The factor structure of the general health questionnaire (GHQ12) in Saudi Arabia

Dimensionality of the Swahili version of the General Health Questionnaire (GHQ-12) in a Kenyan population: A confirmatory factor analysis

The current study evaluated the Kiswahili version of General Health Questionnaire (GHQ-12) in a Kenyan context comprising of women exposed to gender-based violence. Participants were randomly drawn from community sampling using household screening methods in peri-urban areas in Nairobi. A total of 1,394 participants with varying levels of literacy (years of education: mean [M] = 9.42; standard deviation [SD] = 3.73) and aged between 18 and 89 years were recruited for the study. The observed factor structure of the GHQ-12 was evaluated using six most tested models querying the dimensionality of the instrument insofar as the impacts of positive and negative wording effects in driving multidimensionality. Results from the confirmatory factor analysis supported a bifactor model, consisting of a general distress factor and two separate factors representing common variance due to the positive and negative wording of items. Overall, the findings support the use of the Kiswahili version of the GHQ-12 as a unidimensional construct with method-specific variance owing to wording effects. Importantly, GHQ-12 responses from a sample of Kenyan women with relatively low levels of literacy are congruent with the factor structure observed in other cross-cultural settings in low- and-middle-income countries.

Mental health and natural land cover: a global analysis based on random forest with geographical consideration

Natural features in living environments can help to reduce stress and improve mental health. Different land types have disproportionate impacts on mental health. However, the relationships between mental health and land cover are inconclusive. In this study, we aim to accurately fit the relationships, estimate the impacts of land cover change on mental health, and demonstrate the global spatial variability of impacts. In the analysis, we show the complex relationships between mental health and eight land types based on the random forest method and Shapley additive explanations. The accuracy of our model is 67.59%, while the accuracy of the models used in previous studies is usually no more than 20%. According to the analysis results, we estimate the average effects of eight land types. Due to their scarcity in living environments, shrubland, wetland, and bare land have larger impacts on mental health. Cropland, forest, and water could improve mental health in high-population-density areas. The impacts of urban land and grassland are mainly negative. The current land cover composition influences people's attitudes toward a specific land type. Our research is the first study that analyzes data with geographical information by random forest and explains the results geographically. This paper provides a novel machine learning explanation method and insights to formulate better land-use policies to improve mental health.

The association between transient childhood psychotic experiences and psychosocial outcomes in young adulthood: Examining the role of mental disorders and adult attachment

AIM

Evidence suggest individuals with mental disorders and psychotic experiences (PE), even transient PE, show poorer psychosocial outcomes relative to those with mental disorders. The concept of "attachment" is hypothesized as the mechanism by which people seek support in times of need. This can be measured as discrete styles or as positive (low avoidance/anxiety)/negative (high avoidance/anxiety) dimensions. Adult attachment has previously been examined on PE risk factors, but not outcomes. This study aimed to examine the relationship between transient childhood PE and adult psychosocial outcomes, comparing those with and without mental disorders. Second, to examine the role of adult attachment.

METHOD

Participants (n = 103) attended baseline (age 11-13) and 10-year follow-up. PE and mental disorders were measured using the Schedule for Affective Disorders and Schizophrenia for School-aged Children. Attachment and outcomes were measured using self-report measures. Analysis compared those with PE (with/without mental disorders), and mental disorders without PE, to controls, using linear and Poisson regression.

RESULTS

PE was associated with lower self-esteem (β = -2.28, p = .03), perceived social support from friends (β = -2.80, p = .01), and higher stress in platonic relationships (IRR = 1.64). PE and mental disorders were associated with lower self-esteem (β = -5.74, p = .002), higher stress in romantic (IRR = 1.40) and platonic (IRR = 1.59) relationships, general stress (β = 5.60, p = .006), and mental distress (β = 5.67, p = .001). Mental disorders alone was not associated with any measure. Adult attachment dimensions attenuated some results.

CONCLUSIONS

This paper illustrates the association between transient PE and adult psychosocial outcomes, with & without co-occurring mental disorders, and demonstrates the role of adult attachment.

Factor Structure of the GHQ-12 and Their Applicability to Epilepsy Patients for Screening Mental Health Problems

Epilepsy, a severe neurological disorder impacting approximately 50 million individuals worldwide, is associated with a high prevalence of mental health issues. However, existing research has predominantly examined the relationship between epilepsy and depression or anxiety, neglecting other dimensions of mental health as assessed by factor scores from the general health survey (GHQ), such as the GHQ-12. This study aimed to explore how epilepsy affects both general mental health and specific dimensions of mental health. By employing a factor analysis and a predictive normative modeling approach, the study examined 426 epilepsy patients and 39,171 individuals without epilepsy. The findings revealed that epilepsy patients experienced poorer general mental health and specific aspects of mental health. Consequently, this study highlights the validity of GHQ-12 as a measure of mental health problems in epilepsy patients and emphasizes the importance of considering the impact of epilepsy on various dimensions of mental health, rather than focusing solely on depression or anxiety. Clinicians should incorporate these study results into the development of interventions aimed at enhancing mental well-being in epilepsy patients, ultimately leading to improved outcomes.

Using GHQ-12 to Screen Mental Health Issues in People with Emphysema

Although previous studies have investigated the presence of psychometric comorbidities in individuals with emphysema, our understanding of the impact of emphysema on general mental health and specific dimensions of mental health, such as social dysfunction and anhedonia, depression and anxiety, and loss of confidence, remains limited. This research aims to examine the influence of emphysema on general mental health and its dimensions using the GHQ-12 assessment. By employing confirmatory factor analysis (CFA), the predictive normative approach, and one-sample t-test, we analyzed data from Understanding Society: the UK Household Longitudinal Study (UKHLS), including 97 individuals clinically diagnosed with emphysema and 8980 individuals without a clinical diagnosis of emphysema. The findings of this study indicate that individuals with clinically diagnosed emphysema experience poorer general mental health (t(96) = 8.41, p < 0.001, Cohen's d = 0.12, 95% C.I. [0.09, 0.15]), increased levels of social dysfunction and anhedonia (t(96) = 6.02, p < 0.001, Cohen's d = 0.09, 95% C.I. [0.06, 0.11]), heightened depression and anxiety (t(96) = 7.26, p < 0.001, Cohen's d = 0.11, 95% C.I. [0.08, 0.14]), as well as elevated loss of confidence (t(96) = 6.40, p < 0.001, Cohen's d = 0.09, 95% C.I. [0.07, 0.12]). These findings suggest the need for intervention programs aimed at improving the mental health of individuals with emphysema.

Understanding the effect of angina on general and dimensions of psychological distress: findings from understanding society

Background

The current study aimed to examine how the general and dimensions of psychological distress are affected by angina.

Methods

First, a confirmatory factor analysis (CFA) was used to produce the three-factor solution of the GHQ-12. Second, a predictive normative modeling approach to predict the expected scores for 1,081 people with angina based on a model trained on demographics from 8,821 age and sex-matched people without angina. Finally, one-sample t-tests were used to determine the differences between the actual psychological distress scores and expected psychological distress scores in participants with angina.

