Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries

Acceptability and content validity of suicidality screening items: a qualitative study with perinatal women

Background

Suicide is a leading cause of death for perinatal women. It is estimated that up to 50% of women with mental health issues during pregnancy and/or after birth are not identified, despite regular contact with healthcare services. Screening items are one way in which perinatal women needing support could be identified. However, research examining the content validity and acceptability of suicide-related screening items with perinatal women is limited.

Aims

This study sought to: (i) assess the acceptability and content validity of 16 suicide-related items that have been administered and/or validated in perinatal populations; and (ii) explore the potential barriers and facilitators that may affect how women respond to these items when administered during pregnancy and after birth.

Methods

Twenty-one cognitive and semi-structured interviews were conducted with pregnant and postnatal women in the UK. The sample included women who had experienced self-reported mental health problems and/or suicidality during the perinatal period, and those who had not. Interviews were transcribed verbatim, and a coding framework based on the Theoretical Framework of Acceptability was applied to explore the data using deductive and inductive approaches.

Results

Findings indicated that the acceptability and content validity of suicide-related items were largely unacceptable to perinatal women in their current form. Women found terms such as 'better off dead' or 'killing myself' uncomfortable. Most women preferred the phrase 'ending your life' as this felt less confronting. Comprehensibility was also problematic. Many women did not interpret 'harming myself' to include suicidality, nor did they feel that abstract language such as 'leave this world' was direct enough in relation to suicide. Stigma, fear, and shame was central to non-disclosure. Response options and recall periods further affected the content validity of items, which created additional barriers for identifying those needing support.

Conclusions

Existing suicide-related screening items may not be acceptable to perinatal women. Maternity practitioners and researchers should consider the phrasing, clarity, context, and framing of screening items when discussing suicidality with perinatal women to ensure potential barriers are not being reinforced. The development of specific suicidality screening measures that are acceptable, appropriate, and relevant to perinatal women are warranted.

Anthropometric, biochemical, dietary, morbidity and well-being assessments in women and children in Indonesia, India and Senegal: a UKRI GCRF Action Against Stunting Hub protocol paper

INTRODUCTION

Child stunting has a complex aetiology, especially in the first 1000 days of life. Nutrition interventions alone have not produced expected impacts in reducing/preventing child stunting, indicating the importance of understanding the complex interplay between environmental, physiological and psychological factors influencing child nutritional status. This study will investigate maternal and child nutrition, health and well-being status and associated factors through the assessment of: (1) anthropometry, (2) biomarkers of nutrition and health status, (3) dietary intakes, (4) fetal growth and development, (5) infant morbidity, (6) infant and young child feeding (IYCF) and (7) perinatal maternal stress, depression and social support.

METHODS

This study will be conducted in a prospective pregnancy cohort in India, Indonesia and Senegal. Pregnant women will be recruited in the second (Indonesia, Senegal) and third (India) trimester of pregnancy, and the mother and infant dyads followed until the infant is 24 months of age. During pregnancy, anthropometric measures will be taken, venous blood samples will be collected for biochemical assessment of nutrition and health status, dietary intakes will be assessed using a 4-pass-24-hour dietary recall method (MP24HR), fetal ultrasound for assessment of fetal growth. After birth, anthropometry measurements will be taken, venous blood samples will be collected, MP24HR will be conducted, infant morbidity and IYCF practices will be assessed and a sample of breastmilk will be collected for nutrient composition analyses. Perinatal maternal stress, depression, social support and hair cortisol levels (stress) will be measured. The results from this study will be integrated in an interdisciplinary analysis to examine factors influencing infant growth and inform global efforts in reducing child stunting.

ETHICS AND DISSEMINATION

Ethical approval was granted by the Ethics Committee of the London School of Hygiene and Tropical Medicine (17915/RR/17513); National Institute of Nutrition (ICMR)-Ministry of Health and Family Welfare, Government of India (CR/04/I/2021); Health Research Ethics Committee, University of Indonesia and Cipto Mangunkusumo Hospital (KET-887/UN2.F1/ETIK/PPM.00.02/2019); and the Comité National d'Ethique pour la Recherche en Santé, Senegal (Protocole SEN19/78); the Royal Veterinary College (URN SR2020-0197) and the International Livestock Research Institute Institutional Research Ethics Committee (ILRI-IREC2020-33). Results will be published in peer-reviewed journals and disseminated to policy-makers and participating communities.

The effect of common mental disorders on suicidal attempts by women, during pregnancy and six to nine years after birth

There is scarcity of global data on suicide attempts (SA). The higher frequency of mental disorders places women at a higher risk for SA. Mental disorders (MD) are ranked first in the Global Burden of Diseases (GBD) in terms of years lived with disability (YLD) and common mental disorders (CMD) affect women the most. IN this light, the present study aimed to investigate the impact of CMD during pregnancy, as well as 6 to 9 years after birth, on SA in women who were registered in the Family Health Strategy from the town of Recife, Pernambuco, Brazil. This study consisted of two stages of a prospective cohort. 643 adult women were included. The prevalence of CMD in stage I (pregnancy) and in stage III (six to nine years after birth) were, respectively, 19.3% and 12.6%. The incidence of SA was 10.9%. The multivariate analysis demonstrated a cumulative effect of CMD for SA: only during pregnancy (OR 5.4; 95%CI 2.2-13.3); only in the third stage (OR 5.8; 95%CI 2.3-14.9); and in both stages (OR 6.0; 95%CI 2.5-14.4). The increase of CMD in women increases the chances of SA, hence the importance of implementing public policies for women's health, especially for those with a history of mental disorders and unhealthy habits, and those who suffer violence.

Occupational stressors and mental illness in healthcare work: An intersection between gender, race, and class

BACKGROUND

Previous studies have supported the relevance of using broad and complex approaches, including multiple explanatory categories, to analyze mental disorders in the working population. This study aimed to assess the direct and indirect effects of gender, race, social class, and occupational stressors on mental health.

METHODS

A cross-sectional study used a random sample of 3343 health workers. The effort-reward imbalance (ERI) scale measured occupational stressors. The World Health Organization Self-Reporting Questionnaire (SRQ-20) evaluated common mental disorders (CMDs) as outcomes. The role of gender, race/color, and class determinants (level of schooling and income) in the relationship between occupational stressors and CMD was assessed. Structural equation modeling was used to determine associations and effects.

RESULTS

Occupational stressors were directly associated with CMD and mediated the relationship between income and CMD. Gender was directly associated with occupational stressors, income, and domestic overload. Race was associated with education and with CMD through indirect paths mediated by class indicators. Class indicators contributed to increasing exposure to occupational stressors and the occurrence of CMD.

CONCLUSION

The results highlight the relevance of gender, race/color, and class in understanding the unequal distribution of work stressors and mental illness in health workers.

Social determinants, symptoms and mental problems in adults internally displaced by armed conflict. Soacha, Colombia, 2019

OBJECTIVE

To characterise social determinants of health, mental health problems and potentially problematic symptoms in the adult population displaced by internal armed conflict in Colombia.

METHODS

Cross-sectional descriptive study with a random sample of 98 adults forcefully displaced to Soacha, Colombia, due to internal armed conflict. The Self Report Questionnaire to detect potentially problematic mental health problems and symptoms, and a structured questionnaire on social determinants of health were applied.

RESULTS

The median age was 38 [interquartile range, 28-46] years, and women predominated (69.39%). The median time since displacement was 36 [16-48] months, and time since settlement in Soacha, 48 [5-48] months. 86.32% survived on less than the minimum wage per month and 93.87% did not have an employment contract. 42.86% and 7.14% reported being owners of their homes before and after displacement, respectively. Upon arriving in Soacha, 79.60% went to primary support networks and 3% to institutions. Before displacement, 16.33% lacked health insurance and 27.55% afterwards. Regarding mental health problems; there were possible depressive or anxious disorders in 57.29%; possible psychosis in 36.73%; and potentially problematic symptoms in 91.66%, being more prevalent and serious in women (p = 0.0025).

CONCLUSIONS

A deterioration in living conditions and a higher prevalence of potentially problematic mental health problems and symptoms was reported in displaced adult populations settled in Soacha compared to other regions of the country. Analyses with complementary perspectives are required to evaluate these differences.

