Close-in Research Articles

Psychiatric Morbidity Is Common Among Children With Juvenile Idiopathic Arthritis: A National Matched Cohort Study.

Juvenile idiopathic arthritis (JIA) is a chronic rheumatic disease that causes joint inflammation and pain. Previous studies have indicated affected mental health and increased risk of psychiatric conditions among patients with JIA. We aimed to explore differences in psychiatric morbidity between children with JIA and their peers. We further studied if parental socioeconomic status (SES) influences the association between JIA and the risk of psychiatric morbidity. We used a matched cohort design to estimate the association between JIA and psychiatric disease. Children with JIA, born between 1995 and 2014, were identified in Danish national registers. Based on birth registers, we randomly selected 100 age- and sex-matched children per index child. Index date was the date of the fifth JIA diagnosis code or the date of matching for reference children. End of follow-up was the date of psychiatric diagnosis, death, emigration, or December 31, 2018, whatever came first. Data were analyzed using a Cox proportional hazard model. We identified 2086 children with JIA with a mean age at diagnosis of 8.1 years. Children with JIA had a 17% higher instantaneous risk of a psychiatric diagnosis when compared with the reference group, with an adjusted hazard ratio of 1.17 (95% CI 1.02-1.34). Relevant associations were found only for depression and adjustment disorders. Stratifying our analysis for SES showed no modifying effect of SES. Children with JIA had a higher risk of psychiatric diagnoses compared to their peers, especially diagnoses of depression and adjustment disorders. The association between JIA and psychiatric disease did not depend on parental SES.

Cross-sectional field study comparing hippocampal subfields in patients with post-traumatic stress disorder, major depressive disorder, post-traumatic stress disorder with comorbid major depressive disorder, and adjustment disorder using routine clinical data.

The hippocampus is a central brain structure involved in stress processing. Previous studies have linked stress-related mental disorders, such as post-traumatic stress disorder (PTSD) and major depressive disorder (MDD), with changes in hippocampus volume. As PTSD and MDD have similar symptoms, clinical diagnosis relies solely on patients reporting their cognitive and emotional experiences, leading to an interest in utilizing imaging-based data to improve accuracy. Our field study aimed to determine whether there are hippocampal subfield volume differences between stress-related mental disorders (PTSD, MDD, adjustment disorders, and AdjD) using routine clinical data from a military hospital. Participants comprised soldiers (N = 185) with PTSD (n = 50), MDD (n = 70), PTSD with comorbid MDD (n = 38), and AdjD (n = 27). The hippocampus was segmented and volumetrized into subfields automatically using FreeSurfer. We used ANCOVA models with estimated total intracranial volume as a covariate to determine whether there were volume differences in the hippocampal subfields cornu ammonis 1 (CA1), cornu ammonis 2/3 (CA2/3), and dentate gyrus (DG) among patients with PTSD, MDD, PTSD with comorbid MDD, and AdjD. Furthermore, we added self-reported symptom duration and previous psychopharmacological and psychotherapy treatment as further covariates to examine whether there were associations with CA1, CA2/3, and DG. No significant volume differences in hippocampal subfields between stress-related mental disorders were found. No significant associations were detected between symptom duration, psychopharmacological treatment, psychotherapy, and the hippocampal subfields. Hippocampal subfields may distinguish stress-related mental disorders; however, we did not observe any subfield differences. We provide several explanations for the non-results and thereby inform future field studies.

Somatic symptoms, perceived stress, and preventive behavior during the COVID-19 pandemic

