is a prevalent and overlooked mental disorder. Pathophysiology is thought to originate from a combination of biological and social factors, including hormones, and genetics. The consequences of untreated postpartum depression can be severe and negatively impact maternal and infant health. Zuranolone was approved as an oral agent in August 2023 for the treatment of postpartum depression in adults. The purpose of this article is evaluating the clinical aspects of zuranolone, including safety and efficacy pertaining to the drug and the clinical data that led to its approval.

METHODS

A literature search was conducted using PubMed, Web of Science, and EMBASE with the terms postpartum depression, postpartum depression management, and zuranolone to locate relevant data for this narrative review. The prescribing information of zuranolone and clinicaltrials.gov were also utilized.

FINDINGS

Two Phase III trials (Study 1-NCT04442503 and Study 2-NCT02978326) led to the approval of zuranolone by the Food and Drug Administration (FDA) based on clinically meaningful improvement in depressive symptoms. The trials met their primary endpoint, a change from baseline in HAM-D total score at day 15 (Study 1; 95% CI -6.3 to -1.7, P = 0.001: Study 2; 95% CI (-6.9 to -1.5, P = 0.003).

IMPLICATIONS

Zuranolone, an oral and rapidly acting antidepressant, represents a promising new oral treatment option for individuals with postpartum depression.

What does routine depression screening in the ambulatory orthopedic clinic teach us? Results from nearly 60,000 patient encounters

Background

It remains unclear what role depression screening plays in routine ambulatory orthopedic care. The purpose of this study was to determine (1) the floor and ceiling effects of the Patient-Reported Outcomes Measurement Information System Depression (PROMIS-D) form, (2) the prevalence of positive PROMIS-D screening forms across an orthopedic service line, and (3) the prevalence of previously diagnosed depression and interventions among a representative sample of patients.

Methods

This retrospective study analyzed 58,227 patients who presented to ambulatory orthopedic clinics across an orthopedic service line between January 1, 2019 to December 31, 2021. All patients completed a self-administered PROMIS-D form as part of the ambulatory encounter. Scores were analyzed with respect to patient characteristics including age, gender, and presenting orthopedic complaint. A sample of 1000 patients was evaluated for prevalence of depressive symptoms and formal psychiatric diagnosis and interventions in the 5 years preceding the clinic visit.

Results

PROMIS-D displayed a negligible ceiling effect (<0.001 %) but a large floor effect (19.0 %). PROMIS-D scores indicating depressive symptoms were highest among patients presenting with spine complaints (42.8 %) and lowest among patients presenting to orthopedic pediatric clinics (28.6 %). Women and those in the lowest quartile median household income (MHI) were more likely to report depressive symptoms. Among the 1000 patient sample, 31.3 % exhibited depressive symptoms. Of these, 39 % had previously received some form of mental health treatment, including 33.2 % who were prescribed antidepressants.

Conclusions

PROMIS-D is a useful screening questionnaire for patients in the orthopedic clinic, although there is a consistent floor effect. There are a number of patients who present to the orthopedic clinic who have depressive symptoms but have had no interaction with behavioral health. Given the impact depression can have on outcomes, screening for depressive symptoms should be considered as part of routine orthopedic practice.

AI-powered mental health communication: Examining the effects of affection expectations on health behavioral intentions

OBJECTIVES

This study proposed and examined users' expectations of chatbots in mental health communication and compared them with human doctors. Focusing on the affective expectation, we aimed to unveil the impacts of changes in affection on individuals' expectations and behavioral intentions.

METHODS

A 2 (chatbot vs. human doctor) x 2 (affective vs. neutral) online experiment (N = 364) was conducted. Participants were asked about their expectations towards communicating health with chatbots and human doctors, watched pre-recorded conversations, and answered questions about expectancy violation toward affection and willingness to further health actions.

RESULTS

Individuals have higher expectations from human doctors in almost all aspects. Individuals' expectation of online chat with doctors is more likely to be violated compared with chatbots. Significant results are found on individuals' behavioral intentions, with a greater likelihood of switching to online chatbots when chatbots use an affective approach or doctors use a neutral tone. Individual's past experiences with chatbots play a key role in expectancy violations.

CONCLUSION

Individuals have higher expectations of human doctors, but using an affective approach may better meet individuals' expectations toward chatbots and switch their behavioral intentions.

PRACTICE IMPLICATIONS

Chatbots that meet expectations can be designed and applied to address mental health concerns.

ChatGPT as a Complementary Mental Health Resource: A Boon or a Bane

The launch of Open AI's chatbot, ChatGPT, has generated a lot of attention and discussion among professionals in several fields. Many concerns and challenges have been brought up by researchers from various fields, particularly in relation to the harm that using these tools for medical diagnosis and treatment recommendations can cause. In addition, it has been debated if ChatGPT is dependable, efficient, and helpful for clinicians and medical professionals. Therefore, in this study, we assess ChatGPT's effectiveness in providing mental health support, particularly for issues related to anxiety and depression, based on the chatbot's responses and cross-questioning. The findings indicate that there are significant inconsistencies and that ChatGPT's reliability is low in this specific domain. As a result, care must be used when using ChatGPT as a complementary mental health resource.

Exercise habits and health behaviors on adolescent obesity

BACKGROUND AND PURPOSE

Obesity among children and adolescents continues to increase globally, and it is important to determine the factors associated with obesity among adolescents for the prevention and reduction of obesity. The purpose of this study is to understand the factors associated with the increase in the obesity rate among adolescents, providing a reference basis for the development of projects aimed at promoting adolescent health.

METHODS

Using the raw data of 2021 adolescent health behavior online survey, this study analyzed demographic sociological factors, mental health, exercise habits, health behaviors and other categorical variables, and conducted the frequency, χ2 test for the difference in the proportion of obese and non-obese. According to the hierarchy model of obesity-related variables, binary logistics regression is used for multivariate analysis. This study used the original data of the 2021 Youth Health Behavior Online Survey, and performed frequency, χ2 tests on the differences in the proportion of obese and non-obese for categorical variables such as demographic sociological factors, mental health, exercise habits, and health behaviors. Multivariate analysis was performed using binary logistic regression based on hierarchical models of obesity-related variables.