Voice Acoustic Parameters as Predictors of Depression

OBJECTIVE

To analyze whether voice acoustic parameters are discriminant and predictive in patients with and without depression.

METHODS

Observational case-control study. The following instruments were administered to the participants: Self-Reporting Questionnaire (SRQ-20), Beck Depression Inventory-Second Edition (BDI-II), Voice Symptom Scale (VoiSS) and voice collection for subsequent extraction of the following acoustic parameters: mean, mode and standard deviation (SD) of the fundamental frequency (F0); jitter; shimmer; glottal to noise excitation ratio (GNE); cepstral peak prominence-smoothed (CPPS); and spectral tilt. A total of 144 individuals participated in the study: 54 patients diagnosed with depression (case group) and 90 without a diagnosis of depression (control group).

RESULTS

The means of the acoustic parameters showed differences between the groups: F0 (SD), jitter, and shimmer values were high, while values for GNE, CPPS and spectral tilt were lower in the case group than in the control group. There was a significant association between BDI-II and jitter, shimmer, CPPS, and spectral tilt and between CPPS and the class of antidepressants used. The multiple linear regression model showed that jitter and CPPS were predictors of depression, as measured by the BDI-II.

CONCLUSION

Acoustic parameters were able to discriminate between patients with and without depression and were associated with BDI-II scores. The class of antidepressants used was associated with CPPS, and the jitter and CPPS parameters were able to predict the presence of depression, as measured by the BDI-II clinical score.

Atuação da enfermagem em unidades dedicadas e não dedicadas à COVID-19: implicações na saúde ocupacional

Resumo Objetivo: analisar as implicações da pandemia sobre a saúde ocupacional da equipe de enfermagem conforme a atuação em unidades dedicadas e não dedicadas à COVID-19. Método: estudo multicêntrico, de método misto, estratégia explanatória sequencial. Participaram 845 profissionais na primeira etapa, respondendo a um formulário eletrônico contendo variáveis sociodemográficas, laborais, sobre a pandemia e sua saúde e o Self-Reporting Questionnaire. Na segunda etapa, 19 profissionais foram entrevistados. Os dados quantitativos foram submetidos à estatística analítica e os qualitativos à análise temática de conteúdo, sendo integrados por conexão. Resultados: os impactos da pandemia sobre a saúde dos profissionais ocorreram tanto nas áreas dedicadas como nas não dedicadas à COVID-19. Contudo, a composição das equipes apresentou características distintas entre as áreas, bem como as percepções de risco e das exigências no trabalho. Conclusão: os profissionais que atuam em áreas dedicadas e não dedicadas à COVID-19 estão igualmente adoecidos, mas com exposição laboral distinta quanto às exigências no trabalho nas unidades dedicadas e o medo da contaminação nas unidades não dedicadas.

Trabajo de enfermería en unidades dedicadas y no dedicadas al COVID-19: consecuencias para la salud ocupacional

Resumen Objetivo: analizar las consecuencias que tuvo la pandemia en la salud ocupacional de los enfermeros según si se desempeñaban en unidades dedicadas y no dedicadas al COVID-19. Método: estudio multicéntrico, método mixto, estrategia explicativa secuencial. En la primera etapa participaron en total 845 profesionales que respondieron un formulario electrónico que contenía variables sociodemográficas, ocupacionales, sobre la pandemia y la salud y el Self-Reporting Questionnaire. En la segunda etapa, fueron entrevistados 19 profesionales. Los datos cuantitativos fueron sometidos a estadística analítica y los datos cualitativos al análisis de contenido temático, posteriormente, ambos fueron integrados por conexión. Resultados: los impactos de la pandemia en la salud de los profesionales se produjeron tanto en las áreas dedicadas como en las no dedicadas al COVID-19. Sin embargo, la composición de los equipos presentó distintas características entre las áreas, así como también diferentes percepciones de riesgo y exigencias en el trabajo. Conclusión: los profesionales que trabajan en áreas dedicadas y no dedicadas al COVID-19 se enfermaron por igual, pero tuvieron diferente exposición ocupacional debido a las exigencias que presentaba el trabajo en las unidades dedicadas y al miedo al contagio en las unidades no dedicadas.

Investigating the association of prenatal psychological adversities with mother and child telomere length and neurodevelopment

BACKGROUND

Exposure to prenatal maternal psychological adversities can negatively affect the offspring's developing brain. Shortened telomere length (TL) has been implicated as a mechanism for the transgenerational effects of maternal psychological adversities on offspring. This study aimed to determine associations between prenatal psychological stressors and distress with maternal and early life TL, and associations between maternal, newborn and child TL with neurodevelopmental outcomes at 2 years of age.

METHODS

Follow-up TL was measured in a subgroup of African mothers (n = 138) and their newborns (n = 142) and children (n = 96) at 2-years in the Drakenstein Child Health Study. Prenatal symptoms of depression, distress, intimate partner violence, posttraumatic stress-disorder and childhood trauma were measured at 27 weeks gestation. Neurodevelopment was assessed at 2 years using the Bayley Scales of Infant and Toddler Development III. TLs were measured in whole bloods from mothers and their children at 2-years, and cord bloods in newborns.

RESULTS

Maternal prenatal stressors and distress were not significantly associated with TL in mothers or their children at birth or at 2-years. Furthermore, maternal psychological measures were not associated with early-life attrition of TL. Longer TL in children at 2-years was associated (p = 0.04) with higher motor functioning.

LIMITATIONS

Limited numbers of participants and single time-point psychological measures.

CONCLUSIONS

This study is the first to provide information on the association of early life TL with prenatal psychological adversities and neurodevelopmental outcomes in a population of low-income African mothers and their children.

Common mental disorders in Brazilian female shift workers: prevalence and associated factors

This study aimed to identify the prevalence of common mental disorders (CMD) and associated factors in female shift workers. A cross-sectional study was conducted with a sample of 450 female workers, aged 18 years or older (± 36.1 years), from an industry located in Southern Brazil. CMD was assessed using the self-reporting questionnaire (SRQ-20 ≥ 8 points), and sociodemographic, occupational, behavioral, morbidity, and self-rated health characteristics were assessed using a questionnaire survey. The prevalence of CMD was 47.3% (95% CI: 42.6-52.1). After adjusting, female workers with black/brown race/skin color had a 22% higher probability of CMD than white workers (prevalence ratio (PR) = 1.22; 95% CI: 1.01-1.49), and workers with sleep disorders or poor sleep quality were 147% more likely to have CMD compared with those with good sleep quality (PR = 2.47; 95% CI: 1.70-3.58), and workers with fair/poor self-rated health were twice as likely to have CMD (PR = 2.00; 95% CI: 1.43-2.80) compared to those with excellent/very good self-rated health. A high prevalence of CMD was observed in female shift workers, especially in workers with a black/brown race/skin color and with poor sleep quality and self-rated health.

Intimate Partner Violence among women living in families with children under the poverty line and its association with common mental disorders during COVID-19 pandemics in Ceará, Brazil

BACKGROUND

Intimate partner violence (IPV) is a pervasive public health issue that affects millions of women worldwide. Women living below the poverty line experience higher rates of violence and fewer resources to escape or cope with the abuse, and the COVID-19 pandemic has significantly impacted women's economic well-being worldwide. We conducted a cross-sectional study in Ceará, Brazil, on women in families with children living below the poverty line at the peak of the second wave of COVID to assess the prevalence of IPV and its association with common mental disorders(CMD).

METHODS

The study population comprised families with children up to six years of age who participated in the cash transfer program "Mais Infância". The families selected to participate in this program must meet a poverty criterion: families must live in rural areas, in addition to a monthly per capita income of less than US$16.50 per month. We applied specific instruments to evaluate IPV and CMD. To access IPV, we used the Partner Violence Screen (PVS). The Self-Reporting Questionnaire (SRQ-20) was used to assess CMD. To verify the association between IPV and the other evaluated factors with CMD, simple and hierarchical multiple logistic models were used.

RESULTS

Of the 479 participant women, 22% were positively screened for IPV (95% CI 18.2-26.2). After multivariate adjustment, the chances of CMD are 2.32 higher in women exposed to IPV than in those not exposed to IPV ((95%CI 1.30-4.13), p value = 0.004). CMD was also associated with job loss during the COVID-19 pandemic (ORa 2.13 (95% CI 1.09-4.35), p-value 0.029). In addition to these, separate or single marital status, as well as non-presence of the father at home and food insecurity were associated with CMD.

