Factors Affecting Psychological Distress in Patients with Crohn's Disease: Path Analysis Based on a Common-Sense-Model.

Atrial fibrillation (AF) is a prevalent, life-complicating illness associated with psychological distress. Interventions to manage the psychological challenges of living with AF are needed. Evidence suggests that illness perceptions, coping strategies, and symptoms that contribute to psychological distress may be modified by psychoeducational interventions to reduce psychological distress. However, little is known about how illness perceptions, coping strategies, and symptoms contribute to psychological distress in patients with AF. The aim of this correlational study guided by Levethal's Common Sense Model of Self-regulation was to identify the extent to which illness perceptions, coping strategies, symptom frequency, and symptom severity contributed to psychological distress in patients with recurrent symptomatic AF. The contribution of these factors was considered with respect to the effects of gender, age, type of AF, and time since AF diagnosis. Participants (n = 207; 56% male; 64.2 ± 12.3 years old) completed the Illness Perception Questionnaire-Revised, the COPE Inventory, the Symptom Checklist-Frequency and Severity, and the Profile of Mood States. Data were analyzed using Pearson correlation and hierarchical multiple regression. Illness perceptions contributed most to psychological distress, followed by coping strategies and symptom frequency. Illness perceptions explained the largest portion of the total variance for the following: Tension-Anxiety, 44/56%; Depression-Dejection, 38/50%; Fatigue-Inertia, 43/53%; Confusion-Bewilderment, 41/49%; Vigor-Activity, 24/35%; and Total Mood Disturbance, 47/63%. Illness perceptions of AF as having serious consequences, a psychological cause, and perceived poor understanding of AF together contributed more (.47) to Total Mood Disturbance than did coping by focusing on emotion (.08) or symptom frequency (.06). Illness perceptions are important contributors to psychological distress in patients with AF. Assessment of patients' illness perceptions may reveal those that increase the risk for psychological distress. Research is warranted to evaluate interventions to modify psychological cause and consequence beliefs and to promote understanding of AF.

This study aimed to explore the psychological distress and its predictors among Chinese patients with thyroid cancer during their transitional period from hospital to home. A cross-sectional study was conducted in a cancer hospital in Tianjin, China. A total of three hundred patients with thyroid cancer completed the Chinese version of the National Comprehensive Cancer Network Distress Thermometer (DT), Cancer Fatigue Scale, and the Brief Illness Perception Questionnaire. Logistic regression was used to obtain the model of predictors of psychological distress among patients with thyroid cancer during the transitional period. The DT score of 300 patients with thyroid cancer ranged from 0 to 10, and the median DT score was 2 [1-4]. The prevalence of clinically relevant psychological distress (DT score ≥ 4) in Chinese patients with thyroid cancer during their transitional period was 29.33% (88/300). The results of logistic regression analysis showed that gender (OR = 2.505, P = 0.036), fatigue (OR = 1.086, P = 0.005), and illness perception (OR = 1.137,P < 0.001) were significantly related to psychological distress in patients with thyroid cancer. The psychological distress of patients with thyroid cancer during the transitional period is medium level. Patients with thyroid cancer who are female, easily fatigued, and have worse illness perceptions are more likely to experience psychological distress. Therefore, clinical attention should be paid to female patients and potential interventions aimed at improving fatigue and illness perception. It may reduce the prevalence of psychological distress during the transitional period.

Recent studies proved that psychological distress is an accelerator of Alzheimer disease (AD). However, the factors that affect the psychological distress of AD patients are still unknown. The aim of this study was to predict the incidence and identify the risk factors of psychological distress in AD patients. Artificial neural networks and Machine learning models were used to predict the incidence of psychological distress in AD patients. Linear regression and decision tree models were used to identify the factors of psychological distress in AD patients. Among all models for predicting the incidence of psychological distress in AD patients, the artificial neural networks with 8 hidden neurons achieved the highest predictive accuracy of 81.92%. In the five machine learning models, the ADTree algorithm made the highest Predictive Accuracy of 77.94%. As for risk factor analysis, the Linear Regression and Decision Tree models reported similar sets of variables that affect the psychological distress of AD patients. Three variables were reported by Linear Regression to be in negative correlation with psychological distress: the use of professional care service, caregiver consuming cigarette, and caregiver consuming alcohol. The incidence of psychological distress in AD patients can be predicted by artificial neural networks with an accuracy of 81.92%. There are four main risk factors for psychological distress of AD patients: "Caregiver experiencing psychological distress", "Caregiver suffering from chronic disease or cancer", "Care recipient's health status being serious or getting worse", and "Lack of professional care service". These findings are potentially helpful for the prediction, prevention and intervention of psychological distress in AD patients.