RESULTS

The obesity rate among Korean adolescents was 18.25 %. The obesity risk for females was reduced by 0.344 times compared to males (95 % CI = 0.327-0.361, p < 0.001); high school students had a 1.4 times higher obesity risk than middle school students (95 % CI = 1.379-1.511, p < 0.001); students with "Subjective household economic status" rated as "Medium" and 'Low' had their obesity risk increased by 1.07 times (95 % CI = 1.020-1.124, p < 0.01) and 1.254 times (95 % CI = 1.165-1.350, p < 0.001), respectively, compared to students with 'Subjective household economic status' rated as 'High'; students with 'Moderate' and 'Low' levels of 'Perceived stress' had their obesity risk reduced by 0.78 times (95 % CI = 0.74-0.823, P < 0.001) and 0.75 times (95 % CI = 0.70-0.803, P < 0.001), respectively, compared to students with 'High' levels of 'Perceived stress'; students engaging in 'Muscle strengthening exercise' '1-2 times/week' and "≥ 3 times/week" had their obesity risk reduced by 0.844 times (95% CI = 0.797-0.895, P < 0.001) and 0.575 times (95% CI = 0.537-0.616, P < 0.001), respectively, compared to students not participating in "Muscle strengthening exercise".

CONCLUSION

The obesity rate of boys is higher than that of girls and high school students is higher than that of middle school students, and obesity is inversely proportional to family economic status. Mental health factors, exercise habits and eating habits are all important factors affecting adolescent obesity. It is suggested that gender differences, psychological factors, health habits, obesity education and healthy eating habits suitable for different age groups should be considered in the formulation of adolescent obesity policy.

"I Think Peer Support Helps to Demystify People Who Have Mental Health Issues and Helps to Remove That Stigma": Exploring the Defining Characteristics and Related Challenges of Youth Peer Support Through Participatory Research

Despite the emerging body of literature on the benefits of youth peer support, there is also evidence that peer support can have unintended negative impacts on peers themselves. It is important to explore what aspects of the peer role contribute to these difficulties in order to mitigate risks. This paper uses a participatory approach to examine the unique attributes of youth peer practice and the related challenges. We conducted semi-structured interviews and focus groups with both peer and non-peer staff from a community-based youth mental health program that provides peer support services (N = 29). Thematic analyses were completed using QSR NVivo. Analyses capture the defining features and related challenges of the peer support role (self-disclosure, boundaries, role confusion and dynamic recovery), and risk factors that affect peers (stigma, exposure to harm and burnout). This paper contributes to the literature on peer support as well as youth participatory evaluation. The findings will be useful to support the development of improved organizational contexts for peer practice and more effective peer support programming.

Going Beyond Waitlists in Mental Healthcare

Managing waitlists for outpatient mental health services particularly in community health settings is difficult to standardize, poses an administrative burden, and are barriers rather than gateways to access to care particularly for low-income communities. While telehealth has initially expanded access to mental healthcare at the onset of the COVID-19 pandemic, it has not resolved the challenges associated with the increasing demand for services and the shortage of available providers. This commentary explores the intricate interconnections between wait times, readiness for and appropriateness of therapy, and engagement in treatment. Drawing on insights from waiting line theory to question the attachment to and utility of waitlists for non-emergency, outpatient mental healthcare, this commentary questions the utility and efficacy of waitlists. Alternative solutions that capitalize on community resources and collaboration and harness patients' agency for change are discussed.

Mental Health Outcomes of Mothers of Children With Congenital Gastrointestinal Anomalies Are Similar to Control Mothers: A Longitudinal Retrospective Cohort Study

PURPOSE

Mothers of infants born with congenital gastrointestinal surgical anomalies experience a unique caregiving role. Whether these challenges result in more mental health diagnoses than the general population is unknown. This study assessed mental health diagnoses in mothers of children born with congenital surgical anomalies (CSA) compared to mothers of children without CSA.

METHODS

A total of 780 mothers of children with CSA (case-mothers) and 6994 control-mothers were included. Mental health diagnoses were obtained using International Classification of Diseases 9 codes from an administrative database. Multivariate hazard ratios (HR) of mental health diagnoses were determined for mothers following childbirth, controlling for socioeconomic status, mental health diagnoses prior to childbirth, and age at childbirth. Subgroup analyses were completed for anxiety, depression, and post-traumatic stress disorder (PTSD). The association between a woman's mental health history and becoming a case-mother was analyzed using risk ratios (RR).

RESULTS

Case-mothers were not at increased risk of mental health disorders compared to controls (HR = 1.00; CI95 = 0.92-1.09). In aggregate analysis, no increased risk of anxiety, depression, or PTSD was found. Subgroup analyses revealed that congenital diaphragmatic hernia case-mothers had an increased risk of depression (HR = 1.43; CI95 = 1.08-1.88). No other case-mothers were at increased risk of mental health diagnoses, anxiety, depression, or PTSD. Only omphalocele was associated with mental health diagnoses before childbirth (RR = 1.89; CI95 = 1.58-2.26).

CONCLUSIONS

Collectively, mothers of children with CSAs did not have a greater risk of a mental health disorder, anxiety, depression, or PTSD compared to control-mothers. Only mothers of children with congenital diaphragmatic hernia had an increased risk of depression.

LEVEL OF EVIDENCE

II.

Development and Implementation of a Pediatric Nursing Emergency Behavioral Health Assessment Tool

INTRODUCTION

The national pediatric mental and behavioral health crisis dramatically increased emergency department mental and behavioral health visits and changed emergency nursing practice. Acuity assessment determines patient severity level and supports appropriate resources and interventions. There are no established nursing tools that assess pediatric mental or behavioral health acuity in the emergency department setting. Our goal was to develop and implement the novel pediatric emergency nurse Emergency Behavioral Health Acuity Assessment Tool.

METHODS

This quality-improvement project used the plan, do, study, act model to design/refine the Emergency Behavioral Health Acuity Assessment Tool and a non-experimental descriptive design to assess outcomes. The setting was a 47-bed urban level 1 pediatric trauma center with more than 60,000 annual visits. The team designed the tool using published evidence, emergency nurse feedback, and expert opinion. The tool objectively captured patient acuity and suggested acuity-specific nursing interventions. Project outcomes included acuity, length-of-stay, restraint use, and patient/staff injuries. Analyses included descriptive statistics and correlations.