CONCLUSION

We conclude that the prevalence of intimate partner violence in families with children up to six years of age living below the poverty line in Ceará is high and is associated with greater chances of common mental disorders in mothers. Also, job loss and reduced access to food caused by the Covid 19 pandemic exacerbated both phenomena, constituting a double burden generator factor on mothers.

A systematic review of the psychosocial factors associated with pain in children with juvenile idiopathic arthritis

BACKGROUND

Pain is one of the most frequently reported experiences amongst children with Juvenile Idiopathic Arthritis (JIA); however, the management of JIA pain remains challenging. As pain is a multidimensional experience that is influenced by biological, psychological, and social factors, the key to effective pain management lies in understanding these complex relationships. The objective of this study is to systematically review the literature on psychosocial factors of children with JIA and their caregivers 1) associated with and 2) predictive of later JIA pain intensity, frequency, and sensitivity in children 0-17 years of age.

METHODS

The Joanna Briggs Institute methodology for etiology and risk and Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement guided the conduct and reporting of this review. Terms related to pain and JIA were searched in English without date restrictions across various databases (PubMed, CINAHL, PsycINFO, Embase, Scopus, and the Cochrane Central Register of Controlled Trials) in September 2021. Two independent reviewers identified, extracted data from, and critically appraised the included studies. Conflicts were resolved via consensus.

RESULTS

Of the 9,929 unique studies identified, 61 were included in this review and reported on 516 associations. Results were heterogeneous, likely due to methodological differences and moderate study quality. Results identified predominantly significant associations between pain and primary and secondary appraisals (e.g., more child pain beliefs, lower parent/child self-efficacy, lower child social functioning), parent/child internalizing symptoms, and lower child well-being and health-related quality of life. Prognostically, studies had 1-to-60-month follow-up periods. Fewer beliefs of harm, disability, and no control were associated with lower pain at follow-up, whereas internalizing symptoms and lower well-being were predictive of higher pain at follow-up (bidirectional relationships were also identified).

CONCLUSIONS

Despite the heterogeneous results, this review highlights important associations between psychosocial factors and JIA pain. Clinically, this information supports an interdisciplinary approach to pain management, informs the role of psychosocial supports, and provides information to better optimize JIA pain assessments and interventions. It also identifies a need for high quality studies with larger samples and more complex and longitudinal analyses to understand factors that impact the pain experience in children with JIA.

TRIAL REGISTRATION

PROSPERO CRD42021266716.

Anxiety, Depression, and Other Factors Associated With Voice Handicaps in Active Older People During the COVID-19 Pandemic

During the COVID-19 pandemic, older people had to remain isolated, which could cause not only anxiety and depression but also voice and communication problems and lifestyle, demographic, and socioeconomic changes. This study aimed to analyze the influence of anxiety and depression and other associated factors on the voice handicap of active older adults during the COVID-19 pandemic. This cross-sectional and analytical research approached older people enrolled at a reference health care unit for this age group in Recife. Demographic, socioeconomic, and lifestyle data were surveyed with interviews. Mental health measures were obtained with the Self-Reporting Questionnaire, State-Trait Anxiety Inventory, and Geriatric Depression Scale. Voice handicap was assessed with the Voice Handicap Index. Analyses were performed with descriptive and inferential statistics. The study compared older people with lesser and greater voice handicaps, using the chi-square and Wald tests. The association was assessed according to the binary and multivariate logistic regression model. Altogether, 91 older people with a mean age of 69 years participated in the research, most of whom (54.9%) did not have voice handicaps. Trait anxiety (P = 0.031) and age (P = 0.036) were associated with voice handicaps. Active older adults with higher trait anxiety were five times as likely to have voice handicaps (odds ratio = 5.151) as those with low trait anxiety. Moreover, the ones with more advanced age were 10% more likely to have voice handicaps (odds ratio = 1.100) than younger participants. It is concluded that, during the pandemic, voice handicap in active older people was associated with trait anxiety and age.

Minor psychiatric disorders among university students during the COVID-19 pandemic

OBJECTIVE

To identify the prevalence and factors associated with the manifestation of Minor Psychiatric Disorders (MPD) among university students in southern Brazil during the COVID-19 pandemic.

METHOD

Cross-sectional study, conducted in August and September 2020, with 464 university students. The Self-Reporting Questionnaire (SRQ-20) was used with a cut-off point ≥ 7, and associated factors were identified through crude and adjusted analyses using logistic regression.

RESULTS

The prevalence of MPD was 76.5%. Factors positively associated with the outcome were female gender, job loss during the pandemic, use of psychoactive substances, and difficulties in following online classes. Being in social distancing for seven months or more was negatively associated with the outcome.

CONCLUSION

High prevalence of MPD among the studied sample, as well as a relationship between this outcome and the consequences of the COVID-19 pandemic.

Suicide ideation among Brazilian college students: Relationship with academic factors, mental health, and sexual abuse

BACKGROUND

Suicide is one of the leading causes of death among youth and its occurrence among college students is a matter of great concern. Challenges of transitional adulting and mental illness increase the likelihood of suicidal cognition in students. The objective of present study was to investigate the prevalence of suicide ideation and associated factors in a representative sample of Brazilian college students (n = 12,245).

METHODS

Data were drawn from a nationwide survey and further subjected to estimate the prevalence of suicide ideation and its association with socio-demographic and academic characteristics. We performed logistic regression analyses upon a conceptual framework, considering individual and academic factors.

RESULTS

The point-prevalence of suicide ideation among college students was 5.9 % (SE = 0.37). In the final regression model, variables associated with the likelihood of suicide ideation were psychopathology, sexual abuse, and academic variables, such as dissatisfaction with the chosen undergraduate course (OR = 1.86; IC95 % 1.43-2.41) and low academic performance (OR = 3.56; IC95 % 1.69-7.48). Having children and religious affiliation were inversely associated with the likelihood of suicide ideation.

LIMITATIONS

Participants were recruited from state capitals, which limited data generalizability to non-urban college students.

CONCLUSIONS

The impact of academic life on the mental health of students should be carefully monitored in in-campus pedagogical and health services. Early identification of poor-performance students with social disadvantages could indicate vulnerable ones who are much in need of psycho-social support.

Association of Sociodemographic Factors and Maternal Educational Attainment with Child Development among Families Living below the Poverty Line in the State of Ceará, Northeastern Brazil

Maternal educational attainment has been identified as relevant to several child health and development outcomes. This study aimed to evaluate the association of sociodemographic and maternal education factors with child development in families living below the poverty line. A cross-sectional study was conducted through telephone contact from May to July 2021 in Ceará, a state in Northeastern Brazil. The study population comprised families with children up to six years of age participating in the cash transfer program “Mais infância”. The families selected to participate in this program must have a monthly per capita income of less than US$16.50. The Ages and Stages Questionnaire version 3 was applied to assess the children’s development status. The mothers reported maternal educational attainment as the highest grade and or degree obtained. The final weighted and adjusted model showed that maternal schooling was associated with the risk of delay in all domains except for the fine motor domain. The risk of delay in at least one domain was 2.5-fold higher in mothers with a lower level of schooling (95% CI: 1.6–3.9). The findings of this study suggest that mothers with higher educational attainment have children with better child development outcomes.

Maternal educational practices and mental health disorders of school-age children

OBJECTIVE

To investigate the association between emotional and behavioral difficulties in schoolchildren and maternal educational practices.

METHODS

Participants and Setting: 631 mother-child pairs were evaluated in a poor urban district in Recife, northeastern Brazil. Cross-sectional study carried out between 2013 and 2014. It integrates a prospective cohort study designed to investigate the consequences of intimate partner violence that occurred during pregnancy, postpartum, and seven years after birth for the physical and mental health of women and their children. Maternal educational practices were assessed using the Parent-Child Conflict Tactics Scale (CTSPC - mother-child version) and the child's behavioral and emotional disorders through the Strengths and Difficulties Questionnaire (SDQ) mother-version. The association was estimated through crude and adjusted prevalence ratios, using Poisson regression considering the 95% confidence interval.