Results

There were three underlying structures of the GHQ-12 labeled as GHQ-12A (social dysfunction & anhedonia), GHQ-12B (depression & anxiety), and GHQ-12C (loss of confidence). Moreover, participants with angina had more psychological distress as indicated by the GHQ-12 summary score (Cohen's d = 0.31), GHQ-12A (Cohen's d = 0.34), GHQ-12B (Cohen's d = 0.21), and GHQ-12C (Cohen's d = 0.20) comparing to controls.

Conclusion

The current study implies that GHQ-12 is a valid measure of psychological distress in people with angina, and there is a need to consider the dimensions of psychological distress in angina rather than solely focusing on certain dimensions of psychological distress such as depression or anxiety issues in people with angina. Clinicians should come up with interventions to reduce psychological distress in people with angina which can then lead to better outcomes.

Mental Health in Coronary Heart Disease (CHD) Patients: Findings from the UK Household Longitudinal Study (UKHLS)

OBJECTIVES

Mental health conditions in patients with coronary heart disease (CHD) are closely related to clinical outcomes. Thus, this study's goal is to investigate how CHD affects general and specific aspects of mental health.

METHODS

We analyzed data from Wave 10 Understanding Society: the UK Household Longitudinal Study (UKHLS), which were collected between 2018 and 2019. After removing people who had missing data, there were 450 participants who indicated that they have CHD, and 6138 age- and sex-matched healthy participants indicated that they were not clinically diagnosed with CHD.

RESULTS

The main findings were that participants with CHD had more mental health problems, as shown by the GHQ-12 summary score (t (449) = 6.00, p < 0.001, 95% C.I. [0.20, 0.40], Cohen's d = 0.30), social dysfunction and anhedonia, (t (449) = 5.79, p < 0.001, 95% C.I. [0.20, 0.40], Cohen's d = 0.30), depression and anxiety (t (449) = 5.04, p < 0.001, 95% C.I. [0.15, 0.33], Cohen's d = 0.24), and loss of confidence (t (449) = 4.46, p < 0.001, 95% C.I. [0.11, 0.30], Cohen's d = 0.21).

CONCLUSION

This study implies that GHQ-12 is a valid assessment of mental health problems in CHD patients, and there is a need to consider how different aspects of mental health are affected by CHD rather than solely focusing on depression or anxiety problems alone in patients with CHD.

The Relationship between Happiness and Mental Health among Saudi Women

The happiness and mental health of individuals are crucial for national developments. In Saudi Arabia, wellbeing occupies a central position in Vision 2030, along with women's empowerment. Rapidly changing rights and responsibilities might result in more sources of stress. The aim of this study was to explore happiness and mental health among Saudi women during their contributions to a fast-growing nation in all fields. We assessed happiness and mental health (somatic symptoms, depression, anxiety, insomnia, and social dysfunction) in 308 Saudi women aged 15-50 years using a self-administered online survey comprising the short Oxford Happiness Questionnaire (OHQ-8) and the General Health Questionnaire (GHQ-28). The participants demonstrated general satisfaction yet showed rising psychological distress. Married women reported better mental health compared to single women, particularly with regards to anxiety, insomnia, and depression. Depression was highest among younger women. Employed women demonstrated lower social functioning compared to unemployed women. Women with a higher educational level showed lower social functioning. Happiness scores were significantly and inversely related with overall mental health scores as well as mental health subscales (somatic, anxiety, and depression), except for social dysfunction, which showed a positive correlation to happiness scores. This study contributes to the body of literature on women's mental health and happiness by providing recommendations for improving both as well as directions for future research.

General Health Questionnaire (GHQ12): new evidence of construct validity

This study aimed to gather evidence on the adequacy of the General Health Questionnaire (GHQ-12) in Brazil, considering a random sample of Brazilian physicians. Specifically aimed: (1) to test the GHQ-12 bifactor structure compared to alternative models, (2) to check its factorial invariance regarding to gender and the diagnosis of mental and behavioral disorders, and (3) to know the association of this measure with indicators of poor health (e.g., suicidal thoughts, decreased libido, medication use). The study included 1,085 physicians with a mean age of 45.7 (SD = 10.6), mostly male (61.5%), married (72.6%) and Catholic (59.2%). They answered the GHQ-12, the Positive and Negative Suicidal Ideation Inventory, and demographic questions. The best fit model was the bifactor structure composed of anxiety and depression, in addition to a general dimension, which presented Cronbach's alpha, McDonald's ω and composite reliability higher than 0.70 just for a general fact. Psychological distress scores correlated with suicidal ideation and indicators of health and sexual satisfaction. This is a psychometrically suitable instrument that can be used in terms of its total, but its specific factors need to be used with caution.

Global and Dimensions of Mental Health in Arthritis Patients

Arthritis is one of the main clusters of long-lasting musculoskeletal and joint disorders. Recently, there has been increasing interest in the impact of arthritis patients' mental health, which has mainly focused on depression and anxiety in clinical samples. However, much less is known about how domains of mental health based on the widely used 12-item version of the general health survey (GHQ-12) are affected by arthritis. The current research answered this question using confirmatory factor analysis, general linear models, and one-sample t-tests on a nationally representative sample from the United Kingdom with 5588 arthritis patients and 8794 participants indicating that they were not clinically diagnosed with arthritis. The current study found that (1) a total of three factors of GHQ-12 that are labeled GHQ-12A (social dysfunction and anhedonia; six items), GHQ-12B (depression and anxiety; four items), and GHQ-12C (loss of confidence; two items), and (2) both the global mental health and dimensions of mental health are negatively affected by arthritis. Clinicians could use the results from the present study to make better treatment decisions for patients with arthritis.

Night eating syndrome is associated with mental health issues among palestinian undergraduate students-cross sectional study

BACKGROUND

University students are exposed to several factors associated with Night Eating Syndrome NES, which is distinguished by nocturnal consumption and/or evening hyperphagia. The main purpose of the current study is to examine the state of NES, and to explore its relationship with selected factors (e.g. sociodemographic factors, lifestyle habits, body mass index "BMI", and mental health) among a sample of undergraduates.

METHODS

A cross-section design was done among undergraduates recruited from three universities in the southern part of Palestine. Students completed a self-administrated questionnaire including demographic information, lifestyle habits, medical profile, and the Arabic version of Night Eating Questionnaire (NEQ). Mental health status was also assessed using the Arabic version of the 12-item General Health Questionnaire (GHQ-12). Cronbach alpha was used to check the reliability of the Arabic version of NEQ. Data were analyzed using univariate and multivariate approach.

RESULTS

A total of 475 participants were included in the study, 197 (47%) males, 253(54%) females. Mean age was 19.8 ± 1.4 years, ranged from 18 to 25 years old. It is found that 141 university students (29.7%) screened positive for NES. According to univariate analysis, NES was significantly related to gender (p = 0.023), major (p = 0.005), personal monthly income (p = 0.007), source of funding (p = 0.005), and mental health (p < 0.005). Besides, the results of binary logistic regression revealed that having mental health problems (Exp (B) = 4.18; 95% CI = 2.50-6.98; p = 0.000), males (Exp (B) = 1.99; 95% CI = 1.17-3.39; p = 0.014), and those who study expenses was not covered either by scholarship or parents (Exp (B) = 2.75; 95% CI = 1.29-5.8; p = 0.08) were significantly associated with NES.