RESULTS

With over 3000 annual mental/behavioral-related visits, the emergency department had an average daily census of 23 mental and behavioral health patients. Implementation occurred in August 2021. The Emergency Behavioral Health Acuity Assessment Tool dashboard provided the number of patients, patient location, and acuity. Length-of-stay did not change; however, patient restraint use and patient/staff injuries declined. Number of restraints positively correlated with moderate acuity levels (r = 0.472, P = 0.036).

DISCUSSION

For emergency nurses, the Emergency Behavioral Health Acuity Assessment Tool provided an objective measure of patient acuity. Targeted interventions can improve the care of this population.

Examining racial/ethnic inequities in treatment participation among perinatal individuals with depression

OBJECTIVE

A cluster randomized controlled trial (RCT) of two interventions for addressing perinatal depression treatment in obstetric settings was conducted. This secondary analysis compared treatment referral and participation among Minoritized perinatal individuals compared to their non-Hispanic white counterparts.

METHODS

Among perinatal individuals with depression symptoms, we examined rates of treatment 1) referral (i.e., offered medications or referred to mental health clinician), 2) initiation (i.e., attended ≥1 mental health visit or reported prescribed antidepressant medication), and 3) sustainment (i.e., attended >1 mental health visit per study month or prescribed antidepressant medication at time of study interviews). We compared non-Hispanic white (NHW) (n = 149) vs. Minoritized perinatal individuals (Black, Asian, Hispanic/Latina, Pacific Islander, Native American, Multiracial, and white Hispanic/Latina n = 157). We calculated adjusted odds ratios (aOR) for each outcome.

RESULTS

Minoritized perinatal individuals across both interventions had significantly lower odds of treatment referral (aOR = 0.48;95% CI = 0.27-0.88) than their NHW counterparts. There were no statistically significant differences in the odds of treatment initiation (aOR = 0.64 95% CI:0.36-1.2) or sustainment (aOR = 0.54;95% CI = 0.28-1.1) by race/ethnicity.

CONCLUSIONS

Perinatal mental healthcare inequities are associated with disparities in treatment referrals. Interventions focusing on referral disparities across race and ethnicity are needed.

The impact of COVID-19 on deaths from dementia and Alzheimer's disease in Chile: an analysis of panel data for 16 regions, 2017-2022

Background

Although several studies have documented the detrimental impacts of global COVID-19 containment measures on individuals with Alzheimer's disease and dementia, a comprehensive analysis of mortality rates for these conditions within the Chilean population is notably lacking. This study aimed to analyze the impact of COVID-19 on mortality rates among individuals with dementia and Alzheimer's disease in Chile.

Methods

A retrospective longitudinal cross-sectional study was conducted, considering mortality data for specific mental health conditions during the pre-pandemic and pandemic contexts of COVID-19 in Chile. Quantile regression techniques were employed to analyze the existence of differences between the two periods, while non-observable heterogeneity models for panel data methods were used to evaluate the effect of COVID-19 mortality on crude mortality rates.

Findings

Statistically significant differences were observed in the number of deaths from dementia and Alzheimer's disease between the pre-pandemic and COVID-19 pandemic periods. Specifically, crude mortality rates decreased by 10% (-0.10 [95% CI: -0.16, -0.05]) during the pandemic period. Furthermore, the number of deaths from COVID-19 during the pandemic period has a very weak incidence of deaths from mental health conditions such as dementia and Alzheimer's. Specifically, a unit percentage increase in confirmed cases from COVID-19 would result in a 7% (-0.07 [95% CI: -0.13, -0.001]) decrease in the number of deaths from dementia and Alzheimer's. These findings are supported by the application of panel regression with one-way random effects models.

Interpretation

The study findings indicate a reduction in mortality rates attributed to dementia and Alzheimer's disease during the COVID-19 pandemic in Chile. This decline could be attributed to the potential underreporting of mental illness as the cause of death during the pandemic period. Several studies have highlighted that approximately 30% of death certificates fail to document the presence of a dementia syndrome. Moreover, the cause of death recorded for individuals with mental health conditions may be influenced by the physician's familiarity with the patient or reflect the prevailing approach to managing end-stage dementia patients.

Funding

This work received no funding.

The association between economic uncertainty and suicide in Japan by age, sex, employment status, and population density: an observational study

Background

Suicide is one of the ten leading causes of death globally, and previous research has revealed a link between economic conditions and mental health. However, the literature has focused primarily on recessions and unemployment, i.e. actual economic developments, as opposed to uncertainty, which relates to economic developments that have not (yet) materialised. This study examines the differential association between economic uncertainty and suicide in Japan, depending on age, sex, employment status, and population density, in order to identify the groups that are affected the most.

Methods

Using monthly prefectural suicide mortality data from the Ministry of Health, Labour and Welfare and a monthly economic uncertainty index for the period 2009 to 2019, we employed a fixed effects panel data approach to examine the association between uncertainty and suicide by population group.

Findings

We found that a 1% increase in economic uncertainty is associated with a 0.061 increase in the monthly number of suicides per 100,000 people per prefecture, on average (coefficient: 6.08; 95% CI: 5.07-7.08), which constitutes a 3.62% increase. Self-employed people, as well as men in their 50s and unemployed men, experience the highest additional risk of suicide when uncertainty increases. The association was approximately three times stronger for males than for females, and a strong association was observed for self-employed males living in more densely-populated areas.

Interpretation

Uncertainty appears to relate to suicides for most groups, but self-employed people, males, and those living in more densely populated areas appear to be more at risk of suicide in periods of increased economic uncertainty. Our results provide an indication of which groups mental health services and prevention strategies can focus on in times of economic uncertainty.

Funding

None.

Suicidal thoughts and behaviors in the Kingdom of Saudi Arabia

OBJECTIVE

Suicidal thoughts and behaviors (STB) constitute an escalating public health concern globally. Despite the growing burden of suicidal ideation, plan, and attempts, national information on the trends of STB is lacking in the Kingdom of Saudi Arabia (KSA). Therefore, we aim to report on the prevalence, correlates, and treatment-seeking behaviors associated with STB in the country using nationally representative information from The Saudi National Mental Health Survey (SNMHS).

