From social stigma to physical health: mediation effect of internalized stigma and mental health among people with HIV in rural China

Objective: This study aimed to examine the mental health and somatic distress among migrant returnee population in Ethiopia. Background: Mental health and psychosocial distress are frequent among people who have faced adversity, such as exposure to abuse, exploitation, loss, displacement, and human trafficking. Returned Migrants are the most vulnerable population for such adversities, especially when they work in under-regulated sectors such as domestic work entered through illegal migration. Addressing the mental health issues of returnees has to be a cross- cutting activity of any migration -crisis intervention. However, knowledge about the frequency, severity, and risk factors as they affect migrants' mental health in Ethiopian is limited at best. Method: In a sample of 1,035 returnee migrants, data were collected on the mental distress based on SRQ-20 and somatic distress based on PHQ-15. A descriptive statistics correlation, t-test, and factorial MANOVA analysis were run to determine the distress status and the relationship between different variables. Results: Using a cut of point of 8, 26.08% of the sample was considered to be a probable case (n=270), with females endorsing more items than males. Twenty- three percent (11.7%, Mild; 8.2% Moderate; and 3% Sever) of the participants reported somatic manifestation of psychological distress. A significant relationship is found between participants' mental health distress and somatic psychological distress. Religious affiliation and ethnicity are found to be associated with mental health distress, while gender and education are found to be significantly associated with somatic psychological distress. Conclusion: Ethiopian migrant returnees deal with significant mental health distress and endorsed somatic symptoms in outpatient setting. Migrant returnees should access to a mental health service that is exclusively geared towards their mental health problems instead of clustering them together under the umbrella of general health services. Future studies are needed into the nature and efficacy of mental healthcare intervention in Ethiopia.

The relationships between opioid use disorder (OUD), chronic pain, and mental health distress are complex and multidirectional. The objective of this exploratory study was to examine the relationship between mental health conditions and Chronic pain severity and interference among patients stabilized on either buprenorphine or methadone. We report baseline data from a randomized trial of a mind-body intervention conducted at 5 outpatient clinics that provided either buprenorphine or methadone treatment. Validated scales were used to measure substance use, mental health distress, and pain severity and interference. Statistical analyses examined the relationship between mental health conditions and pain severity and interference. Of 303 participants, 57% (n = 172) reported Chronic pain. A total of 88% (n = 268) were prescribed buprenorphine. Mental health conditions were common, with one-quarter of the sample screening positive for all 3 mental health conditions (anxiety, depression, and posttraumatic stress disorder [PTSD]). Compared to participants without Chronic pain, participants with Chronic pain were more likely to screen positive for moderate-severe anxiety (47% vs 31%); moderate-severe depression (54% vs 41%); and the combination of anxiety, depression, and PTSD (31% vs 18%). Among participants with Chronic pain, mental health conditions were associated with higher pain interference. Pain severity was higher among participants with mental health conditions, but only reached statistical significance for depression. Pain interference scores increased with a higher number of co-occurring mental health conditions. Among individuals stabilized on either buprenorphine or methadone, highly symptomatic and comorbid mental health distress is common and is associated with increased pain interference. Adequate screening for, and treatment of, mental health conditions in patients with OUD and Chronic pain is needed.

Gender differences on mental health distress: Findings from the economic recession in Portugal

University students typically enter a dynamic transitional period of new independence from their parents that are characterized by many factors. These factors such as social, financial, and environment can be a burden and puts them at risk of mental health distress. Engaging in physical activity has proved to give benefits to mental health. However, not many university students are active during their years at the university. Few psychosocial factors such as emotional intelligence were seen to increased students physical activity and decrease mental distress. Therefore, the purpose of the study is to see whether emotional intelligence can mediate the relationship between physical activity and mental health (distress) among university students at Universiti Putra Malaysia, Malaysia. A correlation study with path analysis was conducted on 266 students at Universiti Putra Malaysia. Few instruments were used such as International Physical Activity Questionnaire SF (IPAQ-SF), General Health Questionnaire-28 (GHQ-28), and Schutte Self Report Emotional Intelligence Test (SSEIT) was used in this study. Path analysis was used to explore association between these aspects. Physical activity, mental health distress and emotional intelligence were significantly correlated and emotional intelligence showed partial mediation effect towards the relationship between physical activity and mental health distress (p<0.00). Thus, there was an association between physical activity with mental health distress, and emotional intelligence partially mediated this relationship. We interpret these novel data to suggest that physical activity can boost mental health and these physical activity-associated of emotional intelligence relevantly gives benefits in mental health. Such data have important implications for both health practice and policy especially in higher education institutions. Keywords : Emotional intelligence, physical activity, mental health, undergraduate students.