Numerous studies of the COVID-19 effects on mental health have documented increases in anxiety and depressive symptoms, panic and adjustment disorders, suicidal ideation and suicide attempts, somatic and psychological distress, feelings of loneliness, and alcohol use problems [21]. These findings suggest the need for further examination of the COVID-19 effects on mental health and adherence to preventive behavior regarding the risks of SARS-CoV-2 infection.Objective. The aim of this study was to examine the prevalence and relationship between somatic symptoms, perceived stress, and preventive behavior during the COVID-19 pandemic in Russia.Material and Methods. The participants were 1,987 volunteers who were recruited with the help of Anketolog, an empirical data collection company in Russia. All respondents completed a questionnaire with a sociodemographic form and Russian versions of the Somatic Symptom Scale-8, Perceived Stress Scale-10, and COVID-19 Preventive Behavior Index.Results. Results showed that 39.1% of Russians had clinically significant somatic symptoms, 81% of Russians experienced moderate to high perceived stress, and from 46.5% to 84.4% of Russians were willing to follow some form of COVID-19 pandemic preventive behavior. Russians with somatic symptoms experienced more perceived stress than Russians without somatic symptoms, while Russians with higher perceived stress did not differ from Russians with lower perceived stress in frequency and severity of somatic symptoms.Conclusion. Preventive and psychoeducational interventions can be useful in reducing somatization and perceived stress, maintaining and increasing the adherence of Russians to preventive behavior during the COVID-19 pandemic.

Relieved Depressive State and Glycemic Control in Type 2 Diabetes (T2D) Patient Treated by Imeglimin (Twymeeg)

The patient is a 66-year-old female being treated for hypertension. She developed a cerebral vascular accident (CVA) in October 2019, and was subsequently diagnosed with type 2 diabetes (T2D) due to an HbA1c level of 9.8%. She began a low carbohydrate diet (LCD) and started taking oral hypoglycemic agents (OHAs) such as metformin and linagliptin. From July 2021, she occasionally experienced anxiety and palpitations, leading to a diagnosis of reactive depression (adjustment disorder). Despite treatment with etizolam as needed, these symptoms persisted. In December 2022, due to an increase in HbA1c levels to 7.7%, metformin was switched to imeglimin (Twymeeg). By April 2023, her HbA1c had decreased to 6.9%, and she reported a sustained sense of well-being without psychosomatic symptoms.

Flat nodular lymphoid hyperplasia resembling "apple tree branches" in the colon.

A 19-year-old woman with a history of adjustment disorder presented with abdominal pain, bloating, and chronic diarrhea. Colonoscopy revealed multiple flat whitish areas, less than 3 mm in diameter, diffusely distributed throughout the entire colon and rectum. These findings were prominent under narrow-band imaging (NBI) ([Fig. 1 a]) and more difficult to distinguish with white-light imaging ([Fig. 1 b]). The flat areas and the surrounding superficial vessels were described in the report as resembling “apple tree branches” ([Video 1]). Inspection of the terminal ileum was unremarkable, and esophagogastroduodenoscopy was unrevealing. Histologic examination of the colonic biopsy specimens showed nodules of benign lymphoid tissue with enlarged germinal centers and an intact mantle zone, consistent with a diagnosis of nodular lymphoid hyperplasia (NLH) ([Fig. 2]). Laboratory investigations and fecal calprotectin were within normal limits. Stool pathogen testing was negative. The patient was diagnosed with irritable bowel syndrome (IBS) and diffuse flat NLH.

Adjustment disorder, moral injury and the case of Marine "A".

Adjustment disorder, moral injury and the case of Marine "A".

A nationwide questionnaire survey of physicians regarding the impact of the COVID-19 pandemic on patients and treatment system of psychosomatic medicine