METHODS

The SNMHS is a national household survey of Saudi citizens aged 15-65 (n = 4004). The adapted Composite International Diagnostic Interview (CIDI) 3.0 was administered to produce lifetime and 12-month prevalence and treatment estimates of STB in the KSA. Associated correlates were calculated using cross tabulations and logistic regressions.

RESULTS

Suicidal ideation, plan, and attempt had respective lifetime prevalence rates of 4.90 %, 1.78 %, and 1.46 %; 12-month prevalence rates of 1.82 %, 0.89 %, and 0.63 %. Significant correlates of STB include younger age, female gender, low education, urban rearing, and singe marital status. STB were also significantly associated with the presence of prior mental disorders, childhood adversities, and low treatment-seeking.

CONCLUSIONS

High unmet need and significant sociocultural and psychological risk factors have been identified in association with STB in the KSA. Given the community-based nature of the SNMHS and the limited national data on STB in the Middle East and North Africa region, our findings can extend to inform the necessary healthcare policies, treatment plans, and prevention strategies needed to alleviate the burdens of STB in the region.

The mediating role of internalized weight bias and body esteem

BACKGROUND

Weight stigma is increasingly common in early adolescence and may lead to weight bias internalization, with negative consequences for mental health outcomes. This study aimed to: examine the relations of perceived weight stigma and internalized weight bias with early adolescents' internalizing symptoms and disordered eating behavior; explore the mediating role of internalized weight bias on the relations of perceived weight stigma with internalizing symptoms and disordered eating behaviors; examine body esteem as a mediator between internalized weight bias and mental health outcomes.

METHODS

A sample of 406 early adolescents (59.6% girls) aged between 11 and 13 participated in this cross-sectional study. They completed self-report measures assessing perceived weight stigma, internalized weight bias, body esteem, internalizing symptoms and disordered eating.

RESULTS

Path analysis indicated that perceived weight stigma was positively related with internalizing symptoms and internalized weight bias. Further, internalized weight bias was negatively related with body esteem and positively related with internalizing symptoms and disordered eating. Internalized weight bias mediated the relations of perceived weight stigma with internalizing symptoms, disordered eating and body esteem. Further, body esteem mediated the relations of internalized weight bias with internalizing symptoms and disordered eating behavior.

CONCLUSIONS

The findings highlight internalized weight bias as a psychological mechanism potentially explaining negative links of weight stigma with internalizing symptoms and disordered eating in early adolescence. The results emphasize the need for early intervention during this developmental stage, in order to prevent psychological and behavioral outcomes of weight stigma and internalized weight bias.

StresSense: Real-Time detection of stress-displaying behaviors

BACKGROUND

Wrist-worn gadgets like smartphones are ideal for unobtrusively gathering user data, in various fields such as health and fitness monitoring, communication, and productivity enhancement. They seamlessly integrate into users' daily lives, providing valuable insights and features without the need for constant attention or disruption. In sensitive domains like mental health, these devices provide user-friendly, privacy-protected means of diagnosis and treatment, offering a secure and cost-effective avenue for seeking help.

OBJECTIVES

This study addresses the limitations of traditional mental health assessment techniques, such as intrusive sensing and subjective self-reporting, by harnessing the unobtrusive data collection capabilities of smartphones. Equipped with accelerometers and other sensors, these devices offer a novel approach to mental health research. Our objective was to develop methods for real-time detection of stress and boredom behavior markers using smart devices and machine learning algorithms.

METHODOLOGY

By leveraging data from accelerometers (A), gyroscopes (G), and magnetometers (M), we compiled a dataset indicative of stress-related behaviors and trained various machine-learning models for predictive accuracy. The methodology involved collecting data from motion sensors (A, G, and M) on the dominant arm's wrist-worn smartphone, followed by data preprocessing, transformation from time series format, and training a Deep Neural Network (DNN) model for activity recognition.

FINDINGS

Remarkably, the DNN achieved an accuracy of 93.50% on test data, outperforming traditional and ensemble machine learning methods across different window sizes, and demonstrated real-time accuracy of 77.78%, validating its practical application.

CONCLUSION

In conclusion, this research presents a novel dataset for detecting stress and boredom behaviors using smartphones, reducing reliance on costly devices and offering a more objective assessment. It also proposes a DNN-based method for wrist-worn devices to accurately identify complex activities associated with stress and boredom, with benefits in terms of privacy and user convenience. This advancement represents a significant contribution to the field of mental health research, providing a less intrusive and more user-friendly approach to monitoring mental well-being.

Psychosocial Burden During the COVID-19 Pandemic in Adolescents With Type 1 Diabetes in Germany and Its Association With Metabolic Control

PURPOSE

To investigate the psychosocial burden during the COVID-19 pandemic in adolescents with type 1 diabetes and its association with metabolic control.

METHODS

Prospective multicenter observational cohort study based on data from the German Diabetes Prospective Follow-up Registry. Adolescents aged 12-20 years with type 1 diabetes were asked during routine follow-up visits to complete a questionnaire on psychosocial distress and daily use of electronic media during the COVID-19 pandemic from June 2021 to November 2022. Well-being, anxiety, and depression symptoms were assessed using World Health Organization Five Well-Being Index (WHO-5), General Anxiety Disorder scale 7 (GAD-7), and Patient Health Questionnaire-9 questionnaires. The impact of mental health symptoms on metabolic control was analyzed by using multivariable linear regression models adjusted for sex, diabetes duration, treatment, socioeconomic deprivation, and immigrant background.

RESULTS

Six hundred eighty eight adolescents (45.6% females) from 20 diabetes centers participated. Compared with a prepandemic cohort, WHO-5 scores were lower during the COVID-19 pandemic (estimated mean difference -9.6 [95% confidence interval -11.6; -7.6], p < .001), but GAD-7 scores were not different (estimated mean difference 0.6 [95% confidence interval -0.2; 1.5], p = .14). HbA1c was significantly positively associated with GAD-7 and Patient Health Questionnaire-9 and negatively associated with WHO-5 scores (all p < .001). Daily electronic media use was positively associated with adjusted mental health symptoms (all p < .01).

