The relationship between physical and mental health: A mediation analysis

Equal before luck? Well-being consequences of personal deprivation and transition

Past trauma resulting from personal life shocks, especially during periods of particular volatility such as regime transition (or regime change), can give rise to significant long-lasting effects on people's health and well-being. We study this question by drawing on longitudinal and retrospective data to examine the effect of past exposure to major individual-level shocks (specifically hunger, persecution, dispossession, and exceptional stress) on current measures of an individual's health and mental well-being. We examine the effect of the timing of the personal shocks, alongside the additional effect of 'institutional uncertainty' resulting from regime change in post-communist European countries. Our findings are as follows. First, we document evidence of the detrimental effects of shocks on a series of relevant health and well-being outcomes. Second, we show evidence of more pronounced detrimental consequences of such personal shocks experienced by individuals living in formerly communist countries (which accrue to about 8% and 10% in the case of persecution and hunger, respectively) than in non-communist countries. The effects are robust and take place in addition to the direct effects of regime change and exposure to personal shocks.

The association between red blood cell distribution width-to-albumin ratio and risk of depression: A cross-sectional analysis of NHANES

BACKGROUND

The red blood cell distribution width-to-albumin ratio (RAR) serves as an indicator of systemic inflammation and nutritional status. This study examines the relationship between RAR and depressive disorder in U.S. adults, utilizing data from the National Health and Nutrition Examination Survey (NHANES).

METHODS

We applied logistic regression to evaluate the link between RAR and depressive risk, with its corresponding odds ratios (OR) and 95 % confidence intervals (CI) calculated. Restricted cubic spline (RCS) was adopted to assess the potential linear association, while the receiver operating characteristic (ROC) curve was used to evaluate the ability of RAR to predict the depressive risk, with the result presented as an area under the curve (AUC).

RESULTS

After adjusting for relevant covariates, a positive association between RAR and clinically relevant depression persisted (OR = 1.33, 95 % CI: 1.18-1.51, P < 0.001). Participants in the highest RAR quartile exhibited a greater risk of clinically relevant depression than those in the lowest quartile (OR = 1.36, 95 % CI: 1.10-1.67, P = 0.005). A linear relationship between RAR and clinically relevant depression was identified (P for non-linear = 0.473), with RAR showing a strong predictive ability for depressive risk (AUC = 0.7467). Stratified analysis showed significant interactions among smoking (P = 0.045), marital status (P < 0.001), and RAR's effect on depression outcome.

CONCLUSIONS

Elevated RAR is independently linked to clinically relevant depression, indicating its potential as a novel biomarker for mental health risk assessment. Further longitudinal studies are necessary to establish causality and evaluate its clinical relevance.

Does being defiant and irritable take a toll on physical health? Examining the covariation between symptoms of physical health and oppositional defiance across adolescence to young adulthood

Methods. Participants (N = 662; 52% female) from the Victoria Healthy Youth Survey (V-HYS) were assessed for ten years across six biennial occasions from ages 12-18 to ages 22-30. A multilevel time -varying covariation model, disaggregating within- and between - person variability, examined whether change in ODS was systematically associated with change in physical health symptoms.

Results. On average, individuals with higher ODS reported more physical health symptoms. Moreover, ODS also shared a significant within - person time - varying association with physical health, suggesting that the two symptom domains fluctuated together within - individuals across time, irrespective of between - person differences.

Conclusion. This study provides a novel within- and between - person demonstration of the link between ODS and physical health symptoms from youth to young adulthood.

Does Weather Have an Influence on Pain in Patients With Arthroplasty?

BACKGROUND

Patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA) often report fluctuations in pain levels associated with weather conditions. Despite common clinical observations, the literature remains inconclusive. This study aimed to evaluate the correlation between postoperative pain scores and weather parameters, considering demographic and comorbidity factors.

METHODS

A retrospective chart review was conducted on 558 patients who underwent TKA or THA between January 1, 2020 and December 31, 2023. Patients without significant comorbidities affecting surgical outcomes were included. Postoperative pain scores recorded using a numerical rating scale were correlated with historical weather data (temperature, barometric pressure, humidity) and compared to the entire group (both TKA and THA) and to subgroups (TKA or THA).

RESULTS

The mean pain score reported was 3.87. Weather parameters, including temperature and barometric pressure, did not yield significant results with pain scores. Analysis revealed a significant negative correlation between age and pain scores (r = -19 0.293, p < 0.001), indicating that older patients reported lower pain levels. Body mass index (BMI) was positively correlated with pain scores (p < 0.05), while sex and race/ethnicity showed no significant associations (p > 0.05). Notably, mental health diagnoses significantly influenced pain ratings (p < 0.05).

CONCLUSIONS

This study found no significant relationship between postoperative pain and weather parameters in patients who underwent TKA/THA, challenging common assumptions that weather significantly influences pain perception. However, age, BMI, and mental health were identified as significant factors affecting postoperative pain experiences. These findings underscore the need for personalized pain management strategies that account for individual patient characteristics.

The cumulative and individual effects of stressful life events on first-episode psychosis

While there is some evidence linking stressful life events (SLEs) to the risk of first-episode psychosis (FEP), literature remains inconclusive. This study aims to investigate the cumulative influence of SLEs experienced throughout the lifespan, across various domains, on the development of FEP and to explore the specific SLEs that contribute to the onset of psychosis. A descriptive, cross-sectional, case-control study was conducted as part of the PROFEP study in Barcelona, Spain. The sample included 86 FEP patients (24 females; 62 males) and 93 healthy controls (38 females;55 males), aged 13-52 years. SLEs were assessed using the Questionnaire of Stressful Life Events (QSLE). A higher total number of SLEs was associated with FEP. Associations were also found among higher SLEs in the education, work, family, social and health domains, and FEP. Specific SLEs related to FEP were: failing more than three subjects during a school year, being bullying, being fired, being promoted to a higher position, being demoted to a lower position, experiencing sexual problems, being abused by a partner, having an abortion, experiencing abandonment, abuse or mistreatment by family, having separated parents, emancipation or the departure of a family member, death of a non-first degree familiar, and breaking up with a circle of friends. SLEs contribute cumulatively to the development of FEP, particularly those events related to education, work, family, social life, and health. Certain specific events may also impact FEP, highlighting the importance of evaluating SLEs both cumulatively and individually.

Mental Health Consequences of Age-Related Macular Degeneration: Exploring Depression Prevalence and Severity in Wet and Dry Forms

OBJECTIVES

Age-related macular degeneration (AMD) is a leading cause of vision loss, affecting quality of life. Although AMD is associated with an increased risk of depression, differences between dry and wet forms are not well understood. This study examined depressive symptoms in Greek patients with dry and wet AMD compared to healthy-controls using the Zung Self-Rating Depression Scale (SDS).

METHODS

A cross-sectional study included 146 AMD patients (74 dry, 72 wet) and 60 controls. Depressive symptoms were assessed using the Zung SDS. Demographic and clinical data were collected. Statistical analyses compared depression severity and prevalence between groups, adjusting for potential confounders.

RESULTS

Wet AMD patients had significantly higher Zung SDS scores (50.4 ± 7.81) than dry AMD (44.8 ± 6.75) and controls (41.4 ± 7.85, p < .001). Depression prevalence was 56% in wet, 27% in dry AMD, and 20% in controls. After adjusting for visual acuity, age, sex, and other factors, wet AMD remained significantly associated with greater depression severity (p < .001).

CONCLUSIONS

Wet AMD is associated with higher depression severity compared to dry AMD, emphasizing the need for integrated ophthalmologic and mental health care.

CLINICAL IMPLICATIONS

Depression is common among AMD patients, particularly those with wet AMD. Screening and psychological support should be incorporated into AMD management.

Empowering refugee voices: Using Nominal Group Technique (NGT) with a diverse refugee Patient Advisory Committee (PAC) to identify health and research priorities in Calgary, Canada

BACKGROUND

Despite rising forced displacement globally, refugees' health and research priorities are largely unknown. We investigated whether a diverse refugee committee could utilize participatory methods to identify health priorities and a research agenda to address them.

METHODS

We conducted a qualitative study with focus groups of current and former refugees, asylum claimants and evacuees from a specialized refugee clinic over a year in Calgary, Alberta, Canada. We collected sociodemographic data using standardized instruments, then utilized a four-step nominal group technique process (idea generation, recording, discussion, and voting) to identify and rank participants' health and research priorities. Participants ranked their top five priorities across three time periods: Pre-migration/early arrival (0-3 months), post-migration (3 months-2 years), and long-term health (>2 years). Participants created overarching priorities and corroborated findings via a member checking step.