RESULTS

The prevalence of violent maternal educational practices was 91.8% (572/631) being 89.7% (566/631) of psychological aggression and 75.6% of physical aggression, subdivided into corporal punishment (73.5%), physical maltreatment (35.8%) and severe physical maltreatment (1.7%). Corporal punishment (Adjusted PR 1.5; CI 95%: 1.1-2.1; p = 0.010) and severe physical maltreatment (Adjusted PR 1.9; CI 95%: 1.3-2.8; p = 0.002) were associated with emotional and behavioral difficulties in schoolchildren.

CONCLUSION

The high prevalence of violent maternal educational practices, especially corporal punishment and severe physical maltreatment is associated with emotional and behavioral disorders in children. Therefore, it is necessary to interventions that promote parental support and effective use of non-violent discipline in conducting the educational process to establish healthier family relationships and to prevent/mitigate the impact of emotional and behavioral problems in children.

Associations between chronotype, sleep quality, maternal mental health, and child development in mother-infant dyads

OBJECTIVE/BACKGROUND

Studies on circadian rhythms throughout development and their physiological and behavioral impacts at early stages are still scarce. Previous studies have shown that mother-infant interactions are important for both sleep and child development. In this cross-sectional study we investigated whether infants' chronotype, sleep and development were associated with their respective mothers' chronotype, sleep, mental health and socioeconomic status.

PATIENTS/METHODS

the following were used to evaluate mothers: the Morningness-Eveningness Questionnaire (MEQ), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and Self-Reporting Questionnaire 20 (SRQ-20). To assess the infants' characteristics, the following were used: the 19th question from the Morningness-Eveningness Questionnaire (MEQ), infant nocturnal midpoint of sleep (iMSF), Brief Infant Sleep Questionnaire (BISQ) and Ages and Stages Questionnaire-3 (ASQ3). Socioeconomic aspects were assessed using the Brazilian Economic Class Criterion of the Brazilian Association of Research Companies (ABEP).

RESULTS

A hundred and eight mother-infant dyads participated in the study. Sleep disorders were observed in 38 (35%) infants and atypical development (ASQ3) in 35 (32%). The infants' sleep phases were partially explained by the mother's chronotype. Infants' sleep duration was negatively correlated with sleep latency, which was higher in the group with atypical development. Mothers of infants with sleep disorders or discordant chronotypes (32%) had higher Pittsburgh scores (worse sleep quality) and higher SRQ-20 scores (screen for Common Mental Disorders).

CONCLUSIONS

We found evidence for the contribution of sleep quality and chronotypes to mothers' mental health and infant development. However, further studies are needed to confirm the influence of sleep and circadian phenotypes in the early stages.

Measures of suicidality in perinatal women: A systematic review

BACKGROUND

Suicide is a leading cause of death for perinatal women. Identifying women at risk of suicide is critical. Research on the validity and/or reliability of measures assessing suicidality in perinatal women is limited. This review sought to: (1) identify; and (2) evaluate the psychometric properties of suicidality measures validated in perinatal populations.

METHODS

Nine electronic databases were systematically searched from inception to January 2022. Additional articles were identified through citation tracking. Study quality was assessed using an adapted tool, and the psychometric properties of measures were reviewed and presented using a narrative synthesis.

RESULTS

A total of 208 studies were included. Thirty-five studies reported psychometric data on ten suicidality measures. Fifteen studies reported both validity and reliability data, 12 reported more than one type of validity, seven validated more than one measure and four only reported reliability. Nearly all measures primarily screened for depression, with an item or subscale assessing suicidal ideation and/or behaviours. Three measures were specifically developed for perinatal women, but only two were validated in more than one study. The Postpartum Depression Screening Scale (PDSS), suicidal thoughts subscale, was validated most frequently.

LIMITATIONS

Methodological differences and variability between the measures (e.g., suicidality construct assessed, number of items and administration) precluded direct comparisons.

CONCLUSION

Further validation of suicidality measures is needed in perinatal women. Screening for perinatal suicidality often occurs in the context of depression. The development of a standalone measure specifically assessing suicidality in perinatal women may be warranted, particularly for use in maternity care settings.

Transtornos Mentais Comuns em Motoristas de Transporte Coletivo de Passageiros

Este estudo teve como objetivo a identificação dos fatores associados aos transtornos mentais comuns (TMC) em motoristas de transporte coletivo de passageiros, em uma amostra de 258 motoristas pertencentes ao quadro funcional de duas empresas de transporte coletivo. Para a coleta de dados, foram utilizados o Questionário de Dados Sociodemográficos, Laborais e Estressores Ocupacionais e o Self-Reporting Questionnaire (SRQ-20). Realizaram-se análises bivariadas (qui-quadrado de Pearson) entre todas as variáveis independentes. Para a análise dos TMC e relação com as variáveis independentes, foi utilizada análise de regressão logística bivariada e a odds ratio (OR), que consiste na razão de chances de aquisição do agravo entre expostos e não expostos. Os resultados identificaram como preditoras dos transtornos mentais comuns as variáveis pouco tempo de intervalo; falta de suporte social; falta de autonomia; e escala de trabalho.

Executive Functions Contribute to the Differences Between ADHD and Sluggish Cognitive Tempo (SCT) in Adults

OBJECTIVES

This paper analyses the relationship between sociodemographic variables, executive dysfunctions, Sluggish Cognitive Tempo (SCT) and the mainly dimensions of ADHD: hyperactivity-impulsivity (ADHD-H/I) and inattention (ADHD-IN) in Brazilian adults.

METHOD

A cross-sectional, exploratory, and comparative design was used. A total of 446 participants (295 women) aging from 18 to 63 years old (M = 3,499 years, SD = 10.7) were recruited on the internet. Correlations, t independent tests and regressions were conducted.

RESULTS

Higher scores in ADHD dimensions were associated to more executive functioning problems and time perception distortions in comparison to those participants without significant ADHD symptoms. However, ADHD-IN dimension as well as SCT were higher associated with these dysfunctions than ADHD-H/I. The regression results showed that ADHD-IN was more related to Self-Management to time while ADHD-H/I to Self-Restraint and SCT to Self-Organization/Problem Solving.

CONCLUSION

This paper contributed to the distinction between SCT and ADHD in adults in important psychological dimensions.

Knowledge of women who have sex with women about Sexually Transmitted Infections and AIDS

Abstract This article aims to study the knowledge of women who have sex with women about Sexually Transmitted Infections and AIDS. Cross-sectional study of 260 women, 81 women who either have sex with women or with men and women (WSW) and 179 women who have sex exclusively with men (WSM). Data were collected in 2019/2020 by means of a form and validated instruments. To study the association between sexual partnership and level of knowledge about Sexually Transmitted Infections and AIDS, multiple Cox regression models were adjusted, producing significant associations of p<0,05. The median percentage of correct answers was lower among WSW when compared to WSM [68% (18-96) vs 75% (14-96); p=0.023]. Having sex with woman [PR=2.36 (1.07-5.21); p=0.033] and less than 11 years of schooling [PR=2.64 (1.12-6.21); p=0.026] were independently associated with low knowledge. WSW had a lower level of knowledge about Sexually Transmitted Infections and AIDS than WSM, and lower education was independently associated with this finding.

The Body in Crisis: A Health Needs Assessment among Female Survivors of Interpersonal Violence

BACKGROUND

When women who experience violence seek social services, they are looking to meet immediate needs: shelter, safety, and support. Seeking assistance as part of a crisis may inadvertently detract attention away from other critical needs. Literature illustrates the emotional and physical effects of violence on women's bodies, as well as their long-term health. While health may present as an urgent need in cases of serious injury, it is often overlooked in crisis-oriented service delivery systems. This study explored the experience with violence, health status, and holistic healthcare needs among women accessing interpersonal violence services in Texas.

METHODS

A tablet-based survey was conducted at a family justice center, rape crisis center, and emergency shelter among women (N = 99) in Fort Worth, Texas. Survey questions assessed the participants' demographic information, health status, health needs, healthcare utilization, barriers to accessing healthcare, and experience with interpersonal violence among participating women.