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has affected the treatment system of medical institutions across the world. Studies of the populations and patients have reported mental health problems caused by the pandemic. However, there are few large-scale studies that have examined the effects of the COVID-19 on diseases from the perspective of psychosomatic medicine. The purpose of this study was to examine changes made to the psychosomatic treatment system of Japan during the COVID-19 pandemic and the impact of the pandemic on patients with diseases treated in psychosomatic medicine.MethodsWe conducted a nationwide questionnaire survey of members of the Japanese Society of Psychosomatic Medicine and the Japanese Society of Psychosomatic Internal Medicine from December 24, 2021 to January 31, 2022.ResultsOf the 325 respondents, 23% reported restrictions in initial outpatient admissions, 66% implemented telemedicine, 46% reported a decrease in outpatient admissions, and 31% working in facilities with inpatient units reported decreased inpatient admissions. To reduce in-person visits, 56% of the respondents decreased the frequency of patient visits and 66% introduced telemedicine. Seventy-eight percent of the respondents reported that the COVID-19 pandemic affected the onset or exacerbation of diseases treated in psychosomatic medicine, including psychosomatic disorders, anxiety disorders, mood disorders, adjustment disorders, and eating disorders.ConclusionsThis study revealed that the COVID-19 pandemic might have affected the practice of psychosomatic treatment in Japan and that various alternative measures were taken to prevent infection. In addition, although the items in this study were not compared to pre-pandemic data, the COVID-19 pandemic, it could have significant psychosocial effects on Japanese patients requiring psychosomatic care. Furthermore, respondents believed that numerous psychosocial factors were behind the impact of the COVID-19 pandemic on patients with diseases treated in psychosomatic medicine.

Metabolic syndrome and the increased risk of medically-certified long-term sickness absence: a prospective analysis among Japanese workers.

Metabolic syndrome (MetS) has been associated with various chronic diseases which may lead to long-term sickness absence (LTSA), but there is lacking information on the direct association between MetS and LTSA. The present study aimed to investigate the all-cause and cause-specific associations between MetS and the risk of medically-certified LTSA among Japanese workers. We recruited 67,403 workers (57,276 men and 10,127 women), aged 20-59 years, of 13 companies in Japan, during their health check-ups in 2011 (11 companies) and 2014 (2 companies), and followed them up for LTSA events (≥ 30 consecutive days) until March 31, 2020. MetS was defined according to the Joint Interim Statement. A Cox proportional hazards regression model was used to estimate hazard ratio (HR) and its 95% confidence interval (CI) for LTSA associated with MetS and its components. During 408,324 person-years of follow-up, 2,915 workers experienced LTSA. The adjusted HR for all-cause LTSA was 1.54 (95% CI, 1.41-1.68) among those with vs without MetS. In cause-specific analysis, HRs associated with MetS significantly increased for LTSA due to overall physical disorders (1.76), cardiovascular diseases (3.16), diseases of the musculoskeletal system and connective tissue (2.01), cancers (1.24), obesity-related cancers (1.35), mental, behavioral and neurodevelopmental disorders (1.28), reaction to severe stress and adjustment disorders (1.46) and external causes (1.46). The number of MetS components were also significantly associated with increased LTSA risk. MetS was associated with an increase in the risk of LTSA due to various diseases among Japanese workers.

Parenting amidst COVID-19: Pandemic-related stressors, inequities, and treatment utilization and perceptions.

Many parents of children under age 18 are faced with additional COVID-19 parenting-related stressors and may be experiencing increases in psychological difficulties;however, we have yet to investigate parent's levels of posttraumatic stress symptoms (PTSS) and adjustment disorder. Further, COVID-19 has served as a sobering reminder of the significant public health disparities in our society and it is critical to identify risk factors for poorer clinical outcomes. The primary objectives of the present study were to: (a) determine whether parents are reporting higher levels of pandemic-related stress, PTSS, and adjustment disorder than controls, (b) identify specific individual-level factors (e.g., age, gender, race, number of children, age of children) that may be related to higher levels of stress and symptoms among parents, and (c) report parents' utilization of, and perceived efficacy of, psychological interventions during COVID-19. A U.S. nationally representative sample (N = 2,019) from Qualtrics Data panels was recruited in July-August 2020. Parents endorsed higher levels of stress, PTSS, and adjustment disorder, particularly younger parents. Further, 38.3% of parents reported PTSS above clinical cutoff. Younger participants and persons of color reported higher levels of pandemic-related stress. One-third of parents (33.1%) reported using online mental health services. Taken together, parents may be at greater risk for pandemic stress, PTSS, and adjustment disorder symptoms. Individual-level risk factors, such as age and minority status, are important to consider when understanding COVID-19 stress. Clinical intervention efforts should prioritize trauma-focused treatments for parents, especially those who are younger and identify as a person of color. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

EE148 Anxiety, Depression, Stress Reaction and Adjustment Disorders, and Their Associations with Healthcare Costs Among Newly Diagnosed Patients with Breast Cancer: A Retrospective Observational Cohort Study

Newly diagnosed patients with breast cancer often experience psychological distress. We evaluated the incidence and prevalence of psychiatric disorders including anxiety, depression, stress reaction and adjustment disorders and their associations with healthcare costs among newly diagnosed patients with breast cancer.

