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Zhang Z, Lin R, Qiu A, Wu H, Wu S, Zhang L, Wu Z, Li M, Zhang X, Zhou J. Application of DASS-21 in Chinese students: invariance testing and network analysis. BMC Public Health 2024; 24:2934. [PMID: 39443919 PMCID: PMC11515758 DOI: 10.1186/s12889-024-20123-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 09/18/2024] [Indexed: 10/25/2024] Open
Abstract
BACKGROUND The Depression Anxiety Stress Scale-21 Items (DASS-21) is commonly used to assess the mental health of students, but there is a need for further clarification regarding its equivalence, structure, and core items. METHODS We conducted a confirmatory factor analysis (CFA) on a sample of 7943 Chinese students to examine the performance of the DASS-21 and assess measurement invariance. Additionally, we utilized network analysis to investigate the structure and centrality of students' mental health. RESULTS Our findings revealed a stable three-factor structure for the DASS-21, characterized by high correlations among depression, anxiety, and stress. The DASS-21 demonstrated strict invariance across genders and weak invariance across levels of education. Network analysis indicated that symptoms of depression, anxiety, and stress form clusters, with some symptoms exhibiting strong correlations with each other. CONCLUSION Our study highlights a substantial interrelation among depression, anxiety, and stress, revealing a structurally clustered pattern. Network analysis underscores the interconnectedness and centrality of these symptoms, recommending a shorter version of the DASS, and emphasizing the imperative for targeted interventions aimed at improving the psychological well-being of students.
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Affiliation(s)
- Zheng Zhang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
- School of Educational Science, Anhui Normal University, Wuhu, China
| | - Ruoheng Lin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Andi Qiu
- Faculty of Social Sciences, School of Education, The University of Sheffield, Sheffield, S10 2TN, UK
| | - Huifeng Wu
- School of Educational Science, Anhui Normal University, Wuhu, China
| | - Shuo Wu
- School of Economics, East China Normal University, Shanghai, 200241, China
- Center for Economics and Management, East China Normal University, Shanghai, 200241, China
| | - Le Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, PR China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zijun Wu
- Xiangya School of Public Health, Central South University, Changsha, 410083, China
| | - Mengna Li
- Nanmen Middle and Special Primary School in Chengxiang District, Putian, 351100, China
| | - Xiangbin Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, PR China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
- Multi-Modal Monitoring Technology for Severe Cerebrovascular Disease of Human Engineering Research Center Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Jiansong Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.
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Lehti V, Salama E, Niemelä S, Tanskanen A, Gissler M, Suvisaari J, Taipale H. Use of benzodiazepine and related drugs in migrants and Finnish-born persons: a nationwide register-based study. Scand J Public Health 2023; 51:1222-1230. [PMID: 35876428 PMCID: PMC10642218 DOI: 10.1177/14034948221112470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 05/20/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022]
Abstract
AIMS Benzodiazepines and related drugs (BZDR) are often used longer than generally recommended. The aim is to study patterns of use among migrant and Finnish-born users of BZDR, and to identify factors that are associated with long-term use and BZDR polytherapy. METHODS This register-based study includes a nationwide sample of migrants (n=8729) and their Finnish-born controls (n=11 388) who had purchased BZDR in 2011-2014, but not in 2009-2010. Information on drug purchases was obtained from the National Prescription Register and the duration of drug use was estimated using PRE2DUP method. The main outcomes were long-term use of BZDR, polytherapy and time until discontinuation of BZDR use. Sociodemographic variables and information on preceding psychiatric diagnoses were included as covariates. Logistic and Cox regression analyses were the statistical methods used. RESULTS Only migrants from Sub-Saharan Africa were more likely to discontinue the medication once initiated than Finnish-born users. Migrants were significantly less likely to be long-term users (adjusted odds ratio 0.79, 95% CI 0.70-0.89) or polytherapy users (aOR 0.90, 95% CI 0.84-0.97) of BZDR compared with Finnish-born participants. CONCLUSIONS Migrants had less long-term and concomitant use of several BZDR than Finnish-born participants. The pattern of use is more optimal among migrants, but it may also reflect poorer access to mental health treatment.