DISCUSSION

Although the overall well-being of adolescents with type 1 diabetes was reduced during the later phase of the COVID-19 pandemic, the additional psychological burden was relatively low. However, mental health symptoms were associated with poorer metabolic control and higher use of electronic media.

Evolution of Sleep Duration and Screen Time Between 2018 and 2022 Among Canadian Adolescents: Evidence of Drifts Accompanying the COVID-19 Pandemic

PURPOSE

We quantified the joint evolution of sleep duration and screen time between 2018 and 2022 in a large sample of adolescents from Quebec, Canada, to ascertain changes that occurred during the COVID-19 pandemic.

METHODS

A natural experiment design was used to compare variations from year to year and in association with the pandemic outbreak. Using structural equation modeling on data collected between 2018 and 2022 among adolescents attending 63 high schools, we analyzed the joint evolution of sleep duration and screen time while adjusting for previous year values, concurrent flourishing score, sex, age, and family level of material deprivation.

RESULTS

A total of 28,307 adolescents, aged on average 14.9 years, were included in the analyses. Between 2019 and 2022, sleep duration increased by 9.6 (5.7, 13.5) minutes and screen time by 129.2 (120.5, 138.0) minutes on average. In 2022, the adolescents spent almost equal amounts of time sleeping and using screens. Lower flourishing scores were associated with shorter sleep duration and lengthier screen time. Girls' screen time became similar to boys' over time.

DISCUSSION

Adolescents now spend almost equal amounts of time sleeping and using screens, a situation that calls for urgent public health actions. These findings highlight the importance of tracking changes in adolescents' behaviours over time, to design and implement interventions adapted to the changing health needs of different groups.

Positive school climate and strong school identification as protective factors of adolescent mental health and learning engagement: A longitudinal investigation before and during COVID-19

The COVID-19 pandemic resulted in significant disruptions for children and youth around the world, especially given school closures and shifts in teaching modes (on-line and hybrid). However, the impact of these disruptions remains unclear given data limitations such as a reliance on cross-sectional and/or short-interval surveys as well as a lack of broad indicators of key outcomes of interest. The current research employs a quasi-experimental design by using an Australian four-year longitudinal survey with student responses from Grade 7 to 10 (aged 12-15 years old) (N = 8,735 from 20 schools) in one education jurisdiction. Responses are available pre-pandemic (2018 and 2019) and during the pandemic (2020 and 2021). Importantly the survey included measures of well-being, mental health and learning engagement as well as potential known school-environment factors that could buffer against adversity: school climate and school identification. The findings were generally in line with key hypotheses; 1) during COVID-19 students' learning engagement and well-being significantly declined and 2) students with more positive school climate or stronger school identification pre-COVID-19 fared better through the disruption of the pandemic. However, these same students suffered from a steeper decline in well-being and engagement which may be explained through the impact of losing meaningful social or group connections. This decline was evident after controlling for gender, academic grade (as a proxy of age), parental education, and socioeconomic status. It is concluded that investing in the social environment of schools is important in crisis preparedness and can facilitate better crisis response among youth.

The effectiveness of virtual reality training on knowledge, skills and attitudes of health care professionals and students in assessing and treating mental health disorders: a systematic review

BACKGROUND

Virtual reality (VR) training can enhance health professionals' learning. However, there are ambiguous findings on the effectiveness of VR as an educational tool in mental health. We therefore reviewed the existing literature on the effectiveness of VR training on health professionals' knowledge, skills, and attitudes in assessing and treating patients with mental health disorders.

METHODS

We searched MEDLINE, PsycINFO (via Ovid), the Cochrane Library, ERIC, CINAHL (on EBSCOhost), Web of Science Core Collection, and the Scopus database for studies published from January 1985 to July 2023. We included all studies evaluating the effect of VR training interventions on attitudes, knowledge, and skills pertinent to the assessment and treatment of mental health disorders and published in English or Scandinavian languages. The quality of the evidence in randomized controlled trials was assessed with the Cochrane Risk of Bias Tool 2.0. For non-randomized studies, we assessed the quality of the studies with the ROBINS-I tool.

RESULTS

Of 4170 unique records identified, eight studies were eligible. The four randomized controlled trials were assessed as having some concern or a high risk of overall bias. The four non-randomized studies were assessed as having a moderate to serious overall risk of bias. Of the eight included studies, four used a virtual standardized patient design to simulate training situations, two studies used interactive patient scenario training designs, while two studies used a virtual patient game design. The results suggest that VR training interventions can promote knowledge and skills acquisition.

CONCLUSIONS

The findings indicate that VR interventions can effectively train health care personnel to acquire knowledge and skills in the assessment and treatment of mental health disorders. However, study heterogeneity, prevalence of small sample sizes, and many studies with a high or serious risk of bias suggest an uncertain evidence base. Future research on the effectiveness of VR training should include assessment of immersive VR training designs and a focus on more robust studies with larger sample sizes.

TRIAL REGISTRATION

This review was pre-registered in the Open Science Framework register with the ID-number Z8EDK.

Changes and predictors of mental health of Chinese university students after the COVID-19 pandemic: A two-year study

BACKGROUND

Psychological repurcussions of COVID-19 pandemic has received wide attention, but there's limited attention paid to psychological recovery afterwards. This study focuses on the changes and predictive factors of mental health of Chinese university students post-pandemic.

METHODS

This study included 1175 Chinese undergraduate students sampled in May 2022 and May-June 2023, right before and after peaks of infections following the end of lockdown policy in China. The participants completed a survey of demographic variables, and three questionnaires: 12-item General Health Questionnaire, Positive Psychological Capital Questionnaire, and Prosocial Tendencies Measure.

RESULTS

The participants sampled in 2023 have significant lower GHQ scores and higher PPQ scores than those sampled in 2022, while there is no significant difference in PTM scores between them. The proportion of participants with GHQ-12 scores exceeding 12 in 2023 showed slightly decrease compared to that in 2022. The infection of significant others, the sense of hope, and PPQ self-efficiency, hope and optimism subscale scores were significantly associated with GHQ-12 scores in 2023, but actual infection or quarantine experience were not.