CONCLUSION

It is found that NES is common among Palestinian university students. In this study, NES was significantly more prevalent among males, and those who were studying scientific majors, having a personal income between 500 and 1000 new Israeli shekel per month, and having mental problems, and those whose studies were funded by neither by a scholarship nor by their parents.

Psychological well-being among Saudi adults during the context of COVID-19 lockdown: a psychometric analysis of the 12-item General Health Questionnaire

BACKGROUND

Most communities' mental health and perceptions of psychological well-being are known to be profoundly disrupted by large-scale pandemics. Despite the wide range of available screening measures, few reliable and valid screening measures exist for assessing overall psychological well-being in nonclinical populations during a health emergency situation such as the COVID-19 outbreak.

OBJECTIVE

This study aims to conduct a psychometric analysis of Goldberg's 12-item General Health Questionnaire (GHQ-12) to validate its use among a sample of Saudi adults during the COVID-19 lockdown using reliability and factor analyses.

METHODS

A total of 473 individuals (aged 18 years and over) were recruited from the general Saudi population living in the Makkah (Western) Province of Saudi Arabia to complete the virtual format of the Arabic GHQ-12 (Ar-GHQ-12). In addition to a descriptive statistics measurement and reliability analysis, confirmatory factor analyses (CFA) were performed to examine the unidimensionality and validity of the Ar-GHQ-12.

RESULTS

In line with previous works from several cultures, the Ar-GHQ-12 with two-factor solution considered to be the best-fitting model because it fits the data better than the one-factor (unidimensional) model did, and adequate reliability indices were achieved for each factor (.83 for factor 1 and .65 for factor 2).

DISCUSSION

The Ar-GHQ-12 was determined to be suitable for assessing the overall psychological well-being of the general population in Saudi Arabia in emergency contexts and may be applied among Saudis and other Arabic-speaking populations in research and primary care settings.

A cross-sectional study of health and well-being among newly settled refugee migrants in Sweden-The role of health literacy, social support and self-efficacy

Structural barriers such as inadequate housing, lack of employment opportunities, and discrimination are known to adversely affect the health of newly settled refugee migrants. However, these barriers remain largely unresolved and unaddressed. Thus, there is a need to better understand how other factors, such as individual-level health resources, may influence health and mitigate ill health in the early post-migration phase. In this study, we aimed to explore the relationship between health outcomes and individual health resources including health literacy, social support, and self-efficacy in newly settled refugee migrants. Survey data was collected from 787 refugee migrants in Sweden. Logistical regression analysis showed that limited health literacy, lack of emotional support, and low self-efficacy were consistently associated with poor health outcomes. Demographic variables such as gender, education, and type of residence permit were not as imperative. Individual-level health resources may play an important role in the general and psychological well-being of newly settled migrants. Promoting health literacy and facilitating the attainment of social support may buffer for structural challenges in the establishment phase and enhance the prospects of later health and social integration.

Wellbeing and mental health among medical students in Indonesia: A descriptive study

BACKGROUND

Medical students face high pressures to perform academically, which may lead to poor psychological well-being, burnout, and even mental illness.

AIMS

This study aims to evaluate the mental health, degree of burnout and substance misuse among medical students in Indonesia in order to to build a system that supports the prosperity of future doctors.

METHODS

In February to March 2020, we conducted an online survey of Indonesian medical students to assess burnout (using Oldenburg Burnout Inventory, OLBI), minor psychiatric illness (General Health Questionnaire 12, GHQ12), and alcohol abuse (CAGE questionnaire).

RESULTS/CONCLUSION

A total of 1,729 students from 29 universities participated in the study; 93% felt disengaged, 95% felt exhausted, and 74% were identified to have mild psychiatric illness. We discuss potential factors that need to be explored in further research, including further concerns related to developments since the pandemic, and the need for potential interventions at both local and national levels to enhance the wellbeing of medical students.

An Evaluation of Psychological Well-Being among Physicians and Nurses in Makkah’s Major Hospitals

Background: Physicians and nurses experience poor psychological well-being relative to other employees in healthcare fields. This study aimed to evaluate the psychological well-being among physicians and nurses in Makkah’s major hospitals. Methods: In this cross-sectional study, 460 physicians and nurses from seven major hospitals in Makkah were recruited to investigate their psychological well-being using the General Health Questionnaire-12 (GHQ-12) based on social dysfunction, anxiety, and confidence loss. Results: Over half (64.3%) of the physicians and nurses in this study scored at or above the GHQ-12 cut-off point (12), which is a positive result for poor psychological well-being. There were significant differences in the psychological well-being mean between Saudis and non-Saudis (t = 2.203, p = 0.028), years of work experience (t = 3.349, p = 0.001), hospitals (F = 2.848, p = 0.010), attending psychological support sessions (t = 2.082, p = 0.038), and history of visiting psychological clinics (t = −4.949, p < 0.001). There was also a significant association between the three GHQ-12 factors and the participants’ socio-demographic characteristics. Conclusion: The psychological well-being of physicians and nurses is low. The alarming number of physicians and nurses suffering from social dysfunction, anxiety, and loss of confidence should be addressed in Makkah’s major hospitals. The employee assistance program (EAP) could be highly valuable and effective for addressing the well-being of employees and their personal problems that may impact their work performance, conduct, health, and overall well-being at the Ministry of Health.

How to Measure the Mental Health of Teachers? Psychometric Properties of the GHQ-12 in a Large Sample of German Teachers

To improve the health status of teachers, there is a need for good and reliable instruments to continuously assess their mental health. The current study proposed the GHQ-12 questionnaire as an appropriate instrument for measuring the mental health of teachers. The GHQ-12 is a well-established screening instrument that has mostly been applied in non-teaching samples. In the current study, the psychometric properties of the questionnaire were analyzed using a large sample of German teachers (N = 3996). The data was collected yearly over an extended period of time (2012-2020). Results showed good to very good reliability, as well as high correspondence to burnout and life satisfaction scales. Principal axis factor analysis supported a two-factor structure: Factor 1 represents "depression/stress" and Factor 2 represents "loss of confidence". However, the mental health of the investigated teachers was worse than that of a representative sample in Germany. Consequently, this study highlighted the fact that the teaching profession is vulnerable to mental strain and underlined the importance of promoting prevention programs that could help to sustain and foster the mental health of teachers. In this context, the GHQ-12 could be proposed as a good and economic tool to assess and analyze mental health in German teachers. The presented norm could help practitioners and teachers to compare individual scores within a larger peer group.

Psychological distress among immigrant women who divorced: Resilience as a mediator

PURPOSE

The purpose of this study was to investigate relationships among the demands of immigration, resilience, and psychological distress in divorced immigrant women, and determine the mediating effects of resilience on the relationship between demands of immigration and psychological distress.

DESIGN

The cross-sectional study included 117 women who had immigrated and married Taiwanese men but later got divorced.