Pain is prevalent among people with HIV (PWH), and many PWH who experience pain also use substances (illicit drug and/or unhealthy alcohol use). While cocaine use and cocaine and alcohol co-use are prevalent in this population, their effects on pain in PWH are unknown. This study aims to investigate the association of cocaine use and co-use of cocaine and alcohol with pain interference among PWH. We completed a secondary analysis of the Boston Alcohol Research Collaboration on HIV/AIDS (ARCH) study, a longitudinal cohort of PWH with a history of substance use. The outcome was pain interference (Brief Pain Inventory). Exposures were recent cocaine use (Addiction Severity Index) and recent unhealthy alcohol use (Timeline Follow Back). Generalized Estimating Equation (GEE) ordinal logistic regression models were employed, adjusted for demographic factors, illicit/non-medical opioid use and cannabis use. Among 251 participants, 22.3% reported unhealthy alcohol use only, 11.1% reported cocaine use only, and 13.2% reported use of both. Cocaine use was associated with greater pain interference (adjusted odds ratio [aOR]: 1.73, 95% confidence interval [CI]: 1.15-2.60), whether or not participants had unhealthy alcohol use (interaction term, p = 0.695). Participants reporting both cocaine and unhealthy alcohol use had greater pain interference than participants reporting neither (aOR: 2.27, 95%CI: 1.35-3.79). Cocaine use was associated with greater pain interference as was co-use of cocaine and unhealthy alcohol among PWH. Considering patterns of substance use can inform clinicians conversations with PWH who may be using substances for pain management.

Previous research suggested that during the COVID-19 pandemic, mental distress did not affect all people equally. This longitudinal study aims to examine joint trajectories of depressive, anxiety, and stress symptoms in a sample of Italian adults during the pandemic, and to identify psychosocial predictors of distress states. We analyzed four-wave panel data from 3,931 adults who had received assessments of depressive, anxiety and stress symptoms between April 2020 and May 2021. Trajectories of individual psychological distress were identified by Latent Class Growth Analysis (LCGA) with parallel processes, and multinomial regression models were conducted to identify baseline predictors. Parallel process LCGA identified three joint trajectory classes for depression, anxiety and stress symptoms. Most individuals (54%) showed a resilient trajectory. However, two subgroups showed vulnerable joint trajectories for depression, anxiety and stress. Expressive suppression, intolerance to uncertainty, and fear of COVID-19 were risk characteristics associated with vulnerable trajectories for mental health distress. Moreover, vulnerability to mental health distress was higher in females, younger age groups and those unemployed during the first lockdown. Findings support the fact that group heterogeneity could be detected in the trajectories of mental health distress during the pandemic and it may help to identify subgroups at risk of worsening states.

Background Mental distress affects people's health in many ways and at different levels. However, anxiety and depressive disorder have significantly increased since the outbreak of the COVID-19 pandemic. Controlling the spread of COVID-19 resulted in isolation protocols such as stay-at-home orders, social distancing, and quarantining. Though well intended, the protocols exacerbated the already increasing number of mental distress cases prior to the pandemic. During the rollout of these pandemic interventions to control the spread, there was a noticeable increase in technology use. For instance, to cope with their mental health concerns, several people, including students, turned to technology to sustain their connection to the society and to access mental health services. Although a plethora of technological tools exist for communication and socialization, it is unknown which types of technologies are effective in the management of anxiety and depression symptoms. Hence, there is a need for a sociotechnical model that can identify technologies effective in addressing an individual's mental health symptoms, specifically among college students. Objective The objective of this study is to identify the effectiveness of current technologies used in coping with a mental distress situation and to develop a model that college students can use to effectively handle their mental health distress during and after a pandemic. Methods The proposed model is built on the Stallman's Health Theory of Coping. The model expands the theory with 5 significant components, namely Mental Health Distress Situation, Level of Distress, Coping Strategy, Technology Used, and the Mental Health Distress Outcome. This paper describes the conceptualized functionality of each component. The model will be implemented as a prototype mobile app and evaluated using a case study with students from 2 colleges. Results The study is underway. However, the model will be evaluated using 2 categories of nonrandomized focus groups of college students to determine the usefulness and the effectiveness of the model. Each group will consist of 8 participants. Data collected from each group will be qualitatively evaluated to identify themes from the responses, which will be used to refine the model to meet the study objective. Conclusions Many people experienced an increase in mental distress due to the isolation requirements arising from the COVID-19 pandemic. With limited access to traditional coping strategies in public and large gatherings, people turned to technology to manage their stress, anxiety, and depression. However, there is no “one-size-fits-all” technology that can address every individual distress level and coping strategy. Thus, developing a model to identify effective technologies used as coping strategies will be helpful for an individual in alleviating their mental health distress symptoms during and after a pandemic. Conflicts of Interest None declared.

