Using the GHQ-12 to screen for mental health problems among primary care patients: psychometrics and practical considerations

Health literacy and mental health: a national cross-sectional inquiry

Health literacy and mental health are among the most important issues in the modern health and era of public health. This study aimed to investigate the association between health literacy and mental health status. This was a national cross-sectional study that was conducted in Iran. A sample of literate individuals aged 18-65 was entered into the study using multistage sampling. The data were collected by the Health Literacy Instrument for Adults (HELIA) and the 12-item General Health Questionnaire (GHQ-12). Logistic regression and path analysis were used for data analysis. A total of 20,571 individuals completed the questionnaires. The mean(± SD) age of participants was 34.9(± 11.8) years old, 51% were female, and 38.1% had higher education. The mean(± SD) health literacy score was 68.3(± 15.2), and 29.8% of the respondents reported some mental health problems. Logistic regression analysis showed that limited health literacy was associated with poor mental health status (OR 2.560, 95% CI 2.396-2.735, P = 0.001). The path analysis showed that an increase in health literacy could reduce psychological and social dysfunction (the effect of health literacy on reducing psychological distress is more profound). It is recommended to carry out interventions that strengthen adult's cognitive and communication skills to improve their ability to access and use health information to make healthy choices.

Factors Associated with Poor Mental Health in Patients with Axial Spondyloarthritis: Results from the International Map of Axial Spondyloarthritis (IMAS)

BACKGROUND

This study aims to assess the prevalence of poor mental health in axial spondyloarthritis (axSpA) and its associated factors in a large sample of patients from the International Map of Axial Spondyloarthritis (IMAS) study from around the globe.

METHODS

IMAS is a cross-sectional online survey (2017-2022) that includes 5557 unselected patients with axSpA worldwide. Mental health was evaluated by the 12-item General Health Questionnaire (GHQ-12) and the cut-off point for poor mental health was set at 3. Logistic regression analysis was used to evaluate relationships between the investigated factors and poor mental health (GHQ-12≥3) in patients with axSpA (n=4335).

RESULTS

Of 5351 patients, the mean of GHQ-12 was 4.7 and 59.4% were having poor mental health, being 69.9% in South Africa, 63.7% in Latin America, 60.8% in Europe, 54.3% in North America and 51.8% in Asia. Overall, 40.5% and 37.2% of patients experienced anxiety and depression. The factors associated with poor mental health were younger age (OR=0.99), female gender (OR=1.16), being on sick leave or unemployed (OR=1.63), non-physical activity (OR=1.22), smoking (OR=1.20), higher Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] (OR=1.42), functional limitation (OR=1.02) and shorter symptoms duration (OR=0.98).

CONCLUSIONS

Globally, 6 in 10 patients with axSpA had poor mental health, with a higher proportion in South Africa and lower in Asia. The factors associated with poor mental health include domains such as younger age, female gender, employment difficulties, harmful habits, disease burden and symptom duration. A holistic management approach to axSpA should encompass both physical and mental health.

Experiences of stigma, discrimination and violence and their impact on the mental health of health care workers during the COVID-19 pandemic

Health care workers have been exposed to COVID-19 more than people in other professions, which may have led to stigmatization, discrimination, and violence toward them, possibly impacting their mental health. We investigated (1) factors associated with stigma, discrimination, and violence, (2) the association of stigma, discrimination, and violence with mental health, (3) everyday experiences of stigmatization, discrimination, and violence. We chose a combination of a quantitative approach and qualitative content analysis to analyze data collected at three time points: in 2020, 2021 and 2022. A higher age was associated with lower odds of experiencing stigma, discrimination, and violence, whereas female gender was related to more negative experiences. The intensity of exposure to COVID-19 was associated with greater experience with stigmatization, discrimination, and violence across all three years (for example in 2022: odds ratio, 95% confidence interval: 1.74, 1.18-2.55 for mild exposure; 2.82, 1.95-4.09 for moderate exposure; and 5.74, 3.55-9.26 for severe exposure, when compared to no exposure). Stigma, discrimination, and violence were most strongly associated with psychological distress in 2020 (odds ratio = 2.97, 95% confidence interval 2.27-3.88) and with depressive symptoms in 2021 (odds ratio = 2.78, 95% confidence interval 2.12-3.64). Attention should be given to the destigmatization of contagious diseases and the prevention of discrimination, violence, and mental health problems, both within workplaces and among the public.

Conceptual framework for establishing twins prevention and continuous health promotion programme: a qualitative study

BACKGROUND

Twin registries and cohorts face numerous challenges, including significant resource allocation, twins' recruitment and retention. This study aimed to assess expert feedback on a proposed pragmatic idea for launching a continuous health promotion and prevention programme (HPPP) to establish and maintain twin cohorts.

DESIGN

A qualitative study incorporating an inductive thematic analysis.

SETTING

Tehran University of Medical Sciences.

PARTICIPANTS

Researchers with expertise in twin studies participated in our study.

ANALYSIS AND DESIGN

Expert opinions were gathered through focus group discussions (FGDs). Thematic analysis was employed to analyse the findings and develop a model for designing a comprehensive, long-term health promotion programme using ATLAS.ti software. Additionally, a standardised framework was developed to represent the conceptual model of the twin HPPP.

RESULTS

Eight FGDs were conducted, involving 16 experts. Thematic analysis identified eight themes and seven subthemes that encompassed the critical aspects of a continuous monitoring programme for twin health. Based on these identified themes, a conceptual framework was developed for the implementation of an HPPP tailored for twins.

CONCLUSION

This study presented the initial endeavour to establish a comprehensive and practical solution in the form of a continuous HPPP designed to tackle the obstacles of twins' cohorts.

Cross-culturally adapting the GHQ-12 for use with refugee populations: Opportunities, dilemmas, and challenges

This article discusses the opportunities, dilemmas, and challenges involved in the cross-cultural adaptation (CCA) of psychological scales for use with refugee populations. It draws on insights derived from an attempt to adapt the 12-item General Health Questionnaire (GHQ-12) to the particular culture and context of Eritrean refugees residing in Israel. Multiple techniques including expert translations, a focus-group discussion, a survey, and piloting, were employed to attain a cross-cultural and conceptually equivalent measure. During the CCA process, the research team encountered issues pertaining to conceptual non-equivalence, the structure of the measure's responses and scoring system, and acceptability. These issues required the team to move beyond semantic translation by adapting certain items. This study demonstrates the compromises which need to be made in the adaptation process and indicates the potential bias which each of these compromises introduces. Despite its limitations, CCA does appear to significantly improve detection of mental health symptoms in refugee populations. Overall, the results of the present study provide support for the notion that the sensitive and appropriate assessment of individuals from refugee backgrounds requires adopting a rigorous, systematic, and contextual approach to instrument adaptation, with an emphasis on the integration of idioms of distress as well as the adaptation of Likert-type scales.