RESULTS

Two-thirds of the sample reported suffering injuries from victimization experiences. More than half of the sample (62%) reported they went to the emergency room at least one time in the last 6 months, with 11 women reported staying five or more nights in the hospital in the last 6 months. Participants described urgent (e.g., advised by healthcare provider, too serious for a clinic) and non-urgent (e.g., not having another source of care, closest provider) reasons for using the emergency room. Roughly, half of the sample (50%) reported having at least three chronic conditions.

DISCUSSION

This study illustrated that women seeking interpersonal violence related (IPV) services have multiple unmet needs and lack adequate access to physical and mental health care. Since the majority of the sample was living in poverty, there are multiple costs and investments in the participants' health that were forgone for their survival. This study provides data in support of the development of health-related services for IPV survivors.

Nursing performance in COVID-19 and non-COVID-19 units: Implications for occupational health

OBJECTIVE

to analyze the implications of the pandemic on the Nursing team's occupational health according to its performance in COVID-19 and non-COVID-19 units.

METHOD

a multicenter and mixed-methods study, with a sequential explanatory strategy. A total of 845 professionals took part in the first stage, answering an electronic form which contained sociodemographic and work-related variables, as well as about the pandemic and their health, in addition to the Self-Reporting Questionnaire. 19 professionals were interviewed in the second stage. The quantitative data were submitted to statistical analysis and the qualitative ones to thematic content analysis, with integration by connection.

RESULTS

the pandemic exerted impacts on the professionals' health, both in the COVID-19 and non-COVID-19 areas. However, composition of the teams presented different characteristics between the areas, as well as the risk perceptions and the work demands.

CONCLUSION

the professionals working in areas COVID-19 and non-COVID-19 areas are equally affected, although with different work exposure regarding the requirements at work in the COVID-19 units and the fear of contamination in non-COVID-19 units.

Knowledge of women who have sex with women about Sexually Transmitted Infections and AIDS

This article aims to study the knowledge of women who have sex with women about Sexually Transmitted Infections and AIDS. Cross-sectional study of 260 women, 81 women who either have sex with women or with men and women (WSW) and 179 women who have sex exclusively with men (WSM). Data were collected in 2019/2020 by means of a form and validated instruments. To study the association between sexual partnership and level of knowledge about Sexually Transmitted Infections and AIDS, multiple Cox regression models were adjusted, producing significant associations of p<0,05. The median percentage of correct answers was lower among WSW when compared to WSM [68% (18-96) vs 75% (14-96); p=0.023]. Having sex with woman [PR=2.36 (1.07-5.21); p=0.033] and less than 11 years of schooling [PR=2.64 (1.12-6.21); p=0.026] were independently associated with low knowledge. WSW had a lower level of knowledge about Sexually Transmitted Infections and AIDS than WSM, and lower education was independently associated with this finding.

Prevalence and factors associated with substance use among university students in South Africa: implications for prevention

BACKGROUND

Substance use is an important public health concern in many countries across the globe. Among the general public, institutions of higher learning have developed a reputation for inducing new substance use among students. In addition to socio-demographic factors, substance use and abuse among university students often appear to be related to psychological stressors typically related to the demand to adapt to the new environment and the pressures associated with academia. The purpose of this study was to identify the prevalence of, and factors associated with substance use among university students.

METHODS

This quantitative study employed convenience sampling to recruit university students who were 18 years and older from a university in the Western Cape. The study made use of self-administered online questionnaires, which participants completed via SurveyMonkey. The sample consisted of 2915 students. Descriptive statistics were used to describe and provide the prevalence and overview of the demographic characteristics of the respondents. Associations between variables were explored using Chi-square and Mann-Whitney U tests.

RESULTS

The main findings revealed a substance use prevalence rate of 62.7%. The most prominent substances used by students were alcohol (80.6%), cannabis (46%), and ecstasy (5.3%). The study further  revealed clear associations between students' substance use and mental health. Students who reported substance use at university reported higher depression and anxiety scores than those who did not. However, findings reveal no significant association (p = 0.233) between being a substance user and a nonsubstance user and students' respective self-perceived stress scores.

CONCLUSION

Results show the majority of sampled students had started using substances (both alcohol and other substances) only after entering university. The results call into question seminal findings relating to substance use and the university environment. The novel findings of this study could serve as a baseline input to inform policymakers, programme developers, service providers, parents, and other stakeholders who are involved in the design and implementation of more effective awareness, prevention and, needs-based intervention services.

Chronic Aflatoxin Exposure and Cognitive and Language Development in Young Children of Bangladesh: A Longitudinal Study

Aflatoxin can cross the blood-brain barrier, damage brain tissues, and have the potential to harm the development of the human brain. Although dietary aflatoxin exposure is common in children, there is a paucity of data on aflatoxin exposure and child developmental outcomes. The child's cognitive, motor, and language functions were assessed using the Bayley Scales of Infant and Toddler Development-III or BSID-III at the same time points. Association between exposure to aflatoxin and subtests of BSID-III were examined using mixed-effect linear regression. Aflatoxin assays were performed on 194, 167, and 163 children at 15, 24, and 36 months of age, and chronic aflatoxin exposure was detected in 20.6%, 16.8%, and 60.7% of children, respectively. Multi-variable analyses showed that aflatoxin exposure was independently related to the children's cognitive score (β: -0.69; 95% CI: -1.36, -0.02), receptive language score (β: -0.90; 95% CI: -1.62, -0.17), and expressive language score (β: -1.01; 95% CI: -1.96, -0.05). We did not observe any association between exposure to aflatoxin and the motor function of children. Chronic exposure to aflatoxin exposure was linked to reduced cognitive, expressive, and receptive language scores of the study children. Further research is needed in a different setting to confirm this novel finding.

Aromatherapy on Psycho-Emotional Symptoms and Fatigue in Nursing Professionals in the COVID-19 Setting

Objective: To compare the effectiveness of aromatherapy with lavender essential oil (EO) versus an EO synergy on psycho-emotional symptoms and fatigue of nursing professionals in the COVID-19 setting. Materials and Methods: This is a quasi-experimental pilot study conducted in 2020. The professionals were randomized in Group 1 — lavender, and in Group 2 — lavender and other EOs synergy. The instruments were validated in Brazil, namely the Self-Reporting Questionnaire (SRQ-20) and the Fatigue Pictogram, which were applied at three moments: before the intervention, after 21 days of intervention, and three weeks after the end of the intervention follow-up. The data were evaluated using Pearson’s x2 test or Fisher’s exact test (dichotomous variables) and Student’s t-test or Mann-Whitney test (continuous variables). Results: A total of 18 professionals participated, and both groups presented improved SRQ-20 scores (p < 0.010), which was maintained in the follow-up for Group 1 compared to the pre-intervention moment (p = 0.033). There was a significant decrease in fatigue in professionals in both groups (p = 0.010), but no difference was observed in the improvement of the impact of fatigue on daily life. Conclusions: There was a reduction in psycho-emotional symptoms and fatigue in nursing professionals who used aromatherapy during the COVID-19 pandemic in both groups.

Multidimensional poverty and adolescent mental health: Unpacking the relationship

Extensive research suggests that poverty is associated with adolescent mental health problems. However, studies typically focus on monetary poverty and have not examined how other dimensions of poverty relate to adolescent mental health. This study examines the association between multidimensional poverty and mental health among adolescents using a Multidimensional Poverty Index. Based on data from the National Mental Health Survey in Colombia, we show that adolescents living in multidimensionally poor households have 50% higher risk of having mental health problems compared to adolescents in non-poor households. We unpack and assess the relation between each of the dimensions of poverty and mental health, and whether deprivations directly experienced by the adolescent are more strongly associated with mental health problems than deprivations experienced by other household members. Individual deprivations associated with human capital linked to schooling, work, health insurance and employment are more strongly associated with adolescent mental health problems than material deprivations. Lagging behind in school and working while studying has the strongest association with adolescent mental health problems. Results suggest that public policies that address dimensions of poverty associated with adolescents human capital accumulation may be critical to address mental health problems among adolescents.