METHODS

The Chinese health questionnaire-12 scale, the resilience scale-Chinese version, and the demands of immigration (DI) scale were used to measure in this study. A multiple regression and Sobel test were used to examine whether resilience mediated the relationship between demands of immigration and psychological distress.

FINDINGS

In this study, 47% of the divorced immigrant women were experiencing psychological distress, and 25.6% exhibited high levels of demands of immigration. Women with psychological distress had higher demand scores (t = 2.592, p = 0.011) and lower resilience scores (t = -3.965, p < 0.001) compared to women without psychological distress. The demands of immigration negatively predicted resilience (t = -3.050, p = 0.003). Finally, resilience mediated the association of demands of immigration with psychological distress (z = 2.497, p = 0.0125).

CONCLUSIONS

Relationships among the demands of immigration, resilience, and psychological distress in divorced immigrant women were demonstrated in this study. Resilience played an important role in the relationship between demands of immigration and psychological distress.

CLINICAL RELEVANCE

Tailored programs that foster resilience to reduce risks of demands of immigration and psychological distress in this vulnerable population should be developed.

Psychological Wellbeing of Diabetic Individuals, Prediabetics, and Non-diabetics: A Population-Based Study in Saudi Arabia

Background

The increased burden of diabetes affects the quality of life, including psychosocial problems. The study aims to compare the psychological well-being of individuals who are prediabetic, diabetic, or non-diabetic.

Methods

A cross-sectional exploratory study was conducted from January to June 2016 (n = 1,019) in Al Kharj, Saudi Arabia. After consent and questionnaires were filled out, trained staff took blood samples followed by anthropometry. Chi-squared tests, one-way ANOVA, and multiple linear regression analyses were conducted to examine the association between diabetes classes defined by HbA1c cut-off levels set by the American Diabetes Association (three categories), individual items, and total score in general health questionnaire (GHQ). An ROC curve was plotted for the total GHQ-12 score against HbA1c.

Findings

The mean GHQ score for psychological distress was significantly higher (F = 6.569, P = 0.038) in the diabetics (mean = 14.7) and the prediabetics (12.4) than in the non-diabetics (10.71). Four out of six positive GHQ items and three out of six negative GHQ items significantly differed among the three classes of diabetes. The adjusted multivariate analysis revealed that people with diabetes were most likely to report psychological distress compared to non-diabetics (unstandardized beta = 2.414; P = 0.037). The AUC examining the relationship between HBA1c and GHQ scores showed a moderate but statistically insignificant sensitivity/specificity of 0.643 (P = 0.23).

Conclusion

This study demonstrates that psychological wellbeing is substantially poorer among diabetic or prediabetic individuals than non-diabetic individuals. Future longitudinal studies are required to examine a plausible causal relationship between diabetes/prediabetes and psychological distress.

Combined' Neck/Back Pain and Psychological Distress/Morbidity Among the Saudi Population: A Cross-Sectional Study

Background

Psychological distress/morbidity is amongst the primary reason for the cause of pain at multiple sites, its progression, and recovery. Though still not very clear if physical pain in the neck or the back may predict psychological morbidities or not. Thus, we investigated the association between combined neck or back pain and psychological distress/morbidity.

Methods

A cross-sectional study was conducted in Al-Kharj, Saudi Arabia, including 1,003 individuals. The questionnaire comprised of General Health Questionnaire-12 (GHQ-12) and some questions about neck and back pain. Data analysis was done using statistical software SPSS version 26.0.

Results

The results of the multivariate analysis revealed a significant positive association between neck/back pain status and total GHQ score (unstandardized Beta = 2.442, P ≤ 0.0001). Having neck/back pain had almost a 2.5 times greater risk of psychological distress/morbidity. Further, females were more likely to have a higher risk of psychological distress/morbidity (unstandardized Beta = 1.334, P = 0.007) than males while adjusting for sociodemographic and clinical characteristics.

Conclusion

The combination of neck and back pain was significantly associated with the Saudi population’s psychological problems. Therefore, the Saudi government needs to devise high-risk strategies and allocate adequate resources to the cause so that at-risk people can be shielded from the adverse complications arising from this condition in the long run.

Effect of cognitive behavioral therapy program on mental health status among medical student in Palestine during COVID pandemic

BACKGROUND

The COVID-19 pandemic had a profound psychological influence on everyone in society, and the impact it had on students, particularly medical students, cannot be underestimated. The main purpose of this study is to (1) determine the prevalence of mental disorders among medical students and their associated factors, and (2) examine the effectiveness of cognitive behavior therapy on mental health problems among medical students.

METHODS

Between March and May 2021, we conducted a randomized controlled study on two phases among medical students at An-Najah National University. Data were collected using an online questionnaire and the Arabic version of the 12-item General Health Questionnaire (GHQ-12). We also used the MEDAS tool to assess their Mediterranean Diet (MD) adherence. In the second phase, sixty-six students were recruited and assigned randomly to control and intervention groups. Intervention impact was assessed using 12-item General Health Questionnaire at two-time points; baseline, and 8 weeks post-intervention. The interventional model used was cognitive behavioral therapy, and the control group received no treatment.

RESULTS

A total of 329 students were included in the analysis of the first phase of the study. Approximately 28% of students had mental health problems. We found a significant relationship between good mental health status with a higher level of physical activity level, longer sleeping hours, and shorter entertainment time (p < 0.05). In the second phase of the study, a total of 91 students were included. Overall, using the CBT program showed a significant improvement in the outcome measures. At 8 weeks post-intervention, students had lower scores on total GHQ-12, depression, anxiety, and social dysfunction.

CONCLUSION

These findings propose that adequate attention must be paid to the mental health of medical students and that CBT programs can be used for the management of mental health problems among medical students.

Mental health status of informal waste workers during the COVID-19 pandemic in Bangladesh

The deadliest coronavirus disease 2019 (COVID-19) is taking thousands of lives worldwide and presents an extraordinary challenge to mental resilience. This study assesses mental health status during the COVID-19 pandemic and its associated factors among informal waste workers in Bangladesh. A cross-sectional survey was conducted in June 2020 among 176 informal waste workers selected from nine municipalities and one city corporation in Bangladesh. General Health Questionnaire (GHQ-12) was used to assess respondents’ mental health. The study found that 80.6% of the individuals were suffering from psychological distress; 67.6% reported anxiety and depression, 92.6% reported social dysfunction, and 19.9% reported loss of confidence. The likelihood of psychological distress (Risk ratio [RR]: 1.23, 95% confidence interval [CI]: 1.02–1.48) was significantly higher for female than male. Multiple COVID-19 symptoms of the family members (RR: 1.20, 95% CI: 1.03–1.41), unawareness about COVID-19 infected neighbor (RR: 1.21, 95% CI: 1.04–1.41), income reduction (RR: 1.60, 95% CI: 1.06–2.41) and daily household meal reduction (RR: 1.34; 95% CI: 1.03–1.73) were also found to be associated with psychological distress. These identified factors should be considered in policy-making and support programs for the informal waste workers to manage the pandemic situation as well as combating COVID-19 related psychological challenges.