Burdening caregivers of patients with schizophrenia at Edward Francis Small Teaching Hospital, The Gambia

PURPOSE

Deinstitutionalization of persons living with mental illness has led to many patients residing in communities with family members and shifting the burden of care and caregiving from hospitals to homes. The aim of the study was to determine the burden on caregivers of patients with schizophrenia at Edward Francis Small Teaching Hospital (EFSTH).

METHODS

This was a descriptive cross-sectional study design with a sample consisting of 161 randomly selected caregivers of patients with schizophrenia. The GHQ-12 questionnaire was used to determine the general health status of the caregivers. The caregivers' burden was assessed using the Zarit Burden Scale. The data were collected using the researcher-administered method. The collected data were analyzed with IBM SPSS Version 20 using descriptive statistics, mean differences, and the general linear model (GLM).

RESULTS

The main findings of this study were that caregivers experienced a significantly high level of burden. Most of them experienced high levels of physical (70%), psychological (93.2%), social (78.3%) and financial (55.3%) burdens. Employment status, specifically unemployment status and belonging to the Wolof ethnic group, was a significant predictor of the level of financial burden on the caregivers. Similarly, the total score for social burden was also significantly greater among unemployed caregivers. Educational level was a significant predictor of the total score on the psychological and physical burden scale.

CONCLUSION

The caregivers of patients with schizophrenia at EFSTH are experiencing a high level of burden as a result of their caregiving role, which affects their health, and this calls for urgent intervention.

Assessment of mental wellbeing of university students in Bangladesh using Goldberg's GHQ-12: A cross-sectional study

Background and Aims

The mental well-being of university students is a primary public health concern worldwide, including in Bangladesh. The objective of this study was to determine the prevalence of the overall mental health status among Bangladeshi university students. The study used larger and more diverse sample compared to previous studies, and also explored factors associated with the mental health well-being of those students.

Methods

Data were collected through an online questionnaire, utilizing the proportional allocation method, from students in various universities across Bangladesh. The sample included 2036 participants. The study applied Goldberg's General Health Questionnaire (GHQ-12) using the GHQ2+ threshold (i.e., having more than two symptoms). A binary outcome variable was created with two levels: "good mental health" and "poor mental health," to assess the mental health status of the university students. The explanatory variables were age, gender, academic year, type of university, and sources of personal expenses. Exploratory data analysis, association tests, and binary logistic regression models were used to identify factors influencing the outcome variable.

Results

A total of 55.9% of students (male: 52.6% and female: 62.8%) exhibited poor mental health status. Female students' mental health was found to be worse (odds ratio [OR]: 1.49, 95% confidence interval [CI]: 1.23-1.81) compared to that of males. Similarly, public university students displayed a worse mental health condition than their counterparts in private universities (OR: 1.29, 95% CI: 1.03-1.61).

Conclusion

The overall mental health of university students in Bangladesh is concerning. There is a pressing need for effective mental health policies and interventions to bolster the mental well-being of university students, with a specific focus on students from public universities and females.

"Trust people you've never worked with" - A social network visualization of teamwork, cohesion, social support, and mental health in NHS Covid personnel

Background

The unprecedented rapid re-deployment of healthcare workers from different care pathways into newly created and fluid COVID-19 teams provides a unique opportunity to examine the interaction of many of the established non-technical factors for successful delivery of clinical care and teamwork in healthcare settings. This research paper therefore aims to address these gaps by qualitatively exploring the impact of COVID work throughout the pandemic on permanent and deployed personnel's experiences, their ability to effectively work together, and the effect of social dynamics (e.g., cohesion, social support) on teamwork and mental health.

Methods

Seventy-five interviews were conducted across the UK between March and December 2021 during wave 2 and 3 of COVID-19 with 75 healthcare workers who were either permanent staff on Intensive Care/High Dependency Units used as COVID wards, had been rapidly deployed to such a ward, or had managed such wards. Work Life Balance was measured using the WLB Scale. Interview transcripts were qualitatively coded and thematic codes were compared using network graph modeling.

Results

Using thematic network analysis, four overarching thematic clusters were found, (1) teamwork, (2) organizational support and management, (3) cohesion and social support, and (4) psychological strain. The study has three main findings. First, the importance of social factors for teamwork and mental health, whereby team identity may influence perceptions of preparedness, collaboration and communication, and impact on the collective appraisal of stressful events and work stressors. Secondly, it demonstrates the positive and negative impact of professional roles and skills on the development of teamwork and team identity. Lastly the study identifies the more pronounced negative impact of COVID work on deployed personnel's workload, mental health, and career intentions, exacerbated by reduced levels of social support during, and after, their deployment.

Conclusion

The thematic network analysis was able to highlight that many of the traditional factors associated with the successful delivery of patient care were impeded by pandemic constraints, markedly influencing personnel's ability to work together and cope with pandemic work stressors. In this environment teamwork, delivery of care and staff well-being appear to depend on relational and organizational context, social group membership, and psycho-social skills related to managing team identity. While results hold lessons for personnel selection, training, co-location, and organizational support during and after a pandemic, further research is needed into the differential impact of pandemic deployment on HCWs mental health and teamwork.

Understanding the impact of children's and young people's self-harm on parental well-being: a systematic literature review of qualitative and quantitative findings

BACKGROUND

Self-harm in children and young people is increasing. Parents are vital in supporting young people; however, parents may experience distress linked to the self-harm. Previous reviews have highlighted the emotional impact and need for information and support, however, have not elucidated the relationships between these themes, nor examined the quantitative data examining parents' well-being.

METHODS

We conducted a mixed methods review, with qualitative meta-synthesis focusing on links between themes and quantitative synthesis of parental well-being findings, including pooled means. PsycInfo, Medline, EMBASE, AMED, CINHAL and Web of Science were searched to identify relevant records. References of included studies were also searched. Every abstract was screened by two authors. Data were extracted by one author and checked by another.

RESULTS

We identified 39 reports of 32 studies: 16 with qualitative data and 17 with quantitative data (one had both). Qualitative findings showed how parents' emotions were associated to their knowledge and beliefs about self-harm. Parents' emotions often evidenced the need to self-care, but emotions of guilt reduced engagement in self-care. How parents supported their young person was linked to their knowledge, and the management of their own emotions, and influenced if they could engage in self-care. Quantitative findings were mixed, however suggested poor general mental health amongst these parents.

CONCLUSIONS

Further good quality quantitative studies are needed, with measurement of psychological mechanisms that may underpin parental distress. Current evidence supports peer-support and interventions that go beyond information provision to address the connected factors of knowledge, emotion, self-care, and parenting behaviours.

Residential mobility restrictions and adverse mental health outcomes during the COVID-19 pandemic in the UK

During the COVID-19 pandemic, several governments tried to contain the spread of SARS-CoV-2, the virus that causes COVID-19, with lockdowns that prohibited leaving one's residence unless carrying out a few essential services. We investigate the relationship between limitations to mobility and mental health in the UK during the first year and a half of the pandemic using a unique combination of high-frequency mobility data from Google and monthly longitudinal data collected through the Understanding Society survey. We find a strong and statistically robust correlation between mobility data and mental health survey data and show that increased residential stationarity is associated with the deterioration of mental wellbeing even when regional COVID-19 prevalence and lockdown stringency are controlled for. The relationship is heterogeneous, as higher levels of distress are seen in young, healthy people living alone; and in women, especially if they have young children.

