Anxiety, stress, depression, and psychosocial functioning of Indian adolescents

Effect of Yoga Therapy on Hypothyroidism: A Systematic Review

Background

Hypothyroidism (HT) is the most prevalent endocrine disorder, affecting approximately one in 10 out of 35 adults, with a higher prevalence in females and the elderly.

Purpose

This systematic review (SR) aimed to discuss the effects of yoga on markers and comorbid conditions of HT.

Methods

The SR was registered with the PROSPERO (PROSPERO 2022 CRD42022312990). Google Scholar, PubMed, Cochrane, and EMBASE were searched for the relevant English language interventional studies published from 31 December 1947 to 31 December 2023 by using the keywords 'meditation OR breath regulation OR yoga OR yoga nidra AND hypothyroidism OR hypothyreosis OR underactive thyroid OR low thyroid'. Of the 4078 screened studies, eight eligible studies (three RCTs, two pilot studies, two pre-post trials, and one case study) with 421 HT patients (392 females and 29 males) and three to six-month yoga interventions were included. Two independent review authors extracted study characteristics and synthesised them descriptively. RCTs and NRSIs were assessed for risk-of-bias (RoB) using Cochrane tools RoB2 and ROBINS-1.

Results

The findings suggest that yoga effectively improves the thyroid profile, lipid profile, heart rate variability, pulmonary functions, anxiety, depression, and quality of life among HT patients.

Conclusion

Yoga may be an inexpensive add-on preventive and therapeutic option for HT. The clinical and methodological heterogeneity among the studies did not allow for meta-analysis (MA). Well-designed MAs are warranted by including rigorous RCTs to draw valid conclusions and defined mechanisms regarding the efficacy of yoga practices/interventions on HT.

Factors associated with generalized anxiety disorder in adolescents with cultural diversity: secondary data analysis

BACKGROUND

The number of culturally diverse adolescents in South Korea has reached 290,000 and is increasing every year; however, they still represent only 2.5% of the total adolescent population in middle and high schools, making them a minority. Adolescents experiencing cultural diversity are psychologically vulnerable because they grow up in bicultural environments and experience prejudice. Given the nature of generalized anxiety disorder, which can be exacerbated by stress, these adolescents may face an increased risk of developing the disorder not only because of developmental stress but also because of the stress of cultural adaptation. To identify the prevalence of generalized anxiety disorder among adolescents with cultural diversity, we analyzed related factors. Based on the results, strategies have been proposed to reduce anxiety in adolescents with cultural diversity and generalized anxiety disorders.

METHODS

This study used data from the 16th - 18th Korea Youth Risk Behavior Survey. Factors associated with generalized anxiety disorders were identified based on the social determinants of the health framework. Statistical analyses were conducted using IBM SPSS 25.0, and statistical methods were used for complex samples.

RESULTS

Among adolescents with cultural diversity, 12.8% exhibited generalized anxiety disorders. Among the structural factors, economic status, mother's education level, and gender were significantly associated with the disorder, whereas among the psychosocial factors, suicidal ideation, depressive mood, loneliness, perceived stress level, and subjective health status were significant factors influencing it.

CONCLUSION

The factors identified in our research can be used as a resource for the early identification of culturally diverse adolescents who are vulnerable to generalized anxiety disorders. To prevent generalized anxiety disorder among adolescents with cultural diversity, school or community nurses can implement interventions to reduce loneliness or stress management programs.

Insomnia in teachers at the time of resumption of in-person instruction at schools amidst the COVID-19 pandemic: A cross-sectional study

BACKGROUND

The coronavirus (COVID-19) pandemic has affected people's economies, lifestyles, and physical, emotional, and sleep health. This research aimed to estimate the prevalence of insomnia and symptoms of stress, anxiety, and depression among teachers with the resumption of in-person instruction at schools following a hiatus after COVID-19 lockdowns in India. We also studied the association of teachers' insomnia with psychological symptoms and demographic variables.

METHODS

We conducted a cross-sectional survey between October -November 2021 after schools had reopened during the COVID-19 pandemic. Data was collected using standard questionnaires online among schoolteachers. We explored the association of insomnia with teachers' symptoms of stress, anxiety, depression, sex, school boards, and age groups.

RESULTS

Of 124 schoolteachers surveyed, the prevalence of insomnia was 37.9% (subthreshold in 25% and clinical in 12.9%). The prevalence of stress, depression, and anxiety was 20.2%, 30.6%, and 45.2%, respectively. There was a significant association (p<0.001) of insomnia with symptoms of anxiety, stress, and depression in univariate analysis. On multivariate analysis, we found that those feeling stressed had a 6.4 times higher risk of insomnia (95% CI: 1.5-28.3, p - 0.01). There was no association of insomnia with age, sex, school educational boards, and type of institution.

CONCLUSIONS

Over one-third (37.9%) of teachers reported having trouble sleeping when they returned to the school's typical face-to-face instruction modalities through COVID-19 times, and insomnia was more prevalent in those with stress.