FINDINGS

Twenty-three participants (median age 35 years) attended one or more of five focus groups. Twenty-one completed sociodemographic surveys: 16/21 (76%) were women, representing 8 countries of origin. Participants identified "more family physicians" and "improving health system navigation" (11/60 votes each) as top health and research priorities respectively across all resettlement periods. Participants also prioritized pre-departure healthcare system orientation and improved post-arrival and long-term mental health services. Twelve participants completed the member checking process, affirming the results with minor clarifications.

INTERPRETATION

This proof-of-concept study illustrates how refugees can use a rigorous consensus process without external influence to prioritize their healthcare needs, direct a health research agenda to address those needs, and co-produce research. These low-cost participatory methods should be replicated elsewhere.

Occupational Therapy Interventions and Outcomes in United States' Early Intervention in Psychosis Programs: A Mixed Methods Survey Study

Young adults experiencing psychosis are at high risk for disengagement from their daily lives. Occupational therapy (OT) services play an important role in fostering participation, yet their intervention efficacy in Early Intervention in Psychosis (EIP) remains poorly understood. To determine the commonly utilized OT interventions and measurement tools that require further research to determine their efficacy and effectiveness. Cross-sectional, mixed-methods survey study. Quantitative descriptive statistics were completed on Microsoft Excel and qualitative thematic analysis was completed by two researchers using Dedoose. Online survey. Occupational therapy practitioners (OTPs) working on EIP programs in the United States were recruited through purposive and snowball sampling. The survey consisted of 24 closed and open-ended questions assessing use of interventions, outcomes tracked, and measurement tools. Study had 21 respondents. The most frequent interventions were self-regulation and activities of daily living (ADL). Self-regulation interventions were overwhelmingly sensory-based. Most commonly reported outcome measure was observation of participation in occupations. This study confirms the use of sensory and ADL-based interventions by OTPs in EIP programs. Findings suggest a strong sense of the role of OT within EIP as intervention use is relatively consistent across programs and focuses on client-centered, occupation-based interventions. Outcome tracking and quality improvement were gaps as most OTPs are not using standardized methods or not performing this. Additional study is required to determine the efficacy of commonly used interventions and to improve outcome measurement methods in EIP programs. Occupational therapy is an undervalued profession on teams that provide services to young adults dealing with the onset of a psychotic illness. This study is the first of many needed to demonstrate the impact OT services can have on the outcomes of the young adults who receive care for their psychotic illness. This study identifies what OT interventions are common, and what outcomes OT professionals track to determine their services' impact on these mental health care teams. These results will help to build the needed research on how helpful these common interventions are for young adults facing psychotic illnesses.

Factors Influencing the Mental Health of First-Year College Students: Evidence from Digital Records of Daily Behaviors

The mental health of college students, particularly first-year students, deserves significant attention. As they transition from high school to college, they experience substantial changes not only in their learning behaviors but also in their daily behaviors, which may pose mental health challenges. However, existing studies exploring the factors influencing college students' mental health still have limitations in the selection of predictor variables and behavior assessment. Building on this, our study adopted a cross-sectional design involving 110 first-year college students in China (M = 17.94 years; 47 males, 63 females) and analyzed the impact of daily behaviors on mental health. We collected daily behavioral data through a designed mini program, and assessed mental health using the GHQ-28. LASSO regression was applied to identify key behavioral predictors, and semi-structured interviews were conducted to further explore the impact of these factors. The results show that sleep quality, planned and implemented physical exercise, average self-evaluation scores, average daily number of planned tasks, and the completion rate of planned tasks have a positive impact on mental health. These findings contribute to enhancing the theoretical understanding of how daily behaviors shape college students' mental health and offer practical guidance for universities to carry out mental health education.

Major sight-threatening eye disorders and mental disorders

The purpose of this study was to: (a) investigate the comorbidities of major sight-threatening eye disorders with mental disorders, (b) investigate the associations and prevalence of reported comorbidities and (c) identify potential influencing factors. A systematic review of the PubMed, Embase, Web of Science and Cochrane Library databases was conducted from inception to 30 December 2023. Studies that presented only laboratory results or used non-representative sampling methods were excluded. Meta-analyses were performed using the inverse variance method with a random-effects model. A total of 67 studies were included in the analysis. The most prevalent comorbidities were diabetic retinopathy (DR) and depression (pooled prevalence of 30%) and DR and anxiety (pooled prevalence of 29%). Significant associations were found between glaucoma and depression (odds ratio [OR] = 1.42, 95% confidence interval [CI] = 1.21-1.66), glaucoma and anxiety (OR = 2.11, 95% CI = 1.22-3.66), glaucoma and schizophrenia (OR = 1.38, 95% CI = 1.28-1.50), age-related macular degeneration (AMD) and depression (OR = 1.36, 95% CI = 1.18-1.57), and DR and depression (OR = 1.03, 95% CI = 1.01-1.06). Income was identified as a significant contributing factor to the prevalence of comorbidity between glaucoma and depression. Major sight-threatening eye disorders were significantly associated with mental disorders, particularly depression and anxiety. The burden of comorbidity between major sight-threatening eye disorders and mental disorders is not optimistic and may be influenced by income disparities. Healthcare providers are encouraged to assess and manage potential comorbidities to optimize patient outcomes.

Graphical model analysis of subjective well-being and various factors in Japanese adults from the Iwaki cross-sectional study

The relationship between Subjective well-being (SWB) and other factors is complex. However, few studies have reported a complex relationship between SWB and other factors across domains. We aimed to explore and clarify the one-to-many relationships between SWB and various factors among Japanese adults aged 20-85 years, using graphical modeling and data from the Iwaki Health Promotion Project (IHPP). An undirected graph that included factors such as nutrient intake, eating behavior, mental and physical health, social situations, and SWB was created using data from 519 participants in the IHPP of 2021. The graph indicated that four variables such as "CES-D", "Enjoying the taste of foods", "Health considerations" and "Household financial stability" were directly related to SWB. Additionally, we divided the participants into subgroups based on gender, age, employment status, educational background, and marital status and performed modeling to evaluate the differences in the structure of the SWB based on these attributes. Each graph indicated that the variables directly linked to SWB differed for each subgroup. Therefore, the mechanisms of SWB differed depending on people's backgrounds. We believe that these findings will be useful in proposing policies for improving the SWB of the Japanese people.

Mental health and contributing factors to mental wellbeing in older people at high risk of hospitalization in Sweden

OBJECTIVES

Aging is linked to physiological changes, increased vulnerability, and often psychological, cognitive, and social changes that might affect mental health. Our aim was to explore factors that contribute to mental wellbeing in older people with increased risk of hospitalization.

METHOD

This study is a part of a Swedish clinical trial: Secure And Focused primary care for older pEople (SAFE), and included 1169 community-dwelling people aged 75 years or older, with a high risk of hospitalization. An individual self-assessment questionnaire that included questions about health-related quality of life was analyzed. We focused on the health concepts of emotional wellbeing and energy/fatigue in RAND 36 and used multiple logistic regression to analyze associations.

RESULTS

The levels of emotional wellbeing were significantly positively associated with the body mass index (BMI), and negatively associated with the frequency of falling, feeling of loneliness, worry about the future, and the level of pain/discomfort (p < 0.05). The levels of energy were also significantly positively associated with activity level and the level of independency in activities of daily living (ADL) (p < 0.05).

CONCLUSION

Our study identifies several areas of concern for the mental health of older people with a high risk of hospitalization, making it possible to work proactively with these problem areas.

School-Based Disease Prevention and Control Programs: A Comprehensive Analysis of Health, Academic Outcomes, and Mediating Factors

Schools play a crucial role in shaping the health and well-being of children and adolescents. With the global impact of COVID-19, the need for robust disease prevention and control programs within educational settings has become more apparent than ever. This study examined the association between school-based disease prevention and control programs and students' physical health and academic performance in Ghana, a developing country, with a focus on the mediating roles of mental health and health literacy. Conducted with 386 students using a descriptive cross-sectional design and a quantitative research approach, the study employed questionnaires for data collection and structural equation modeling (PLS-SEM) for analysis. The findings indicated that school-based disease prevention and control programs are associated with higher health literacy among students and linked to better physical health and academic performance. However, the impact on mental health was not significant. The results indicated that these programs are positively associated with physical health outcomes and academic achievement, with mental health serving as a partial mediator. This research highlights the importance of integrating comprehensive disease prevention and control programs, including mental health workshops, to address gaps in mental health outcomes in schools. It also emphasizes the need for governments and development partners to develop robust health policies focused on school-based health programs. Adapting these initiatives to local contexts while implementing evidence-based strategies aligns with the Sustainable Development Goals of good health and well-being (SDG 3) and quality education (SDG 4).