Association between perceived discrimination and physical activity among adolescents

Abstract Perceived discrimination is a major producer of stress and social trauma and can have negative effects on the physical and mental health of those exposed to it. This study aims to analyze the direct and indirect association between perceived discrimination and physical activity, mediated by common mental disorders in adolescents. This is a cross-sectional study with 2,484 adolescents (aged 18 and 19 years old) from a cohort in São Luís, Maranhão. Structural equation models were used to verify the direct effect of perceived discrimination on physical activity (PA) and its indirect effect mediated by common mental disorders (CMD). The potential of sex to act as an effect-modifying variable was also tested. Discrimination was associated with higher levels of PA in women (SC - Standardized Coefficient direct =0.105, p-value=0.005), and indirectly associated with lower PA via CMT among men (SCindirect =-0.024, p-value=0.017) and women (SCindirect =-0.024, p-value=0.015). Our findings show the association between perceived discrimination and PA in this population of adolescents, attesting that its effects can alter health behaviors and that gender can modify the relation between these variables.

Association between perceived discrimination and physical activity among adolescents

Perceived discrimination is a major producer of stress and social trauma and can have negative effects on the physical and mental health of those exposed to it. This study aims to analyze the direct and indirect association between perceived discrimination and physical activity, mediated by common mental disorders in adolescents. This is a cross-sectional study with 2,484 adolescents (aged 18 and 19 years old) from a cohort in São Luís, Maranhão. Structural equation models were used to verify the direct effect of perceived discrimination on physical activity (PA) and its indirect effect mediated by common mental disorders (CMD). The potential of sex to act as an effect-modifying variable was also tested. Discrimination was associated with higher levels of PA in women (SC - Standardized Coefficient direct =0.105, p-value=0.005), and indirectly associated with lower PA via CMT among men (SCindirect =-0.024, p-value=0.017) and women (SCindirect =-0.024, p-value=0.015). Our findings show the association between perceived discrimination and PA in this population of adolescents, attesting that its effects can alter health behaviors and that gender can modify the relation between these variables.

Prevalence and factors associated with suicidal ideation among farmers

This study aimed to analyze the prevalence and factors associated with suicidal ideation among farmers. Cross-sectional study carried out between 2019 and 2020 with 450 farmers in Rio Grande do Norte. The prevalence of suicidal ideation was evaluated using the Beck Suicidal Ideation Inventory, and sociodemographic, health, income, work and alcohol abuse variables were analyzed. The Chi-square test was used to compare the proportions of the outcome between the categories of each variable. Poisson regression with robust variance was used to analyze associated factors and estimate prevalence ratios [PR]. The prevalence of suicidal ideation was 12.4% [95%CI 9.69-15.84] and, in the bivariate analysis, it was associated with sociodemographic, health, income and work variables. In the final multivariate model, the variables that remained significant and were associated with a higher prevalence of SI were: female gender [PR = 3.28], diagnosis of mental disorder in the family [PR = 2.37], presence of common mental disorder [PR = 2.50], alcohol abuse [PR = 2.22] and employment relationship-salaried or temporary [R = 1.91]. Thus, suicidal ideation among farmers is mainly associated with health aspects, especially mental health, work and the female sex, and signals the need to strengthen public policies for suicide prevention with the targeting of effective strategies for the farmers.

Relationship of burden with depressive symptoms, mental disorders and older adults' functional dependence: A study with paid and unpaid caregivers in Brazil

The objective of this study was to identify the relationship of burden with depressive symptoms, mental disorders and older adults' functional dependence in paid and unpaid caregivers. This is a quantitative and cross-sectional study, carried out in the inland of the state of São Paulo with 111 caregivers, 60 of whom were unpaid and 51 were paid. The caregivers answered a questionnaire for the assessment of sociodemographic and care characteristics, the Zarit Burden Inventory (ZBI), the Patient Health Questionnaire (PHQ-9), the Self-Report Questionnaire (SRQ-20), and the Functional Assessment Questionnaire (FAQ). Unpaid caregivers were older, married, have been providing care for a longer period of time, and devoted more days and hours per week to care when compared to paid caregivers. Depressive symptoms and mental disorders (non-psychotic) are related to the levels of burden in both paid and unpaid caregivers (p < 0.001). The care process causes harm such as burden, depressive symptoms, and mental disorders in paid and unpaid caregivers. Thus, it is important to think about coping strategies to minimize the psychological consequences of the care process.

Mental distress among university students in the Eastern Cape Province, South Africa

Introduction

Mental distress is a global health concern. Studies show that the prevalence of mental distress is higher in students’ population than in the general population. Therefore, there is need to understand the extent and factors associated with mental distress among students to help policymakers and practitioners in South Africa.

Aim of the study

The study was designed to investigate into the prevalence and factors associated with mental distress among students at universities in the Eastern Cape Province, South Africa.

Methods

A cross-sectional study was conducted among students from four universities in the Eastern Cape Province. The data were collected from 844 students using an online self-reporting questionnaire-20 to assess mental distress of students. Multivariable logistic regression modelling determined the association between socio-demographic and psychosocial factors with students’ mental distress.

Findings

The prevalence of mental distress among students was 53.3% (95% CI 47.0%, 58.1%). Female students were more prone to mental distress than male students ([AOR]: 4.67; 95% CI 2.82, 7.72, P = 0.001). Field of study ([AOR]: 3.9; 95% CI 1.74, 5.50, P = 0.010), year of study ([AOR]: 4.29; 95% CI 0.86, 21.46, P = 0.002), academic workload ([AOR]: 4.66; 95% CI 2.81, 7.71, P = 0.003), poor sleep quality ([AOR]: 2.24; 95% CI 1.13, 3.67, P = 0.010) and using cannabis ([AOR]: 3.10; 95% CI 1.755, 5.51, P = 0.020) were other factors significantly correlated with students’ mental distress.

Conclusions and recommendations

The study found the level of mental distress to be higher among students than what is reported in most of the previous studies on the student population in South Africa. Being a female student, a user of cannabis, and field of study, academic workload and having poor sleep quality were predictors of mental distress. Findings point to the need to devise evidence-driven interventions and strategies to prevent and reduce the problem of mental distress among students.

Factors associated with common mental disorders among farmers in a medium-sized municipality in Northeastern Brazil

OBJECTIVE

To identify the prevalence and factors associated with common mental disorders among farmers living in a medium-sized municipality in Northeastern Brazil between 2019 and 2020.

METHODS

Trained interviewers applied the standardized questionnaire in 450 participants. Sociodemographic, health, income and working characteristics were assessed. The screening of common mental disorders was performed using the Self-Reporting Questionaire, with the cutoff point ≥ 7 for women and ≥ 5 for men. Poisson regression with robust estimation was applied to verify the prevalence ratios in the bivariate and multivariate analysis.

RESULTS

The prevalence of common mental disorders among farmers was 55.1% (95%CI: 50.4–59.6). The variables that remained significant and associated with common mental disorders were: men (PR = 1.7), > 60 years old (PR = 0.5), poor or very poor self-assessment of health (PR = 1.4), previous mental health treatment (PR = 1.2), alcohol abuse (PR = 1.2) and loss of production (PR = 1.3).

CONCLUSION

These results indicate that common mental disorders are associated with individual factors and with the farmers’ context of life and work, which shows the importance of social, economic and health services support to this group of workers.

Effects of intranasal oxytocin on the self-perception and anxiety of singers during a simulated public singing performance: A randomized, placebo-controlled trial

Professional musicians experience intense social exposure and high levels of preoccupation with their performance and potential negative reactions from the audience, which favor anxiety. Considering that oxytocin (OXT) has a potential therapeutic effect on anxiety, cognitive processes, and decreased psychosocial stress, this study's objective was to assess the effects of a single dose of 24 UI of intranasal OXT among professional singers, during a public singing simulation test, on self-rated performance and mood. This crossover, randomized, double-blinded, placebo-controlled trial addressed 54 male singers with different levels of musical performance anxiety (42% high). The participants took part in different phases of a simulated public singing performance and completed instruments rating their performances (Self Statements During Public Performance- State version) and mood (Visual Analogue Mood Scale). Data were analyzed using ANOVA 2 × 2 for crossover trials. The results show that the use of OXT during the performance and immediate post-stress favored more positive (effect size: d > 1.04) and less negative assessments of musical performance (effect size: d > 1.86) than when placebo was used. No treatment effects were found in any VAMS subscales, indicating no direct anxiolytic effects. The conclusion is that OXT can minimizes social stress, especially during performances. This finding is exploratory and, if confirmed in future studies, may have relevance for musicians, especially those who constantly experience and recognize the impact of negative and catastrophic thoughts on performance and professional activities.