Prevalence and correlates of depression, anxiety, and stress among adolescents in urban and rural areas of Mysuru, South India

Background

Adolescence, a volatile period of growth between the ages of 10 and 19, is associated with increased vulnerability to mental health problems. Factors such as academic pressure can contribute to these challenges.

Objectives

The current study aimed to evaluate the factors and prevalence of depression, anxiety, and stress among adolescents in the urban and rural areas of Mysuru district.

Materials and Methods

A cross-sectional study was conducted in private high schools in both urban and rural regions. Prior permission and informed consent were obtained from participants and their legal guardians aged 18 years and older.

Results

The gender distribution in urban areas was 60.2% female and 39.8% male, while in rural areas, it was 51% male and 49% female. The prevalence of depression was higher in rural (39.3%) than in urban areas (24.2%), while anxiety was more prevalent in urban (50.6%) than in rural areas (49%). Stress was also more common in rural (16.6%) than urban adolescents (14.6%). Factors significantly associated with mental health outcomes included monthly family income, parenting practices, academic pressures, and self-esteem. Key needs identified were mobile mental health applications, online counseling services, and access to school counselors.

Conclusion

This study provides insights into the prevalence and correlates of common mental health issues among adolescents in this region of South India. The findings emphasize the necessity of providing mobile applications and offline counseling services to effectively support and meet the needs of adolescents in these settings.

Bodily sensations and quality of life in adolescents with non-cardiac chest pain: a comparative study for the undetermined part of a frequent health problem

BACKGROUND

Chest pain in adolescents represents a considerable burden for health services and is rarely associated with cardiac disease. Since chest pain could be related to psychosocial factors there is a need for exploring the relationships among stressful situations, drug consumption, suicidal behaviors, accompanying bodily symptoms and health-related quality of life in adolescents with non-cardiac chest pain.

METHODS

In this study, we assessed these determinants in 108 adolescents with non-cardiac chest pain (NCCP) and a control group of 77 patients using a structured interview applied to the patients presented to the cardiology outpatient clinics of Tepecik Training and Research Hospital, İzmir, Türkiye, between 30 October 2018 and 30 June 2019. After the interview, the adolescents were given a self-administered pediatric quality of life inventory and the body sensations questionnaire for assessing aspects of fear.

RESULTS

Adolescents with NCCP expressed more panic associated bodily symptoms and reported worse subjective physical, academic, and emotional functioning in addition to more suicidal ideation.

CONCLUSIONS

NCCP could be accepted as a warning sign of an underlying psychosocial problem and requires a more interdisciplinary collaborative care by pediatricians, psychologists, and psychiatrists.

Post-quarantine anxiety and depression levels of COVID-19 positive patients, Northern Cyprus

Background

The COVID-19 Pandemic, which started to be seen in Northern Cyprus (NC) as of March 2020, has affected the psychological mood of many people in our country as well as all over the world.

Objectives

It was aimed to evaluate the post-illness anxiety and depression levels of people who were diagnosed with COVID-19 positive, completed the quarantine period and then received a negative PCR report.

Methods

Through the questionnaire used in the study carried out between 1-30 April 2021, the sociodemographic characteristics of the participants and their personal experiences about COVID-19 were questioned and they were asked to answer the questions about the hospital anxiety and depression (HAD) scale.

Results

The average score of the participants (n=120) in the HAD scale was determined as 11.66±5.90. According to the average scores of the scale, the anxiety and depression levels of the patients fall into the category of '11 and above abnormal'. The patients' general average scores of anxieties were 6.20±3.48 (normal) and depression was 5.46±3.55 (normal).

Conclusion

Although it was determined that the HAD scores of the individuals from NC infected with COVID-19 were not high, most of them needed psychological support as they stated in their own statements.

The Validation of Beck's Depression Inventory in Patients With Systemic Diseases: A Psychometric Study at a Dental Institute

Background Depression seriously threatens the world's public health, manifesting symptoms like loss of interest, fatigue, guilt, and impaired focus. Major depressive disorder is a common problem for those with chronic systemic illnesses. Since this illness has an impact on psychosocial well-being and interacts with anxiety and stress, it is crucial to assess psychological functioning. Depression-related issue has a negative impact on oral health and can cause cognitive dysfunction, social interaction problems, and low self-esteem. For the purpose of identifying and effectively managing depression in patients with systemic illnesses undergoing dental procedures, screening tools like the Beck's Depression Inventory (BDI) were used. The BDI's benefits include its strong internal consistency, sensitivity to change, broad concept validity, adaptable criteria validity for separating depressed and nondepressed people, and global dissemination. Materials and methods A cross-sectional prospective study was carried out after receiving the necessary institutional ethical approvals, and the participant's agreement was also obtained. The questionnaire was explained to the patients. The entire participation was voluntary. Results In the current study patient's ages ranged from 34 years to maximum age of 83 years with a mean age of 59.70±13.16 years, with 40% of the population falling into the 51-65 years age group. According to the results, participants who had multiple systemic disorders were more likely to experience depression than people who had one systemic illness. The chi-square test showed no statistically significant results between the depression scores and the number of systemic diseases (p-0.574). Seventy-five per cent of individuals with depression required tooth extractions. Conclusion Those with systemic disorders who were receiving dental care in the current study showed elevated levels of depression. An important finding was the correlation between depression and tooth extraction, highlighting the need for proactive mental health assessments in dental care. Tailored interventions can mitigate the impact, enhancing the holistic well-being of patients suffering from systemic diseases and depression.