Investigating the association between diabetes and mental health: A train-and-test approach

Diabetes is a chronic health condition that affects how the body turns food into energy. Research has demonstrated a relationship between diabetes and various mental health issues, which include psychiatric disorders and other problems that are specific for people living with diabetes. Although previous studies have shed light on the associations between diabetes and various types of mental health issues with a focus on depression and anxiety, much less is known about how diabetes is associated with other dimensions of mental health such as social dysfunction and anhedonia and loss of confidence in a large nationally representative survey from the United Kingdom. The aim of the current study is to replicate the factor structure of the GHQ-12 and investigate how diabetes is related to general mental health and dimensions of mental health. By adopting a train-and-test approach to data from the UKHLS including 2,255 diabetes patients and 14,585 age and sex-matched participants who indicated that they were not clinically diagnosed with diabetes, the current study found that hypotheses are well-supported by the results.

How different domains of quality of life are associated with latent dimensions of mental health measured by GHQ-12

BACKGROUND AND OBJECTIVES

A short form of the General Health Questionnaire (GHQ-12) is a useful screening instrument for assessing mental health. Furthermore, Quality of life (QoL) is a critical treatment outcome in many clinical and health care research settings. This study aimed to reassess the dimensionality of GHQ-12 using Multidimensional Graded Response Model (MGRM) and evaluate how its extracted dimensions are associated with the QoL's domains.

METHODS

Isfahan Cohort Study 2 (ICS2) is a population-based, ongoing prospective cohort study among adults aged 35 years and older who were free of cardiovascular diseases (CVDs) at the beginning of the study in 2013. A total of 1316 participants, all living in urban and rural areas of Isfahan and Najafabad, Iran was completed the GHQ-12 and WHO QoL-brief version at baseline. Five competing MGRMs with different latent structures were specified for GHQ-12. Factor scores derived from the best fitted model were used to associate with various domains of QoL.

RESULTS

The Three-Dimensional model for GHQ-12 was the best-fitted model explaining the Social Function (SF), Self Confidence (SC), and Anxiety/Depression (A/D) as three correlated yet different latent dimensions of mental health. Our findings in full adjusted multivariate regression models showed that a one-SD increase in dimensions of SC and SF was associated with a 38- to 48%-SD and 27- to 38%-SD increase in the domains scores of QoL, respectively. Moreover, for each one-SD increase in score of A/D dimension, the domains scores of QoL decreased by 29- to 40%-SD. The highest to the lowest standardized coefficients for all latent dimensions of mental health were respectively related to the psychological, physical health, social relationships, and environmental condition domains of QoL. Furthermore, SC, A/D, and SF dimensions of GHQ-12 showed the highest to the lowest degree of association with all domains of QoL.

CONCLUSIONS

Our findings confirm that the GHQ-12 as a multidimensional rather than unitary instrument measures distinct dimensions of mental health. Furthermore, all aspects of QoL changed when the intensity of latent dimensions of mental health increased. Moreover, the psychological domain of QoL is the most affected by all latent dimensions of mental health, followed by physical health, social relationships, and environmental condition domains. It seems that in an attempt to full recovery as assessed by improved QoL outcomes, treatment of clinical symptoms may not be sufficient. Identifying and differentiating the structures of mental health in each community as well as implementing intervention programs aimed at focusing on specific dimensions may help in the prevention of further deterioration of mental health and improved QoL in the community.

Association between prehypertension and psychological distress among adults in Saudi Arabia: A population-based survey

Background

Prehypertension is a precursor to hypertension status. Psychological distress has been identified earlier among hypertensives; however, there is little evidence for the presumptive relationship between prehypertension and psychological distress.

Objective

The study aimed to assess the psychological wellbeing of the Al-Kharj, Saudi Arabia population, using the General Health Questionnaire (GHQ-12) and correlating it with prehypertensive patients in the same population.

Methods

A cross-sectional analysis of the population of Al-Kharj, Saudi Arabia, was carried out between January and June of 2016. With an 85 percent response rate, a total of 1016 participants participated in the study. A multiple linear regression analysis was performed to assess the relationship between prehypertension and psychological distress.

Results

The findings of the adjusted analysis demonstrated that, on average prehypertensive patients were more distressed psychologically than non-hypertensive patients (unstandardized Beta regression coefficient = 3.600; P-value 0.025). Similarly, on average women were found to be more psychologically distressed than men (unstandardized Beta = 1.511, P-value 0.002). Civil workers and unemployed individuals were more psychologically distressed than employed individuals (unstandardized Beta = 1.326, P-value 0.041) while adjusting for the sociodemographic and other variables such as BMI, diabetes status, cholesterol, and smoking status.

Conclusion

The current study shows that as compared to normotensive patients, self-rated mental wellbeing and psychological wellbeing are all considerably poorer among prehypertensive patients. To prevent individuals from having negative psychological outcomes and their long-term complications, the Government of Saudi Arabia needs to concentrate on prehypertensive, female, and unemployed individuals. Well-designed longitudinal studies, primarily in Saudi Arabia, are needed in the future to research the cause and impact of poor mental health and prehypertension.

COVID-19, Inter-household Contact and Mental Well-Being Among Older Adults in the US and the UK

Interacting with family members and friends from other households is a key part of everyday life and is crucial to people's mental well-being. The COVID-19 pandemic severely curtailed face-to-face contact between households, particularly for older adults (aged 60 and above), due to their high risk of developing severe illness if infected by COVID-19. In-person contact, where possible, was largely replaced by virtual interaction during the pandemic. This article examines how inter-household contact in face-to-face and virtual forms, as well as combinations of the two forms of contact, related to older adults' mental well-being during the pandemic. Data from two national longitudinal surveys, collected from the same respondents before (2018-2019) and during (June 2020) the pandemic, were comparatively analysed: the Health and Retirement Study in the US and Understanding Society in the UK. The findings showed a notable increase in loneliness in the US and a decline in general mental well-being in the UK following the outbreak of COVID-19. In both countries, more frequent inter-household face-to-face contact during the pandemic was associated with better general mental well-being, but inter-household virtual contact, via means such as telephone and digital media, was not associated with general mental well-being in either the US or the UK. In the US, older adults who engaged more frequently in virtual contact were more likely to feel lonely during the pandemic, particularly if their face-to-face contact was limited. In both countries, the increase in loneliness following the outbreak of the pandemic was greater for older adults who reported more virtual contact. The findings suggest that household-centred crisis management during the COVID-19 pandemic had unintended mental health implications in both the US and the UK, despite contextual differences between the two countries. Although face-to-face contact between households helped to sustain older adults' mental well-being, virtual contact was not a qualitatively equivalent alternative. The findings also provide an important evidence base for informing policy developments and for supporting the mental health of older people during the COVID-19 pandemic and in the longer term.

Associations between family social circumstances and psychological distress among the university students of Bangladesh: To what extent do the lifestyle factors mediate?

Background

While there is a growing body of empirical studies focusing on the social and behavioral predictors of psychological health, the mechanisms that may underlie the reported associations have not been adequately explored. This study aimed to examine the association of social and lifestyle factors with psychological distress, and the potential mediating role of the lifestyle factors in the estimated associations between social circumstances and psychological distress.