Clinical Trial Registration

[https://ensaiosclinicos.gov.br/rg/RBR-5r5sc5], identifier [RBR-5r5sc5].

Suicidal ideation in mothers of asthmatic children and adolescents in a subspecialty outpatient practice

We aimed to investigate prevalence and factors associated with Suicide ideation (SI) in mothers of asthmatic children. This cross-sectional study included 362 dyads of mothers and children with asthma aged 2 to 14 years who attended two pediatric outpatient clinics in Brazil. We assessed the presence of SI (Self-Report Questionnaire-20), the occurrence of stressful events and maternal social support. The prevalence of SI was 8.6%. Low maternal education, exposure to serious illness, and low perception of social support in its affective–social interaction dimension remained significantly associated with SI in the final model. Thus, life stressors, social support and low maternal education accounted for most of the variation in prevalence of maternal SI. There were no effects of child asthma severity on maternal SI in this study.

Decreased self-reported receiving of social touch and social support predict loneliness in healthy adults

Loneliness has emerged as a public health concern. Previous research has reported its deleterious effects on physical and mental health; however, some specific psychophysiological mechanisms in healthy adults remain to be elucidated. The aim of the current study is to investigate whether self-reported social support and social touch (giving and receiving social touch), as well as resting heart rate variability (HRV), are significant negative predictors of loneliness in healthy adults. The study sample consists of 120 healthy students (50% female) with a mean age of 21.85 years old (DP= 2.21). The students were asked to complete a psychiatric screening questionnaire utilizing loneliness, social support, and social touch scales. HRV was derived from an electrocardiographic signal recorded for 15 min, with the participant relaxed in a supine position. Linear regression analyses were conducted to evaluate loneliness as a function of social support, social touch (giving or receiving touch), and resting HRV. The results show that social support (p< 0.001) and social touch, specifically receiving touch (p< 0.002), accounted for a significant proportion of the variance in loneliness. However, neither giving touch nor resting HRV was a significant predictor of loneliness. The current study highlights specific psychosocial factors in healthy adults that should be considered as promising pathways in order to reduce or work toward preventing loneliness, thus promoting better health and well-being.

Aromaterapia em residentes de emfermagem na pandemia de COVID-19

Objetivo: verificar o efeito da aromaterapia nos sintomas emocionais e fadiga de residentes de Enfermagem que atuavam em hospitais durante a pandemia de COVID-19. Método: estudo piloto do tipo pré e pós intervenção com abordagem quantitativa. Os residentes utilizaram uma sinergia de óleos essenciais (limão siciliano, lavanda, bergamota e tea tree) a 2 %, via cutânea, por três semanas. Foram aplicados o Self-Report Questionnaire-20 (SRQ-20) e o Pictograma de fadiga antes, após a intervenção e três semanas após o término (follow up). Resultados: participaram 15 residentes. As médias dos três momentos do SRQ-20 foram 9,73; 7,00 e 8,13, respectivamente. Houve redução dos sintomas emocionais pós-intervenção (p = 0,026) e no follow up não houve aumento significativo do escore do SRQ-20 (p=0,666). Não houve evidência significativa de mudança de estado do nível de fadiga para as três fases do estudo. Conclusões: o uso da aromaterapia impactou na melhora de sintomas emocionais dos residentes de Enfermagem que atuaram em hospitais durante a pandemia

Stressful work in primary health care and mental health: The role of gender inequities in Brazil

BACKGROUND

This study aims to analyze the association between occupational stressors, evaluated by the Effort-Reward Imbalance Model (ERI), and the occurrence of common mental disorders (CMD) among healthcare workers (HCW), additionally considering mediation by over-commitment from work (OW) and mediation of gender effects by work stressors.

METHODS

Cross-sectional study, including a random sample of 3343 HCWs, from six municipalities of Bahia, Brazil. The ERI scale measured the occupational stressors (main exposure), and the Self-Reporting Questionnaire (SRQ-20) was used to screen for CMD. Data analysis used Structural Equation Modeling techniques to understand the relationships between gender, occupational stressors, and the occurrence of CMD.

RESULTS

ERI and OW were associated with CMD. OW mediated the negative effect of ERI on the mental health of HCW. Female workers had higher levels of ERI, OW, and CMD prevalence; the total gender effect on CMD prevalence was mediated by ERI and OW.

CONCLUSIONS

The findings highlight the association of work psychosocial stressors and CMD among HCW, including partial mediation by OW. Gender inequalities persisted among HCW, with women most exposed to occupational stressors and CMD. ERI and OW partially mediated the effect of gender on CMD.

Psychometric properties and factor structure of the Kessler-10 among Ethiopian adults

BACKGROUND

Many common mental disorders are underdiagnosed and undertreated in low-resource countries. The ten-item Kessler Psychological Distress Scale (K10) is a brief screening tool widely used to assess psychological distress. We evaluated the K10's performance in an Ethiopian population by assessing internal consistency and construct validity through factor structure.

METHODS

K10 survey responses and sociodemographic data were collected from 1928 adults, including patients and caregivers from a general medical setting, who served as controls of a large epidemiological study.

RESULTS

The K10 had good internal consistency, with a Cronbach's alpha of 0.83. Results from exploratory factor analyses showed that the K10 had a two-factor solution that accounted for approximately 66% of the variance. Confirmatory factor analyses demonstrated that a unidimensional model with correlated errors, informed by a theoretical model, was the best fitting model for the setting (comparative fit index of 0.90 and root mean square error of approximation of 0.10).

LIMITATIONS

We did not assess the K10's test-retest reliability or its criterion validity (i.e., agreement with a reference measure).

CONCLUSIONS

Based on internal consistency and construct validity, the K10 can effectively assess psychological distress among Ethiopian adults for population-based research and potentially clinical screening, consistent with previous findings in this setting. Further studies are needed to test its criterion validity against a reference measure of psychological distress.

Cognitive Health and Differential Cortical Functioning in Dissociative Trance: An Explorative Study About Mediumship

Aim

To evaluate the cognitive functioning of subjects practicing trance mediumship in Brazil.

Method

The study was based on the measurement of cognitive functions of 19 spirits mediums through neuropsychological tests such as the Brief Cognitive Screening Battery (BCSB), the Verbal Fluency Test (FAS), the digit span test, the cube test, the five digit test (FDT) and an evaluation of mental health through scales such as the Beck Depression Inventory (BDI), the Self-Report Questionnaire (SRQ), and the Trauma History Questionnaire (THQ). The sample included the participation of spirit mediums divided into two groups. The more experienced group (MEG) with 11 subjects had more than 10 years of mediumistic practice, while the other less experienced group (LEG) with 8 subjects had 1–5 years of experience. The inclusion criteria were psychophonic mediums (who have the ability to communication when deceased beings communicate directly via speaking) with regular trance practices for at least one year. The data collected were analyzed using the SPSS statistical package.

Results

Regarding performance on the BCSB and digit span test, all subjects reached scores at the median or higher in comparison to standardized scores of Brazilians. Scores of 90% on the cube test and 42% on the FAS were reached in comparison to median or higher values, versus the median of standardized scores among Brazilians. On the FDT, we found statistical significance (p = 0.038) in the choice stage, with higher performance of subjects whose initial age of trance recognition occurred before 21 years old. On the BDI scale, no participant met the criteria for major depression. The SRQ showed an incidence of common mental disorders in 21% of the sample, which was more prevalent in the LEG (p = 0.008).

Conclusion

The cognitive functioning of subjects who practice trance mediumship in Brazil is associated with cognitive health. Executive dysfunction may be a tendency in LEG. However, an incidence of common mental disorders in the LEG was observed. Executive processing was higher in the subgroup with early practices of recognizing the phenomenon.

