Mental Health Conditions According to Stress and Sleep Disorders

Challenges of poor sleep quality and mental health issues among Syrian medical residents in 22 major hospitals across Syria

A nationwide survey in the USA reported that healthcare workers had the highest prevalence of short sleep duration compared with other professions. Moreover, several studies have reported poor sleep quality among healthcare professionals and described insufficient sleep as a potential driver of reduced physician well-being. This study aims to explore sleep quality and mental health issues among Syrian medical residents, with the goal of informing targeted interventions to enhance their well-being and professional performance. This cross-sectional study in Syria involved 2071 residents from 22 major hospitals. Conducted between 27 October 2023 and 4 April 2024, it used face-to-face interviews with validated questionnaires following STROBE guidelines. Hospitals were categorized for comparative analysis. Measures included demographics, Pittsburgh Sleep Quality Index, Patient Health Questionnaire for depression, and Generalized Anxiety Disorder 7-item. In a study involving 2071 hospital residents across Syria's major hospitals, significant findings reveal a high prevalence of poor sleep quality (67.7%), depressive symptoms (46%) and anxiety symptoms (42.2%). Analysis by hospital categories highlighted varied rates, with Damascus and Hama General Hospitals showing notably higher incidences. Females exhibited higher rates of depressive and anxiety symptoms compared with males, with predictors including gender, age and marital status. The relatively high prevalence of poor sleep quality, depressive symptoms and anxiety symptoms among Syrian medical residents necessitates proper action, which will probably include limits on work hours, to enhance mental health outcomes and ensure proper patient care.

Improving the Process of Managing Psychosocial Risks in Organizations

Introduction

Psychosocial risks (PSRs) are identified as one of the main modern occupational safety issues, primarily related to occupational stress, and need to be reduced to safe levels in accordance with international requirements. The research purpose is to improve the process of managing the PSRs in the occupational safety and health management systems of employees, taking into account the impact of psychosocial dangers in accordance with the requirements of ISO 45001:2018 and ISO 45003:2021 standards.

Methods

To develop the process of managing the PSRs, a system analysis method is applied, which allows determining the structural relationships between the variable elements of dangerous psychosocial factors described in the ISO 45003:2021 standard.

Results

The bow-tie model has been improved to determine the relationship between psychosocial dangers and the dangerous event occurrence - experiencing stress by an employee, taking into account the influence of various dangerous psychosocial factors, which provides for an additional risk level assessment for restoring the health of an employee who has experienced stress. The process of psychosocial risk management consisting of ten steps is proposed, which involves identifying the relationship between psychosocial dangers and consequences for human health, taking into account the impact of various dangerous psychosocial factors based on questionnaires, followed by analysis and processing of the duration and intensity of experiencing stress. To reduce the impact of subjective assessments of the duration and intensity of experiencing stress on the psychosocial risk level, it is proposed to take into account the value of individual perception of experiencing stress (stress resistance) and the employees' health condition.

Discussion

The scientific novelty is to determine the psychosocial risk level as the sum of the risk values from the impact of each dangerous psychosocial factor, which are characteristic of aspects of work organization, social conditions at work, working environment, equipment, dangerous tasks and the level of employee health. The practical value is the development of scales for assessing the impact of dangerous psychosocial factors and a form for documenting the process of managing psychosocial risks with the indication of precautionary measures to control them.

Cross-cultural validation of the Jenkins Sleep Scale in Spanish-speaking countries

The study aimed to validate the Jenkins Sleep Scale (JSS-4) in six Spanish-Speaking countries. A total of 1726 people participated and were distributed between men (32.4%) and women (67.6%). Confirmatory factor analysis confirmed the unidimensional structure and high reliability of the JSS-4 overall (α = 0.85, ω = 0.81) and within each country. The invariance analysis revealed that JSS-4 exhibited complete invariance across countries, thus establishing a robust foundation for inter-group comparisons. Interestingly, a comparative analysis revealed significant differences in the average levels of sleep difficulties, with particularly high rates in Spain and Chile. Item Response Theory (IRT) showed sufficient discrimination parameters for all items, and a correlation of 0.998 between Confirmatory Factor Analysis (CFA) and IRT highlighted the robustness and reliability of the results obtained. In summary, JSS-4 exhibits strong evidence of validity and consistency in measurement invariance across the six countries.

How acute stress affects sleep: large-scale observations from continuous smart ring measurements in free-living conditions

Stress management may be crucial to improving sleep quality due to the intertwined relationship between stress and sleep. Commercial wearables offer both acute stress tracking and sleep tracking, yet the effects of acute physiological stress on sleep have not been widely studied in uncontrolled, free-living conditions. This study employs stress and sleep data from over 45,000 individuals collected with the Oura Ring during daily life. A group of stressed individuals were compared with a group of individuals with high daytime recovery. Sleep related data were analyzed with respect to the number of accumulated stressful or restorative days, respective to the group in question, within a one-week period. The results highlight the destructive effect that the accumulation of stressful days may have on sleep biometrics, indicating significant decrease in sleep quality. Vice versa, the results also imply the opposite effect from restorative days, emphasizing the importance of balancing acute stress with rest and the potential benefits from data driven stress management.