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Affiliation(s)
- Venla Lehti
- Finnish Institute for Health and Welfare, Equality Unit, Finland
- University of Helsinki and Helsinki University Hospital; Department of Psychiatry, Finland
| | - Essi Salama
- Doctoral Programme for Clinical Investigation, Faculty of Medicine, University of Turku, Finland
- Department of Child Psychiatry, Turku University Hospital, Finland
| | - Solja Niemelä
- Department of Psychiatry, University of Turku, Finland
- Department of Psychiatry, Addiction Psychiatry Unit, Turku University Hospital, Finland
| | - Antti Tanskanen
- University of Eastern Finland, Department of Forensic Psychiatry, Niuvanniemi Hospital, Kuopio, Finland
- Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden
- Finnish Institute for Health and Welfare, Impact Assessment Unit, Finland
| | - Mika Gissler
- Karolinska Institutet, Department of Molecular Medicine and Surgery and Region Stockholm, Academic Primary Health Care Centre, Sweden
- Finnish Institute for Health and Welfare, Department of Knowledge Brokers, Helsinki, Finland
- University of Turku, Research Centre for Child Psychiatry, Finland
| | - Jaana Suvisaari
- Finnish Institute for Health and Welfare, Equality Unit, Finland
| | - Heidi Taipale
- Finnish Institute for Health and Welfare, Equality Unit, Finland
- University of Eastern Finland, Department of Forensic Psychiatry, Niuvanniemi Hospital, Kuopio, Finland
- Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden
- University of Eastern Finland, School of Pharmacy, Kuopio, Finland
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Jing F, Li Z, Qiao S, Ning H, Zhou S, Li X. Association between immigrant concentration and mental health service utilization in the United States over time: A geospatial big data analysis. Health Place 2023; 83:103055. [PMID: 37311276 PMCID: PMC10527759 DOI: 10.1016/j.healthplace.2023.103055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/27/2023] [Accepted: 05/31/2023] [Indexed: 06/15/2023]
Abstract
Immigrants (foreign-born United States [US] citizens) generally have lower utilization of mental health services compared with US-born counterparts, but extant studies have not investigated the disparities in mental health service utilization within immigrant population nationwide over time. Leveraging mobile phone-based visitation data, we estimated the average mental health utilization in contiguous US census tracts in 2019, 2020, and 2021 by employing two novel outcomes: mental health service visits and visit-to-need ratio (i.e., visits per depression diagnosis). We then investigated the tract-level association between immigration concentration and mental health service utilization outcomes using mixed-effects linear regression models that accounted for spatial lag effects, time effects, and covariates. This study reveals spatial and temporal disparities in mental health service visits and visit-to-need ratio among different levels of immigrant concentration across the US, both before and during the pandemic. Tracts with higher concentrations of Latin American immigrants showed significantly lower mental health service utilization visits and visit-to-need ratio, particularly in the US West. Tracts with Asian and European immigrant concentrations experienced a more significant decline in mental health service utilization visits and visit-to-need ratio from 2019 to 2020 than those with Latin American concentrations. Meanwhile, in 2021, tracts with Latin American concentrations had the least recovery in mental health service utilization visits. The study highlights the potential of geospatial big data for mental health research and informs public health interventions.
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Affiliation(s)
- Fengrui Jing
- Geoinformation and Big Data Research Lab, Department of Geography, University of South Carolina, Columbia, SC, 29208, USA; Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA.
| | - Zhenlong Li
- Geoinformation and Big Data Research Lab, Department of Geography, University of South Carolina, Columbia, SC, 29208, USA; Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA
| | - Shan Qiao
- Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA; Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Huan Ning
- Geoinformation and Big Data Research Lab, Department of Geography, University of South Carolina, Columbia, SC, 29208, USA; Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA
| | - Suhong Zhou
- School of Geography and Planning, Sun Yat-sen University, Guangzhou, 510275, China
| | - Xiaoming Li
- Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA; Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
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Masoud A, Kurki T, Brunila K, Holm G. Racialised Integration: Arabic-Speaking Refugees and Immigrants’ Experiences on the Paradoxes of Integration. NORDIC JOURNAL OF MIGRATION RESEARCH 2023. [DOI: 10.33134/njmr.543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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Mesa-Vieira C, Haas AD, Buitrago-Garcia D, Roa-Diaz ZM, Minder B, Gamba M, Salvador D, Gomez D, Lewis M, Gonzalez-Jaramillo WC, Pahud de Mortanges A, Buttia C, Muka T, Trujillo N, Franco OH. Mental health of migrants with pre-migration exposure to armed conflict: a systematic review and meta-analysis. THE LANCET PUBLIC HEALTH 2022; 7:e469-e481. [DOI: 10.1016/s2468-2667(22)00061-5] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/23/2022] [Accepted: 03/02/2022] [Indexed: 01/08/2023] Open
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