The relationship between physical function and psychological symptoms in Parkinson's: Perceptions of People with Parkinson's and Carers

BACKGROUND

People with Parkinson's (PwP) can experience both physical and psychological symptoms, and understanding the perspectives of people affected is crucial for improved management, and clinical outcomes.

OBJECTIVES

This online survey aimed to gain a better understanding of the relationship between the subjectively experienced physical and psychological symptoms by PwP and their carers, while also considering the influence of personal roles and past symptom experiences.

METHODS

A UK-wide survey of 251 PwP and 62 carers was conducted. The survey focused on reported diagnosed and non-diagnosed psychological symptoms experienced, their onset, and the perceived impact of physical and psychological symptoms on one another. Responses were summarised using descriptive statistics.

RESULTS

A substantial proportion of respondents reported at least one diagnosed psychological condition (38.5%) or undiagnosed psychological symptoms (44.6%) such as anxiety and depression. Half of respondents reported perceiving a bi-directional interaction between physical and psychological symptoms, with this perception most reported in people with prior experience of psychological symptoms. Our sample shows that while PwP and carers have similar views on the impact of psychological symptoms, carers perceive the impact of physical symptoms to be greater than PwP.

CONCLUSIONS

PwP and carers appear to perceive an interaction between physical and psychological symptoms in Parkinson's, noting that psychological symptoms frequently precede Parkinson's diagnosis but are often under-recognised. Improved awareness of the potential link between physical and psychological symptoms in PwP may help to improve assessment, and onward referral processes to enhance care. Further research may assist in identifying potential disease subtypes and allow the prediction of changes in physical and psychological presentation.

Gigantomastia: Advancing a Preference Score System to Enhance Care Quality and Life Standards

BACKGROUND

This study introduces a new Gigantomastia Preference Score (GPS) to prioritize surgical candidates based on clinical severity and quality of life impact.

METHODS

This retrospective study applied the newly developed GPS to the existing surgery waiting list of 213 patients at our center. The GPS was developed from evidence-based clinical practice indicators and a thorough literature review, selecting nine variables. The GPS was then used to reorder the waiting list, and comparisons were made between the original and reordered lists.

RESULTS

Implementation of the GPS significantly reordered the waiting list. The Spearman's Rank Correlation coefficient between the original and new rankings was 0.5679 (p-value = 1.38e-19), indicating a moderate to strong positive correlation. The Wilcoxon Signed-Rank Test yielded a statistic of 3485.0 (p-value = 8.44e-21), showing significant changes in patient positions. ANOVA results highlighted significant differences in BMI and largest breast weight across priority levels. Chi-Square tests revealed significant associations between priority levels and Trauma and Psychiatry reports.

CONCLUSIONS

The GPS significantly improved the prioritization of patients with gigantomastia by incorporating multiple clinically relevant factors. This led to a more equitable and informed ordering of the surgical waiting list, potentially improving patient outcomes and optimizing healthcare resource allocation.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

Evaluating the role of simple assistive devices in promoting motivation and self-care in chronic disease management

OBJECTIVE

This study evaluates the development and distribution of simple assistive devices designed to support individuals in managing their health conditions at home. The focus is on older adults from lower socio-economic groups in Stoke-on-Trent and Newcastle-under-Lyme, UK.

METHODS

Assistive kits were distributed to participants between December 2021 and April 2022, addressing weight management, diabetic foot care, mental wellbeing, and daily living independence. Each kit contained affordable and accessible assistive devices, including portion plates, exercise bands, and remote-operated plugs, alongside educational materials to promote self-care. Feedback was collected between March and June 2022 to assess user satisfaction and engagement. A qualitative analysis, informed by self-determination theory, explored how these kits supported autonomy, competence, and relatedness in self-management.

RESULTS

Over 90 % of recipients reported using the kits more than once weekly and an increased confidence in managing their health conditions independently. Qualitative analysis indicated that the kits facilitated motivation towards self-management by enhancing users' autonomy, competence, and social connectedness. However, barriers such as cost, availability, and lack of support were identified as limiting factors for broader adoption.

CONCLUSIONS

This study highlights the potential of affordable, simple assistive devices to empower individuals in managing their health and wellbeing. The initiative demonstrates a promising approach to addressing health management challenges in lower socio-economic groups. Further research is needed to expand access and refine interventions to maximise impact and improve quality of life.

Physical and Psychosocial Challenges as Predictors of Vision Difficulty in Children: A Nationally Representative Survey Analysis

PURPOSE

To elicit associations between vision difficulties and physical or psychosocial challenges in children in the United States.

METHODS

Children aged 2-17 years old from the 2021 National Health Interview Survey with data pertaining to vision difficulty were included in our retrospective, population-based analysis. Our primary aim was investigating physical and psychosocial challenges as predictors of vision difficulty. Logistic regression models were performed on Stata version 17.0 (StataCorp LLC, College Station, Texas). Analyses were accompanied by an odds ratio (OR) and 95% confidence interval (CI).

RESULTS

A total of 7,373 children had data pertaining to their level of vision difficulty and were included in our sample. In our multivariable analysis, children with a good/fair (OR = 1.84, 95% CI = [1.31, 2.60], p < 0.01), or poor (OR = 5.08, 95% CI = [1.61, 16.04], p < 0.01) general health status had higher odds of vision difficulty relative to children with an excellent/very good health status. Furthermore, children with difficulties hearing (OR = 8.67, 95% CI = [5.25, 14.31], p < 0.01), communicating (OR = 1.96, 95% CI = [1.18, 3.25], p < 0.01), learning (OR = 1.93, 95% CI = [1.27, 2.93], p < 0.01), and making friends (OR = 1.94, 95% CI = [1.12, 3.36], p = 0.02) had higher odds of vision difficulty. Nonetheless, the following factors were only predictors of vision difficulty in our univariable analysis: requiring equipment for mobility (p < 0.01), experiencing anxiety (p < 0.01), and experiencing depression (p < 0.01).

CONCLUSION

Several factors pertaining to physical and psychosocial challenges in children are associated with vision difficulty. Future research should further explore potential causal links between vision difficulty and physical or psychosocial factors to aid in coordinating public health efforts dedicated to vision health equity.

Rural disability, self-reliance, and the utilization of mental health services

BACKGROUND

The intersection of rurality, disability, self-reliance values, and utilization rates of mental health services (MHS) is under-researched.

OBJECTIVE

To better understand the differences between unmet need and no perceived need for MHS between noncore, micropolitan, and metropolitan adults with disabilities.

METHODS

We conducted logistic regression analyses of the 2022 National Survey on Health and Disability (NSHD) to identify associations between demographic characteristics and odds of reporting unmet need for MHS or no perceived need for MHS.

RESULTS

Living in a noncore area, being male, lower educational attainment, older age, vision disability, and ambulatory disability were significantly associated with increased odds of reporting no perceived need for MHS. Being LGBTQIA+, poor transportation access, and cognitive disability were significantly associated with decreased odds of reporting no perceived need for MHS. Cognitive disability, cohabitation, and poor transportation access were significantly associated with increased odds of reporting unmet need for MHS. Conversely, being male, having some college and/or a two-year degree were significantly associated with decreased odds of reporting unmet need for MHS. There were not significant differences in unmet need for MHS across rural indicators.

CONCLUSION

No perceived need of MHS is an underexplored factor among rural and urban adults with disabilities. Solutions include policies to expand MHS access, tailored public health outreach, and provider communication training.

Sources of Distress for Secure Mental Healthcare Staff: A Cross-Sectional Study of the Impact of Personal and Occupational Problems on Psychological Wellbeing and Functioning

Despite a global drive to improve staff well-being in healthcare, distress and absenteeism continue to persist, posing consequences for patient care and organisational functioning. Current research and subsequent strategies implemented to remediate such problems have primarily focused on occupational experiences, disregarding the contribution of problems occurring outside of the workplace. The current study sought to establish the prevalence of work and non-work problems, and their respective impacts on several well-being outcomes, in this occupational group. Secondary analysis of data from a cross-sectional survey of 323 staff in a secure UK mental healthcare organisation was conducted. Exposure to non-work problems was pervasive across the sample (79.3%). Demographic discrepancies in exposure to types of problems were apparent, though number of problems reported was comparable across the sample. Number of non-work problems was a significant predictor of depression, anxiety, functional impairment, and complex post-traumatic stress disorder symptoms, when controlling for exposure to work problems. The findings implicate the need for a broader conceptualisation of distress in secure mental healthcare staff, who typically report exposure to several non-work problems, in the context of occupational challenges. Policy, practice and service implications are discussed, with consideration for the availability and modality of support offered to staff.