Impact of mental health distress on preconception health.

HIV-associated painful neuropathies affect up to 69% of people with HIV (PWH), and chronic pain often promotes additional negative affective co-morbidities (e.g., anxiety, depression, PTSD) that dramatically reduce quality of life in PWH. Alcohol and cannabis are frequently used to manage pain and negative affective conditions, although chronic self-medication with these substances may facilitate the development of substance use disorders in PWH over time.The current study examined relationships among alcohol use (blood phosphatidylethanol levels, PEth), recent and lifetime cannabis use (addiction severity index), pain-related symptoms (SF-36 pain and pain interference measures), and negative affect (Hospital Anxiety and Depression Scale, HADS) in the baseline New Orleans Alcohol Use in HIV (NOAH) cohort (n=365) of PWH. Recent alcohol consumption (PEth-positive status) was significantly associated with reductions in pain intensity and interference while positive relationships were observed between pain symptoms and negative affect. Alcohol use appeared to promote sex-dependent associations between pain and negative affect. Pain symptoms correlated with HADS-Anxiety in female drinkers (but not non-drinkers), while pain symptoms correlated with HADS-Depression in male drinkers (but not non-drinkers). Additionally, 71% of the NOAH cohort had a history of one year or more of cannabis use, with 36% of the cohort using cannabis in the past month. Neither recent nor lifetime cannabis use was associated with self-reported pain symptoms. However, lifetime cannabis use was significantly associated with self-reported pain interference, and this effect was specifically pronounced in males. These findings suggest strong interactions between both alcohol and cannabis use and somatic and affective pain symptomatology in PWH in a sex-specific manner. As a mechanistic integration of our clinical studies, ongoing work in our non-human primate model of SIV infection is examining adaptations in brain and peripheral endocannabinoid signaling produced by chronic alcohol exposure. R01-AA025996 (SE) P60-AA009803 (PM) T32-AA007577 (PM) F30-AA031900 (SL) This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.

IntroductionDue to the increased effectiveness of and access to antiretroviral therapy (ART), people with HIV (PWH) are living longer. As a result, the population of older PWH has increased. Mental and substance use disorders (MSDs) are common and frequently co‐occurring among PWH and are associated with poor HIV care outcomes. Research into the prevalence and co‐occurrence of MSDs among ageing PWH remains limited, particularly in low‐ and middle‐income countries (LMICs).MethodsWe analysed data collected between 2020 and 2022 from the International epidemiology Databases to Evaluate AIDS (IeDEA) Sentinel Research Network cohort of PWH aged 40 years or older on ART at 11 HIV clinics in Brazil, Côte d'Ivoire, India, Kenya, Mexico, Uganda, Rwanda, Togo, Vietnam, Zambia and Zimbabwe. We estimated the prevalence and co‐occurrence of unhealthy alcohol use (AUDIT‐C ≥3 for women, ≥4 for men), unhealthy drug use (ASSIST >3 for cannabis, cocaine, amphetamines, inhalants, sedatives, hallucinogens and/or opioids), and moderate to severe symptoms of depression (PHQ‐9 ≥10), anxiety (GAD‐7 ≥10) and post‐traumatic stress disorder (PTSD) (PCL‐5 ≥33). Psychiatric multimorbidity was defined as having symptoms of two or more disorders assessed. Log binomial models assessed the association between socio‐demographic and HIV care characteristics and symptoms of anxiety, depression, PTSD or unhealthy substance use.ResultsOf 2821 participants, the prevalence of unhealthy alcohol and drug use was 21% and 5%, respectively. The prevalence of moderate to severe symptoms of depression, anxiety and PTSD was 14%, 9% and 6%, respectively. Overall, the prevalence of psychiatric multimorbidity was 11%. Among those with symptoms of at least one mental health or substance use outcome assessed (n = 1036), the prevalence of psychiatric multimorbidity was 31%. In binomial models, the prevalence of symptoms of depression and anxiety was higher, while the prevalence of unhealthy alcohol and drug use was lower among women than men.ConclusionsUnhealthy alcohol use and symptoms of depression were most commonly reported, among this cohort of PWH aged 40 or older across 11 LMICs. Integration of MSD screening and treatment into HIV care should be prioritized. The effectiveness and implementation of transdiagnostic or multi‐focus mental health treatment approaches in HIV care settings should be examined.