Prevalence and risk factors for falls in community-dwelling older population in Kerala; results from a cross sectional survey

Background

Falls and their incapacitating effects are a significant concern for older people, especially in low- and middle-income countries. Falls are a significant concern among older people which requires immediate public health action. The current study examines multiple fall risk factors among community-dwelling older people in Kerala, India, to devise prevention strategies.

Methods

A cross-sectional survey was conducted between April and May 2020 among the community-dwelling older population aged 60 and above. Data was collected through door-knock surveys using standardized scales. Fall history and associated risks were the primary outcome variables, whereas behavioral and cognitive risk factors of depression, anxiety and stress were the other factors.

Results

The study included 301 older people (aged over 60) from 573 households and found the prevalence of falls in the last year was 37.5%. Older women with moderate levels of physical activity, cognitive symptoms of anxiety and stress, and who are unemployed had higher chances of falls risk. Further, older people with higher functional disability and average and below self-rated health had higher chances of fall risk in the current population. Anxiety was the only significant risk factor which was statistically significant in multiple regression model.

Conclusion

The older population with a combined risk of behavioral and cognitive factors is at higher odds of fall-related risk in Kerala.

Depression, sleep, body image, and lifestyle: Prevalence and associated factors of depression among school-going adolescents in Delhi National Capital Region

Background

Adolescents are known to be vulnerable to depression, which worsened during the COVID-19 pandemic. They also exhibit poor sleep quality and body image issues (BIIs) which are considered risk factors for depression. There is a paucity of Indian studies regarding adolescent depression and its correlation with lifestyle.

Aims

To detect the prevalence of depression in adolescents, and understand its association with sociodemographic variables, sleep quality, BIIs, and lifestyle factors.

Materials and Methods

A cross-sectional study was conducted among 392 adolescents attending classes 8th-12th in two schools in Delhi National Capital Region. A pre-tested semi-structured questionnaire was used to collect sociodemographic and lifestyle data. Depression anxiety stress scale-21 was used to detect depression. Pittsburgh Sleep Quality Index and Stunkard Figure Rating Scale were used to evaluate sleep quality and BIIs. Data was analyzed using Statistical Package for Social Sciences Version-25.

Results

Depression was present in 40.3% of students. It was more common in girls, older students, students in higher classes, who lacked siblings and whose mothers were engaged in professions as well as those with BIIs. However, after multivariate analysis, the association of depression with poor sleep quality, meal skipping, lack of exercise, family history of mental illness, and inverse association with open discussion of one's thoughts and worries with family remained significant.

Conclusions

Depression is common among adolescents and shows associations with poor sleep quality and lifestyle choices. Awareness of these associations may enable better screening and early intervention for vulnerable adolescents.

Social-emotional issues among children with strabismus higher than among non-strabismus children in Western India

Purpose

Data on social-emotional aspects among children with strabismus in India are scanty. We compared the emotional symptoms (ES), loneliness and social dissatisfaction (LSD), and self-esteem (SE) and their associated risk factors among children with and without strabismus in India.

Methods

A cross-sectional case-control study design was used to recruit 101 children with strabismus aged 8 to 18 years and a control group of 101 children that were age- and gender-matched. Interviews were performed using standardized scales to assess ES, LSD, and SE. Variations in the intensity of ES, LSD, and SE were assessed using multiple classification analysis (MCA).

Results

A total of 202 children participated in the study. The mean ES, LSD, and SE scores were 3.4 (standard deviation [SD] 1.9), 48.4 (SD 3.2), and 22.1 (SD 3.8) for the strabismus group and 1.8 (SD 1.5), 33.3 (SD 3), and 31.3 (SD 2) for the non-strabismus group, respectively. Among the strabismus group, the highest levels of mean ES, LSD, and SE scores were observed among children facing problems in performing daily tasks. Amongst the non-strabismus group, children studying at the primary level and those facing neglect had the highest mean scores. In MCA, being affected with strabismus had the highest effect on the intensity of ES, LSD, and SE with a beta (β) value of 0.223 (P = 0.016), 0.922 (P < 0.001), and 0.853 (P < 0.001).

Conclusion

A significantly high proportion of children with strabismus deal with elevated levels of ES, LSD problems, and low SE as compared with non-strabismus children, highlighting the need to address the poor social-emotional health of children.