Impact of physical activity on the depression and self-care ability among Chinese older adults during the COVID-19 pandemic: propensity score matching analysis

INTRODUCTION

The present study aimed to explore the effect of different levels of physical activity on depression, instrumental activities of daily living (IADLs), and activities of daily living (ADLs) among older adults over the age of 60.

METHODS

Data on older adults' health were obtained from the China Longitudinal Aging Social Survey (CLASS) conducted in 2021. A questionnaire was used to survey older adults aged 60 years and older in 28 regions of China. The International Physical Activity Questionnaire (IPAQ) was used to evaluate physical activity, and participants were categorized into groups based on their physical activity levels: vigorous (5.38%), moderate (16.33%), light (74.58%), and no physical activity (control group). The CES-D9 scale was used to assess the level of depression, and both the activities of daily living (ADLs) scale and the instrumental activities of daily living (IADLs) scale were used to evaluate self-care ability. Propensity score matching was used to determine the intensity of physical activity that affected depression, instrumental daily activity ability (IADLs), and activities of daily living (ADLs) among the participants.

RESULTS

The participation rates of vigorous, moderate, and light physical activities among the older adult Chinese participants were 5.38%, 16.33%, and 74.58%, respectively. Propensity score matching (PSM) showed moderate and light physical activity decreased depression by -0.367 and - 0.409 units, respectively. Moderate and light physical activity increased instrumental activities of daily living (IADLs) by 0.165 and 0.607 units, respectively. Light physical activity increased the level of activities of daily living (ADLs) by 0.265 units.

CONCLUSION

Moderate and light physical activity in older adults alleviates depression and improves instrumental activities of daily living (IADLs), and light physical activity improves the level of activities of daily living (ADLs).

Team Survivors: Preliminary Analysis of an Innovative Intervention to Promote Physical Activity in Survivors of Childhood Cancer and Hematopoietic Stem Cell Transplant

(1) Background: Inadequate physical activity is an ongoing issue for pediatric survivors of childhood cancer and hematopoietic stem cell transplant (HSCT), increasing their risk for chronic health conditions and decreasing quality of life. Team Survivors is a 12-week program in which survivors train as a group to participate in a community triathlon. Preliminary findings from a quality improvement project of Team Survivors were used to assess its feasibility in influencing survivors' physical activity and quality of life and their family's perception of the program. (2) Methods: Repeated measures t-tests evaluated changes in caregiver-reported exercise self-efficacy and health-related quality of life (HRQoL). These findings were supplemented by a narrative review of qualitative data from caregivers and survivors on their overall experience and satisfaction with the program. (3) Results: All participants successfully completed the triathlon, and families reported satisfaction with the program's logistics (i.e., coordination, coaching, and practice). Neither caregiver-reported exercise self-efficacy nor HRQoL significantly differed between pre- and post-intervention, but notable improvements were reported in all domains of HRQoL. Qualitatively, the perceived benefits reported by caregivers and survivors were multifaceted. Physical benefits included improvements in survivors' physical activity level and endurance. Psychosocially, caregivers and survivors reported greater confidence and motivation for physical activity, improved coping, and increased social engagement and feelings of normalcy. (4) Conclusions: Mixed method results support the feasibility of Team Survivors in positively impacting survivors' ability to engage in physical activity. The multifaceted structure of the program may more broadly impact psychosocial functioning in addition to physical activity. Future studies require a larger sample size to adequately power the analyses.

Heterogeneity in Health-Related Quality of Life of Patients with Aplastic Anemia: A Latent Profile Analysis

Purpose

Concerns over health-related quality of life (HRQOL) in patients with aplastic anemia (AA) have been increasing worldwide. However, most researches on HRQOL in AA patients have ignored individual-level variability. Thus, our study was designed to explore practical classification of HRQOL and related variables among AA patients.

Methods

A cross-sectional study was conducted from May 2022 to March 2023, utilizing convenience sampling to enroll AA patients. Data of HRQOL, sociodemographic characteristics, and clinical variables were collected. Latent profile analysis (LPA) was used to analyze the latent categories of HRQOL in AA patients, utilizing scores from eight subscales of the Medical Outcomes Study 36-Item Short Form Health Survey version 2.0.

Results

A total of 229 patients completed the survey and were included in the analysis. The LPA results showed significantly individual differences and identified three subgroups of HRQOL: Group 1, poor HRQOL with role emotional limitation (n=54, 23.58%); Group 2, moderate HRQOL with role physical limitation (n=56, 24.45%), and Group 3, good HRQOL (n=119, 51.97%), respectively among AA patients. Childless, no comorbidities, transfusion independence, no AA-related symptoms, and higher annual household income were associated with Group 3, whereas higher Eastern Cooperative Oncology Group performance status (ECOG-PS) scores were associated with Group 1.

Conclusion

The findings of our study revealed significant heterogeneity in HRQOL among AA patients, providing valuable information for tailoring interventions to meet individual needs, especially for those in the poor HRQOL with role emotional limitation group. To improve their quality of life, healthcare professionals should fully take into account how the HRQOL subgroups are affected by AA-related symptoms, household annual income, ECOG-PS score, children, comorbidities, and transfusion-dependence.

How does social support mediate the relationship between functional status and mental health among older adults in China? An exploration of the role of children's visits

OBJECTIVE

To examine the mediating role of social support, as outlined in the Convoy Model of Social Relations, in the association between functional status and mental health, with a focus on those with disabilities.

METHODS

The study included 15,498 participants aged 65 to 105 years old from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Spearman analysis and mediation analysis were performed.

RESULTS

Social support was significantly positively correlated with mental health (p < 0.001), except for financial aid. Social support partially mediated the effect of functional status on mental health. Among those with disabilities, the frequency of children's visits mediated this relationship (effect = -0.009, 95 % CI:0.016 to -0.004).

CONCLUSIONS

Social support mediated the relationship between functional status and mental health, with children's visits emerging as a more potent mediating factor compared to other types of support, particularly for those with disabilities.

Shielded by Education? The Buffering Role of Education in the Relationships Between Changes in Mental Health and Physical Functioning Through Time Among Older Europeans

This study investigated among older Europeans how physical function limitations lead to depressive symptoms and reductions in quality of life and well-being, and vice-versa. Further examined was how years of education moderate these relationships. These objectives were pursued using a sample of Europeans aged 50+ years (N = 46,492) within waves 5 (2013) and 6 (2015) of the Survey of Health, Ageing and Retirement in Europe. The analyses employed conditional change multilevel mixed-effects linear regressions. Mental health was found to affect physical function limitations, and vice-versa. More education significantly reduced only how earlier mental health problems lead to later physical function limitations, plausibly because of the former's higher controllability. Thus highlighted are education-linked psychosocial resources' protective effects.

Osteoporotic Fragility Fracture Is Associated With an Increased Rate of New Mental Disorder Diagnosis

INTRODUCTION

Fragility fractures can be substantially life-altering with notable effects on patient well-being and mental health. The purpose of this study was to evaluate the risk of developing a new mental disorder diagnosis within 2 years following osteoporotic fragility fracture.

METHODS

A retrospective cohort study was conducted using a large national insurance claims database. Patients with proximal humerus, wrist, pelvis, hip, and spine fractures were matched in a 1:4 ratio with nonfracture control patients. Rates of mental disorders after primary fragility fractures were compared using multivariable logistic regression. Mental disorders evaluated included alcohol use disorder, generalized anxiety disorder, bipolar disorder, major depressive disorder, drug use disorder, panic disorder, posttraumatic stress disorder, and suicide attempt.

RESULTS

Elderly patients who sustained fragility fractures had a statistically significant increased risk of being diagnosed with many of the queried mental disorders within 2 years following fracture compared with control patients with no fracture. Comparing each individual fragility fracture demonstrated that hip fractures had the greatest risk of developing any of the queried mental disorders (OR:1.88, CI: 1.74-2.03).

CONCLUSION

There is an increased risk of being diagnosed with a new mental disorder following fragility fracture in patients older than 65 years. Mental health screening and potential psychiatric evaluation should be considered for patients following fragility fracture.

STUDY DESIGN

Original Research (Level III).