Pregnancy Concerns as Predictors of Sleep Quality in Primigravid Women: A Cross-Sectional Study

Introduction Poor sleep quality may be a risk factor for adverse pregnancy outcomes. Identifying the predictors of sleep disorders can help design effective interventions. The present study aimed to evaluate the impact of pregnancy concerns on the sleep quality of primigravid women. Methods This cross-sectional study was conducted on 220 primigravid women referred to health centers in Hamadan, Iran. In addition to completing the demographic characteristics questionnaire, the Parkinson's Disease Questionnaire (PDQ) questionnaire was completed to determine the level of pregnancy concerns, and the Pittsburgh Sleep Quality Index (PSQI) questionnaire was completed to determine the quality of sleep by pregnant women. Data were analyzed using descriptive statistics, the Pearson correlation coefficient, independent t-test, and univariate and multivariate logistic regression models with a backward method at a 95% confidence level. Results Pregnant women's total PSQI score was 13.8 ± 3.08, and with a PSQI ≥ 5 as a cut-off point, 76.3% of the study's participants had poor sleep quality. There was a significant direct correlation between the total score of PDQ and its subscales with the total PSQI score (P < 0.05). The adjusted regression logistic model showed a significant relationship between the PDQ scores, women's educational level (adjusted odds ratio (AOR) 1.19; confidence interval (CI) 95%: 0.19-2.18), and their spouse's educational level (AOR 1.03; CI 95%: 0.02-2.03) with sleep quality scores. Conclusion Pregnancy concerns, including concerns about birth and the baby, concerns about physical symptoms and body image, and concerns about emotions and relationships, can reduce the sleep quality of primigravid women. Designing and implementing effective interventions to reduce or modify these common concerns can improve the sleep quality of pregnant women and prevent the adverse effects of poor sleep quality on pregnancy outcomes.

Screen Time and Child Behavioral Disorders During COVID-19 Pandemic: A Systematic Review

Background

The extensive use of various electronic games and communication devices, particularly among children and adolescents, has raised concerns, particularly during the COVID-19 pandemic. This study investigated the link between screen time and internalizing disorders, such as anxiety and depression, among individuals aged ≤18 during the global COVID-19 pandemic.

Methods

This systematic review aims to summarize scientific publications from 2019 to early 2022 by searching databases, including the Cochrane Library, PubMed, Web of Science, Scopus, and PsycINFO, to identify suitable studies. In each paper, we searched the following keywords and their synonyms: screen, child, high school, middle school, and psychiatric disorders. The quality of the selected papers was evaluated using a checklist recommended by the National Institutes of Health (NIH) for observational cohort studies.

Results

Out of 986 reports identified, we included 12 papers with 14,483 participants. The study revealed a negative correlation between screen time (TV, computer, video games, and mobile phones) and behavioral outcomes. Smartphones were the most frequently used devices, with video games being more prevalent among older participants for education, communication, and entertainment purposes. The prevalence of depression ranged between 10% and 25%. Furthermore, anxiety and depression were identified as predictors of increased screen usage. Some results displayed variation based on the type of screen exposure, the questionnaires used, and the age of the participants.

Conclusions

The findings imply an indirect association between increased screen time and depression and anxiety. It is crucial to consider limitations on screen time exposure and parental supervision as measures to prevent certain mental disorders.

Efficacy of 1,5-anhydro-D-fructose on reducing mental stress: a randomized, double-blind, placebo-controlled trial-a pilot study

Brain-derived neurotrophic factor (BDNF) plays an important role in mental stress. We have previously reported that 1,5-anhydro-D-fructose (1,5-AF) increases brain BDNF in vivo. The present randomized, controlled, double-blind study aimed to clinically evaluate the effects of 1,5-AF oral intake on mental stress in terms of three parameters: sleep, mood, and bowel issues. Healthy volunteers aged between 22 and 71 years (n = 24) were randomly assigned to receive 5.5 g of 1,5-AF or placebo orally, once daily for 4 weeks. Pre- and post-intervention, the subjects completed the Oguri-Shirakawa-Azumi Sleep Inventory, Middle-Aged and Aged Version (OSA-MA); Profile of Mood States, Second Edition (POMS2); and Constipation Assessment Scale (CAS) questionnaires. In the OSA-MA, both "sleepiness on rising" and "sleep length" were significantly improved after treatment with 1,5-AF compared with before treatment. Furthermore, in the POMS2, there was a clear tendency toward reduced "Anger-Hostility" in the 1,5-AF group after treatment, and in the CAS, there was a clear tendency toward reduced "diarrhea or liquid stool" in the 1,5-AF group after treatment. Together, our findings indicate that 1,5-AF has some effects on reducing post-intervention mental stress levels.