Performance analysis of mmWave radio propagations in an indoor environment for 5G networks

Existing wireless communications in the sub-6 GHz bands are facing challenges from the growing demand for higher data rates and better quality of services. To satisfy these demands, the fifth generation (5G) mobile network would consider unused spectrum in the millimeter wave (mmWave) spectrum (30–300 GHz). The shortage of bandwidth in the sub-6 GHz band is solved using mmWave technology. Furthermore, mmWave provides significantly higher throughput, data rate, and capacity. Despite the fact that a huge bandwidth is employed, mmWave technology suffers from diffuse scattering from rough materials, path loss, reflection loss, atmospheric attenuation, building penetration loss, and shadowing which leads to a decrease in the transmitted signal power. Therefore, a reliable and accurate channel model is important in the mmWave bands, particularly for the indoor environment. Moreover, by using technologies like beam-forming and others coupled with mmWave, the listed impairments are minimized. In this work, we analyze the performance of different path loss models (CI, free space, and two rays) at 38, 60, and 73 GHz carrier frequencies in terms of path loss in terms of separation distance between transmitter and receiver. Additionally, we have evaluated the performance of the path loss with respect to the break point distance to enhance the received signal power and throughput. We have also done analysis of the directional power delay profile with received signal power, path loss and path loss exponent (PLE) at 38 GHz and 73 GHz mmWave bands for both LOS and NLOS by using uniform linear array (ULA) 2 × 2 and 64 × 16 antenna configurations using the channel model simulator (NYUSIM). The simulation results show the performance of different path loss models in the mmWave and sub 6 GHz bands. Path loss in the close-in (CI) model at mmWave bands is larger than that of free space and two ray path loss models, because it considers all shadowing and reflection effects between transmitter and receiver.

Improving Functional Capacity and Quality of Life in Parkinson's Disease Patients through REAC Neuromodulation Treatments for Mood and Behavioral Disorders.

Parkinson's disease is a neurological disorder that affects both motor and non-motor functions, including depression, anxiety, and cognitive decline. Currently, it remains a challenge to distinguish the correlation between these aspects and their impact on one another. To try to clarify these reciprocal influences, in this study we have used specific radio electric asymmetric conveyer (REAC) technology neuromodulation treatments for behavioral mood disorders and adjustment disorders. In particular, we employed the neuro-postural optimization (NPO) and neuro-psycho-physical optimization (NPPOs) treatments. The study enrolled randomly 50 subjects of both genders previously diagnosed with Parkinson's disease for at least six months. Prior to and following REAC NPO and NPPOs treatments, we assessed the subjects using functional dysmetria (FD) evaluation, five times sit to stand test (FTSST) for postural stability, and the 12-item Short-Form Health Survey (SF-12) for quality of life (QLF) evaluation. The positive results produced by the REAC NPO and NPPOs neuromodulation treatments, specific for mood and adaptation disorders, on dysfunctional motor disorders, and quality of life confirm how the non-motor components can condition the symptomatology of Parkinsonian motor symptoms. These results also highlight the usefulness of REAC NPO and NPPOs treatments in improving the overall quality of life of these patients.

An open trial of VA CONNECT: Caring for Our Nation's Needs Electronically during the COVID-19 Transition.