Background: This study examines the factors contributing to psychological distress in elderly patients with lung cancer and comorbid COPD, while also investigating the mediating roles of distress disclosure and recovery experience in the relationship between perceived social support and psychological distress. The findings aim to inform clinical interventions for this population. Methods: From December 2021 to December 2024, 162 elderly patients diagnosed in our hospital with lung cancer accompanied by COPD were recruited as the research subjects. The general information Questionnaire, Perceived Social Support Scale (PSSS), Distress Disclosure Index (DDI), Recovery Experience Questionnaire (REQ) and Kessler Psychological Scale K10 (Kessler10) were used to conduct a cross-sectional survey. The data were statistically analyzed by chi-square test, binary logistics regression and linear regression, and the mediating effect was tested by Hayes’ SPSS-Process program model 6. Results: 162 lung cancer patients with COPD were included in this study, of which 98 patients had psychological distress, accounting for 60.5%. The results showed that self-paid medical treatment, advanced cancer, and the presence of complications were the covariates affecting the psychological distress of patients. Results of the correlation analysis demonstrated that patients is perceived social support exhibited a positive correlation with distress disclosure and recovery experience, while showing a negative correlation with psychological distress. Bootstrap mediating effect test demonstrated that the total effect value of perceived social support on psychological distress in COPD patients with lung cancer was −0.890. Distress disclosure and recovery experience had a partial mediating effect between perceived social support and psychological distress, accounting for 19.3% and 22.9% of the mediating effect, respectively. Conclusion: Negative psychological problems such as psychological distress are still serious in elderly lung cancer patients with COPD. distress disclosure and recovery experience play a chain mediating role between perceived social support and psychological distress in elderly patients. Therefore, by improving distress disclosure and recovery experience, our efforts can enable them to better recognize the role of social support in relieving psychological distress and ultimately elevate their mental health status.

Psychological distress symptoms and illness perception in patients with epilepsy in Northwest Greece

Psychological distress of postoperative chemotherapy patients with breast cancer is significant and has a serious impact on their quality of survival. Risk prediction models can efficiently assess patients' psychological distress and risk factors. To investigate the factors influencing psychological distress in postoperative chemotherapy patients with breast cancer and construct a nomogram model to predict the occurrence of psychological distress in patients. Two hundred forty-seven women in treatment for breast cancer who were postoperative and receiving chemotherapy were recruited. Participants completed a distress management screening measure, a numerical rating scale, the Pittsburgh Sleep Quality Index, and demographic and clinical items. Experiencing significant psychological distress was reported by 65.6% of participants. The psychological distress risk prediction model included 5 variables: financial problems, appearance/shape, distant metastases, the Numerical Rating Scale Pain score, and fatigue. A web calculator was designed based on the model ( https://77nomogram.shinyapps.io/dynnomapp/ ). This study found that financial and appearance/shape problems, distant metastases, pain scores, and fatigue were predictors of greater psychological distress in women undergoing chemotherapy after breast cancer surgery. The model constructed in this study has good predictive efficacy. This web-based nomogram model can help healthcare professionals quickly assess the likelihood of psychological distress in patients and screen for risk factors for psychological distress.

Previous studies implied detrimental effects of adverse childhood experiences (ACE) on cardiovascular disease and mental health. Still, data on the influence of ACE on psychological distress in patients with an implantable cardioverter-defibrillator (ICD) are lacking. We prospectively recruited 423 patients with an ICD. To determine associations between ACE (ACE questionnaire, cut-off ≥4), depression (Patient Health Questionnaire-8), anxiety (Generalized Anxiety Disorder-7 scale), and post-traumatic stress disorder (PTSD) symptoms (Post-Traumatic Stress Diagnostic Scale), we conducted a binary logistic regression analysis. Regression models were adjusted for conventional risk factors of psychological distress in ICD patients. To identify indirect mediating effects of resilience (Resilience Scale) on ACE and psychological distress, we applied the PROCESS regression path analysis modeling tool. 49.1% of all patients reported at least one ACE, and 9.7% experienced even four or more ACE. A high-risk ACE profile (≥ 4) was associated with higher levels of anxiety (OR 3.68, 95% CI 1.37-9.84, p=0.009), depression (OR 4.08, 95% CI 1.67-9.97, p=0.002), and PTSD symptoms (OR 2.20, 95% CI 1.03-5.21, p=0.041). Greater resilience partially mediated the relationship between ACE and depression (indirect effect 0.11, 95% CI 0.01-0.26) as well as anxiety (indirect effect 0.08, 95% CI 0.008-0.19). The current study suggests an association between ACE and psychological distress in patients with an ICD. However, resilience could mitigate the adverse effects of ACE. Future studies should strive to unravel the complex mechanisms of ACE and its effects on cardiovascular and mental health in ICD patients.