The use of 12-item General Health Questionnaire (GHQ-12) in Ukrainian refugees: translation and validation study of the Ukrainian version

Following the Russian-Ukrainian conflict, the well-being of millions of Ukrainians has been jeopardised. This study aims to translate and test the psychometric features of the Ukrainian version of the General Health Questionnaire 12 (GHQ-12). The study included Ukrainian refugees housed in Verona (Italy) between November/2022 and February/2023. The Ukrainian translation was obtained through a 'forward-backward' translation. Questionnaire was completed by 141 refugees (females: 78.7%). Median age was 36 years (IQR 23-43). Individuals with a score suggestive of psychological distress were 97 (68.8%). Cronbach's coefficient was 0.84 (0.95CI 0.80-0.88). According to confirmatory factor analysis, both single- (modelB1) and two-factor (model B2) structures with bimodal scoring method fitted the data satisfactorily. The two factors of model B2 had a 0.88 correlation. Pearson coefficient showed a positive significant correlation between the GHQ-12 and International Trauma Questionnaire scores (ρ = 0.53, 0.95CI 0.40-0.64, p < 0.001). The GHQ-12 Ukrainian translation showed good psychometric features being a reliable and valid instrument to assess Ukrainian refugees' general well-being.

GESTACOVID Project: Psychological and Perinatal Effects in Spanish Pregnant Women Subjected to Strict Confinement Due to the COVID-19 Pandemic and Their Evolution during De-Escalation

The lockdown and de-escalation process following the COVID-19 pandemic led to a period of new normality. This study aimed to assess the confinement impact on the mental health of peripartum women, as their psychological well-being may be particularly vulnerable and thus affect their offspring's development. A cross-sectional epidemiological study was conducted among women who gave birth during strict confinement (G0) and the new normality period (G1), in which a self-administered paper-based questionnaire assessed 15 contextual factors and the General Health Questionnaire-12 (GHQ-12). For each item, it was verified whether the positive screening rate differed in each confinement phase, and a risk factor study was conducted. For G0, significantly higher positive screening and preterm birth rates were observed in the positive screening group. In the case of G1, maternal age (>35 years), decreased physical activity, and normal weight were found to be protective factors against distress. This study underscores the heightened mental health risk for postpartum women during major psychosocial upheavals (war, economic crisis, natural disasters, or pandemics), along with their resilience as the positive screening rate decreases with the new normality. Findings encourage adopting strategies to identify high-risk women and promote effective measures, such as promoting physical activity.

Impact of therapeutic education on the evolution of social representations of medication in patients with Parkinson's disease: A quantitative and qualitative study (ETPARK REMED)

BACKGROUND

Among the workshops of our therapeutic patient education (TPE) program, the medication workshop (TPEM workshop) is very frequently proposed to patients in view of the difficulties they encounter related to the complexity of managing antiparkinsonian treatment. Patients' appropriation of their medications could depend on their social representations.

OBJECTIVES

To evaluate the effect of our TPEM workshop on the social representations PD patients have of their medications and to compare it with that of another therapeutic intervention such as a talking group defined as the control group.

METHODS

This single-center, prospective, randomized, parallel-group study investigated the social representations of medication through a questionnaire on knowledge about antiparkinsonian medications, a questionnaire on beliefs about medication (BMQ), and a word association task.

RESULTS

In the TPEM group (n=16), the workshop induced significant effects over time on the knowledge questionnaire (P=0.01), BMQ specific necessity and concerns scores (P=0.04 and 0.01, respectively), necessity-concerns differential (P=0.04), and BMQ general harm (P=0.04). No significant difference was found in the talking group (n=6). Comparison of the two groups showed a significant difference of the BMQ general harm with a decrease in belief in the harmfulness of the medications in the workshop group (P=0.03). The results of the verbal association task showed a modification in the content and structure of the social representations of medication in the TPEM group.

DISCUSSION

The TPEM workshop helped reduce initial negative aspects of medication representations. Improved knowledge of their medication allowed patients to feel more competent and legitimate in communicating with caregivers, modifying their beliefs about medications. Indeed, the medication was perceived as less restrictive, care becoming central as shown by the emergence of the medical team in the social representations of the medication.

CONCLUSION

All the results show a specific beneficial effect of the TPEM workshop through an evolution of the social representations of medications, which became more positive in our PD patients.

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.

A scoping review of the methodological quality of research on mental health of healthcare professionals in low- and lower-middle income countries

Background: SARS-CoV-2 has resulted in widespread awareness of health workers' work realities and their mental health impacts, and corresponding unprecedented research effort. Reviews of the quantitative literature on mental health of clinical skilled healthcare personnel in low- and lower-middle income countries (LLMIC), however, point at quality issues in the pre-pandemic literature. We used the evidence generated in the context of one pre-pandemic review to understand methodological strengths and weaknesses in detail, with the aim of distilling recommendations for future research. Methods: Our study used the literature identified in a systematic search from inception to the end of 2020, in English or French language, in MEDLINE, EMBASE, PsychINFO, Global Health, and CAIRN. Following a scoping review approach, we extracted and charted data on key study characteristics as well as on study quality. In regard to the latter, we developed nine quality criteria on the basis of existing quality checklists, but expanding on issues of particular relevance to the measurement and interpretation of levels of mental health or illness. We collated the charted data in descriptive fashion. Results: We included data from 152 studies, which assessed a range of mental health outcomes, although most burnout. Most studies were conducted in India, Nigeria, Pakistan, or Egypt, in urban secondary- and tertiary-care settings. We judged only 20% of studies as of high quality due to shortcomings particularly regarding sample representativeness, context-specific measurement tool validity, and reporting of methodological detail. Conclusion: We conclude that despite its impressive size, we can learn comparatively little from the body of literature up to the end of 2020 due to narrow study focus on specific settings and strong limitations in quality. Based on our findings, we outline areas for expansion, methodological improvement, and standardization of reporting in future research. PROSPERO Registration: CRD42019140036.

Association between Phase Angle and Subjective Perceptions of Health Variables in Cancer Patients

The phase angle, an increasingly studied healthcare tool, was studied to explore its relationship with psychological factors in cancer patients. The aim of this study was to investigate the relationship between the phase angle (PhA), obtained by the bioimpedance analysis of body composition, and psychological factors measured by questionnaire in cancer patients. The study included 311 patients who underwent bioimpedance testing to determine their PhA value; their psychological profiles were assessed using SF-36, FACIT, QLQ-C30, and GHQ-12 questionnaires. Mixed linear regression models were used to analyze the relationship between PhA and the psychological tests. The results showed a statistical correlation between PhA and the GHQ-12, FACIT, and SF-36 questionnaires, with higher PhA values associated with better results on the questionnaires. In the QLQ-C30 questionnaire, a correlation was observed between PhA and the functioning scales (p < 0.001), except for emotional and cognitive functioning (p = 0.148 and p = 0.544, respectively), but not in most of the symptom scales. The PhA is a useful tool for assessing the subjective health perception of cancer patients, especially with regard to psychological factors. While there is a statistically significant correlation, further research is required before confidently applying it in clinical practice. The current predictive value of this predictor for certain psychological aspects is limited, underscoring the need for additional research.