CONCLUSIONS

The mental health and psychological capital of the university students have been significantly improved within a year. It is worthy to pay attention to the infection of significant others, the sense of hope, and psychological capital in a pandemic to improve the mental health of university students.

LIMITATIONS

Compared to a cross-sectional study, longitudinal research is the better choice for a two-year comparison.

Understanding Wellbeing Profiles According to White Matter Structural Connectivity Sub-types in Early Adolescents: The First Hundred Brains Cohort from the Longitudinal Adolescent Brain Study

Wellbeing is protective against the emergence of psychopathology. Neurobiological markers associated with mental wellbeing during adolescence are important to understand. Limited research has examined neural networks (white matter tracts) and mental wellbeing in early adolescence specifically. A cross-sectional diffusion tensor imaging analysis approach was conducted, from the Longitudinal Adolescent Brain study, First Hundred Brains cohort (N = 99; 46.5% female; Mage = 13.01, SD = 0.55). Participants completed self-report measures including wellbeing, quality-of-life, and psychological distress. Potential neurobiological profiles using fractional anisotropy, axial, and radial diffusivity were determined via a whole brain voxel-wise approach, and hierarchical cluster analysis of fractional anisotropy values, obtained from 21 major white matter tracts. Three cluster groups with significantly different neurobiological profiles were distinguished. No significant differences were found between the three cluster groups and measures of wellbeing, but two left lateralized significant associations between white matter tracts and wellbeing measures were found. These results provide preliminary evidence for potential neurobiological markers of mental health and wellbeing in early adolescence and should be tracked longitudinally to provide more detailed and robust findings.

Increased Care Provision and Caregiver Wellbeing: Moderation by Changes in Social Network Care Provision

OBJECTIVES

Previous research links increased care provision to worse wellbeing among family and friend caregivers, both before and during the coronavirus disease 2019 (COVID-19) pandemic. We expand on this by incorporating data on caregivers' social networks and exploring the relationships between own and network changes in care during the pandemic and caregiver wellbeing.

METHODS

We use nationally representative data from 1,876 family and friend caregivers in the first wave of our Care Network Connections over Time study (fielded 12/17/2020-1/4/2021) who had provided care continuously since before the COVID-19 pandemic began. Caregivers were asked about the amount of care that they and each member of their social networks were providing at the time of the survey relative to before the pandemic. We use multivariate regression models to examine the associations between five caregiver wellbeing outcomes and changes in care, and explore the moderating role of networks' changes in care.

RESULTS

Among caregivers who had provided care since prior to the pandemic, most increased (42.0%) or maintained the same (40.8%) care. Their networks also typically increased (33.4%) or maintained (46.5%) care. Increasing one's own care provision was associated with higher levels of anxiety, depression, loneliness, and emotional difficulty than maintaining stable care. Among those who increased care, these levels were highest when the network also increased or decreased care.

DISCUSSION

Increased care provision was most strongly associated with poor caregiver wellbeing in contexts where caregivers' social networks also changed care provisions. Supports for caregivers undertaking additional care tasks should take into account caregivers' networks.

Adverse childhood experiences among doctor of pharmacy students

OBJECTIVE

Adverse Childhood Experiences (ACEs) have demonstrated negative impact on physical, emotional, and cognitive health outcomes. This study aimed to assess prevalence of ACEs among Doctor of Pharmacy (PharmD) students, and their associations with mental health, substance use, academic performance, and sleep patterns.

METHODS

A cross-sectional survey was conducted on PharmD students at a private University. ACE scores, mental health history, substance use, academic performance, and sleep habits were self-reported. Descriptive statistics and chi-square tests were used for analysis.

RESULTS

From 54 participants across all cohorts of students in the curriculum (response rate: 19%), 48% reported ≥4 ACEs. A majority of students reported having been diagnosed with or sought treatment for depression (56%) or anxiety (67%), while 42.9% reported a history of contemplating suicide. Participants with ACE scores of ≥4 were more likely to have sought treatment for depression, any mental health condition, contemplated suicide, or used alcohol for mental health purposes. No differences in academic performance based on ACE scores were found.

CONCLUSION

High numbers of ACEs were common and linked to mental illness, suicidality, and use of alcohol for mental health purposes. While no direct academic impact was found in this small sample size, adopting a trauma-informed approach is crucial to supporting student well-being. Further research in this area is needed to optimize interventions to support academic and professional success among students with ≥4 ACEs.

Homelessness and Food Insecurity During Emerging Adulthood: Associations With Changes in Behavioral and Physical Health Over a Two-Year Period

PURPOSE

For emerging adults in the United States, economic instability is a widespread problem with implications for the successful transition to adulthood. This study examines how two indicators of economic instability, homelessness and food insecurity, are associated with changes in health-related outcomes over a two-year period.

METHODS

The analytic sample (N = 2,182) completed online surveys in 2019-2020 (mean age 23 years) and 2021-2022 (mean age 25 years). Regression analyses were conducted for the full sample, as well as by sexual or gender diverse (SGD) identity (17.8% of sample identified as SGD) and race/ethnicity (76.3% identified as non-White).

RESULTS

At age 23, 8.2% of participants reported homelessness and 31.2% reported food insecurity. In the full sample, homelessness and food insecurity were associated with increased depression, anxiety, physical ailments, and drug problems two years later. A similar pattern emerged for those identifying as non-SGD. The only associations for SGD-identifying participants were food insecurity with increased anxiety, depression, and physical ailments. Racial/ethnic differences indicated that homelessness was associated with increased depression and anxiety among Hispanics, and physical ailments and drug consequences among Asians, but fewer drug problems among Whites. Food insecurity was associated with increased depression in all racial/ethnic groups, anxiety among Hispanics and Asians, physical ailments among Whites and Asians, and drug problems among Asians.

DISCUSSION

Homelessness and food insecurity predicted worse health outcomes during the transition to adulthood, with varying results across SGD and racial/ethnic subgroups. It is important for future research to continue examining long-term effects of economic instability on health disparities during this important developmental period.