The COVID-19 pandemic impacted emotional well-being due to safety concerns, grief, employment impacts, and social interaction limitations. Face-to-face mental health treatment restrictions were especially impactful to veterans who often gain social enrichment from Veterans Health Administration (VHA) care. We present results from a novel group-based telehealth intervention, VA Caring for Our Nation's Needs Electronically during the COVID-19 Transition (VA CONNECT), which integrates skills training and social support to develop a COVID-19 Safety & Resilience Plan. Veterans (n​=​29) experiencing COVID-related stress participated in an open trial of this 10-session, manualized group VHA telehealth intervention. We examined whether COVID-19-related stress, adjustment disorder symptoms, and loneliness decreased, and coping strategy use increased after participation in VA CONNECT. Between baseline and two-month follow-up, participants reported a significant reduction in perceived stress and adjustment disorder symptoms, and an increase in planning coping skills use. Significant changes were not observed in loneliness or other specific coping strategies. Findings may support the utility of VA CONNECT as an intervention for pandemic-related stress and improving certain coping skills. Future research should explore group-based telehealth interventions like VA CONNECT with other populations within and outside of the VA, which have value during major disruptions to face-to-face mental healthcare access.

COMPARATIVE AGE FEATURES OF CLINIC AND PATHOGENETIC ASPECTS OF SCHOOL DISADAPTATION

Intensive processes of maturation of certain biological systems of the body in conjunction with an increase in the level of socio-psychological requirements for students, increase the possibility of psihotrauvmatik personality. The clinic manifestations and the main factors of pathogenesis of school disadaptation in the comparative-age aspect (7-11 years old, n = 950) and (12-17 years old, n = 550). More significant factors of risk together with the psycho - social ones (conditions of micro social sphere of family and school) are genetic and cerebral organic. The feature of found out by children and teenagers disadaptation is its massive somatisation, which charactrised by polymorph vegetative and visceral disorders in different organs and systems (digestive, skin, respiratory, moving, heart-vessel,secretory,endocrine) and paintful manifestation. Results. Thus, clinical and population-based studies conducted amonghealthy schoolchildren, revealed a greater incidence of children and adolescents with adjustment disorders (72%), among which is dominated by Grade III - a relative maladjustment. The most significant risk factors, along with psycho-social (micro social status of the family and school environment) are genetic and cerebro-organic. A feature of the identified children and adolescents maladjustment was its massive somatic, which was characterized by polymorphic vegetative-visceral disorders in various organs and systems (digestive, skin, respiratory, locomotor, cardiovascular, excretory, endocrine) and algic manifestations.

(013) Dance Movement Therapy for Patients Suffering from Breast Cancer: How Does it Impact Their Sexuality and Sense of Intimacy?

Abstract Introduction Dance Movement Therapy (DMT) has been used in the past decade to reduce the special stress and biological sequels associated with chronic and traumatizing diseases and Cancer. Nearly 47% of patients suffering from breast cancer were suffering from a diagnosable psychiatric disorder most commonly adjustment disorders, anxiety, depression and/or sexual disorders. Objective Aim of the study is to examine the impact of DMT as a novel modality in treating psychiatric disorder and improving sexuality and intimacy amid dealing with the breast cancer storm. Methods 110 females suffering from Breast Cancer and suffering from depressive symptoms and/or sexual disorders were included. Those psychotic manifesting psychosis or other psychiatric illnesses that alter level of consciousness were excluded. As well as physically unfit patients to participate in DMT intervention group were excluded. Age groups ranged from 18-60 years old. Patients were randomly assigned by Tombola method into 2 groups: an intervention DMT group and a wait -list control group. Clinical examination and psychometry were conducted on both intervention DMT and control groups before and after intervention. Detailed psychiatric sheet and PLISSIT model followed for assessment of psychiatric and sexual disorder consecutively. Psychometry included: Beck Depression Scale (BDS), Body image (BI) scales and General Health Survey (GHS) were applied. DMT Intervention Techniques comprised 12 sessions in total in group setting. Each group included 20 females maximum. We met three times per week. 90 minutes every group for 4 weeks. Each session included DMT techniques of warm up, centering, use of props starting with Swiss Ball, Plastic Buttons, Elastic Bands, Bubble Soap blow, Yoga Blocks, and started seated before diving into standing and interactive moving DMT techniques. Free association lapses with culturally sensitive songs and music were given every session but mainly Yoga Therapy Restorative techniques, Modified tai-Chi, Modified Lebed techniques, followed by verbal feedback in the here and now and de-rolling. The session before the last, therapist invited the patient’s life partners/husbands/caretaker to the group vicinity and dyadic techniques were used. Results Patients were diagnosed in stage III at the time of examination and inclusion in the study. The most common histopathological type was Infiltrating Duct Carcinoma IDC 95%. 80% had positive lymph Nodes LN. ER positive in 95% of patients and only 10% negative PR. HER 2- neu negative by IHC staining in 55% of patients. 80% of patients in the intervention group had undergone mainly surgery Modified Radical Mastectomy MRM. Chemotherapy namely Anthracyclines/Taxanes received in 85% of patients participating in the study and 45% received Hormonal therapy and other 45% adjuvant radiotherapy as well according to guidelines of treatment regimen. Intervention group improved on BDS, BI and GHS scales and improved intimacy more than sexuality at the time of the study while control wait-list group worsened on BDS, BI scales and GHS and no change was detected on intimacy nor sexual disorder initially diagnosed. Conclusions DMT is an effective modality welcomed by patients suffering from breast cancer and their life partners/care takers. DMT was shown to boost mood, perception of body image and boosts intimacy. Disclosure No