Protective Role of Social Networks for the Well-Being of Persons with Disabilities: Results from a State-Wide Cross-Sectional Survey in Kerala, India

The current study presents the findings from a cross-sectional survey on social factors associated with the well-being of persons with disabilities (PWDs) in Kerala, India. We conducted a community-based survey across three geographical zones, North, Central, and South of Kerala state, between April and September 2021. We randomly selected two districts from each zone using a stratified sample method, followed by one local self-government from each of these six districts. Community health professionals identified individuals with disabilities, and researchers collected information on their social networks, service accessibility, well-being, and mental health. Overall, 244 (54.2%) participants had a physical disability, while 107 (23.78%) had an intellectual disability. The mean well-being score was 12.9 (S.D = 4.9, range = 5-20). Overall, 216 (48%) had poor social networks, 247 (55%) had issues regarding service accessibility, and 147 (33%) had depressive symptoms. Among the PWDs with issues with service access, 55% had limited social networks. A regression analysis revealed that social networks (b = 2.30, p = 0.000) and service accessibility (b = -2.09, p = 0.000) were associated with well-being. Social networks are more important than financial assistance because they facilitate better access to psycho-socioeconomic resources, a prerequisite for well-being.

Returning to work at school during the COVID -19 pandemic, is it stressful for schoolteachers? Assessment of immediate psychological effects: a cross sectional study

Background: The adoption of remote classes for students has been in vogue since the onset of the pandemic. Schools reopened in a phased manner after the second wave of coronavirus disease 2019 (COVID-19) in India. Reverting to the regular face-to-face teaching for students became a challenge to the teachers and students, especially at times when there was an impending third wave on the way. The study aimed to assess the presence of symptoms of depression, anxiety, and stress in teachers who attended reopened schools in the scenario of face-to-face classes. In addition, we studied the association of psychological symptoms with teachers' age groups, gender, school boards, and school institution type. Methods: A cross-sectional study was conducted between October to December 2021 after schools had reopened. Data was collected using Google Form questionnaires in 124 schoolteachers. The Depression, Anxiety, and Stress Scale - 21 Items (DASS-21) questionnaire assessed the psychological symptoms. Results: Of 124 schoolteachers, 108(87.1%) were female, 112 (90.3%) were from private institutions, and 70(56.5%) were from Central Board of Secondary Education (CBSE) school boards. The prevalence of depression, anxiety, and stress in teachers was 30.6%, 45.2%, and 20.2%, respectively. Nearly 80% of the female teachers expressed depression, anxiety, and stress symptoms. Amongst all the age groups, symptoms were higher in 40-49 group. We found anxiety to be statistically significant when compared with gender (p-0.042). We found no statistically significant differences concerning age groups, school boards, or school institutions with any psychological symptoms. Conclusions: The prevalence of psychological symptoms was high among schoolteachers after schools reopened for regular face-to-face teaching. Gender was associated with anxiety in teachers. We agree that identifying teachers' symptoms and providing adequate psychological counseling/support would improve their mental health status and thereby the quality of teaching to students.

Returning to work at school during the COVID -19 pandemic, is it stressful for schoolteachers? Assessment of immediate psychological effects: a cross sectional study

Background: The adoption of remote classes for students has been in vogue since the onset of the pandemic. Schools reopened in a phased manner after the second wave of coronavirus disease 2019 (COVID-19) in India. Reverting to the regular face-to-face teaching for students became a challenge to the teachers and students, especially at times when there was an impending third wave on the way. The study aimed to assess the presence of symptoms of depression, anxiety, and stress in teachers who attended reopened schools in the scenario of face-to-face classes. In addition, we studied the association of psychological symptoms with teachers' age groups, gender, school boards, and school institution type. Methods: A cross-sectional study was conducted between October to December 2021 after schools had reopened. Data was collected using Google Form questionnaires in 124 schoolteachers. The Depression, Anxiety, and Stress Scale - 21 Items (DASS-21) questionnaire assessed the psychological symptoms. Results: Of 124 schoolteachers, 108(87.1%) were female, 112 (90.3%) were from private institutions, and 70(56.5%) were from Central Board of Secondary Education (CBSE) school boards. The prevalence of depression, anxiety, and stress in teachers was 30.6%, 45.2%, and 20.2%, respectively. Nearly 80% of the female teachers expressed depression, anxiety, and stress symptoms. Amongst all the age groups, symptoms were higher in 40-49 group. We found anxiety to be statistically significant when compared with gender (p-0.042). We found no statistically significant differences concerning age groups, school boards, or school institutions with any psychological symptoms. Conclusions: The prevalence of psychological symptoms was high among schoolteachers after schools reopened for regular face-to-face teaching. Gender was associated with anxiety in teachers. We agree that identifying teachers' symptoms and providing adequate psychological counseling/support would improve their mental health status and thereby the quality of teaching to students.

Antenatal depressive symptoms and behavioral outcomes in children at 78 months: A study from South India

Background

Low and middle income countries report a higher prevalence of antenatal depression. The association between antenatal depressive symptoms and behavioral outcomes in children at 78 months in motherchild dyads who participated in a randomized control trial of maternal B12 supplementation during pregnancy was examined in this study.

Methods

Children of 140 women, out of 366 who had participated in the placebo-controlled, randomized trial of vitamin B12 supplementation during pregnancy and 6 weeks post-partum, on whom serial assessments of depressive symptoms in each of the trimesters were done using the Kessler's 10 Psychological Distress Scale (K10), were assessed using the Strength and Difficulties Questionnaire (SDQ) at 78 months.