This study aims to investigate the prevalence of significant psychological distress and identify risk factors associated with it among early-stage lung cancer patients in the preoperative period. Lung cancer is a major cause of cancer deaths worldwide, with low survival rates and significant psychological distress. While much research has focused on distress in advanced-stage patients, less is known about the prevalence and risk factors of psychological distress in early-stage lung cancer patients before surgery. A cross-sectional study. The study included 427 early-stage lung cancer patients preparing for surgery. Researchers used a study-specific questionnaire to gather general information and employed the Distress Management Screening Measurement, Patient Health Questionnaire-9 and Generalised Anxiety Disorder-7 to assess personal situations and psychological distress levels. Statistical analyses investigated distress across various patient characteristics and examined correlations with anxiety and depression. Binary logistic regression identified significant predictors of psychological distress. The study found that 41.9% of early-stage lung cancer patients experienced significant psychological distress preoperatively, with an average score of 3.31 ± 2.18. Psychological distress was significantly positively correlated with depression (r = 0.474, p < 0.001) and anxiety (r = 0.591, p < 0.001). Significant risk factors for psychological distress included pulmonary nodules (OR = 2.884, 95% CI: 1.496-5.559), smoking history (OR = 2.092, 95% CI: 1.016-4.306) and chronic diseases (OR = 2.013, 95% CI: 1.073-3.776). Early-stage lung cancer patients often experience a high incidence of clinically significant psychological distress during the preoperative period, strongly associated with depression and anxiety. Adverse factors contributing to psychological distress include multiple indeterminate pulmonary nodules, smoking history and concurrent chronic diseases. Routine screening for psychological distress in these patients is recommended, along with personalised interventions and self-management strategies to help alleviate their distress during the perioperative period.

PurposeThe aims of the study were first to investigate the association between illness perception and psychological distress and second to determine whether mindfulness affects psychological distress via illness perception and perceived stress in patients with lung cancer.MethodsAmong 300 patients with lung cancer who participated in this cross-sectional study, 295 patients made valid responses to distress thermometer (DT), the Five Facet Mindfulness Questionnaire (FFMQ), the Brief Illness Perception Questionnaire (B-IPQ), and the Perceived Stress Scale (PSS) between January and July 2021. The possible pathways of mindfulness affecting psychological distress were analyzed based on the structural equation modeling analysis.ResultsA total of 24.4% patients with lung cancer had DT > 4. Illness perception (β = 0.17, p = 0.002) and perceived stress (β = 0.23, p < 0.001) had a direct effect on psychological distress. Mindfulness had a direct effect on illness perception (β = −0.16, p = 0.006) and mindfulness indirectly influenced psychological distress (β = −0.04, p = 0.009) through affecting illness perception alone or simultaneously affecting both the illness perception and perceived stress in patients with lung cancer.ConclusionLung cancer suffered from varying levels of psychological distress. Mindfulness may alleviate psychological distress by reducing the level of illness perception and perceived stress. We suggest developing a comprehensive factor model to clarify potential mechanisms of mindfulness on psychological distress due to the very low effect of mindfulness on psychological distress via illness perception and perceived stress.

Psychological distress, social support, and disease activity in patients with inflammatory bowel disease

The objectives of this study were to compare the psychological status of patients in active and inactive disease states, to assess social support, and to identify correlates of psychological distress in patients with inflammatory bowel disease (IBD). This cross-sectional study was conducted in 200 patients (mean age 36.7 yr [SD = 14.8], 119 [59.5%] female) with long-standing IBD who were seen in tertiary care. Psychosocial assessments included psychological distress (Symptom Checklist-90R), social support (Social Support Questionnaire-6), perceived stress (Perceived Stress Scale-10), and recent minor stressful events (Weekly Stress Inventory). Disease activity was assessed with the Harvey Bradshaw Index. Patients reported higher levels of satisfaction with social support and smaller network sizes compared with normative values. Using multiple linear regression, the independent correlates of psychological distress (p = 0.0001; adjusted R2 = 0.62) were as follows: active disease (p = 0.0234), less time since diagnosis (p = 0.0012), and greater number (p = 0.0001) and impact of stressful events (p = 0.0003). A statistically significant interaction term (p = 0.0171) revealed that the relationship between psychological distress and perceived stress changes depending on the level of satisfaction with social support. For patients with low levels of perceived stress, satisfaction with social support did not affect levels of psychological distress. However, for patients who experienced moderate to high levels of perceived stress, high satisfaction with social support decreased the level of psychological distress. These findings suggest that strategies aimed at improving social support can have a favorable impact on psychological distress and, ultimately, can improve health outcomes in patients with IBD.