Introduction: Mental health of workers is an essential determinant of their workproductivity and their overall health. Poor mental health contributes meaningfully to arange of chronic physical illnesses such as hypertension, diabetes, and cardiovasculardisorders. Besides, mental health distress can severely impact the ability to work,leading to increased absenteeism and/or presenteeism. Consequently, employers andbusinesses are negatively affected by poor mental health among their employees due tothe lost productivity and profits, as well as the increased direct costs of managing thesehealth problems. Aim of work: To investigate the association between mental healthdistress and work productivity in terms of absenteeism and presenteeism. Materialsand Methods: One-hundred and eighty male shipyard-workers were interviewed usinga predesigned questionnaire for sociodemographic characteristics, work characteristics,lifestyle behaviors, perceived health status, and chronic diseases. Mental health distresswas measured using the Kessler psychological distress scale (K6), while measuresof work productivity (absenteeism and presenteeism) were calculated according tothe scoring guide of the Health and Work Performance Questionnaire (HPQ-shortform). Results: The mean age of participants was 48.3 years (± 8.17). Operators and service-workers constituted 73.3% of all participants, while professionals andadministrative workers represented 16.7% and 10%, respectively. Eight workers (4.4%)had high mental health distress, while 12.2% had moderate distress. The mean daysof absenteeism and presenteeism were significantly higher among participants withmoderate or high mental distress compared to low distress (p < 0.001). Further, withineach level of mental distress, the mean presenteeism days were significantly higher thanthe mean absenteeism days. Moderate and high mental distresses were associated with2.1 and 3.9 times greater rates of absenteeism and presenteeism compared to low mentaldistress. Conclusion: Mental health distress is associated with both higher absence andpresenteeism rates. Effective workplace policies for mental health promotion and casemanagement could yield substantial increases in worker’s productivity.

Poor mental health significantly impacts people with HIV (PWH) and those who drink alcohol. Limited data exist on the combined effects of social determinants of health (social vulnerability) on mental health in PWH with unhealthy substance use. We investigated the relationship between social vulnerability and poor mental health in PWH and whether this relationship differed by race/ethnicity. We conducted a cross-sectional analysis using data from the Boston ARCH Cohort among PWH with current or past unhealthy substance use. We created a 23-item social vulnerability index (SVI) using a deficit accumulation approach comprised of social determinants of health indicators. We estimated whether higher SVI score is associated with anxiety and depressive symptoms using logistic regression analysis. Among 251 participants with a mean age of 52 (SD = 10) years, 67.3% were male, 52% Black, 21% Hispanic, 19% White, and 73% unemployed. The SVI had a mean of 9.30 (SD = 3.4) with a 1.5-18 range. Nearly two in five persons reported past month heavy alcohol use and 35% illicit drug use. The prevalence of anxiety and depressive symptoms was 34.4% and 54.2% respectively. Higher SVI score was associated with anxiety symptoms (adjusted odds ratio [aOR] = 2.01, 95% confidence interval [CI] 1.46, 2.76, p ≤ 0.001), and depressive symptoms (aOR = 2.42, 95% CI 1.74, 3.36, p ≤ 0.001). Race/ethnicity did not moderate the relationship between SVI and each mental health outcome. SVI was significantly associated with poor mental health across racial/ethnicity groups in this cohort. Interventions that address social vulnerability may improve well-being and quality of life for PWH.