Reliability generalization meta-analysis of the Athens Insomnia Scale and its translations: Examining internal consistency and test-retest validity

The Athens Insomnia Scale (AIS) is a widely used self-report measure to evaluate insomnia symptoms based on the International Classification of Diseases criteria version 10 (ICD-10). Despite its extensive use in clinical and research settings, the reliability of the AIS has not been systematically investigated. This systematic review reports a reliability generalization meta-analysis study to assess the internal consistency and the test-retest reliability of the AIS across various populations and settings. A systematic literature search was conducted to identify studies reporting Cronbach's alpha and test-retest coefficients for the AIS. Pooled estimates of reliability, along with moderator analyses, were calculated. The AIS has an excellent internal consistency of 0.84 (95% CI: 0.81 to 0.86), and re-test reliability of 0.86 (95% CI: 0.80 to 0.92). The significant heterogeneity levels support the recommendation that future studies using the AIS include and discuss reliability estimates based on their own data.

Clarifying sleep characteristics and analyzing risk factors of sleep disorders to promote a predictive, preventive, and personalized medicine in patients with burn scars

Purpose

This study assessed sleep quality in patients with burn scars and investigated risk factors of sleep disorders to guide clinical therapy. From the strategy of predictive, preventive, and personalized medicine (PPPM/3PM), we proposed that risk assessment based on clinical indicators could prompt primary prediction, targeted prevention, and personalized interventions to improve the management of sleep disorders present in patients with burn scars.

Methods

This retrospective study recruited patients with burn scars and healthy volunteers from the Shanghai Burn Treatment Center between 2017 and 2022. Relevant information and data, including demographic characteristics, scar evaluation, and sleep quality, were obtained through the hospital information system, classical scar scale, and self-report questionnaires. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and monitored using a cardiopulmonary-coupled electrocardiograph. Pain and pruritus were assessed using the visual analog scale (VAS). Scar appearance was assessed using the modified Vancouver scar scale (mVSS).

Results

The sample was comprised of 128 hypertrophic scar (HS) patients, with 61.7% males, a mean age of 41.1 ± 11.6 years, and burn area of 46.2 ± 27.9% total body surface area (TBSA). Patients with PSQI ≥ 7 accounted for 76.6%, and the global PSQI score was 9.4 ± 4.1. Objective sleep data showed that initial enter deep sleep time, light sleep time, awakening time, light sleep efficiency, and sleep apnea index were higher but deep sleep time, sleep efficiency, and deep sleep efficiency were lower in HS patients than that in healthy controls. Preliminary univariate analysis showed that age, hyperplasia time of scar, narrow airway, microstomia, VAS for pain and pruritus, and mVSS total (comprised of pigmentation, vascularity, height and pliability) were associated with the PSQI score (p < 0.1). Multivariable linear regression showed narrow airway, VAS for pain and pruritus, and mVSS specifically height, were the risk factors for PSQI score (p < 0.1).

Conclusions

This study model identified that narrow airway, pain, pruritus and scar appearance specifically height may provide excellent predictors for sleep disorders in HS patients. Our results provided a basis for the predictive diagnostics, targeted prevention, and individualized therapy of somnipathy predisposition and progression of HS patients in the setting of PPPM/3PM health care system, which contributed to a paradigm shift from reactive cure to advanced therapy.

An Analysis by State on The Effect of Movement Control Order (MCO) 3.0 Due to COVID-19 on Malaysians’ Mental Health: Evidence from Google Trends

Due to significant social and economic upheavals brought on by the COVID-19 pandemic, there is a great deal of psychological pain. Google Trends data have been seen as a corollary measure to assess population-wide trends via observing trends in search results. Judicious analysis of Google Trends data can have both analytical and predictive capacities. This study aimed to compare nation-wide and inter-state trends in mental health before and after the Malaysian Movement Control Order 3.0 (MCO 3.0) commencing 12 May 2021. This was through assessment of two terms, “stress” and “sleep” in both the Malay and English language. Google Trends daily data between March 6 and 31 May in both 2019 and 2021 was obtained, and both series were re-scaled to be comparable. Searches before and after MCO 3.0 in 2021 were compared to searches before and after the same date in 2019. This was carried out using the differences in difference (DiD) method. This ensured that seasonal variations between states were not the source of our findings. We found that DiD estimates, β_3 for “sleep” and “stress” were not significantly different from zero, implying that MCO 3.0 had no effect on psychological distress in all states. Johor was the only state where the DiD estimates β_3 were significantly different from zero for the search topic ‘Tidur’. For the topic ‘Tekanan’, there were two states with significant DiD estimates, β_3, namely Penang and Sarawak. This study hence demonstrates that there are particular state-level differences in Google Trend search terms, which gives an indicator as to states to prioritise interventions and increase surveillance for mental health. In conclusion, Google Trends is a powerful tool to examine larger population-based trends especially in monitoring public health parameters such as population-level psychological distress, which can facilitate interventions.