Potential strategies for supporting mental health and mitigating the risk of burnout among healthcare professionals: insights from the COVID-19 pandemic

Healthcare professionals (HCPs) experienced prolonged stressful conditions during the coronavirus disease 2019 pandemic, and the global situation (particularly in the United Kingdom) meant that they continue to sustain mental stress related to the subsequent cost-of-living and healthcare budgeting crises. The psychological toll on HCPs may lead to increased staff attrition, adversely impacting the quality of patient care and work security. To help mitigate this psychological impact, the current evidence is strongly supportive of healthcare providers consistently adopting programmes fostering improvement in coping and resilience, facilitating healthy lifestyle, and allocating some resources for therapeutic strategies (e.g. cognitive behavioural therapy-based strategies and other strategies specified to trauma-related issues) which can be delivered by trained professionals. We stress that some approaches are not a one-size-fits-all strategy, and we also highlight the need to encourage treatment-seeking among those who need it. These strategies are highly relevant to healthcare employers and policymakers to support all HCPs in settings marked by prolonged periods of stress. The investment in these strategies are expected not only to reduce staff attrition in the long-term, but are likely to add to the cost-effectiveness of overall healthcare budgetary allocation.

Student loan debt and mental health: a comprehensive review of scholarly literature from 1900 to 2019

PURPOSE

The review had two purposes. The first was to examine the nature and extent of published literature on student loan and the second was to systematically review the literature on student loans and mental health.

MATERIALS AND METHODS

Data from academic databases (1900-2019) were analyzed using two methods. First, topic modeling (a text-mining tool that utilized Bayesian statistics to extract hidden patterns in large volumes of texts) was used to understand the topical coverage in peer-reviewed abstracts (n = 988) on student debt. Second, using PRISMA guidelines, 46 manuscripts were systematically reviewed to synthesize literature linking student debt and mental health.

RESULTS

A model with 10 topics was selected for parsimony and more accurate clustered representation of the patterns. Certain topics have received less attention, including mental health and wellbeing. In the systematic review, themes derived were categorized into two life trajectories: before and during repayment. Whereas stress, anxiety, and depression dominated the literature, the review demonstrated that the consequences of student loans extend beyond mental health and negatively affect a person's wellbeing. Self-efficacy emerged as a potential solution.

DISCUSSION AND CONCLUSION

Across countries and samples, the results are uniform and show that student loan burdens certain vulnerable groups more. Findings indicate diversity in mental health measures has resulted into a lack of a unified theoretical framework. Better scales and consensus on commonly used terms will strengthen the literature. Some areas, such as impact of student loans on graduate students or consumers repaying their loans, warrant attention in future research.

Mothers' Experiences During the 2022 Infant Formula Shortage in Washington D.C

INTRODUCTION

An unprecedented shortage of infant formula occurred in the United States (U.S.) in 2022 and posed widespread challenges to infant feeding nationwide. The purpose of this study is to investigate mothers' experiences during the 2022 infant formula shortage and its perceived impacts on infants' diet and health.

METHODS

Mothers (n = 45) of infants under 8 months old from Washington D.C. were invited to participate in a virtual study meeting during the summer of 2022. Mothers completed surveys regarding their demographics, infants' anthropometrics, infant feeding practices, information they have received about infant feeding, and knowledge about infant feeding practices. They then participated in a qualitative interview about their experiences during the infant formula shortage.

RESULTS

Overarching themes were: the shortage (1) had adverse impacts on mothers' mental and emotional health; (2) had significant financial and intangible costs; (3) led to changes in infant feeding practices; (4) social and family networks were helpful in navigating the shortage; and (5) mothers felt fortunate to have resources to breastfeed and/or obtain formula.

DISCUSSION

The infant formula shortage adversely impacted mothers' mental and emotional health, and was costly, in terms of financial and intangible costs. Findings demonstrate the need to develop clinical and policy approaches to support mothers in feeding their infants and provide education about safe infant feeding practices.

Design, Recruitment, and Implementation of Research Interventions Among Youth Experiencing Homelessness: A Systematic Review

Transitional age youth experiencing homelessness (TAY-EH) represent an underserved and understudied population. While an increasing number of empirical interventions have sought to address the high burden of psychopathology in this population, findings remain mixed regarding intervention effectiveness. In this systematic review of behavioral health interventions for TAY-EH, we sought to examine the structural framework in which these interventions take place and how these structures include or exclude certain populations of youth. We also examined implementation practices to identify how interventions involving youth and community stakeholders effectively engage these populations. Based on PRISMA guidelines, searches of Medline, PsycInfo, Embase, Cochrane Central, Web of Science, and ClinicalTrials.gov databases were conducted, including English language literature published before October 2022. Eligible studies reported on interventions for adolescent or young adult populations ages 13-25 years experiencing homelessness. The initial search yielded 3850 citations; 353 underwent full text review and 48 met inclusion criteria, of which there were 33 unique studies. Studies revealed a need for greater geographic distribution of empirically based interventions, as well as interventions targeting TAY-EH in rural settings. Studies varied greatly regarding their operationalizations of homelessness and their method of intervention implementation, but generally indicated a need for increased direct-street outreach in participant recruitment and improved incorporation of youth feedback into intervention design. To our knowledge, this is the first systematic review to examine the representation of various groups of TAY-EH in the literature on substance use and mental health interventions. Further intervention research engaging youth from various geographic locations and youth experiencing different forms of homelessness is needed to better address the behavioral health needs of a variety of TAY-EH.