Results

Thirty seven women (26.4%) reported depressive symptoms at one trimester (intermittent group) and 28 women (20%) had depressive symptoms in at least 2 trimesters (persistent group). On adjusted bivariate regression analysis, children of women with intermittent antenatal depressive symptoms scored lower on the prosocial behavior subscale of SDQ compared to children of mothers with no depressive symptoms ( B=;-0.91, 95% CI: -1.65,-0.18; p=0.016).

Limitations

The use of a screening measure to assess maternal depression, the assessment of the children's behavior based only on the mothers' reports and the small number of women with persistent depressive symptoms in our sample is important limitations.

Conclusions

The possible association between antenatal depressive symptoms and prosocial behavior in children point to the need for routine assessment and intervention for emotional disorders during pregnancy.

The Social and Emotional Learning and Orientation Scale - Development and Validation of a Brief Measure in Hindi

Accumulating evidence of the impact of social and emotional learning (SEL) on student well-being as well as academic performance has led to an increased interest in understanding and measuring SEL in students. However, most existing measures have been developed in English and there is a paucity of culturally relevant measures in other languages. In this study, we present a short, culturally sensitive 8-item scale in Hindi entitled the Social and Emotional Learning and Orientation Scale (SELOS). Factor structure of SELOS was established through exploratory ( N=2844; Mage=14.65 years) and confirmatory factor analysis ( N=1508; Mage=14.50 years) with responses from 4352 Hindi-speaking students in India. The scale demonstrated a two-factor structure, with good reliability, discriminant validity and partial measurement invariance across gender. These results provide encouraging evidence for conducting culturally sensitive studies of SEL in India and in other Hindi-speaking parts of the world.

The Relationship of Family and School Environments with Depression, Anxiety, and Stress Among Jordanian Students: A Cross-Sectional Study

INTRODUCTION

Depression, anxiety, and stress are highly prevalent among adolescents. The role of impaired family and school environments in adolescents' depression, anxiety, and stress in Jordan has yet to be established.

OBJECTIVE

The purpose of this study was to explore the association of family and school environments with the depression, anxiety, and stress of adolescents in Jordan.

METHODS

A cross-sectional correlational survey was used. A sample of 220 adolescents aged 12-18 years completed the study. Data were collected about family and school environments and adolescents' depression, anxiety, and stress.

RESULTS

School climate had a strong significant relationship with both general family functioning (r = .53, p < 0.01) and family process (r = .58, p < 0.01). General family functioning and school climate were uniquely associated with stress, anxiety, and depression (Β = -.280 or higher), p < 0.05, controlling for demographics.

CONCLUSION

The general family functioning and overall school climate were shown to play important role in adolescents' depression, anxiety, and stress. School nurses and psychiatric nurses may want to respond to the needs of adolescents with depression, anxiety, and stress through campaigns, lectures, and conferences and encourage them to access professional psychological counseling.

The role of parent-to-child maltreatment in the pathway of self-reported depressive symptoms in Pakistani adolescents

Background

Parent-to-child maltreatment has been demonstrated to drastically affect a child’s mental well-being and plays a significant role in developing depressive symptoms. However, little is established about the effect of frequency of parent-to-child maltreatment on the development of depressive symptoms among Pakistani adolescents.

Methods

A longitudinal prospective study was conducted, from 2015 to 2017, with 800 adolescents aged 11–17 years old recruited from 32 systematically selected urban and peri-urban areas of Karachi. First, these adolescents were screened for parent-to-child maltreatment in 2015 in a cross-sectional survey. Children with diagnosed psychiatric conditions were excluded from the study. In the second phase, these individuals were followed for 2 years to investigate the symptoms of depressive disorder using a validated tool, “CES-D (Center for Epidemiological Studies) Depression scale.” The Cox proportional algorithm was used to examine the relationship between the frequency of parent-to-child maltreatment and depressive symptoms.

Results

Approximately 11% of frequently, 9% of occasionally parent-to-child, and 7%of negligibly maltreated adolescents reported depressive symptoms over 2 years. The other significant predictors of depressive symptoms were no formal education of the child (RR: 3.15, 95% CI: 1.35–7.34), presence of stressful home environment (RR: 2.19, 95% CI: 1.22–3.94), and having both uneducated parents (RR: 1.70, 95% CI: 0.90–3.21). The frequently maltreated females were found to have 4 times the higher risk compared to rarely maltreated males. In addition, frequently maltreated males were twice likely to develop depressive symptoms.

Conclusion

The results suggested that frequent parent-to-child maltreatment occurring during childhood leads to the development of depressive symptoms later in the adolescence period. Thus, there is a dire need for interventions to raise awareness among the society on the issue of parent-to-child mistreatment to minimize later mental health consequences.