Psychiatric comorbidities in patients suffering from systemic lupus erythematosus admitted to a tertiary care hospital in Northern India.

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with multiorgan involvement presenting with a myriad of symptoms, including neuropsychiatric symptoms. Although many studies have evaluated screening questionnaires based psychiatric morbidity, very few studies have used contemporary diagnostic criteria. This study aimed to evaluate the prevalence of psychiatric disorders in patients with SLE admitted to a tertiary care hospital. A total of 79 patients diagnosed with SLE for at least for 1year, who were not in delirium were assessed by a qualified psychiatrist for psychiatric morbidity as per the International Classification of Diseases, 10th Revision (ICD-10) criteria. Additionally, these patients were assessed on Patient Health Questionnaire-9 (PHQ-9) item version, Patient Health Questionnaire-15 (PHQ-15) item version, Generalized Anxiety Disorder-7 item scale and Montreal Cognitive Assessment (MoCA). 51% (n = 40) of the participants were diagnosed with a psychiatric diagnosis, with depressive disorders being the most common, seen in 36.7% (n = 29) of the participants. Additionally, 10% (n = 8) participants were diagnosed with adjustment disorder and 2.5% (n = 2) were diagnosed with anxiety (not otherwise specified). Only one patient was diagnosed with organic psychosis. On PHQ-9, 39.8% (n = 33) were diagnosed with depression. 44.3% (n = 35) expressed death wishes and/or suicidal ideations. On PHQ-15, 17.7% (n = 14) of the participants scored for severe somatic distress (score >15). On GAD-7, 55.7% (n = 44) screened positive for anxiety symptoms, but only 7.6% (n = ) had a score of 15 or more to indicate severe anxiety. Nearly half (n = 43; 52%) of the participants also had cognitive impairment as assessed on MoCA, with 13.3% (n = 11) of the participants having scores indicating severe dementia. Patients with SLE have a high prevalence of psychiatric comorbidities and should be routinely screened for psychiatric morbidity. They should be appropriately treated, to improve the overall treatment outcomes.

Adjustment Disorder

Adjustment Disorder

The impact of the pandemic on the perception of stress and danger, and the adjustment of psychiatric and general medical staff of German military hospitals.