The influence of perceived stress and income on mental health in China and Germany

Background

Mental health issues affect rich and poor, young and old, and are widespread in Asia as well as in Europe. However, few studies have investigated the influence of perceived stress and income on mental health among general population in China and in Germany.

Methods

We conducted an online survey from December 2021 to February 2022 to investigate how perceived stress and income affect mental health among the general population in China (N = 1123) and in Germany (N = 1018). Accordingly, we used the 10-item Perceived Stress Scale (PSS-10) and the 12-item General Health Questionnaire (GHQ-12). We ran a multiple linear regression model to investigate the relationship between perceived stress, income, and mental health.

Results

Overall, we found that 53.4% participants reported mental health issues (GHQ-12 score ≥12). The proportion of our sample who reported mental health issues was higher in Germany (60.3%) than in China (44.8%). The regression model revealed that a higher perceived stress score was associated with more mental health issues in both countries (b = 0.60, p < 0.01). Individuals with a low income reported poorer mental health in Germany than those in China. Interestingly, the situation was reversed when incomes were high: individuals with a high income reported worse mental health in China than in Germany (b = -0.40, p < 0.01).

Conclusion

Perceived stress has a negative impact on mental health, while income has differential effects. Mental health promotion programmes may involve teaching stress management, while considering differences in mental health outcomes in developed and developing countries.

The negative impact of loneliness and perceived stress on mental health during two-month lockdown in Shanghai

BACKGROUND

Shanghai undergone COVID-19 lockdown for 2 months in 2022, affecting >25 million population. We aim to find changes in mental health during Shanghai lockdown and if mental health was associated with Shanghai lockdown, loneliness, and perceived stress.

METHODS

We conducted two cross-sectional online surveys in China, which were before and at the end of Shanghai lockdown (survey 1 in January 2022, N = 1123; survey 2 in June 2022, N = 2139). Participants reported mental health, loneliness, and perceived stress through the 12-item General Health Questionnaire (GHQ-12), the short-form UCLA Loneliness Scale (ULS-8), and the 10-item Perceived Stress Scale (PSS-10). We compared data between survey 1 and 2. We ran a multiple linear regression model to investigate the impact of Shanghai lockdown, loneliness and perceived stress on mental health.

RESULTS

There's an increase in the proportion of lonely people during Shanghai lockdown (49.77 % to 65.26 %). During Shanghai lockdown, the proportion of lonely people (68.97 % VS. 61.35 %, p < 0.001) and risk for mental health conditions (50.50 % VS. 43.27 %, p < 0.001) were higher among residents in Shanghai than outside Shanghai. Shanghai lockdown (b = 0.556, p = 0.02), higher ULS-8 (b = 0.284, p < 0.001) and higher PSS-10 (b = 0.365, p < 0.001) were associated with higher GHQ-12.

LIMITATIONS

Participants reported their mental health status during Shanghai lockdown retrospectively.

CONCLUSION

Shanghai lockdown had psychological impacts not only on residents in Shanghai but also outside Shanghai. Addressing loneliness and perceived stress accommodated to the lockdown situation should be considered.

Quality of life among geriatric population residing in Bhavnagar city, Gujarat, Western India

Background

All of the health status, lifestyle, satisfaction, mental state, or well-being, all facets of health status together reflect the multidimensional nature of quality of life (QOL) in an individual. Our objective is to assess quality of life and factors affecting quality of life.

Methods

We conducted a community-based cross-sectional study among 260 subjects (aged ≥ 60 years) residing in 13 wards of Bhavnagar city during September 2019-2020 after taking permission from ethics committee (no. 892) using the World Health Organization Quality of Life BREF-25 (WHO QOL BREF-25) scale. We assessed psychiatric morbidity using General Health Questionnaire-12 scale. Independent t-test was performed to find out factors associated with quality of life.

Result

Among 260 subjects, 36% were males. Study found highest score in psychological domain and lowest score in physical domain of WHO QOL BREF-25 scale. Physical health was better among Muslims, geriatrics <75 year of age, not addicted abusive substance and no co-morbid condition, whereas geriatrics belonged to upper socio-economic status and normal as per General Health Questionnaire-12 scale had better social relationship. Environmental domain score was significantly better among males and geriatric without co-morbidity.

Conclusion

These findings highlight the importance of active ageing interventions in order to improve the quality of life.

Are actual and perceived environmental conditions associated with variation in mental health?

OBJECTIVE

Empirical evidence on the relationship between environmental factors and mental health remains inconclusive. One reason is that there is only scant evidence on the association between mental health and subjective exposure to environmental stressors, relative to objective pollution. We thus focus on how the perceived and actual presence of noise, air pollution, and green spaces relates to mental health.

METHODS AND RESULTS

Our cross-sectional study is based on a large representative sample of the adult population in Switzerland (n = 5729). Using individual-level geocodes of subjects' residence, we combined data from a survey of these individuals with data on objectively measured longer-term environmental conditions (noise, air pollution, green spaces). Subclinical mental health was assessed with the 12-item General Health Questionnaire (GHQ-12). When fitting multiple regressions and mediation models, we find that perceptions of environmental stressors are a better predictor of mental distress than objectively measured stressors. In addition, the predictive power of actual nature visits is stronger than the predictive power of mere proximity to green spaces at the place of residence. We found no direct link between actual environmental stressors and mental health, but mediation via perceived environmental stressors. Further, the association between the frequency of nature visits and mental health is mediated by perceived, but not actual pollution.

CONCLUSION

Since actual environmental stressors are not perceived as equally burdensome by all people, their subjective perception is crucial when evaluating policy interventions aimed at improving mental health. Even a relatively low level of environmental stressors, classified as non-harmful to human health in a physical or biological sense, may thus contribute to negative mental health outcomes. The main policy implication is that attractive and accessible green spaces may provide individuals with an enhanced sense of control over their exposure to environmental stressors and thereby reduce negative impacts.

Association between time spent on smartphones and digital eye strain: A 1-year prospective observational study among Hong Kong children and adolescents

Prolonged electronic screen use can cause digital eye strain. It can be difficult to rectify due to increasing smartphone reliance, potentially leading to serious public health problems. To investigate the association between time spent on smartphones and digital eye strain (DES) among Hong Kong Chinese school-aged children. Of a total of 1,508 students (748 males, 49.6%) from 8 to 14 years old (mean age = 10.91 years, SD = 2.01) who provided valid data on DES, the 1,298 (86%) who completed the DES questionnaire at 1-year follow-up were included in the analysis. DES was measured using a 10-item scale, and the sum of the 10 dichotomised scores was used as the DES total score. The most commonly reported symptoms were eye fatigue (n = 804, 53.3%), blurred vision (changing from reading to distance viewing) (n = 586, 38.9%), and irritated or burning eyes (n = 516, 34.2%). The DES total scores at baseline and 1-year follow-up were 2.91 (SD = 2.90) and 3.20 (SD = 3.19), respectively. Linear regression controlling for demographic and socio-economic confounders showed that participants with baseline smartphone usage of 241 + min/d had a significantly higher baseline total DES score than those with baseline smartphone usage of 0-60 min/d (2.44 vs 3.21, P < 0.001), and participants with baseline smartphone usage of 181-240 min/d had a significantly higher 1-year follow-up total DES score than those with baseline smartphone usage of 0-60 min/d (2.80 vs 3.50, P = 0.003).