Smartphone Addiction, Screen Time, and Physical Activity of Different Academic Majors and Study Levels in University Students

Smartphone addiction is increasing among university students. This study aims to explore the differences in screen time and physical activity among university students with and without smartphone addiction, considering their study majors and levels. One hundred and twenty participants from sixteen faculties were included, divided into three academic majors (health sciences, social sciences and humanities, and science and technology). Data were collected using a screen time behavior questionnaire and a screen time application. Physical activity was measured using the Global Physical Activity Questionnaire (GPAQ). This study demonstrated that the smartphone addiction group had higher screen time on both smartphones (p = 0.02) and other devices (p = 0.04). Students in the social sciences and humanities majors had insufficient physical activity according to WHO recommendations. The results showed no correlation between screen time and physical activity, study time, academic major, or study level (p ≥ 0.05). However, a low correlation was observed between physical activity and study time (r2 = 0.27; p < 0.05), as well as study level (r2 = -0.31; p < 0.05). Our findings show that the total screen time for university students with and without smartphone addiction exceeded 8 h per day. Real-life activities should be promoted to reduce screen time. Encouraging physical activity among senior students and those in social science and humanities majors is crucial for fostering healthy behaviors in the future. Physical education and recreational activities should be emphasized in these groups, along with the development of programs or class activities designed to promote physical activity and reduce screen time.

The Impact of Job Demands, Job Resources, and Organisational Justice on Global Health and Turnover Intentions in Animal Care Workers

Animal care workers in sheltering, rescue, and management are exposed to occupational stressors which negatively impact health. While the negative mental health impacts have been previously documented in this population, physical health, and its contributing factors, have not. This study investigated how job demands, job resources, and organisational justice relate to mental and physical health, and how they subsequently affect turnover intentions. Of the 285 participants, aged 19 to 94 years, who completed the online anonymous questionnaire, below average mental and physical health was reported. Mental health, but not physical health, was inversely related to intentions to leave. After controlling for age, hierarchical multiple regressions showed high emotional demands and direct euthanasia exposure significantly predicted poorer mental and physical health, while high levels of social support predicted better mental and physical health. No additional variance in either health domain was accounted for by organisational justice. It was concluded that both physical and mental health may be negatively impacted in those who work in shelter, rescue, and management environments which could lead to high turnover and poor outcomes for individuals and organisations. Monitoring through ongoing health records to enable early intervention and accommodations should be considered to promote the health of these workers.

Shattered ground, shaken minds: Mental health consequences of earthquakes

Despite growing recognition of the importance of mental health status for the achievement of the global development goals, substantial challenges persist in addressing this issue in both developed and developing countries. The literature has pointed to a variety of conditions as triggers for mental health problems, including exposure to unexpected natural disasters. Contributing to the literature, our study quantifies the mental health consequences of the devastating 2006 Yogyakarta earthquake in Indonesia. We combine the Modified Mercalli Intensity from the United States Geological Survey with individual-level data from the Indonesia Family Life Survey to assess the impacts on municipalities with varying earthquake intensities. Employing a difference-in-differences approach, we identify a significant and persistent deterioration in the mental health condition for individuals in municipalities with stronger earthquake severity. To explore the mechanisms underlying this impact, we analyze the roles of family casualties, physical health declines, and socio-economic disruptions, identifying family loss and worsened physical health as particularly influential factors driving the observed mental health outcomes.

[The physical and mental health of home care recipients: A quantitative secondary data analysis]

The physical and mental health of home care recipients: A quantitative secondary data analysis Abstract: Background: Although more and more people are being supported by home care services, there is a lack of information regarding the health limitations and needs of this group. Aim: The objective of this study was to examine the health status of people with home care needs in Switzerland. Method: A secondary data analysis based on the HomeCareData database, which contains routine data on people with home care requirements in Switzerland, was conducted. All cases with a fully completed Resident Assessment Instrument (RAI-HC) were included. Data on various items of the RAI-HC and other standardized scale scores with reference to physical or mental health were analyzed using descriptive statistics. Results: In total, 74,674 data records were evaluated. Physical limitations most frequently manifested in the form of fatigue (40.6%), pain (29.7%) or within the scope of impaired hearing (21.9%). Around a third of individuals sampled had experienced a fall in the last 90 days. With regard to mental health, the most frequent signs were fear of falling (33.5%), loneliness (13.9%), depression (12.8%) and anxiety (4%). Approximately one third showed signs of impaired cognition and polypharmacy was detected in almost 68% of those evaluated. Conclusion: Considering the comparatively high prevalence of mental health problems among people with home care requirements, there is a need to develop appropriate skills of employees in home care services and for adequate care planning.

Volunteering during early retirement reduces depression

As individuals age, they often face deteriorating health and significant lifestyle changes, including retirement. While retirement can alter individuals' economic and social roles, potentially increasing the risk of depression, involvement in volunteer activities has been found to be beneficial for retirees. Using data from the Health and Retirement Study, we apply the parametric g-formula to simulate an intervention aimed at estimating the effect of volunteering on depression, and to assess the mediating role of limitations in activities of daily living. Our results show that engagement in volunteering reduces the probability of depression by approximately 5% in the whole population, with larger gains among early retirees. The results hold irrespective of gender, and indicate that the benefits are greater for women. Our findings show that about 10% of the positive impact of volunteering on depression operates via a reduction in the likelihood of experiencing limitations in activities of daily living. Therefore, we conclude that the benefits of volunteering extend to improving the overall health of both individuals and the population. Our simulated intervention targeting early retirees may be a viable public health strategy for protecting individuals against depression, while also enabling them to contribute to the public good.

Likes, Shares, and Symptoms: The Hidden Toll of Early Adolescents' Social Media Use on Well-Being

Social media use has rapidly increased over the past decade, especially among young people. To obtain more insight into the potential negative associations with problematic social media use in Dutch early adolescents, we assessed its relation to self-reported well-being. We conducted a cross-sectional study with 585 students in their final year of primary school (11-12 years old) who completed a questionnaire during school hours. We examined the association between problematic social media use and psychosomatic complaints, as well as general life satisfaction and whether perceived social support and sex moderated these associations. Problematic social media use was associated with lower general life satisfaction, as well as all psychosomatic complaints, with the strongest association for having a bad mood or feeling irritated (OR = 3.08, 99% CI = 2.05-4.63). Most associations were not moderated by perceived social support or sex. Our findings indicate that the well-being of early adolescents may be affected by problematic social media use already in primary school. The association persisted regardless of the amount of perceived social support, and without strong gender differences. This suggests that the potential for limiting the potential negative consequences of problematic social media use through increasing social support is limited.

Association between parental phubbing and short-form video addiction: A moderated mediation analysis among Chinese adolescents

BACKGROUND

Short-form video applications have spread rapidly and gained popularity among adolescents for their interactivity, sociality, and personalization. However, excessive and uncontrolled use has also caused some adolescents to develop short-form video addiction (SFVA). Although parental phubbing has been shown to be a risk factor for SFVA in adolescents, its intermediate mechanisms, particularly the emotional mediation mechanisms, remain unclear. Therefore, this study aims to explore the relationships among parental phubbing, SFVA, symptoms of depression and anxiety, and neuroticism in adolescents.

METHODS

Adolescents aged 13-19 (N = 5785) were recruited from Shandong Province, China, as participants in 2023. Participants were asked to complete five self-report questionnaires, including the Parental Phubbing Behavior Questionnaire (PPBQ), Short-Form Video Addiction (SFVA) Scale, The Center for Epidemiological Studies Depression Scale (CESD20), Generalized Anxiety Disorder 7-item (GAD-7) Scale, and Chinese Big Five Personality Inventory (Brief Version) (CBF-PI-B).

RESULTS

The results indicate that the influence of parental phubbing on short-form video addiction among adolescents is mediated by symptoms of depression and anxiety. Additionally, neuroticism moderates the association between parental phubbing and symptoms of depression and anxiety.

LIMITATIONS

Cross-sectional design limits causal inferences. Reliance on self-report scales.

CONCLUSIONS

These findings contribute to a better understanding of the systemic impact mechanisms of negative family interactions on SFVA. Moreover, prevention and intervention strategies targeting high neuroticism and symptoms of depression and anxiety may help prevent the developmental pathway from parental phubbing to SFVA.