The Effect of Mental Health Status on the Quality of Life of Faculty of Medicine Students during the Pandemic Coronavirus Disease 2019 Period

BACKGROUND: The spread of Coronavirus Disease 2019 (COVID-19) disease which has not been balanced with effective protocols can create mental health problems which could affect the quality of life; as of today, there is not any research that examines the influence of both factors. AIM: This study purpose was to analyze the mental health status on the quality of life amongst medicine students during COVID-19 period. METHODS: This is a cross-sectional survey on 361 students from Faculty of Medicine Tanjungpura University. This study was conducted from June 2019 to November 2020 by spreading Depression Anxiety Stress Scale questionnaire and a WHOQOL-BREF questionnaire through online. The data analysis was administered using Kruskal–Wallis statistics. RESULT: The students’ mental health status was dominantly on the normal category with depression domain by 323 students (89.5%), anxiety domain by 311 students (86.1%), and stress domain by 343 students (95%). The quality of life measurement was in category medium in all domains which are physical health (88.6%), psychological health (92.5%), social relationships (50.7%), and environment (78.7%). There was significant effect of mental health status of depression and anxiety toward the aspect of physical health, psychological health, and social relationships (p < 0.05). Stress significantly influenced all domains of quality of life, and there was no significant effect of mental health status domain depression (p = 0.051) and anxiety (p = 0.881) toward the environment aspect. CONCLUSION: Students’ mental health status in this research belongs to the category normal with moderate level in quality of life. To compare, there was a significant effect of mental health status toward the quality of life domains. The good application of self-coping mechanisms and the social encouragement from the environment is suitable intervention strategies during the pandemic COVID-19 period.

Mental Health Status, Coping Strategies During Covid-19 Pandemic Among Undergraduate Students of Healthcare Profession

The present study aimed to assess the prevalence of psychological distress, associated lifestyle behaviors, and associated coping strategies among the students of healthcare profession. A total of 588 medical, dental, and nursing students studying in institutes of health sciences, KIIT University, Bhubaneswar, India participated in this cross-sectional online survey during September-October, 2020. A semi-structured questionnaire, DASS-21questionnaire, and Brief COPE were used to collect relevant information. The proportion of students experiencing symptoms of depression, anxiety, and stress was 26.2%, 27.7%, and 9.7%, respectively. Body mass index, presence of comorbidity, and soft drink consumption were significantly associated with psychological distress. Students experiencing psychological distress were applying emotion-focused coping behaviors (venting, acceptance, self-blame, substance use, religion) and avoidant coping behaviors (self-distraction, behavioral disengagement, denial). The prevalence of psychological distress among the students of health profession studying in KIIT University of Bhubaneswar during the period of Covid-19 pandemic is low and it can be further lowered by designing appropriate interventions incorporating healthy lifestyle behaviors and suitable coping strategies thereby ensuring sound mental health of these students.

Effectiveness of Yoga Nidra in reducing stress in school going adolescents: An experimental study

BACKGROUND AND OBJECTIVES

Academic stress can exert severe stress in adolescents answering their career deciding board exams. The present study attempted to understand the efficacy of Yoga Nidra (YN) in mitigating psychosocial stress.

DESIGN

and Methods: This study was carried on 10th-grade students (ages 14 to 16) and had two arms, one performing YN (experimental) and the other without YN (control) for 21 consecutive days. Modified Adolescent Stress Questionnaire (ASQ-I) was used to assess the stress in the students before and after the intervention.

RESULTS

The results indicate that performing YN was effective and significantly decreased the total stress (P < 0.001) and vital domains like the stress of home life (P < 0.005), school performance (P < 0.026), teacher interaction (P < 0.024), future uncertainty (P < 0.001), school and leisure conflict (P < 0.001). Also, at the end of the study in control, low and moderate stress was observed in 58.06% and 41.93%, while in the YN group, it was 96.15% and 3.85% and was statistically significant (p < 0.001).

CONCLUSIONS

This study shows that YN effectively reduced psychosocial stress in adolescents and could be useful in school curriculum.

Effect of yoga on depression in hypothyroidism: A pilot study

Background

The prevalence of hypothyroidism among Indian women is 15.8%. Depression is frequently reported in hypothyroidism. Yoga is an effective intervention for depression. However, the influence of yoga on depression in patients with hypothyroidism has not been studied.

Aim

The present study investigated the effect of a 3-month integrated yoga intervention (3-IY) on depression, lipid indices, and serum thyroid-stimulating hormone (sTSH) levels among female patients having hypothyroidism, and mild-to-moderate depression.

Method

The present single-arm pre-post design study was conducted in thirty-eight women (average age 34.2 ± 4.7 years). Participants received a 3-IY comprising asanas, pranayama, and relaxation techniques for 60 min daily (5 days a week). Depression, sTSH, lipid profile indices, Body Mass Index (BMI), fatigue, anxiety, and stress were assessed at baseline and after 12 weeks. Thyroid medication was kept constant during the study period. Data were analysed using R Studio software.

Result

A significant (P < 0.05) reduction in depression (58%), sTSH (37%), BMI (6%), fatigue (64%), anxiety (57%), lipid profile indices (HLD increased significanty), and stress (55%) levels was observed after 3 months, compared with the corresponding baseline levels.