Methods

A total of 742 tertiary level students (53% females) from a range of socio-economic backgrounds and multiple educational institutions participated in this cross-sectional study. The 12-items General Health Questionnaire (GHQ-12) was utilized for measuring psychological distress. Data related to students’ socio-demographic characteristics, family social circumstances, and lifestyle factors were also collected. Modified Poisson regression analysis was used to estimate the risk ratios (RR) and their 95% confidence intervals (CI).

Results

The multivariable regression analysis suggests heightened risks of psychological distress associated with low parental Socio-Economic Position (SEP) (RR: 1.36; 95% CI: 1.07, 1.76), childhood poverty (RR: 1.31; 95% CI: 1.11, 1.55), and living away from the family (RR: 1.28; 95% CI: 1.07, 1.54). Among the lifestyle factors, past smoking, physical inactivity, inadequate fruit intake, and poor sleep quality were strongly associated with psychological distress and these associations persisted when the family social circumstances and lifestyle factors were mutually adjusted for. The lifestyle factors did not considerably mediate the estimated associations between family social circumstances and psychological distress.

Conclusion

The social and lifestyle factors operated independently to increase students’ risk of psychological distress. Accordingly, while promoting students’ healthy lifestyles may reduce the overall burden of psychological distress, any equity initiative aiming to minimize the social inequalities in psychological health should be targeted to improving the living conditions in early life.

Psychological distress and burden of care among family caregivers of patients with mental illness in a neuropsychiatric outpatient clinic in Nigeria

BACKGROUND

The wellbeing of family caregivers of mentally ill persons has often been ignored, despite that family caregivers can be predisposed to psychiatric morbidities and burden in caring for their mentally ill family members. This study examined the levels of psychological distress and burden of care experienced by family caregivers who care for their mentally ill relatives in Edo State, Nigeria.

METHODS

This study assessed psychological distress using the General Health Questionnaire (GHQ-12). Burden of care was measured using the 22-item Zarit Burden Interview (ZBI) questionnaire. Multiple linear regression was done to determine factors associated with burden of care and psychological distress, while factor analysis was used to determine the underlying forms of burden of care and psychological distress among participants.

RESULTS

Caregivers studied were relatives of patients diagnosed for depression (25.1%), substance use disorder (22.2%), schizophrenia (20.2%) and bipolar affective disorder (11.1%). Approximately 15% experienced no-to-mild burden, 51.3% mild-to-moderate burden and 34.0% high-or-severe burden. Nearly halve (49.0%) of participants experienced psychological distress. Severe rate of psychological distress was observed among subjects caring for patients with schizophrenia (60.7%), epilepsy (60.0%), substance use disorder (52.2%) and depression (49.0%). High burden of care was more preponderant among caregivers of relatives with mental retardation and epilepsy (50% each) and schizophrenia (39.3%). Having a higher educational qualification and being self-employed was a predictor of psychological distress. Gender of caregiver and the diagnosis schizophrenia among relatives of caregivers predisposed to burden of care. Three factors including social and emotional dysfunction, psychological distress and cognitive dysfunction were identified as components of psychological health through factor analysis. On the burden scale, six factor components were identified as: personal strain, role strain, intolerance, patients' dependence, guilt and interference in personal life.

CONCLUSION

There is a high prevalence of psychological morbidity and burden of care among family caregivers providing care for persons with mental illness.

Psychological predictors of chronic pain in Al Kharj region, Saudi Arabia

BACKGROUND

Psychological distress is one of the major determinants for the experience progression, and recovery of chronic pain. However, it is unclear whether physical pain in specific body sites could be predictive of psychological illness. In this study, we aim to investigate the link between chronic pain in specific anatomical sites and psychological distress represented in the General Health Questionnaire-12 (GHQ-12 items).

METHODS

A population-based cross-sectional study was conducted in Al Kharj region of Saudi Arabia. We included 1003 participants. Data were collected using the GHQ-12, and a subjective report on eight anatomical pain sites. Data analysis used statistical software SPSS version 26.0 for Windows statistical package.

RESULTS

Chronic musculoskeletal pain in the neck and head regions was significantly associated with higher psychological distress. Other sites (back, lower limb, chest, abdominal and upper limb pain) were not associated with psychological distress. In multiple regression analysis, chronic 'general' pain was significantly associated with higher psychological distress (unstandardized Beta regression coefficient = 2.568; P < 0.0001). The patients with younger age were more likely to develop negative psychological disorders (unstandardized Beta = - 3.137; P = 0.038). Females were more likely to have higher psychological distress than males (unstandardized Beta = 2.464, P = 0.003). Single (not-married) people have a higher risk of psychological distress than married people (unstandardized Beta = 2.518, P = 0.025). Also, job type/status whether being unemployed (not working) or 'civilian' (civil servant/worker) was positively and significantly associated with an increased probability of psychological distress (unstandardized Beta = 1.436, P = 0.019).

CONCLUSION

Chronic 'general' pain was significantly associated with negative psychological disorders. The government of Saudi Arabia needs to focus on patients with chronic 'general' pain, females, young and unmarried individuals as potentially 'high-risk' population subgroups for adverse psychological disorders, and subsequent long-term complications.

The association between overweight/obesity and psychological distress: A population based cross-sectional study in Saudi Arabia

Objectives

The objective of this study was to compare the association between mental well-being between obese (classes 1 and 2), over-weight and non-obese population-based individuals

Methods

A population-based cross-sectional study was conducted in Al-Kharj, Saudi Arabia. A total of 1019 Saudi nationals aged ≥ 18 years participated in the survey. BMI scores were used to categorize participants into three groups: Obese, overweighted and non-obese/non-overweight. Mental well-being was evaluated by using the validated Arabic version of the General Health Questionnaire version 12 (GHQ-12).

Results

We used total GHQ score (Mean=12; SD=5.23) to compare mental well-being between the four BMI class categories. The overall one-way ANOVA model was statistically significant (F = 7.018, d = 6, P < 0.001). In multivariate analysis, after adjusting for sociodemographic variables, diabetes and smoking statuses we found that higher psychological distress (as evident by a higher total GHQ score) was associated with higher BMI. The unstandardized Beta regression coefficient = 2.627; P = 0.034). Females were more likely to have higher psychological distress than males (unstandardized Beta = 1.466, P = 0.003). Job status whether being unemployed or ‘civilian’ (civil worker) was significantly associated with higher psychological distress (unstandardized Beta = 1.405, P = 0.041). Being diabetic has a 1.6 times higher risk of psychological distress (unstandardized Beta = 1.604, P = 0.027).

Conclusion

The study highlights the public health implications of psychological distress amongst individuals with overweight and obesity in Saudi Arabia. Future longitudinal studies should explore the temporality of this relationship.

Correlates of psychological distress and self-rated health among Palestinian citizens of Israel: findings from the health and environment survey (HESPI)

OBJECTIVES

Psychological distress is a problem strongly associated with socio-economic conditions. This study aims to assess rates of psychological distress and 'poor' self-rated health among Palestinian citizens of Israel, who constitute 21% of the population and nearly 50% live in poverty, and compare their psychological distress scores with those of the general Israeli population.