The COVID-19 pandemic changed not only the working conditions but also the private conditions we live in. Health care professionals especially were confronted with multiple stressors, e.g., the risk of infection, lack of staff, and high workloads. To estimate some of the pandemic-related impacts this anonymous personnel survey was conducted in two German military hospitals (Hamburg and Berlin). This study presents a comparative analysis of the hospital staff in general vs. the psychiatric personnel (N = 685) at two measurement time points (MTPs) in April 2021 (n = 399) and December 2021 (n = 286). The survey contains the German version of the Covid Stress Scale (CSS) to assess the perceived level of pandemic-related stress, the Patient Health Questionnaire (German Version: PHQ-D) to screen for three major mental disorders, and the adjustment disorder-New Module (ADNM) to estimate the problems of adaptation to change. The results showed a process of adaptation over the two MTPs with significant stress reduction at MTP2 in the general staff. The psychiatric staff did not report significantly higher pandemic-related symptoms. Quite the contrary, not only did the CSS show significantly lower xenophobia, traumatic stress, and compulsive checking, but the PHQ also showed lower stress symptoms and somatic symptoms at both MTPs. Also, the ADNM scores delivered evidence for a more effective adaptation process in psychiatric personnel (e.g., depressive mood, avoidance, anxiety). The presented results must be interpreted while taking the unique situations of German military clinics into account. The supply of protective material was sufficient and there was no dramatic shortage of psychiatric staff during the pandemic. The inpatients were quite often (40%) elective treatments for trauma-related disorders, which could be discontinued in the case of a COVID-19 infection. The results of this study showed good adaptative skills among the psychiatric staff in military hospitals, which could be interpreted as a sign of good resilience. This might have led to lower stress-related symptoms during the COVID-19 pandemic.

Networks of pandemic-specific stressors, risk factors, and clinical symptoms: A comparison between women and men during the early phase of the COVID-19 pandemic

BackgroundDuring the COVID-19 pandemic, female gender was a robust factor associated with mental health problems. This study aimed to investigate associations between pandemic-related risk factors, stressors, and clinical symptoms, with special reference to gender and possible differential gender effects. MethodsParticipants were recruited from June to September 2020 through an online survey (ESTSS ADJUST study). Women (N = 796) and men (N = 796) were matched on age, education, income, and living community. Symptoms of depression (PHQ-9), anxiety (PHQ-4), adjustment disorder (ADNM-8), and PTSD (PC-PTSD-5) and different risk factors including pandemic-specific stressors (PaSS) were assessed. Separate network analyses for men and women were conducted and compared followed by a joint network analysis including gender. ResultsThe networks of women and men did not differ in their structure (M = 0.14, p = .174) or strength of associations (S = 1.22, p = .126). Few relationships differed significantly between genders e.g., the connection between burden through work-related problems and anxiety was stronger in women. In the joint network, single factors were related to gender e.g., men felt more burdened through work-related problems and women through conflicts at home. LimitationsWe cannot imply causal relationships due to the cross-sectional data of our study. The findings cannot be generalized as the sample is not representative. ConclusionMen and women seem to show comparable networks of risk factors, stressors, and clinical symptoms, although differences in individual connections and in levels of clinical symptoms and burdens were found.

Diagnosed Behavioral Health Disorders, Related Duty Limitations, and Return to Duty Time in the U.S. Army: Population-based Data, from 2017 to 2019.

Less than half of service members with a behavioral health (BH) problem seek care. Soldiers may avoid seeking needed care because of concerns related to being placed on a duty-limiting profile and the related medical disclosures that follow. This study used a retrospective population-based design to identify all new BH diagnoses across the U.S. Army. The relationship between diagnostic category, risk of being issued a duty limitation (profile), and time until return to full duty was also examined. Data were collected from a comprehensive data repository that includes medical and administrative records. Soldiers with a new BH diagnosis were identified from 2017 to 2018. All duty limitation profiles within 12 months of initial diagnosis were identified. Records for 614,107 unique service members were reviewed. This cohort was mostly male, enlisted, unmarried, and White. The mean age was 27.13 years (SD = 8.05). Soldiers with a new BH diagnosis accounted for 16.7% (n = 102,440) of the population. The most common diagnostic category was adjustment disorder (55.7%). About a quarter (23.6%) of soldiers with a new diagnosis were issued a related profile. The mean length of these profiles was 98.55 days (SD = 56.91). Of those with a new diagnosis, sex and race failed to have an effect on the odds of being placed on a profile. Overall, enlisted, unmarried, or younger soldiers had greater odds of being placed on a profile. These data provide relevant information for both the service member who seeks care and command teams seeking readiness projections.