A cross-sectional network analysis of successful aging in a resilience-based framework

Aging inevitably gives rise to many challenges and transitions that can greatly impact our (mental) well-being and quality of life if these are not controlled adequately. Hence, the key to successful aging may not be the absence of these stressors, but the ability to demonstrate resilience against them. The current study set out to explore how resilience and successful aging may intersect by investigating how various resilience capacity-promoting (protective) and resilience capacity-reducing (risk) factors relate to mental well-being and quality of life. Through a large-scale (N = 2000, age 55+, 30 factors) network analysis, we established the interplay between risk/protective factors from various domains, including demographics, (mental) health, (environmental) stress, lifestyle, coping/personality, and ageism. We revealed some unique pathways through which each of these factors contribute to individuals' mental well-being and/or quality of life, and interpreted these findings in terms of a resilience-based framework of successful aging. Our findings emphasize the complexity of factors that can impact quality of life and mental well-being in later life and can steer researchers and practitioners in devising efficacious, multi-pronged interventions that target risk and protective factors simultaneously, thereby maximizing their potential in boosting beneficial outcomes among older individuals.

Prevalence of Sarcopenia and Its Association with Mental Health Status in Elderly Patients: A Comparative Cross-sectional Study

Background

Sarcopenia, characterized by loss of muscle mass and function, is a significant health concern in aging populations. While its physical consequences are well-documented, the relationship between sarcopenia and mental health remains understudied. This study aimed to investigate the prevalence of sarcopenia and its association with mental health status, including depression, cognitive function, anxiety, and loneliness, among elderly patients.

Methodology

A comparative cross-sectional study was conducted on 407 participants aged ≥65. Sarcopenia was diagnosed using the modified Asian Working Group for Sarcopenia criteria. Mental health was assessed using validated scales: the 15-item Geriatric Depression Scale, the Mini-Mental State Examination, the 7-item Generalized Anxiety Disorder Scale, and the 3-item UCLA Loneliness Scale (UCLA-3). Logistic regression models were used to examine associations between sarcopenia and mental health outcomes.

Results

The prevalence of sarcopenia was 49.9% (95% confidence interval [CI]: 45.0%-54.8%), with higher rates in older age groups and women. After adjusting for confounders, sarcopenia was significantly associated with depression (odds ratio [OR]: 2.28, 95% CI: 1.51-3.44, P < 0.001) and cognitive impairment (OR: 1.86, 95% CI: 1.17-2.96, P = 0.009). Associations with anxiety (OR: 1.49, 95% CI: 0.93-2.38, P = 0.095) and loneliness (OR: 1.52, 95% CI: 1.00-2.31, P = 0.049) were observed but did not reach statistical significance.

Conclusion

Sarcopenia is highly prevalent among elderly patients and is independently associated with adverse mental health outcomes, particularly depression and cognitive impairment. These findings underscore the importance of integrated physical and mental health interventions in the care of older adults with sarcopenia.

Relationships Between Aging Attitudes and Successful Aging Outcomes in Middle-age and Older Women

OBJECTIVES

This study aimed to explore the relationships between aging attitudes and the outcomes of successful aging, including whether aging attitudinal types moderate psychological adjustment in the context of medical and mental health diagnoses.

METHODS

In total, 409 community-dwelling women aged 40-79 years in Australia completed the Reactions to Aging Questionnaire (RAQ), Geriatric Depression Scale, Center of Epidemiological Studies Depression Scale, and Geriatric Anxiety Inventory. Information about medical and mental health diagnoses were collected.

RESULTS

Overall, aging attitudes and all three RAQ subscales were negatively correlated with scores on measures of depression and anxiety, and number of medical diagnoses. Attitudinal types toward aging were found to moderate the relationship between the number of mental health diagnoses and scores on the psychological measures of depression but not anxiety. Unique RAQ domain-specific relationships were found with the number of mental health diagnoses.

CONCLUSIONS

The findings support the link between aging attitudes and psychological outcomes, the potential clinical value of RAQ attitudinal typologies classification as well as a multidimensional conceptualization of aging attitudes.

CLINICAL IMPLICATIONS

The findings reinforce the need for efforts to reduce ageism on a societal level, as well as informing clinical decision-making with older clients.

Exploring the Characteristics of Men Aged 55+ Who Use Mental Health Community Care and Support Services: A Secondary Analysis of the Adult Psychiatric Morbidity Study in England

ObjectivesThe aim of this study is to understand the demographic and situational characteristics of men over 55 who have used a community support service. Method: Hierarchical multivariable logistic regression was conducted using anonymised data from the Adult Psychiatric Morbidity Study 2014. Results: Need factors such as having a common mental disorder (CMD), poor general health and having counselling/therapy were the most relevant to use of a community support service. It was more common for older men (85+), single men, and those who reported experiencing several traumatic life events to have used a community support service. Discussion: The results are critically discussed by considering the roles of gender, ageing, and social support, which might influence the use of community support services. There is a need for more awareness of categories such as age and previous service use, and how they might influence community support help seeking.

Depression and Accelerated Aging: The Eveningness Chronotype and Low Adherence to the Mediterranean Diet Are Associated with Depressive Symptoms in Older Subjects

BACKGROUND AND OBJECTIVES

Depression often results in premature aging, which increases the risk of other chronic diseases, but very few studies have analyzed the association between epigenetic biomarkers of aging and depressive symptoms. Similarly, limited research has examined the joint effects of adherence to the Mediterranean diet (MedDiet) and chronotype on depressive symptoms, accounting for sex differences. Therefore, these are the objectives of our investigation in a Mediterranean population at high cardiovascular risk.

METHODS

We analyzed 465 older subjects (aged 55-75) with metabolic syndrome and assessed depressive symptoms by the Beck Depression Inventory (BDI-II). MedDiet adherence was measured with the 17-item MedDiet score, and chronotype with the Morningness-Eveningness Questionnaire (MEQ). Blood DNA methylation was analyzed, and epigenomic biomarkers of age acceleration were determined. We focused on the Dunedin Pace of Aging Computed from the Epigenome (DunedinPACE). We fitted multivariable models with interaction terms.

RESULTS

Prevalence of depression was statistically higher in women (p < 0.001). MedDiet adherence was strongly and inversely associated with depressive symptoms in the whole population (p < 0.01), while the MEQ score was inversely associated (p < 0.05). In the joint analysis, both MedDiet adherence and chronotype remained statistically associated with the BDI-II score (p < 0.05), showing additive effects. No interaction effects were observed. In women, a higher score in depressive symptoms was significantly associated with faster age acceleration (measured with the DunedinPACE biomarker). This association remained significant even after adjustment for MedDiet adherence and chronotype.

CONCLUSIONS

In older subjects with metabolic syndrome, the eveningness chronotype was associated with greater depressive symptoms, but a higher adherence to the MedDiet could potentially counteract the chronotype risk with additive effects. Women showed stronger associations, and importantly, we reported for the first time in this population that depressive symptoms were associated with accelerated aging.

The Psychological Impacts of Pill Dysphagia: A Mixed Methods Study

Pill dysphagia is a common problem amongst older adults, with significant health consequences. Previous research has found that dysphagia can negatively affect an individuals mental health and wellbeing. However, this research has not been extended to pill-specific dysphagia, which presents distinct differences from the challenges posed by swallowing food and liquids. These differences extend to causes, demographics, and physical health ramifications. This study aimed to address this gap in the literature by investigating the effects of pill dysphagia on the wellbeing of older adults. A community sample of 132 Australians aged 65-97 years completed a survey about their wellbeing and difficulty swallowing pills. Thirty-one participants who met the criteria for pill dysphagia completed further open-ended questions detailing the effects of pill dysphagia and how they manage it. Analyses of the quantitative data indicated that difficulty swallowing pills was unrelated to negative affect but negatively related to positive affect, life satisfaction, and eudemonic wellbeing. Supplementary analyses controlling for health-related variables found no significant relationships between difficulty swallowing pills and wellbeing. Responses to the open-ended questions revealed a range of physical, psychological, and practical impacts of pill dysphagia, and successful and unsuccessful methods used to assist in swallowing pills. The findings partially support the hypothesised effects of pill dysphagia on wellbeing. However, further research is required to establish if more severe pill dysphagia predicts wellbeing over and above self-rated health. Future interventions should incorporate wellbeing promotion strategies for older adults with pill dysphagia.

The Association of Physical Symptoms and Psychological Problems in the Indonesian Community During the COVID-19 Outbreak

Introduction

Changes in health status and adjustments to new lifestyles during the pandemic have triggered societal psychological problems in society. This study aimed to explore the correlation between physical symptoms and psychological problems in Indonesian society during the COVID-19 outbreak.

Methods

This cross-sectional study employed an online survey to gather data from 9425 participants in Indonesia between June and July 2020, which was selected using convenience sampling. The Self-Reporting Questionnaire (SRQ) instrument was employed to investigate psychological problems, the utilization of psychoactive substances, psychotic symptoms, and post-traumatic stress disorder (PTSD). Physical symptoms were assessed through self-reports indicating the presence or absence of experienced COVID-19 symptoms. The statistical analyses were conducted using Spearman-rank and Cramer's V correlation.