From Housewives to Employees, the Mental Benefits of Employment across Women with Different Gender Role Attitudes and Parenthood Status

Previous studies suggest that paid employment can improve workers' mental health status by offering a series of manifest and latent benefits (i.e., income, self-achievement and social engagement), which motivates policymakers' ongoing promotion of labour force participation as an approach to protect women's mental health status. This study extends the literature by investigating the mental health consequences of housewives' transition into paid employment across different gender role attitude groups. In addition, the study also tests the potential moderating role of the presence of children in relationships. This study yields two major findings by using nationally representative data (N = 1222) from the United Kingdom Longitudinal Household Study (2010-2014) and OLS regressions. First, from the first wave to the next, housewives who transitioned into paid employment reported better mental health status than those who remained housewives. Second, the presence of children can moderate such associations, but only among housewives with more traditional gender role attitudes. Specifically, among the traditional group, the mental benefits of transition into paid employment are more pronounced among those without children. Therefore, policymakers should develop more innovative approaches to promote housewives' mental health by considering a more gender-role-attitudes-sensitive design of future labour market policies.

How COVID-19 News Affect Older Adults' Mental Health-Evidence of a Positivity Bias

BACKGROUND

Media affects the trajectory of many individuals' mental health-with media news, individuals experience negative bias more than positive bias. However, there is also evidence of an age-related positivity effect, with negativity bias generally fading with age. With the rise of COVID-19 cases, older adults (aged 55 years and older) who consume media frequently are at a high risk for declining mental health. To date, there has been no research on the positivity vs. negativity bias of media news on older adults. Here, we investigated whether positivity or negativity bias plays a larger role in affecting how older adults react to COVID-19 news.

METHODS

Sixty-nine older adults (aged 55-95) answered questions about their weekly media consumption and how closely they followed news relating to COVID-19. They also completed a general health questionnaire. They were then randomly assigned to read either positive or negative COVID-19 news (n = 35 and 34, respectively). The adults were asked if the news made them feel happy or fearful, and if they wanted to read more about the news or ignore the news.

RESULTS

An analysis revealed that the more often older adults consumed media and the more closely they followed COVID-19 news, the more they felt unhappy and depressed. Importantly, older adults who read positive news reported stronger responses than those who read negative news. Older adults appeared to have a strong positivity bias for COVID-19 news, reporting feeling happy and wanting to read about positive news. In contrast, negative COVID-19 news did not evoke similar levels of response from the older adults.

CONCLUSIONS

Media consumption of COVID-19 news does negatively impact the mental well-being of older adults, but older adults appear to have a strong positivity bias and a lack of negativity bias for COVID-19 news. These findings suggest that older adults can remain hopeful and positive during periods of public health crises and intense stress, which is essential to sustaining their mental well-being during difficult times.

Psychological State and Exam Performance among Paramedics' Students in Geneva during the COVID-19 Pandemic: A Mixed Methods Study

The COVID-19 pandemic forced higher education institutions in Switzerland to move to distance learning, with certain limitations such as "Zoom fatigue" and a lack of interaction with peers and teachers. This has also impacted the development of interprofessional skills and key concepts such as professional acknowledgement, cooperation, and communication skills. This study was conducted using mixed methods, including performance assessment regarding examination notes, the 12-item General Health Questionnaire, and semi-structured interviews, to assess the impact of the pandemic on the performance of paramedic students and their psychological state. The results of the semi-structured interviews provided insight into the impact of the pandemic. The period of the COVID-19 pandemic appears to have had an impact on the psychological state of the paramedic students, most of whom were considered to be either at risk or in psychological distress. There may have been an effect on their theoretical knowledge performance, with pre-pandemic promotions performing better than pandemic promotions.

Effects of Tele-Pilates and Tele-Yoga on Biochemicals, Physical, and Psychological Parameters of Females with Multiple Sclerosis

BACKGROUND

People with multiple sclerosis (PwMS) suffer from some comorbidities, including physical and psychiatric disorders, low quality of life (QoL), hormonal dysregulation, and hypothalamic-pituitary-adrenal axis dysfunction. The current study aimed to investigate the effects of eight weeks of tele-yoga and tele-Pilates on the serum levels of prolactin and cortisol and selected physical and psychological factors.

METHODS

Forty-five females with relapsing remitting multiple sclerosis, based on age (18-65), expanded disability status scale (0-5.5), and body mass index (20-32), were randomly assigned to tele-Pilates, tele-yoga, or control groups (n = 15). Serum blood samples and validated questionnaires were collected before and after interventions.

RESULTS

Following online interventions, there was a significant increase in the serum levels of prolactin (p = 0.004) and a significant decrease in cortisol (p = 0.04) in the time × group interaction factors. In addition, significant improvements were observed in depression (p = 0.001), physical activity levels (p < 0.001), QoL (p ≤ 0.001), and the speed of walking (p < 0.001).

CONCLUSION

Our findings suggest that tele-yoga and tele-Pilates training could be introduced as patient-friendly, non-pharmacological, add-on therapeutic methods for increasing prolactin and decreasing cortisol serum levels and achieving clinically relevant improvements in depression, walking speed, physical activity level, and QoL in female MS patients.

Adolescent support club attendance and self-efficacy associated with HIV treatment outcomes in Tanzania

HIV treatment outcomes may be improved by ameliorating psychosocial challenges adolescents living with HIV (ALHIV) face. This analysis describes participation in existing facility-based adolescent clubs and the associations between club attendance, adolescent well-being and HIV treatment outcomes. Data were collected through interviews with a sub-sample of adolescents age 10-19 years and medical record abstraction of all adolescents attending HIV services at seven clinics in Tanzania. Independent variables included adolescent club attendance, self-esteem, self-efficacy, mental distress, social capital and other health utilization or HIV experience characteristics. Study outcomes included visit adherence, viral suppression (<1000 cp/ml), and retention. Of 645 adolescents attending HIV services, 75% attended clubs at least once with a median of eight club sessions attended over a two-year period. Mental distress was prevalent, with 67% of the adolescents scoring above a recognized cut-off of ≥5. Adolescents who attended 10 or more clubs, compared to those not attending any clubs over a two-year period were at an almost three-fold increased odds of having good visit adherence (odds ratio [OR] 2.72, 95% confidence interval [CI]: 1.25, 5.94). Club attendance was also associated with sustained retention in the following year: adolescents who attended some clubs (1-9) had three-times the odds of being retained (OR 3.01; 95%CI: 1.86, 4.87) while those who attended 10+ had over seven-times the odds (OR 7.29; 95%CI: 4.34, 12.22). Among the 154 adolescents who were interviewed, being in the top self-efficacy tertile was positively associated with viral suppression (OR 3.04, 95%CI: 1.08, 8.60) and retention (OR 4.44, 95%CI: 1.19, 17.40). Attending the HIV clinic with a guardian/treatment supporter (OR 3.29, 95%CI: 1.17, 9.22) was also associated with viral suppression. Self-efficacy, social capital and treatment support are associated with better health outcomes among adolescents. However, many ALHIV either never attended or did not regularly attend clubs.