Conclusion

The 3-IY is useful for reducing depression, dyslipidemia, and sTSH in women with hypothyroidism and depression. Further studies with a larger sample size and a robust research design using objective variables must be conducted to strengthen the study findings.

Social and behavioural risk factors in the prevention and management of cardiovascular disease in Kerala, India: a catchment area population survey

BACKGROUND

Cardiovascular disease (CVD) is the leading cause of mortality in India. Social and behavioural factors are strongly interrelated in the prevention and control of CVD. The ability to make lifestyle changes to control hypertension and diabetes (major risk factors for CVD) is determined by factors such as education, gender, caste, poverty, and urbanicity. This study aimed to improve our understanding of the inter-relationship of social and behavioural factors in the management of elevated serum glucose and high blood pressure and co-morbid mental health conditions.

METHODS

A population-based catchment area cross sectional survey was conducted in Kerala, India. Data were collected from residents aged over 30 years (n = 997) using standardized tools and clinical measures. We performed latent class analysis incrementally to extract homogeneous latent classes of individuals based on their responses to social and behavioural risk factors in the survey. Using structural equation models, we assessed the mediating effect of depression and anxiety, and social or behavioural risk factors, on management of high blood pressure and raised serum glucose levels.

RESULTS

The prevalence of high blood pressure and blood glucose in the sample was 33 and 26% respectively. Latent class analysis found three clusters of risk factors. One had a predominance of behavioural characteristics, another of social risk factors and the third was a low risk group. Age, female sex, and marital status had an effect on high blood pressure and high glucose, though were mediated by mental health, social and behavioural risk factors.

CONCLUSIONS

Interventions to improve the management of risk factors for CVD need to address social risk factors and be sensitive to the needs of population sub-groups that may require additional support to access health services. An integration of social and health services may be required to achieve this.

Confirmatory factor analysis of the Depression, Anxiety, and Stress Scale among Indian adults

BACKGROUND

The Depression, Anxiety, and Stress Scale (DASS) is a widely used measure of negative emotional states. While the DASS is increasingly used in mental health research in India, to date no study has examined the factor structure among Indian adults.

METHODS

A large community sample of English-speaking Indian adults completed the DASS 21-item version, and confirmatory factor analyses were conducted.

RESULTS

The results indicated a good fit for a three factor (depression, anxiety, and stress) and a one-factor model (general psychological distress). There was no substantial difference between the fit of the models, and the DASS subscales were very strongly correlated with one another (r ≥ .80).

CONCLUSION

The findings from this sample suggest that the DASS-21 items appear to assess general psychological distress, with little evidence that the items assess three distinct subscales.

Depression among undergraduate medical and engineering students: A comparative study

OBJECTIVE

To study the depression among medical and engineering students of different medical and engineering colleges in Karachi, Pakistan.

METHODS

A comparative cross-sectional study was conducted at different medical and engineering colleges of Karachi from 1st March 2018 till 30th August 2018. Sample size of 362 was calculated by using software SPSS version 22. A close ended, self-administered, modified form of standardized questionnaire was used which comprised of two parts. First part included collection of socio-demographic data, second part had questions for the assessment of depression. Hamilton Depression Scale (HAM-D) was utilized in scoring the depression level in the study subjects.

RESULTS

In engineering and medical colleges 82.87% and 56.9% students were found depressed repeatedly. The result was highly statistically significant. Overall, 109 (30.1%) students were normal, 114 (31.5%) were suffering from mild, 67 (18.5%) moderate, 32 (8.8%) severe and 40 (11.0%) had very severe depression.

CONCLUSION

In the present study, rate of depression was higher in engineering students as compared to medical students. It is recommended in future that qualitative studies of the causes of depression reducing interventions need to be encouraged in professional program, especially in engineering students.

Prevalence and Profile of Bullying Involvement among Students of Rural Schools of Anand, Gujarat, India

BACKGROUND

Bullying can have short- and long-term implications on physical as well as mental health. The objective of this study was to assess the prevalence of bullying involvement (bully, victim, and bully-victim) and know profiles of bullying among students of rural schools of Anand, Gujarat, in Western India.

MATERIALS AND METHODOLOGY

A questionnaire in the Gujarati language was administered to sixth to tenth graders of 12 rural schools (n = 2552) in the Anand district. The questionnaire included four questions each to screen for bullying behavior and victim experiences; Peer Interaction in Primary Schools Questionnaire (PIPSQ, a self-reported measure of individuals' levels of bullying behaviors and victimization experiences), and Strength and Difficulties Questionnaire (SDQ, to assess emotional, behavior, and interpersonal difficulties experienced), apart from demographic information. The analysis of variance (ANOVA)/Chi-square test was applied to determine associations.

RESULTS

Prevalence of bullying involvement was 70% (n = 1529; 9.1% bullies, 18.6% victims, and 42.3% bully-victims). The prevalence of bullies was higher in boys (77.5%) compared with girls (58.3%). In addition, the prevalence of victims was higher in boys (67.2%) compared with girls (51%). No association was found between various categories and family type, birth order, number of friends, or grade. Bully-victim was the worst affected group as per the SDQ profile.