Results

The findings suggest that the perceived physical symptoms during the COVID-19 outbreak are significantly associated with psychological problems, (including decreased energy, somatic symptoms, depressive moods, and depressive thoughts, the use of psychoactive substances, psychotic symptoms, and PTSD.

Conclusion

Our study concluded that physical health is significantly associated with psychological problems. It is essential to eliminate factors that cause psychological problems by promoting the physical condition of the general population. Through promotive and preventive efforts, physical and psychological conditions should be improved in COVID-19 outbreaks.

A systematic review of the reasons for quitting and/or reducing alcohol among those who have received alcohol use disorder treatment

Research has primarily studied reasons for quitting and/or reducing alcohol use in non-treatment samples. This systematic review aimed to characterize the reasons for quitting and/or reducing alcohol use among those who have received treatment for AUD and examine how reasons endorsed differ across measurement methods used. Articles were identified through PsycINFO, Web of Science, PubMed, and CINAHL. Twenty-one articles met inclusion criteria. Thematic coding revealed 21 unique themes in reasons for quitting and/or reducing. Common reasons included physical health issues, misalignment with personal goals, family influence, and social factors-also noted in non-treatment populations. Unique themes like hitting rock bottom and avoiding disapproval were identified, potentially linked to treatment initiation or development. The measurement approach influenced the reasons reported, highlighting the need for standardized methods. Common reasons are fundamental and are not a result of treatment, while others are unique to individuals who have received AUD treatment, which may suggest that they are critical in leading one to seek treatment or may be developed during treatment. Assessing and tailoring treatment based on these reasons may enhance outcomes. Standardizing how we measure reasons for quitting or reducing alcohol is crucial for comparing studies and improving treatment. Future research should evaluate reasons over time, assess their importance at different treatment stages, and use varied assessment strategies for comprehensive insights.

Social participation and mental well-being: Does purpose in life mediate the association among older adults?

OBJECTIVES

We investigated the association of social participation with mental well-being among older people and whether purpose in life mediates the potential association.

METHOD

Cross-sectional (n = 1014) and longitudinal (n = 660, four-year follow-up) data comprised of three age cohorts (75, 80, and 85 years) of community-dwelling people. Life satisfaction was measured with the Satisfaction with Life Scale, depressive symptoms with the Centre for Epidemiologic Studies Depression Scale, and purpose in life with the Scales of Psychological Well-Being purpose in life subscale. Social participation was assessed with questions concerning the frequency of meeting close friends and acquaintances, and volunteering. The data were analyzed using structural equation modeling.

RESULTS

Higher social participation was associated with higher life satisfaction and fewer depressive symptoms both cross-sectionally and after a four-year follow-up. Higher purpose in life mediated the associations of more social participation with higher life satisfaction and fewer depressive symptoms cross-sectionally. In the longitudinal data, the mediation effect was not observed.

CONCLUSION

Older people with frequent social participation who had a sense of purpose in their lives will likely have higher mental well-being than those with less social participation. Enabling and supporting them to conduct purposeful actions in social contexts may help maintain their mental well-being.

Biomarkers of Response to Internet-Based Psychological Interventions: Systematic Review

BACKGROUND

Internet-based psychological interventions provide accessible care to a wide range of users, overcoming some obstacles-such as distance, costs, and safety-that might discourage seeking help for mental issues. It is well known that psychological treatments and programs affect the body, as well as the mind, producing physiological changes that ought to be considered when assessing the efficacy of the intervention. However, the literature investigating changes in biomarkers specifically after internet-based psychological and mental health interventions has not yet extensively inquired into this topic.

OBJECTIVE

This systematic review aims to provide a synthesis of literature examining the effects of internet-based psychological interventions-targeting both clinical (mental and physical) and nonclinical conditions-on biomarkers. A secondary aim was to evaluate whether the biomarkers' variations were related to a complementary modification of the psychological or physical symptoms or to a general improvement of the participants' well-being.

METHODS

This review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement. A literature search was performed through 3 databases (PubMed, PsycINFO, and Scopus). Studies examining changes in biomarkers before and after internet-based psychological interventions or programs targeting both clinical and nonclinical samples were included, with no exclusion criteria concerning mental or physical conditions.

RESULTS

A total of 24 studies fulfilled the inclusion criteria. These studies involved individuals with psychiatric or psychological problems (n=6, 25%), those with organic or medical diseases (n=10, 42%), and nonclinical populations (n=8, 33%). Concerning psychiatric or psychological problems, cognitive behavioral therapy (CBT) and CBT-informed interventions showed partial effectiveness in decreasing glycated hemoglobin blood glucose level (n=1) and chemokines (n=1) and in increasing connectivity between the default-mode network and the premotor or dorsolateral prefrontal cortex (n=1). Among individuals with organic or medical diseases, studies reported a significant change in cardiac or cardiovascular (n=3), inflammatory (n=2), cortisol (n=2), glycated hemoglobin (n=2), and immune response (n=1) biomarkers after CBT and CBT-informed interventions, and mindfulness and stress management interventions. Lastly, mindfulness, CBT and CBT-informed interventions, and music therapy succeeded in modifying immune response (n=2), cortisol (n=1), α amylase (n=1), posterior cingulate cortex reactivity to smoking cues (n=1), and carbon monoxide (n=1) levels in nonclinical populations. In some of the included studies (n=5), the psychological intervention or program also produced an improvement of the mental or physical condition of the participants or of their general well-being, alongside significant variations in biomarkers; CBT and CBT-informed interventions proved effective in reducing both psychological (n=2) and physical symptoms (n=2), while a mindfulness program successfully lowered cigarette consumption in a nonclinical sample (n=1).

CONCLUSIONS

Although further evidence is required, we hope to raise awareness on the potential impact of internet-based interventions on biomarkers related to mental and physical health.

Association between functional disability and mental health among Chinese older adults: Examining the moderating effects of social participation and physical exercise

BACKGROUND

Functional disability significantly burdens healthcare services, negatively affecting older adults' social interaction and quality of life. This study aims to identify the association between functional disability and mental health, and examine the moderating effects of social participation and physical exercise on the association.

METHODS

The data were drawn from 2018 wave of Chinese Longitudinal Healthy Longevity Survey, and ordinary least squares regression model was exploited to explore the association between functional disability and mental health.

RESULTS

Activity of daily living (ADL) disability negatively predicted mini-mental state examination (MMSE) score. Furthermore, social participation and physical exercise moderated the association between ADL disability and MMSE score.

CONCLUSION

The results highlight the importance of social participation and physical exercise for the older adults with ADL disability.

Frailty increases depression risk independently of cognitive decline: Insights from Mendelian randomization and cross-sectional analysis

BACKGROUND

Frailty, cognitive decline, and depression are common syndromes among the elderly and are closely interconnected. However, it is still unclear whether the impact of frailty on depression depends on the role of cognitive decline.

METHOD

We conducted the Mendelian randomization (MR) analysis based on the instrumental variables (IVs) from the genome-wide association study (GWAS) databases, and we also performed a cross-sectional study consisting of 1362 older adults aged ≥65 for validation.

RESULTS

The results of the multivariable MR analysis showed that frailty significantly increased the risk of depression, even after controlling for the influence of cognitive performance. Conversely, after controlling for frailty, the effect of cognitive performance on depression risk was noticeably reduced. In the cross-sectional study, frailty mediated 24.04 % of the relationship between cognition and depression, and cognition mediated 7.63 % of the relationship between frailty and depression.

CONCLUSIONS

We provide evidence that frailty could increase depression risk independently of cognitive decline. Further research with a larger sample size is necessary.

Locus of control and the long-term effects of parental smoking on mental health

RATIONALE

Few studies take a life course perspective to explain if exposure to second-hand smoke in childhood influences mental health in adulthood. Importantly, no study provides empirical evidence on the pathways through which exposure to second-hand smoke in childhood influences mental health in adulthood. There is also limited evidence on the factors that moderate the relationship between second-hand smoke exposure and mental health. To inform policy, it is important to explore the pathways through which second-hand smoke influences mental health and understand factors that are likely to moderate this relationship.

OBJECTIVES

The objective of this paper is to examine if exposure to parental smoking in childhood influences mental health in adulthood. The study examines general health and smoking status in later life as potential channels and if locus of control (LoC), a personality trait developed in childhood and adolescence, moderates the relationship between exposure to parental smoking in childhood and mental health in adulthood.