International Comparison of Self-Concept, Self-Perception and Lifestyle in Adolescents: A Systematic Review

Objectives: Adolescence is considered a vital time to address healthy attitudes and values towards an effective transition to adulthood. The aim of this review was to analyse self-concept, self-perception, physical exercise, and lifestyle in the late adolescent population.

Methods: Systematic review of studies assessing the results by the Rosenberg Self-Esteem Scale, the General Health Questionnaire, the Activity Questionnaire for Adolescents, and the Health Behaviour in School-aged Children questionnaires in late adolescents. The PRISMA recommendations were followed. The CASPe quality-check system was applied, excluding articles with a score &lt;8.

Results: 1589 studies were found, and 69 articles were selected. Adolescents with high self-concept and self-perception tend to be emotionally stable, sociable, and responsible. No significant differences were found regarding self-concept and self-perception between different countries, but there were differences between men and women. Physical activity and healthy diet improve self-concept and perception of body image.

Conclusion: Self-concept and self-perception are associated with responsibility, stability, and mental strength. Most healthy behaviours during adolescence are followed during adulthood. Socio-cultural level of Health Science students is a differential factor for overweight and obesity.

La salud mental de los trabajadores de salud en Guatemala durante la pandemia de COVID-19: resultados de base del estudio de cohortes HÉROES

Objetivos.

Evaluar la prevalencia de base de los trastornos de salud mental y exposiciones conexas en una cohorte de trabajadores de salud de Guatemala.

Métodos

Se analizó la información de base del estudio HÉROES (por COVID-19 HEalth caRe wOrkeRs Study, sobre los trabajadores de salud durante la pandemia) en Guatemala, realizado en línea en el 2020. Las variables de resultado fueron malestar psicológico y síntomas depresivos. Las exposiciones incluyeron experiencias con la COVID-19, características sociodemográficas y características del trabajo. En los análisis se utilizaron modelos de regresión de Poisson brutos y ajustados.

Resultados.

De los 1801 trabajadores de salud que aceptaron participar, 1522 (84,5%) completaron el cuestionario; 1014 (66,8%) eran mujeres. De los participantes, 59,1% (intervalo de confianza de 95% [IC 95%] = 56,6-61,5) tuvo un tamizaje positivo para malestar psicológico y 23% (IC 95% = 20,9-25,2) para síntomas depresivos de moderados a graves. Las experiencias con la pandemia de COVID-19, las características sociodemográficas y las características del trabajo se correlacionaron con las variables de resultado del estudio. Los participantes que estaban preocupados por el contagio de la COVID-19 tuvieron un mayor riesgo de malestar psicológico (riesgo relativo [RR] = 1,47; IC 95% = 1,30-1,66) y síntomas depresivos (RR = 1,51; IC 95% = 1,17-1,96). Asimismo, los participantes más jóvenes presentaban un riesgo alto de malestar psicológico (RR = 1,80; IC 95% = 1,24-2,63) y síntomas depresivos (razón de posibilidades [OR] = 4,58; IC 95% = 1,51-13,87).

Conclusiones.

Las afecciones de salud mental tienen una prevalencia sumamente alta en los trabajadores de salud de Guatemala.

Mental Health of Guatemalan Health Care Workers During the COVID-19 Pandemic: Baseline Findings From the HEROES Cohort Study

Objectives. To assess the baseline prevalence of mental health conditions and associated exposures in a cohort of health care workers (HCWs) in Guatemala. Methods. We analyzed baseline information from the 2020 Web-based COVID-19 Health Care Workers Study (HEROES)-Guatemala. Outcomes included mental distress and depressive symptoms. Exposures included COVID-19 experiences, sociodemographic characteristics, and job characteristics. We used crude and adjusted Poisson regression models in our analyses. Results. Of the 1801 HCWs who accepted to participate, 1522 (84.5%) completed the questionnaire; 1014 (66.8%) were women. Among the participants, 59.1% (95% confidence interval [CI] = 56.6, 61.5) screened positive for mental distress and 23% (95% CI = 20.9, 25.2) for moderate to severe depressive symptoms. COVID-19 experiences, sociodemographic characteristics, and job characteristics were associated with the study outcomes. Participants who were worried about COVID-19 infection were at higher risk of mental distress (relative risk [RR] = 1.47; 95% CI = 1.30, 1.66) and depressive symptoms (RR = 1.51; 95% CI = 1.17, 1.96). Similarly, the youngest participants were at elevated risk of mental distress (RR = 1.80; 95% CI = 1.24, 2.63) and depressive symptoms (OR = 4.58; 95% CI = 1.51, 13.87). Conclusions. Mental health conditions are highly prevalent among Guatemalan HCWs. (Am J Public Health. 2022;112(S6):S602-S614. https://doi.org/10.2105/AJPH.2021.306648).

Much research, but little learned to date: A scoping review of the methodological quality of research on mental health of healthcare professionals in low- and lower-middle income countries

Background: SARS-CoV-2 has resulted in widespread awareness of health workers’ work realities and their mental health impacts, and corresponding unprecedented research effort. Reviews of the quantitative literature on mental health of clinical skilled healthcare personnel in low- and lower-middle income countries (LLMIC), however, point at quality issues in the pre-pandemic literature. We used the evidence generated in the context of one pre-pandemic review to understand methodological strengths and weaknesses in detail, with the aim of distilling recommendations for future research. Methods: Our study used the literature identified in a systematic search up to the end of 2020, in English or French language, in MEDLINE, EMBASE, PsychINFO, Global Health, and CAIRN. Following a scoping review approach, we extracted and charted data on key study characteristics as well as on study quality. In regard to the latter, we developed nine quality criteria on the basis of existing quality checklists, but expanding on issues of particular relevance to the measurement and interpretation of levels of mental health or illness. We collated the charted data in descriptive fashion. Results: We included data from 152 studies, assessing a range of mental health outcomes, with a focus on burnout. Most studies were conducted in India, Nigeria, Pakistan, or Egypt, in urban secondary- and tertiary-care settings. We judged only 20% of studies as of high quality due to shortcomings particularly regarding sample representativeness, context-specific measurement tool validity, and reporting of methodological detail. Conclusion: We conclude that despite its impressive size, we can learn comparatively little from the body of literature up to the end of 2020 due to limitations in quality. Based on our findings, we outline areas for expansion, methodological improvement, and standardization of reporting in future research. PROSPERO Registration: CRD42019140036.