Overcoming adversity during the COVID-19 pandemic: Longitudinal stability of psychosocial resource profiles of elite athletes and their association with perceived stress

Previous research has demonstrated that psychosocial resources are associated with elite athletes' perceived stress. However, these resources have mainly been studied separately. Using a person-oriented approach, this study aimed to identify meaningful profiles of athletes' psychosocial resources, their stability over time, and their relationship with perceived stress during the COVID-19 pandemic. To identify such patterns, separate latent profile analyses (LPA) at two measurement points T1 (June 2020) and T2 (March 2021) and a subsequent latent transition analysis (LTA) were conducted with athletic identity, resilience, perceived social support, and self-esteem for a sample of 373 Swiss elite athletes. Perceived stress was analyzed at and between T1 and T2 with a mixed-design ANOVA. For LPA, theoretical considerations and statistical criteria led to a solution of four profiles: (1) Athletic Identifiers With Above-Average Resources (nT1 = 235; nT2 = 240), (2) Below-Average Athletic Identifiers With Below-Average Resources (nT1 = 84; nT2 = 90), (3) Variable Athletic Identifiers With Below-Average Internal and Clearly Below-Average External Resources (nT1 = 14; nT2 = 7), and (4) Athletic Identifiers With Below-Average Internal and Above-Average External Resources (nT1 = 40; nT2 = 36). For LTA, both structural and individual stability was demonstrated. A large and significant main effect of perceived stress was observed for resource profiles, while there was no significant main effect for measurement point nor interaction effect. Direct comparisons revealed that Athletic Identifiers With Above-Average Resources perceived significantly less stress than the other profiles at both time points. In conclusion, regardless of psychosocial resource profile, the perceived stress of elite athletes was stable during the COVID-19 pandemic, but exhibiting a pattern with high psychosocial resources seems to buffer against stress compared to a lack of specific resources. Therefore, sport federations and practitioners should provide tailored support programs to help athletes build all these resources.

Exploring experiences with alcohol and how drinking has changed over time among minority ethnic groups with a diagnosed mental health problem

INTRODUCTION

Minority ethnic groups are more likely to experience poor mental health but less likely to seek formal support. Mental health problems and alcohol use (including non-drinking) co-occur, the reasons for this among minority ethnic groups are not well understood. This study explored i) alcohol use among minority ethnic individuals with a mental health problem,ii) how alcohol was used before individuals received support for their mental health,iii) how alcohol changed whilst and after individuals received treatment for their mental health.

METHODS

Participants were purposively sampled through community/online mental health organisations. Participants took part if they i)were not White British, ii) had a mental health diagnosis, iii) drank at hazardous and above levels or former drinkers. Telephone/online semi-structured interviews were conducted. Data were analysed using framework analysis with an intersectional lens.

RESULTS

25 participants took part. Four themes were developed; "drinking motivations", "mental health literacy and implications on drinking behaviour", "cultural expectations and its influence on mental health problems and drinking practices", and "reasons for changes in drinking". Themes reflect reasons for drinking and the role of understanding the range of mental health problems and implicit cultural expectations. An intersectional lens indicated gendered, ethnic and religious nuances in experiences with alcohol and seeking support. Engaging with formal support prompted changes in drinking which were facilitated through wider support.

CONCLUSION

There were specific reasons to cope among minority ethnic individuals who have a mental health problem. Applying an intersectional lens provided an insight into the role of cultural and gendered expectations on mental health and drinking practices. Mental health literacy and implicit cultural expectations within specific minority ethnic groups can affect both mental health and drinking practices. Healthcare professionals and wider community play an important role in prompting changes in drinking among minority ethnic groups who have a mental health problem.

Mental health treatment utilization among Gulf War era veterans with probable alcohol use disorder

INTRODUCTION

Alcohol use disorder (AUD) is prevalent among veterans, and excessive alcohol use is associated with significant mental and physical health consequences. Currently, the largest cohort of veterans seeking services at the VA are those from the 1990s Gulf War Era. This cohort of veterans is unique due to the nature of their deployment resulting in a myriad of unexplained symptoms collectively known as "Gulf War Illness" and higher rates of mental health problems. The present study sought to examine the association between probable AUD and mental health treatment utilization in a sample of 1126 (882 male) Gulf War-era veterans.

METHODS

Veterans completed a self-report survey including the AUDIT-C, questions about mental health treatment engagement, and demographic questions.

RESULTS

Results demonstrated that approximately 20 % of the sample screened positive for probable AUD, determined by standard AUDIT-C cutoff scores. Among those screening positive for AUD, 25 % reported engaging in mental health treatment in the past year. Veterans with probable AUD who use VA care had 3.8 times the odds of receiving mental health services than veterans not using VA care. Use of mental health services was associated with mental health comorbidity and identifying as Black/African American.

CONCLUSIONS

The results of the present study highlight a significant unmet need for mental health treatment among Gulf War-era veterans with AUD.

Identity Development and Disruption in Older Adults During COVID-19: A Longitudinal, Mixed-Methods Study

OBJECTIVES

Disruptive life events, such as the coronavirus disease 2019 (COVID-19) pandemic, may trigger adjustment and revision of older adults' identities. This mixed-methods study explored how older adults perceived their identities changing as a result of the pandemic, and how such identity dynamics related to pandemic-related events and well-being.

METHODS

Participants included 2,248 older adults who participated in the longitudinal COVID-19 Coping Study spanning from April/May 2020 to April/May 2021. Mean age was 67.8 years, 70% were women, and 93% were White. We used qualitative thematic analysis to identify the ways the pandemic affected participants' identities. We then investigated the association between identity themes and testing positive for COVID-19, having a friend or family member hospitalized or dying due to COVID-19, or being vaccinated. Finally, we tested whether identity disruption was associated with 12-month trajectories of well-being (including life satisfaction, loneliness, depressive symptoms, anxiety, and self-rated health) using latent growth curve models.

RESULTS

Some participants reported positive identity themes, such as rethinking and revising priorities and realization of strength and resilience. Others indicated harmful effects, including identity disruption. Individuals reporting identity disruption had worse well-being at baseline and remained consistently worse over time.

DISCUSSION

Findings highlight that identity remains malleable in later life and that stressful events like the COVID-19 pandemic may trigger positive adaptive identity processes, but can also cause identity disruption that is associated with persistently worse well-being over time.

The Economic Effect of Peer Recovery Support Services: A Review of the Literature

Peer Recovery Support Services (PRSS) have the potential to be an economically valuable intervention. To investigate this potential, we conducted a scoping review to summarize existing research on the economic impact of PRSS. We searched relevant electronic databases for peer-reviewed articles and grey literature between January 2000 and February 2023 that examined an economic outcome related to PRSS. Following a comprehensive search, screening, and full-text evaluation, eight articles were selected for review. The majority of the studies we identified focused on healthcare cost-avoidance. Some studies supported PRSS as a method of avoiding costly medical services, while others had mixed results. Our scoping review revealed limited studies addressing cost savings associated with PRSS and further research on the economic impact of PRSS is warranted.