METHODS

Using 21 waves of longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA), the study conducts regression analyses that adjust for the potential effects of confounders and other biases.

RESULTS

The results show that exposure to parental smoking in childhood is associated with a decline in mental health in later life, and that general health status and smoking status in adulthood are channels through which exposure to parental smoking in childhood influences mental health in adulthood. Specifically, those who are exposed to parental smoking in childhood tend to have poorer general health and a higher probability of being smokers in adulthood, both of which negatively impact mental health. The findings point to the moderating role of LoC, such that being more internal on LoC dampens the negative effects of exposure to parental smoking on mental health.

CONCLUSION

The findings from this study lend support to the need to address the long-term implications of behaviours that are harmful to health. The findings also suggest that LoC has implications for an individual's psychological resilience against the negative effects from exposure to parental smoking in childhood.

Sleep disturbance and other co-occurring conditions in autistic children: A network approach to understanding their inter-relationships

Autistic children frequently have one or more co-occurring psychological, behavioral, or medical conditions. We examined relationships between child behaviors, sleep, adaptive behavior, autistic traits, mental health conditions, and health in autistic children using network analysis. Network analysis is hypothesis generating and can inform our understanding of relationships between multiple conditions and behaviors, directing the development of transdiagnostic treatments for co-occurring conditions. Participants were two child cohorts from the Autism Treatment Network registry: ages 2-5 years (n = 2372) and 6-17 years (n = 1553). Least absolute-shrinkage and selection operator (LASSO) regularized partial correlation network analysis was performed in the 2-5 years cohort (35 items) and the 6-17 years cohort (36 items). The Spinglass algorithm determined communities within each network. Two-step expected influence (EI2) determined the importance of network variables. The most influential network items were sleep difficulties (2 items) and aggressive behaviors for young children and aggressive behaviors, social problems, and anxious/depressed behavior for older children. Five communities were found for younger children and seven for older children. Of the top three most important bridge variables, night-waking/parasomnias and anxious/depressed behavior were in both age-groups, and somatic complaints and sleep initiation/duration were in younger and older cohorts respectively. Despite cohort differences, sleep disturbances were prominent in all networks, indicating they are a transdiagnostic feature across many clinical conditions, and thus a target for intervention and monitoring. Aggressive behavior was influential in the partial correlation networks, indicating a potential red flag for clinical monitoring. Other items of strong network importance may also be intervention targets or screening flags.

Microaggression and discrimination exposure on young adult anxiety, depression, and sleep

BACKGROUND

Increasing research examines social determinants of health, including structural oppression and discrimination. Microaggression - subtle/ambiguous slights against one's marginalized identity - is distinct from discrimination, which typically presents as overt and hostile. The current study investigated the comparative effects of each exposure on young adult anxiety, depression, and sleep. Race-stratified analyses investigated patterns across groups.

METHODS

Young adults (N = 48,606) completed the Spring 2022 American College Health Association-National College Health Assessment III. Logistic regressions tested odds of anxiety symptoms, depressive symptoms, and sleep disturbance in association with microaggression and discrimination exposure.

RESULTS

Microaggression and discrimination equally predicted increased likelihood of anxiety symptoms (ORMicro = 1.42, ORDiscrim = 1.46). Discrimination more strongly predicted depressive symptoms (OR = 1.59) and sleep disturbance (OR = 1.54) than did microaggression (ORDepress = 1.24, ORSleep = 1.27). Race-stratified analyses indicated stronger associations between the each exposure and poor mental health in Whites than Asian American, Black/African American, and Hispanic or Latino/a/x respondents.

LIMITATIONS

Microaggression and discrimination exposure were each assessed using a single item. The outcome measures were not assessed using validated measures of anxiety, depression, and sleep (e.g., GAD-7, MOS-SS); thus results should be interpreted with caution. Analyses were cross-sectional hindering our ability to make causal inferences.

CONCLUSIONS

The findings provide preliminary evidence that microaggression and discrimination exposure operate on health in distinct ways. Racially marginalized individuals may demonstrate a blunted stress response relative to Whites. Treatment approaches must be tailored to the particular exposures facing affected individuals to maximize benefits.

Low Energy Availability Risk Is Associated with Anxiety in Female Collegiate Athletes

This study investigated the association between the risk of low energy availability, disordered eating, and anxiety in collegiate female athletes. Female athletes (n = 115) completed questionnaires that assessed disordered eating (Disordered Eating Screen for Athletes, DESA-6; and the Eating Disorder Examination Questionnaire Short, EDE-QS), anxiety (Generalized Anxiety Disorder-7) and the risk of low energy availability (Low Energy Availability in Females Questionnaire; LEAF-Q). The athletes were 19.9 ± 0.1 years old and presented with no anxiety (14.8%), mild (33.0%), moderate (24.3%), and severe (27.8%) anxiety. The EDE-QS scores revealed that 22.6% of the participants had a high risk of an eating disorder, while the DESA-6 scores revealed that 31.3% of the participants scored positive for a risk of disordered eating. The LEAF-Q total scores revealed that 68.7% of the participants were at risk of low energy availability. Increased GAD-7 scores were associated (p < 0.001) with measures of disordered eating (EDE-QS and DESA-6) and the risk of low energy availability (LEAF-Q total score). Non-parametric partial correlations demonstrated that anxiety (increased GAD-7 scores) correlated with the risk of low energy availability (increased LEAF-Q total scores) while controlling for eating disorder scores (EDE-QS) (r (112) = 0.353, p < 0.001), or while controlling for the risk of disordered eating (DESA-6 scores) (r (112) = 0.349, p < 0.001). In female collegiate athletes, both disordered eating and the risk of low energy availability were positively associated with increased anxiety.

Efficacy of Mind-body Exercise to Reduce Sleep Disturbance and Depression Among Older Adults: A Systematic Review and Meta-analysis

PURPOSE

Mind-body exercise is a promising non-pharmacological approach for managing sleep disturbance and depression that are prevalent among older adults, but its efficacy remains inconclusive across the studies. This study aimed to systematically evaluate and quantify the overall effectiveness of mind-body exercises on sleep disturbance and depression in older adults.

METHODS

We searched eight databases to identify relevant articles from their inception to April 2024. Experimental studies that evaluate the effects of mind-body movement therapy on sleep disturbance and depression in older adults were included. The Cochrane Risk of Bias tool version 2.0 was used to appraise included studies. The pairwise meta-analysis was performed through the software Comprehensive Meta-Analysis Version 3.0. Moreover, subgroup analysis was utilized to understand the effect size on each form of mind-body exercise and to determine the source of heterogeneity.

RESULTS

A total of 27 studies were eligible and synthesized. The mind-body exercise appears statistically significant in reducing sleep disturbance (SMD = -0.60, 95% CI: 0.76 ∼ 0.44) and depression (SMD = -0.56, 95% CI: 0.75 ∼ 0.36) among older adults. Each form of mind-body exercise, including pilates, yoga, qigong, and tai-chi, effectively decreases sleep disturbance and depression, but there were no significant differences in the effects between these practices.

CONCLUSION

The cumulative evidence concludes that older adults who participated in mind-body exercise programs showed potential improvements in sleep disturbance and depression. This finding may serve as evidence for professionals to use this approach as a non-pharmacological approach to help older adults in the community and long-term care facilities who are having sleep disturbance and depression. More clinical trials are needed for an in-depth meta-analysis that can rank and compare the efficacy of each mind-body exercise practice.

Mediation analysis in longitudinal study with high-dimensional methylation mediators

Mediation analysis has been widely utilized to identify potential pathways connecting exposures and outcomes. However, there remains a lack of analytical methods for high-dimensional mediation analysis in longitudinal data. To tackle this concern, we proposed an effective and novel approach with variable selection and the indirect effect (IE) assessment based on both linear mixed-effect model and generalized estimating equation. Initially, we employ sure independence screening to reduce the dimension of candidate mediators. Subsequently, we implement the Sobel test with the Bonferroni correction for IE hypothesis testing. Through extensive simulation studies, we demonstrate the performance of our proposed procedure with a higher F$_{1}$ score (0.8056 and 0.9983 at sample sizes of 150 and 500, respectively) compared with the linear method (0.7779 and 0.9642 at the same sample sizes), along with more accurate parameter estimation and a significantly lower false discovery rate. Moreover, we apply our methodology to explore the mediation mechanisms involving over 730 000 DNA methylation sites with potential effects between the paternal body mass index (BMI) and offspring growing BMI in the Shanghai sleeping birth cohort data, leading to the identification of two previously undiscovered mediating CpG sites.