Psychotic-like experiences of young adults in the general population predict mental disorders

Psychotic-like experiences (PLEs) have been identified as risk markers for psychotic disorders and may indicate an individual's susceptibility to mental disorders in general. We examined whether 23 PLEs (assessed with M-CIDI questionnaire) reported in young adulthood (n = 1313) predict subsequent psychotic or any mental disorders in the general population. We also investigated whether these possible associations are explained by general psychological distress assessed with the General Health Questionnaire-12 (GHQ-12). The register follow-up period spanned 10-12 years. In Cox regression models, PLEs predicted subsequent psychotic disorders (n = 12) when the effects of age, sex, education, and marital status were adjusted for, but not when general psychological distress was added to the model. Having any mental disorders during follow-up (n = 91) was predicted by PLEs reported at a younger age, when controlling for age, sex, education, marital status, and general psychological distress. In line with earlier results in other age groups, PLEs can be seen as a sign of vulnerability to not just psychotic but all mental disorders during the following years also among young adults in the general population. PLEs were a predictive marker of general psychopathology independently from general psychological distress.

Examining the Predictors of Mental Ill Health in Esport Competitors

Few research studies have examined the predictors of mental ill health in esports. This study addresses that gap by investigating stressors, sleep, burnout, social phobia anxiety and mental ill health in esport athletes. An online survey was disseminated to competitive student esport athletes (n = 313) residing in the UK. The survey included measures of stressors resulting from competing in esports, sleep quality, burnout, and social phobia, as well as outcome measures of mental ill health. Hierarchical regression analyses examined these relationships. All the hypotheses were supported, with stressors significantly predicting sleep quality, burnout, and social phobia anxiety, and stressors, sleep quality, burnout, and social phobia anxiety were all significant positive predictors of mental ill health. The strength of these predictions varied, for example, the daytime dysfunction subscale of sleep was a strong predictor of all outcome variables; two subscales of burnout, reduced sense of accomplishment and exhaustion significantly predicted each of the three mental ill health outcome variables, and two subscales of social phobia anxiety, fear and avoidance, significantly predicted mental ill health. Our study has important implications for player health in esports, highlighting interventions that could target specific aspects of stress, sleep, burnout, and social phobia anxiety to improve the mental health of those who compete in esports.

Researching the researchers: psychological distress and psychosocial stressors according to career stage in mental health researchers

Background

Although there are many benefits associated with working in academia, this career path often involves structural and organisational stressors that can be detrimental to wellbeing and increase susceptibility to psychological distress and mental ill health. This exploratory study examines experiences of work-related psychosocial stressors, psychological distress, and mental health diagnoses among mental health researchers.

Methods

This international cross-sectional study involved 207 mental health researchers who were post-graduate students or employed in research institutes or university settings. Work-related psychosocial stressors were measured by the Copenhagen Psychosocial Questionnaire III (COPSOQ III). Psychological distress was assessed using the Depression-Anxiety-Stress Scale-21 (DASS-21). Thoughts of suicide was assessed using an adaptation of the Patient Health Questionnaire-9 (PHQ-9). History of mental health diagnoses was assessed through a custom questionnaire. Pearson’s chi-square test of independence was used to compare mental health diagnoses and suicidal ideation across career stages. The association between work-related psychosocial stressors and psychological distress was conducted using multivariate linear regression controlling for key demographic, employment-related and mental health factors.

Results

Differences in ‘demands at work’ and the ‘work-life balance’ domain were lowest among support staff (p = 0.01). Overall, 13.4% of respondents met the threshold for severe psychological distress, which was significantly higher in students compared to participants from other career stages (p = 0.01). Among the subgroup of participants who responded to the question on mental health diagnoses and suicidal ideation (n = 152), 54% reported a life-time mental health diagnosis and 23.7% reported suicidal ideation since their academic career commencement. After controlling for key covariates, the association between the ‘interpersonal relations and leadership’ domain and psychological distress was attenuated by the mental health covariates included in model 3 (β = −0.23, p = 0.07). The association between the remaining work-related psychosocial stressors and psychological distress remained significant.

Conclusions

Despite working in the same environment, research support staff report experiencing significantly less psychosocial stressors compared to postgraduate students, early-middle career researchers and senior researchers. Future research that targets key modifiable stressors associated with psychological distress including work organization and job content, and work-life balance could improve the overall mental health and wellbeing of mental health researchers.

Questionnaires Assessing Adolescents' Self-Concept, Self-Perception, Physical Activity and Lifestyle: A Systematic Review

Introduction: Adolescence is considered a fundamental time to promote change. During this time, young people consolidate their social and individual identity. By influencing positive changes, chronic diseases can be avoided, delayed or modified in the future. The use of valid and reliable questionnaires is an optimal resource for gathering information and thus useful for this study. Objectives: The objectives of the study were to: (1). identify the questionnaires that assess self-esteem/self-concept, self-perception, physical exercise and lifestyle of adolescents; (2). analyse the psychometric measures of the questionnaires used to assess the self-esteem/self-concept, self-perception, physical exercise and lifestyle of adolescents; and (3). determine which questionnaires are the most reliable and valid for assessing the self-esteem/self-concept, self-perception, physical exercise and lifestyle of adolescents. Method: A bibliographic search was carried out in the following databases: Virtual Health Library, Cochrane, Medline, Cuiden, Scielo, Dialnet, PubMed and Ministry of Health, Consumption and Social Welfare following the PICO method. The recommendations of the PRISMA statement were followed. Results: A total of 71 scientific articles were collected. Within the self-perception/self-concept questionnaires, the Rosenberg Self-Esteem Scale stands out for being an optimal and widely used resource in adolescents. Regarding the questionnaires that evaluate self-perception, the General Health Questionnaire is the most used; it is used in numerous national health surveys in different countries. The Physical Activity Questionnaire for Adolescents ranks first with respect to the rest of the tools. It is a widely used resource internationally and provides enough information on the physical activity carried out by the subject in a given week. Although there are several questionnaires that measure lifestyle, the Health Behavior in School-aged Children instrument was selected. This instrument is at the European level and involves the collaboration of 48 countries and allows us to compare the lifestyle habits of adolescents from different countries. Discussion: The questionnaire that stands out in the assessment of self-esteem/self-concept is the Rosenberg Self-Esteem Scale. The General Health Questionnaire has been selected as the best tool for assessing self-perception. To measure physical exercise, the Physical Activity Questionnaire for Adolescents is identified as the ideal instrument because it is widely used and can be completed quickly. Regarding lifestyle, the Health Behavior in School aged Children is shown to be an effective instrument in assessing lifestyle.