CONCLUSIONS

There is a high prevalence of bullying-related involvement compared with earlier studies and a complete lack of bullying prevention policies at the school level. A simple screening strategy, using a few questions to identify bullying-related involvement, is valid and useful. Guidelines need to be devised to standardize future bullying-related research in India.

Application of mindfulness on stress, anxiety, and well-being in an adolescent student: A case study

BACKGROUND

Stress and anxiety are the major problems students face in their lives and specifically in their academic life, which, in turn, has a significant negative impact on their academic performance. There are different approaches to deal with stress and anxiety, for example, cognitive behavioral therapy and relaxation techniques.

OBJECTIVE

The present study was conducted to evaluate the applicability of mindfulness on stress, anxiety, and psychological well-being in an adolescent student.

METHODS

In this study, single-case study design was used. The Pediatric Symptoms Checklist, Youth Self-Report, Institute of Personality and Ability Testing Anxiety Scale, and Checklist of Psychological Well-Being were administered on ten adolescent students. After the initial assessment, one participant was selected who was having significant level of stress, anxiety, and poor psychological well-being. Further detailed assessment was done using the Raven Standard Progressive Matrices, Parents' Observation Checklist, Teachers' Observation Checklist, and Students' Self-Observation Checklist. The student underwent 24 sessions of mindfulness training with a frequency of three sessions in a week. After completion of sessions, post assessment was done. He was re-assessed after 3 months.

RESULTS

After completion of mindfulness training, improvement was observed in stress, anxiety, well-being, and other variables, and the improvement was maintained till follow-up.

CONCLUSION

Mindfulness training has the potential in effectively reducing stress and anxiety and increasing a sense of well-being, but the major barrier is getting fixated with an idea of what's the right way to do mindfulness and feel it.

The effectiveness of a low-intensity problem-solving intervention for common adolescent mental health problems in New Delhi, India: protocol for a school-based, individually randomized controlled trial with an embedded stepped-wedge, cluster randomized controlled recruitment trial

BACKGROUND

Conduct, anxiety, and depressive disorders account for over 75% of the adolescent mental health burden globally. The current protocol will test a low-intensity problem-solving intervention for school-going adolescents with common mental health problems in India. The protocol also tests the effects of a classroom-based sensitization intervention on the demand for counselling services in an embedded recruitment trial.

METHODS/DESIGN

We will conduct a two-arm, individually randomized controlled trial in six Government-run secondary schools in New Delhi. The targeted sample is 240 adolescents in grades 9-12 with persistent, elevated mental health symptoms and associated distress/impairment. Participants will receive either a brief problem-solving intervention delivered over 3 weeks by lay counsellors (intervention) or enhanced usual care comprised of problem-solving booklets (control). Self-reported adolescent mental health symptoms and idiographic problems will be assessed at 6 weeks (co-primary outcomes) and again at 12 weeks post-randomization. In addition, adolescent-reported distress/impairment, perceived stress, mental wellbeing, and clinical remission, as well as parent-reported adolescent mental health symptoms and impact scores, will be assessed at 6 and 12 weeks post-randomization. We will also complete a parallel process evaluation, including estimations of the costs of delivering the interventions. An embedded recruitment trial will apply a stepped-wedge, cluster (class)-randomized controlled design in 70 classes across the six schools. This will evaluate the added effect of a classroom-based sensitization intervention over and above school-level sensitization activities on the primary outcome of referral rate into the host trial. Other outcomes will be the proportion of referrals eligible to participate in the host trial, proportion of self-generated referrals, and severity and pattern of symptoms among referred adolescents in each condition. Power calculations were undertaken separately for each trial. A detailed statistical analysis plan will be developed separately for each trial prior to unblinding.

DISCUSSION

Both trials were initiated on 20 August 2018. A single research protocol for both trials offers a resource-efficient methodology for testing the effectiveness of linked procedures to enhance uptake and outcomes of a school-based psychological intervention for common adolescent mental health problems.

TRIAL REGISTRATION

Both trials are registered prospectively with the National Institute of Health registry ( www.clinicaltrials.gov ), registration numbers NCT03633916 and NCT03630471 , registered on 16th August, 2018 and 14th August, 2018 respectively).

Profile of Bullies and Victims Among Urban School-going Adolescents in Gujarat

OBJECTIVE

To assess the prevalence of bullying, identifying bullies, victims and their associations.

METHODS

Questionnaire having 'Peer Interaction in Primary Schools' and 'Strength and Difficulty Questionnaire' scales, and demographic information was administered to 7th, 8th and 9th graders (N=1106).

RESULTS

Prevalence of bullying was 49%. Boys were more likely to be bullies (P=0.03), whereas students having less friends (P=0.001), overweight/obese (P=0.02), and boys (P<0.001) were more likely to be victims. Association between bullying behavior and poor academic performance was noted.

CONCLUSION

We found high prevalence of bullying. The reasons for the same and scope of intervention needs further study.