DESIGN

The Health and Environment Survey among Palestinian citizens of Israel (HESPI-2015), included a representative sample of this minority; 2018 individuals aged ≥18 were interviewed. The questionnaire included socio-demographic and health-related information, the General Health Questionnaire-12, (GHQ-12) and Self-rating of health (SRH).

RESULTS

Subjects with GHQ-12 global scores of ≥17 were considered to have high distress. Low education, female gender, obesity and the presence of chronic diseases were significantly associated with high psychological distress over and above the effect of the other variables. Poor SRH was strongly associated with having a chronic disease and additional risk factors were older age group, low education and high psychological distress. Comparing psychological distress scores of Arabs in Israel with those of the general population showed that 30% of the former were classified as asymptomatic, as compared to 75% in the general population while the proportion of symptomatic or highly symptomatic was 14% in the latter as compared with 45% in the former.

CONCLUSIONS

It appears that the burden of poverty, chronic disease and low education in this population, which suffers from multiple stressors, is disproportionate and should be addressed by the authorities, together with concrete plans to improve the education of the younger generations. Clearly, the association between discriminating policies and deprivation with psychological distress is not unique to the case of the Palestinian minority in Israel and therefore this study will allow for the examination and generalization of the current findings to other discriminated and disadvantaged minorities.

Gender-Based Analysis of the Psychological Impact of the COVID-19 Pandemic on Healthcare Workers in Spain

Purpose: This study aims to analyze from a gender perspective the psychological distress experienced by the medical workforce during the peak of the pandemic in Spain. Methods: This is a single-center, observational analytic study. The study population comprised all associated health workers of the Cruces University Hospital, invited by email to participate in the survey. It consisted of a form covering demographic data, the general health questionnaire-28 (GHQ-28), and the perceived stress scale (PSS-14). We used multivariant regression analysis to check the effect of gender on the scores. We used gender analysis in both design and interpretation of data following SAGER guidelines. Results: Females made 74.6% of our sample, but their proportion was higher in lower-paid positions such as nursery (89.9%) than in higher-paid ones. The percentage of women categorized as cases with the GHQ-28 was 78.4%, a proportion significantly higher than in the male population (61.3%, p < 0.001). The multivariant regression analysis showed that being women, working as orderly hospital porters, and having a past psychiatric history were risk factors for higher scores in both the GHQ-28 and PSS-14. Conclusion: Women and those with lower-paid positions were at risk of higher psychological distress and worse quality of life within the medical workforce during the first wave of the pandemic. Gender analysis must be incorporated to analyze this fact better.

Stress and emotional wellbeing of parents due to change in routine for children with Autism Spectrum Disorder (ASD) at home during COVID-19 pandemic in Saudi Arabia

BACKGROUND

Parents of children with Autism Spectrum Disorder (ASD) experience considerable amounts of stress and impaired emotional well-being. Consequently, it is likely that these have been adversely impacted by COVID-19 outbreak due to disruptions to the schedules of children with ASD.

AIM

This study investigated the stress and emotional well-being of parents of children with ASD in Saudi Arabia during the COVID-19 pandemic.

METHOD

The study obtained quantitative data from 150 parents of children with ASD from different regions in Saudi Arabia using an online survey. The data collected included demographic data of the parents, ASD status of the family, ASD support during COVID-19 pandemic, severity of ASD behaviours in comparison to the pre- COVID-19 status eating behaviour of the child with ASD, Parental Stress, and emotional well-being. The PSI-short form (PSI-SF) (Abidin, 1995) scale was utilised to obtain data related to parental stress and the General Health Questionnaire (GHQ-12) (Goldberg, 1992) scale was utilised to obtain data related to parents' emotional well-being.

RESULTS

The study found that family ASD status (in particular, age and gender of child with ASD, and severity of his/her symptoms) had a significant impact on parental stress and emotional well-being. Moreover, parental stress and emotional well-being were negatively impacted by the frequency and usefulness of ASD support received during COVID-19 pandemic. These were also adversely impacted by the change in severity of ASD behaviours of the children with ASD. Finally, parental stress was found to have a negative impact on the emotional well-being of parents. Overall, the study found that the parental stress and emotional well-being of parents of children with ASD in Saudi Arabia had been unfavourably impacted by COVID-19 pandemic.

CONCLUSIONS

Overall, the study found that the parental stress and emotional well-being of parents with ASD in Saudi Arabia had been unfavourably impacted by COVID-19 pandemic. This study recommends the involvement of the Saudi Ministry of Health to establish and extend support services to support parents of children with ASD. Moreover, the provision of training programs to help parents deal with the characteristic behaviour of their children with ASD such as, the ability to maintain routines, aggressive or repetitive behaviour, is also recommended.

Co-Creating and Evaluating an App-Based Well-Being Intervention: The HOW (Healthier Outcomes at Work) Social Work Project

Stress and mental health at work are the leading causes of long-term sickness absence in the UK, with chronically poor working conditions impacting employee physiological and psychological health. Social workers play a significant part in the fabric of UK society, but have one of the most stressful occupations in the country. The aim of this project was to work with UK social workers to co-develop, implement, and evaluate a series of smartphone-based mental health initiatives. A Participatory Action Research (PAR) approach, consisting of semi-structured interviews and focus group and steering group discussions, was utilized to design the mental health and well-being interventions. Study efficacy was evaluated via a pre- and post-intervention survey and post-intervention semi-structured interviews. Interventions developed were psycho-educational, improved top-down and bottom-up communication, and provided access to a Vocational Rehabilitation Assistant for those struggling and at risk of sickness absence. Six months following dissemination, surveys demonstrated significant improvements in communication, and mean score improvements in four other working conditions. This project, therefore, demonstrates that co-developed initiatives can be positively impactful, despite post-intervention data collection being impacted by COVID-19. Future studies should build upon these findings and broaden the PAR approach nationally while taking a robust approach to evaluation.

Prevalence and Socio-Demographic Correlates of Poor Mental Health Among Older Adults in Agricultural Areas of China

Objective: Poor mental health is associated with impaired social functioning, lower quality of life, and increased risk of suicide and mortality. This study examined the prevalence of poor general mental health among older adults (aged 65 years and above) and its sociodemographic correlates in Hebei province, which is a predominantly agricultural area of China. Methods: This epidemiological survey was conducted from April to August 2016. General mental health status was assessed using the 12-item General Health Questionnaire (GHQ-12). Results: A total of 3,911 participants were included. The prevalence of poor mental health (defined as GHQ-12 total score ≥ 4) was 9.31% [95% confidence interval (CI): 8.4-10.2%]. Multivariable logistic regression analyses found that female gender [P < 0.001, odds ratio (OR) = 1.63, 95% CI: 1.29-2.07], lower education level (P = 0.048, OR = 1.33, 95% CI: 1.00-1.75), lower annual household income (P = 0.005, OR = 1.72, 95% CI: 1.17-2.51), presence of major medical conditions (P < 0.001, OR = 2.95, 95% CI: 2.19-3.96) and family history of psychiatric disorders (P < 0.001, OR = 3.53, 95% CI: 2.02-6.17) were significantly associated with poor mental health. Conclusion: The prevalence of poor mental health among older adults in a predominantly agricultural area was lower than findings from many other countries and areas in China. However, continued surveillance of mental health status among older adults in China is still needed.