The Effect of Using Participatory Working Time Scheduling Software on Employee Well-Being and Workability: A Cohort Study Analysed as a Pseudo-Experiment

Shift workers are at increased risk of health problems. Effective preventive measures are needed to reduce the unfavourable effects of shift work. In this study we explored whether use of digital participatory working time scheduling software improves employee well-being and perceived workability by analysing an observational cohort study as a pseudo-experiment. Participants of the Finnish Public Sector cohort study with payroll records available between 2015 and 2019 were included (N = 2427). After estimating the propensity score of using the participatory working time scheduling software on the baseline characteristics using multilevel mixed-effects logistic regression and assigning inverse probability of treatment weights for each participant, we used generalised linear model to estimate the effect of using the participatory working time scheduling software on employees’ control over scheduling of shifts, perceived workability, self-rated health, work-life conflict, psychological distress and short sleep (≤ 6 h). During a 2-year follow-up, using the participatory working time scheduling software reduced the risk of employees’ low control over scheduling of shifts (risk ratio [RR] 0.34; 95% CI 0.25–0.46), short sleep (RR 0.70; 95% CI 0.52–0.95) and poor workability (RR 0.74; 95% CI 0.55–0.99). The use of the software was not associated with changes in psychological distress, self-rated health and work-life conflict. In this observational study, we analysed as a pseudo-experiment, the use of participatory working time scheduling software was associated with increased employees’ perceived control over scheduling of shifts and improved sleep and self-rated workability.

Perceived causes of mental illness and views on appropriate care pathways among Indonesians

BACKGROUND

The mental health system in Indonesia comprises attempts to modernise a colonial relic. There is still a disconnect between available services and help-seeking behaviours at the grassroots level. This study aims to explore the perceptions of Javanese people on the aetiology of mental illness and their ideas on how to deal with individuals who may have mental illness.

METHODS

This qualitative study involves semi-structured interviews, embedded in a cluster randomised trial examining the clinical and cost-effectiveness of primary mental health services. Interviews were conducted with Indonesian and Javanese. The recruitment procedure was aligned to the trial. Participants were primary care patients recruited from 21 sites across Yogyakarta province. Interviews were recorded, transcribed, and translated into English. Thematic analysis was used to analyse the interview transcripts.

RESULTS

75 participants took part in the study: 51 women (68%) and 24 men (32%). Key themes emerged around perceived causes of mental health problems (including 'extrinsic factors'; 'intrinsic factors'; and 'spiritual factors'), and perceived appropriate pathways of care ('modern medical science'; 'social support and activities'; and 'religious or spiritual interventions'). Gender potentially influenced some of the responses.

CONCLUSIONS

Themes indicate the variety of preconceptions towards mental health problems and assumptions regarding the best management pathways. Some of these preconceptions and assumptions support the utility of modern medical care, while the rest promote spiritual or religious healers. Participants' ideas of the appropriate care pathways largely correspond to their perception of what the symptoms are caused by. Despite hints to some understanding of the bio-psycho-social model of mental illness, most participants did not capture the complexity of mental health and illness, indicating the importance of contextual (especially culturally and religiously-aligned) public education around mental health, illness and care.

Impact of Work from Home Policy during the COVID-19 Pandemic on Mental Health and Reproductive Health of Women in Indonesia

Objectives: This study aimed to assess the impact of work from home (WFH) during the COVID-19 pandemic on the mental health and reproductive health of women in Indonesia. To the best of our knowledge, this is the first study evaluating the impact of WFH policy on said health aspects in Indonesia. Methods: We conducted an observational study with a cross-sectional approach using an online survey among premenopausal married women in Indonesia. The survey included the General Health Questionnaire (GHQ-12) for psychological distress, average sexual intercourse frequency (SIF) per week, contraception use, change of menstrual pattern, and desire for having children. To analyze the effect of WFH, the participants were divided into groups based on their WFH compliance: (1) Both couples (her and her spouse) work from home, (2) Only the wife works from home, (3) Only the husband works from home, and (4) Neither works from home. Results: 348 women were included in this study. Psychological distress occurred in 48.0% (n = 167) participants. No significant difference was found between the WFH groups (χ2[3, N = 348] = 2.077, p = .56)). The average weekly SIF was found to be significantly fewer during WFH (T = 5014, z = -5.598, p < .001). However, only 22.7% (n = 79) participants reported the use of contraception and 52.9% (n = 196) participants still wanted to have children. Change of menstrual pattern occurred in 31.6% (n = 110) participants and were significantly correlated to psychological distress (rs= .126, p = .018). Conclusions: WFH does not aggravate the effect of the pandemic on women's mental and reproductive health in Indonesia. A significant number of them still desire to have children and contraceptive prevalence is low.

Accurate Prediction of Children's ADHD Severity Using Family Burden Information: A Neural Lasso Approach

The deep lasso algorithm (dlasso) is introduced as a neural version of the statistical linear lasso algorithm that holds benefits from both methodologies: feature selection and automatic optimization of the parameters (including the regularization parameter). This last property makes dlasso particularly attractive for feature selection on small samples. In the two first conducted experiments, it was observed that dlasso is capable of obtaining better performance than its non-neuronal version (traditional lasso), in terms of predictive error and correct variable selection. Once that dlasso performance has been assessed, it is used to determine whether it is possible to predict the severity of symptoms in children with ADHD from four scales that measure family burden, family functioning, parental satisfaction, and parental mental health. Results show that dlasso is able to predict parents' assessment of the severity of their children's inattention from only seven items from the previous scales. These items are related to parents' satisfaction and degree of parental burden.

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.

Health-related Quality of Life after Laparoscopic Hysterectomy following Enhanced Recovery after Surgery Protocol or a Conventional Recovery Protocol

STUDY OBJECTIVE

To compare the health-related quality of life (HRQoL) and psychologic distress after laparoscopic hysterectomy (LH) following enhanced recovery after surgery (ERAS) and conventional recovery protocols.

DESIGN

A secondary analysis of a single-center randomized controlled trial.

SETTING

University hospital.

PATIENTS

Women assigned to LH were randomly divided into 2 groups: intervention (ERAS protocol) group (IG) (n = 60) and control (conventional protocol) group (CG) (n = 60).

INTERVENTIONS

Women in the intervention group (IG) were treated according to the ERAS protocol.

MEASUREMENTS AND MAIN RESULTS

The primary outcome was a change in HRQoL assessed by the 15D questionnaire and a change in psychologic distress assessed by the General Health Questionnaire-12 at baseline before surgery and 1 month later. One month after surgery, the HRQoL was clinically and statistically better compared with baseline but with no difference between the groups. When following the ERAS protocol, the improvement in HRQoL was clinically greater, the difference in the dimension of sleeping was statistically better (p <.05), and the dimensions of discomfort and symptoms (+0.028), depression (+0.282), distress (+0.018), and vitality (+0.040) were clinically better than when following the conventional recovery protocol. No differences were found in the psychologic distress scores either preoperatively or 1 month after surgery (24 in IG vs 25 in CG [p = .85] and 9 in IG vs 12 in CG [p = .47], respectively).

CONCLUSION

The HRQoL improved after LH with no significant difference between the ERAS and conventional recovery protocols. However, clinically, the change in HRQoL was greater, and the dimensions of sleeping, discomfort and symptoms, depression, distress, and vitality were better when following ERAS. Psychologic distress was equal in both groups. ERAS seems to have a positive impact on recovery after LH.