ABSTRACTWe examined relationships of smoking status and tobacco-related variables with health-related quality of life (HRQoL), a metric of disease burden, among clients in substance use disorders (SUDs) treatment. Participants (N = 2,068; 46.6% female) completed surveys reporting demographics, smoking status, and past-month days they experienced physical and/or mental health distress. Smokers (n = 1,596; 77.2% of sample) answered questions on tobacco-related variables. Multinomial regression models assessed relationships between tobacco-related variables (smoking status, nicotine dependence, menthol smoking, electronic-cigarette use, health concerns, and cost as reasons affecting reducing/quitting smoking, past and future quit attempts) with HRQol in four categories (good health, physical health distress, mental health distress, or both physical and mental health distress). Current smokers were more likely than former smokers to report frequent physical and mental health distress than good health (OR = 1.97, 95% CI = 1.16, 3.34), as were smokers with higher nicotine dependence (OR = 1.18, 95% CI = 1.03, 1.35). Smokers reporting both frequent physical and mental health distress were more sensitive to cigarettes’ cost (OR = 1.56, 95% CI = 1.06, 2.29), and less likely to use e-cigarettes (OR = 0.59, 95% CI = 0.38, 0.94). Findings of poor HRQoL among nicotine-dependent smokers with additional SUDs strengthen the imperative to provide smoking cessation interventions in addictions treatment.

BackgroundThe concept of job crafting and work engagement, which encompasses the proactive modifications that employees make to their tasks, relationships, perceptions, and level of involvement in their work, has been demonstrated to exert a significant influence on both mental and physical health. For nurses working in palliative care, the implementation of such modifications and active engagement in their roles could serve to mitigate the demanding nature of their work and improve their overall well-being. Nevertheless, there is a paucity of research examining the combined impact of job crafting and work engagement on the health outcomes of palliative care nurses.AimThis study aimed to evaluate the relationship between job crafting, work engagement, and the mental and physical health outcomes of palliative care nurses in an oncology setting.MethodsA cross-sectional design was used to examine the relationships between job crafting (independent variable), work engagement (mediating variable), and health outcomes (dependent variables: physical and mental health). Mediation analysis was conducted to explore the role of work engagement in the relationship between job crafting and health outcomes. The study was conducted in the oncology department of Zagazig General Hospital in Egypt, with a stratified random sample of 100 registered nurses who had at least six months of experience in palliative care. Data were collected using the Job Crafting Scale (JCS), Utrecht Work Engagement Scale (UWES), the Depression, Anxiety, and Stress Scales (DASS-21), and the Short Form-36 Health Survey (SF-36).ResultsThe study revealed a positive correlation between job crafting behaviours and physical health (r = 0.52, p < 0.001) and a negative correlation between job crafting behaviors and mental health distress (r = -0.56, p < 0.001). The structural equation modeling (SEM) results demonstrated significant paths from job crafting to both physical health (β = 0.40) and mental health distress (β = -0.45), indicating that job crafting positively affects physical health and negatively affects mental health distress. Mediation analysis revealed that work engagement significantly mediated the relationship between job crafting and health outcomes. Specifically, higher work engagement positively influenced health outcomes, while the negative effects of job crafting on mental health distress were lessened.ConclusionJob crafting positively impacts the physical and mental well-being of palliative care nurses by fostering greater work engagement. This engagement mediates the relationship between job crafting and health outcomes, enabling nurses to better cope with occupational stressors. By adapting their work environment to suit their strengths and preferences, nurses experience improved health and job satisfaction. As a result, higher work engagement not only enhances nurse well-being but also contributes to better patient care, as engaged nurses are more capable of providing compassionate, effective care.Clinical trialNo clinical trial.

We examined the association between discrimination and mental health distress, focusing specifically on the relative importance of discrimination because of particular demographic domains (i.e., race/ethnicity, socioeconomic position [SEP]). The research team surveyed a sample of gay and bisexual men (n = 294) at a community event in New York City. Participants completed a survey on demographics, discrimination experiences in the past 12 months, attributed domains of discrimination, and mental health distress. In adjusted models, discrimination was associated with higher depressive (B = 0.31; P < .01) and anxious (B = 0.29; P < .01) symptoms. A statistically significant quadratic term (discrimination-squared; P < .01) fit both models, such that moderate levels of discrimination were most robustly associated with poorer mental health. Discrimination because of SEP was associated with higher discrimination scores and was predictive of higher depressive (B = 0.22; P < .01) and anxious (B = 0.50; P < .01) symptoms. No other statistically significant relationship was found between discrimination domains and distress. In this sample, SEP emerged as the most important domain of discrimination in its association with mental health distress. Future research should consider intersecting domains of discrimination to better understand social disparities in mental health.