A descriptive study of mental health and wellbeing among medical students in Portugal

In studies around the world, medical students have been identified as being at high risk for poor mental wellbeing, burnout and mental ill health. This can lead on to poorer physical health, substance misuse and reduced academic performance. We surveyed Portuguese medical students to assess burnout (using the Oldenburg Burnout Inventory, OLBI), minor psychiatric illness (General Health Questionnaire 12, GHQ12) and alcohol misuse (CAGE questionnaire). A total of 622 medical students participated in the study. We found high levels of exhaustion (89%), disengagement (81%) and minor psychiatric illness (91%). The CAGE questionnaire was positive in 10% of students. Future research is required to confirm these results, assess and monitor local and global trends and investigate interventions at both local and national level to improve the mental wellbeing of medical students.

Wellbeing and mental health amongst medical students in Jordan: a descriptive study

Across the globe medical students are experiencing high levels of depression, anxiety, and psychological distress. This can ultimately lead to poor academic performance, substance misuse and/or concerns over clinical practice and fitness to practice. We surveyed Jordanian medical students to assess burnout (using the Oldenburg Burnout Inventory, OLBI), minor psychiatric illness (General Health Questionnaire 12, GHQ12) and alcohol/substance abuse (CAGE questionnaire). Results indicate a high level of exhaustion (91%), disengagement (87%) and 'minor' psychiatric illness (92%). OLBI and GHQ12 scores were found to correlate positively (p < 0.001). The CAGE questionnaire was positive in 8% of students. Further research is required to confirm these results and compare them to the global burden of mental illness in medical students. Medical students in Jordan should be considered a high-risk group for burnout and mental health problems and strategies should be employed to recognise and appropriately manage those most at risk.

Prevalence of Prediabetes, Diabetes and Its Predictors among Females in Alkharj, Saudi Arabia: A Cross-Sectional Study

Background/Objective:

The prevalence of prediabetes and diabetes is reaching epidemic proportions across the globe. Therefore, this study aims to determine the prevalence of prediabetes and diabetes, together with its accompanying risk factors, among young females.

Methods:

An exploratory cross-sectional survey was conducted with 638 Saudi females in Alkharj, Saudi Arabia. Statistical analysis was carried out using STATA version 14. Odds ratios for the risk of diabetes and associated factors were calculated using log-binomial and multinomial logistic regression. Standardized prevalence and strata-specific prevalence of diabetes and prediabetes for different risk factors were also calculated.

Findings:

The study revealed that nondiabetics and prediabetics were more prevalent between the ages of 18 and 24 years, while diabetic patients were consistently between 25 to 44 years of age. The average value for HbA1c in females was 5.44. Regression analysis shows that being older, married, obese, a smoker or less educated significantly increases the risk for both prediabetes and diabetes. Mutivariable analysis revealed obesity had a significant association with both prediabetes and diabetes. Prediabetics were 2.35 times more likely to be obese as compared to nondiabetics, with 95% CI (1.38–3.99). Similarly, diabetics were 6.67 times more likely to be obese compared to nondiabetics 95% CI (1.68–26.42).

Conclusion:

Our study shows the prevalence of diabetes and prediabetes among females from Al Kharj was 3.8% and 18.8%, respectively. The diabetic and prediabetic female participants had higher mean BMI and waist circumference, were older in age, were married, and smoked as compared to nondiabetics. In the context of the findings of our study, and keeping in view the the burden of this disease globally and in our population, it has now become extremely important to understand these factors and encourage health-promoting behaviors to construct effective interventions.

The prevalence of chronic pain and its associated factors among Saudi Al-Kharj population; a cross sectional study

Background

Chronic pain (CP) can be a symptom of many underlying health issues. The consequences of CP may vary from slight discomfort to disruption of quality of life and normal functioning. In this study, we aim to investigate the prevalence of CP and its associated factors in Al Kharj, Saudi Arabia.

Methods

This was a cross-sectional study conducted in Al Kharj, Saudi Arabia. We recruited 1031 participants for our study. Data was collected on socio-demographic, health predictors and anthropometric measurements (such as weight, height and waist circumference). The data analysis was performed on JMP®, Version 12. SAS Institute Inc., Cary, NC, 1989–2007.

Results

The prevalence of self-reported chronic pain in Al Kharj population was 19% with a mean age of 26.4 (SD = 8.6) years. The most common locations of pain included; back pain (30%), abdominal pain (26%), headache (13%), and any musculoskeletal pain (56%). Multiple logistic regression revealed that presence of a chronic disease (OR = 3.8; 95% CI = 2.3–6.2), psychological disease (OR = 2.3; 95% CI = 1.2–4.3), high General Health Questionnaire (GHQ)-12 score (OR = 1.06; 95% CI = 1.03–1.1), and pack-years of smoking (OR = 1.05; 95% CI = 1.01–1.08) were significantly related to chronic pain in Al Kharj population.

Conclusions

Our study results found a high burden of chronic pain in this selected Saudi population. The most prevalent pain was low back pain. The presence of chronic and psychological diseases were strongly related to chronic pain. Future prospective studies are needed to establish the temporal relationship of chronic pain with these factors.

Relationship between psychological health and quality of life of people affected by leprosy in the community in Guangdong province, China: a cross-sectional study

BACKGROUND

This paper investigates the relationship between psychological health and quality of life (QOL) of people affected by leprosy (PAL) living in a community in Guangdong province, China.

METHODS

A population-based cross-sectional survey was conducted from April to October 2016 in Guangdong province, China. The 12-item general health questionnaire (GHQ12) and World Health Organization Quality of life-BREF (WHOQOL-BREF) were used to evaluate the psychological health and QOL of the participants. PAL recruited for this study included those who were (1) registered in LEPMIS by the end of 2015 and living in the community, (2) able to be contacted by investigators, and (3) willing to provide informed written consent for enrolling in the study. Proportions, medians, and ratios were used to describe the demographics of the participants and χ2 test was used to compare groups with different psychological health states. Pearson's correlation coefficient and logistic regression analyses were used to assess the relationship between GHQ12 and QOL score.

RESULTS

A total of 7230 PAL (5527 males and 1701 females, average age 67.3 ± 13.1 years) living in the community participated in the study. The participants averaged 1.7 ± 2.7 points on the GHQ12. Of these, 23.5% had scores meeting a psychological disorder (≥3 points). The scores for the physical, psychological, and social relationships, and environment dimensions of QOL were 17.2 ± 2.4, 20.6 ± 2.7, 9.7 ± 1.7, and 24.6 ± 4.0, respectively. Gender, age, employment, profession, and the four dimensions of QOL were independent factors associated with psychological health of PAL.

CONCLUSION

In addition to focusing on the factors associated with poor QOL and psychological health amongst PAL, there is an urgent need for stigma reduction, rehabilitation programs and social integration. This may be achieved by engaging community members together with PAL to design a locally tailored intervention program.