Associations of Enteric Protein Loss, Vaccine Response, Micronutrient Deficiency, and Maternal Depressive Symptoms with Deviance in Childhood Linear Growth: Results from a Multicountry Birth Cohort Study

We identified the determinants of positive (children who had a birth weight < 2.5 kg and/or maternal height < 145 cm but were nonstunted at 24 months of age) and negative (children who had a birth weight ≥ 2.5 kg and maternal height ≥ 145 cm but were stunted at 24 months of age) deviance in childhood linear growth. We found that socioeconomic status (β = 1.54, P < 0.01), serum retinol (β = 0.05, P < 0.01), hemoglobin (β = 0.36, P < 0.01), length-for-age Z-score (LAZ) at birth (β = 0.47, P < 0.01), and tetanus vaccine titer (β = 0.182, P < 0.05) were positively and maternal depressive symptom (β = -0.05, P < 0.01), serum ferritin (β = -0.03, P < 0.01), male sex (β = -1.08, P < 0.01), and α1-antitrypsin (β = -0.81, P < 0.01) were negatively associated with positive deviance. Further, diarrhea episodes (β = 0.02, P < 0.01), male sex (β = 0.72, P < 0.01), and α1-antitrypsin (β = 0.67, P < 0.01) were positively and hemoglobin (β= -0.28, P < 0.01), soluble transferrin receptor level (β = -0.15, P < 0.01), and LAZ score at birth (β = -0.90, P < 0.01) were negatively associated with negative deviance. To summarize, enteric protein loss, micronutrient deficiency, vaccine responses and maternal depressive symptoms were associated with linear growth deviance in early childhood. In such a background, public health approaches aimed at reducing the risk of intestinal inflammation and altered gut permeability could prove fruitful in ensuring desired linear growth in children. In addition, maternal mental health issue should also be considered, especially for promoting better nutritional status in children in the context of linear growth deviance.

Headache-related cognitive distortions questionnaire

Background. - Cognitive distortions are systematic errors in thinking and can be observed in the relationship of headache patients with their own disease and treatment. Objective. - To construct and validate an instrument to evaluate headache-related cognitive distortions in those with primary headache disorders; and to investigate the psychometric properties of this new instrument. Methods. - One hundred thirty-six (136) migraine outpatients from three Brazilian specialized headache hospital services completed the Headache-related Cognitive Distortions Inventory (HCDQ) and validated measures of psychological symptoms, pain catastrophizing, mood disorders, quality of life and headache-related disability. Results. - All hypothesized study measures’ correlations were statistically significant, supporting construct validity. HCDQ scores were positively correlated with headache frequency, headache intensity, psychological symptoms, depression, anxiety, and pain catastrophizing; and negatively correlated with 7 of 8 quality of life domains and time the patient was in treatment. Cronbach’s alpha demonstrated excellent internal consistency for the 17-item total scale (alpha=.92). Along with headache intensity and depression, HCDQ Pain subscale accounted for 46% of variance in the prediction of headache-related disability. Conclusions. - HCDQ is a valid and reliable measure of migraine patients´ cognitive distortions about their headaches and headache treatment.

ICBrainDB: An Integrated Database for Finding Associations between Genetic Factors and EEG Markers of Depressive Disorders

In this study, we collected and systemized diverse information related to depressive and anxiety disorders as the first step on the way to investigate the associations between molecular genetics, electrophysiological, behavioral, and psychological characteristics of people. Keeping that in mind, we developed an internet resource including a database and tools for primary presentation of the collected data of genetic factors, the results of electroencephalography (EEG) tests, and psychological questionnaires. The sample of our study was 1010 people from different regions of Russia. We created the integrated ICBrainDB database that enables users to easily access, download, and further process information about individual behavioral characteristics and psychophysiological responses along with inherited trait data. The data obtained can be useful in training neural networks and in machine learning construction processes in Big Data analysis. We believe that the existence of such a resource will play an important role in the further search for associations of genetic factors and EEG markers of depression.

Prevalence and factors associated with adverse early childhood experiences: a population-based study in Ceará, Brazil

ABSTRACT Objective: To estimate the prevalence of adverse childhood experiences and identify associated factors. Methods: A population-based cross-sectional study comprised data from a sample of 3,200 households with 3,566 children under 6 years of age, representative of the state of Ceará, Brazil. A multistage sampling approach was used, with stratification among the state capital, Fortaleza, and the 28 countryside municipalities, in which 160 census tracts were randomly selected, each one with a cluster of 20 households. The outcome variable was structured based on adverse childhood experiences as suggested by the Center for Disease Control and Prevention, according to the number of situations to which the child was exposed: 0–2, 3–5, and 6–9. Ordinal logistic regression multivariate model was applied to assess associations. Results: Among the 3,566 children studied, 89.7% (95%CI 88.7–90.7) were exposed to at least one adverse experience, of which the most prevalent were neglect, and emotional/physical abuse. The main factors associated were maternal advanced age and smoking, paternal absence, low education level of the head of the family, food insecurity and lack of a social support network. Conclusion: The study found a high occurrence of adverse early childhood experiences, particularly among preschool children born to mothers of older age, solo, who smoke and in a situation of social and economic vulnerability, including food insecurity, who should be target of control and prevention measures.

Prevalence and factors associated with poor sleep quality among nursing professionals during the COVID-19 pandemic

ABSTRACT Objective: to identify the prevalence and factors associated with poor sleep quality among nursing professionals during the COVID-19 pandemic. Method: a cross-sectional study, conducted in June and July 2020, with 890 nursing professionals. To screen the outcome, question 3 of the Self-Reporting Questionnaire was used, assessing poor sleep quality 30 days preceding the application of the questionnaire. Associations between variables of interest were tested using Poisson regression models. Results: the prevalence of poor sleep quality was 68%. Associated factors were moderate or heavy workload, poor assessment of working conditions, suspected infection with COVID-19, more than two thirds of the workload for pandemic and the use of psychotropic drugs. Conclusion: the study pointed out a high prevalence of poor sleep quality among nursing workers with an important relationship with working conditions.

Eficácia Docente e Dificuldades Emocionais/Comportamentais Infantis: Resultados do Programa FAVA

Resumo Este estudo quase-experimental avaliou os resultados do programa FAcilitando o conVívio com Alunos - FAVA, destinado a professores do ensino fundamental I, visando a promoção da eficácia docente e a redução de problemas emocionais/comportamentais infantis, aferidos pela Escala de Avaliação das Crenças de Eficácia do Professor e pelo Questionário de Capacidades e Dificuldades, respectivamente. O FAVA contemplou a psicoeducação sobre o modelo cognitivo, o desenvolvimento socioemocional e a modificação de comportamentos. Comparação entre os grupos experimentais (GE1, que recebeu intervenção completa, e GE2, sem o modelo cognitivo) e o grupo de comparação evidenciou a promoção da eficácia pessoal docente (GE2) e a redução da percepção das dificuldades emocionais/comportamentais infantis (GE1). Ressalta-se a contribuição do modelo cognitivo e da aprendizagem socioemocional em intervenções com professores.

The relationship between multidimensional poverty, income poverty and youth depressive symptoms: cross-sectional evidence from Mexico, South Africa and Colombia

Whereas monetary poverty is associated with increased risk of depressive symptoms in young people, poverty is increasingly understood as a multidimensional problem. However, it is yet to be understood how the associations between different dimensions of poverty and youth mental health differ across countries. We examine the relationship between multidimensional, as well as income poverty, and depressive symptoms in young people (age 11-25 years) across three middle-income countries. Based on harmonised data from surveys in Colombia, Mexico and South Africa (N=16 173) we constructed a multidimensional poverty index that comprised five deprivations We used Poisson regression to examine relationships between different forms of poverty with depressive symptoms across the countries. Multidimensional poverty was associated with higher rates of depressive symptoms in the harmonised dataset (IRR (incidence rate ratio)=1.25, 95% CI 1.10 to 1.42), in Mexico (IRR=1.34, 95% CI 1.11 to 1.64) and Colombia (IRR=2.01, 95% CI 1.30 to 3.10) but not in South Africa, a finding driven by a lack of associations between child labour and health insurance coverage with depressive symptoms. There was only an association with income poverty and depressive symptoms in South Africa, not in Colombia or Mexico. Depressive symptoms were associated with individual deprivations such as school lag, child labour and lack of access to health services in the harmonised dataset, but not with household deprivations, such as parental unemployment and housing conditions, though the opposite pattern was observed in South Africa. Our findings suggest that the importance of specific dimensions of poverty for mental health varies across countries, and a multidimensional approach is needed to gain insights into the relationship between youth depression and poverty.