Depressive and anxiety symptoms are common psychiatric disorders among cancer patients. Among the 137 patients with NMIBC (Non-Muscle-Invasive Bladder cancer), 101 patients who provided answers to the Hospital Anxiety and Depression Scale (HADS) and the Brief Illness Perception Questionnaire (B-IPQ) completed the 12-month longitudinal study. Hierarchical regression analyses were conducted to evaluate the interactions between psychiatric problems and illness perceptions (IPs). Patients with NMIBC displayed less positive IPs and more negative IPs. IPs have explained 42.0% and 39.5% of the variance in anxiety at 3 and 12 months of follow-up. IPs have explained 41.4% and 45.5% of the variance in depressive symptoms at 3 and 12 months of follow-up. The results demonstrated IPs are significantly associated with psychological distress and taken as the potential predictor of psychological distress in patients with NIMBC. Interventions focusing on the modification of poor IPs may be feasible and effective in improving psychiatric disorders and quality of life among patients with NIMBC.

Background and objectiveObstructive sleep apnea syndrome (OSAS) is linked not only to cardiometabolic disorders but also to psychological distress such as depression and anxiety. Although continuous positive airway pressure (CPAP) and regular exercise have been shown to improve psychological well-being, the specific contribution of exercise habits to mental health in OSAS patients, particularly those receiving CPAP therapy, remains unclear. This study aimed to identify clinical and lifestyle-related factors associated with psychological distress in patients with OSAS, focusing particularly on exercise habits.MethodsWe conducted a cross-sectional analysis of 1,204 OSAS patients receiving CPAP therapy. Psychological distress was assessed using the six-item Kessler scale (K6), and a cutoff score of ≥5 was used to define the distress group. Daytime sleepiness was measured using the Japanese version of the Epworth Sleepiness Scale (JESS). Logistic regression was performed to identify predictors of psychological distress, with sex, age, BMI, apnea-hypopnea index (AHI), JESS score, and exercise habit included as independent variables.ResultsAmong the participants, 153 (12.7%) were classified as experiencing psychological distress. Logistic regression revealed that higher JESS scores (odds ratio (OR) = 1.12, 95% confidence interval (CI): 1.08-1.16, p < 0.001) and absence of exercise habits (OR = 0.48, 95% CI: 0.32-0.72, p < 0.001) were significantly associated with psychological distress. Male sex was associated with lower odds of distress (OR = 0.61, 95% CI: 0.38-0.96, p = 0.032). No significant associations were observed for age, BMI, or AHI.ConclusionsLack of regular exercise and increased daytime sleepiness were independently associated with psychological distress in OSAS patients. These findings highlight the importance of exercise promotion and sleep management in addressing mental health in this population. Physical therapists may play a vital role in implementing lifestyle interventions to improve both physical and psychological well-being among individuals with OSAS.

BackgroundDue to the dramatic measures accompanying isolation and the general uncertainty and fear associated with COVID-19, patients and relatives may be at high risk for adverse psychological outcomes. Until now there has been limited research focusing on the prevalence of psychological distress and associated factors in COVID-19 patients and their relatives. The objective of our study was to assess psychological distress in COVID-19 patients and their relatives 30 days after hospital discharge.MethodsIn this prospective observational cohort study at two Swiss tertiary-care hospitals we included consecutive adult patients hospitalized between March and June 2020 for a proven COVID-19 and their relatives. Psychological distress was defined as symptoms of anxiety and/or depression measured with the Hospital Anxiety and Depression Scale (HADS), i.e., a score of ≥8 on the depression and/or anxiety subscale. We further evaluated symptoms of post-traumatic stress disorder (PTSD), defined as a score of ≥1.5 on the Impact of Event Scale-Revised (IES-R).ResultsAmong 126 included patients, 24 (19.1%) had psychological distress and 10 (8.7%) had symptoms of PTSD 30 days after hospital discharge. In multivariate logistic regression analyses three factors were independently associated with psychological distress in patients: resilience (OR 0.82; 95%CI 0.71 to 0.94; p = 0.005), high levels of perceived stress (OR 1.21; 95%CI 1.06 to 1.38; p = 0.006) and low frequency of contact with relatives (OR 7.67; 95%CI 1.42 to 41.58; p = 0.018). The model showed good discrimination, with an area under the receiver-operating characteristic curve (AUC) of 0.92. Among 153 relatives, 35 (22.9%) showed symptoms of psychological distress, and 3 (2%) of PTSD. For relatives, resilience was negatively associated (OR 0.85; 95%CI 0.75 to 0.96; p = 0.007), whereas perceived overall burden caused by COVID-19 was positively associated with psychological distress (OR 1.72; 95%CI 1.31 to 2.25; p<0.001). The overall model also had good discrimination, with an AUC of 0.87.ConclusionA relevant number of COVID-19 patients as well as their relatives exhibited psychological distress 30 days after hospital discharge. These results might aid in development of strategies to prevent psychological distress in COVID-19 patients and their relatives.

Psychological distress in cancer patients in a large Chinese cross-sectional study