Adverse Mental Health Outcomes Research Articles

Epigenetic mechanisms linking early-life adversities and mental health.

Early-life adversities, whether prenatal or postnatal exposure, have been linked to adverse mental health outcomes later in life increasing the risk of several psychiatric disorders. Research on its neurobiological consequences demonstrated an association between exposure to adversities and persistent alterations in the structure, function, and connectivity of the brain. Consistent evidence supports the idea that regulation of gene expression through epigenetic mechanisms are involved in embedding the impact of early-life experiences in the genome and mediate between social environments and later behavioral phenotypes. In addition, studies from rodent models and humans suggest that these experiences and the acquired risk factors can be transmitted through epigenetic mechanisms to offspring and the following generations potentially contributing to a cycle of disease or disease risk. However, one of the important aspects of epigenetic mechanisms, unlike genetic sequences that are fixed and unchangeable, is that although the epigenetic markings are long-lasting, they are nevertheless potentially reversible. In this review, we summarize our current understanding of the epigenetic mechanisms involved in the mental health consequences derived from early-life exposure to malnutrition, maltreatment and poverty, adversities with huge and pervasive impact on mental health. We also discuss the evidence about transgenerational epigenetic inheritance in mammals and experimental data suggesting that suitable social and pharmacological interventions could reverse adverse epigenetic modifications induced by early-life negative social experiences. In this regard, these studies must be accompanied by efforts to determine the causes that promote these adversities and that result in health inequity in the population.

Neurocognitive consequences of adolescent sleep disruptions and their relationship to psychosis vulnerability: a longitudinal cohort study

Adolescence is a key period for neurocognitive maturation where deviation from normal developmental trajectories may be tied to adverse mental health outcomes. Cognitive disruptions have been noted in populations at risk for psychosis and are known to accompany periods of sleep deprivation. This study aims to assess the role of cognition as a mediator between sleep disruptions and psychosis risk. A cohort of 3801 high school students (51% female, mean age = 12.8, SD = 0.45 years) was recruited from 31 Montreal high schools. Measures of sleep, psychotic-like experiences, inhibition, working memory, perceptual reasoning, and delayed recall were collected from participants on a yearly basis over the five years of their high school education. A multi-level model mediation analysis was performed controlling for sex and time squared. Response inhibition was shown to be associated with, and to mediate (B = −0.005, SD = 0.003, p = 0.005*) the relationship between sleep disruptions (B = −0.011, SD = 0.004, p < 0.001*) and psychotic-like experiences (B = 0.411, SD = 0.170, p = 0.005*). Spatial working memory deficits on a given year were associated with a higher frequency of psychotic-like experiences that same year (B = −0.046, SD = 0.018, p = 0.005*) and the following year (B = −0.051, SD = 0.023, p = 0.010*), but were not associated with sleep disturbances. No significant associations were found between our variables of interest and either delayed recall or perceptual reasoning at the within person level. Findings from this large longitudinal study provide evidence that the association between sleep disruptions and psychosis risk is specifically mediated by inhibitory rather than general cognitive impairments. The association of spatial working memory, response inhibition, and sleep disruptions with psychotic-like experiences suggests that these factors may represent potential targets for preventative interventions.

Exploring Titanium Dioxide Nanotubes: Pioneering Advanced Applications in Efficient Water Splitting and Sustainable Hydrogen Generation

This interdisciplinary study synthesizes findings from diverse fields including materials science, psychology, and environmental sustainability to explore the multifaceted challenges and opportunities associated with titanium dioxide (TiO2) nanotubes and social media use. In the realm of materials science, TiO2 nanotubes have garnered attention for their potential applications in sustainable energy generation, particularly in water splitting for hydrogen production. Synthesis methods such as hydrothermal synthesis and nitrogen doping have been investigated to enhance the photocatalytic performance and stability of TiO2 nanotubes. Concurrently, the proliferation of social media platforms has transformed communication patterns and behaviors worldwide, shaping individuals' interactions, perceptions, and mental health outcomes. While social media offers opportunities for connectivity and self-expression, excessive use has been associated with adverse mental health outcomes, including symptoms of depression, anxiety, and loneliness. Additionally, social media engagement has been linked to body image dissatisfaction, sleep disturbances, and academic performance, highlighting the complex interplays between online behaviors and psychological well-being. This study integrates insights from a comprehensive review of peer-reviewed literature, encompassing experimental research, observational studies, and survey-based investigations. The synthesis underscores the need for interdisciplinary collaboration and targeted interventions to address the complex societal challenges posed by TiO2 nanotubes and social media use. Recommendations include further research to optimize synthesis methods, enhance regulatory oversight, and promote responsible digital citizenship. By fostering dialogue and collaboration between researchers, policymakers, and practitioners, this study aims to inform evidence-based interventions and policy initiatives to promote sustainability, well-being, and equity in the digital age.

Maternal distress during the COVID-19 outbreak: A socio-ecological perspective.

Mothers faced an increased risk of adverse mental health outcomes during the COVID-19 pandemic compared to other populations. However, there is little data on the factors that placed mothers at increased risk of distress. The present study explored a range of individual, familial, and environmental factors associated with psychological distress in mothers during the COVID-19 pandemic. This repeated cross-sectional study was composed of a convenience sample of mothers who completed an online survey that included a demographic questionnaire, an emotion regulation questionnaire, and the Depression, Anxiety, and Stress scale. The survey was administered during the second and third lockdowns in Israel in 2020-2021. The study included 575 mothers (M age = 39). The findings of a hierarchical regression indicated that individual-level factors, composed of age and emotion regulation tendencies predicted psychological distress. The family-level factors of household income and number of children in the family also predicted distress. In terms of environmental-level factors, COVID-19-related media consumption and school status (open or closed) were also significant predictors of psychological distress. Importantly, the results showed that the most important predictors of psychological distress in mothers during the COVID-19 outbreak were school closures, household income, and the use of adaptive and maladaptive emotion regulation strategies. The findings highlight the intersection of individual, familial, and environmental factors in mothers' mental health during crises.

Subtypes of childhood maltreatment and posttraumatic stress disorder symptoms in an adult trauma sample: The mechanistic role of sleep.

Childhood maltreatment is indisputably linked to adverse mental health outcomes, including an increased risk to develop posttraumatic stress disorder (PTSD) in adulthood. The role of childhood maltreatment in the context of recovery from a trauma later in adulthood is not well understood. A variable related to both childhood maltreatment and PTSD symptoms, and a potential link between the two, is sleep. The current study aimed to understand how sleep disturbances may play a mechanistic role in the effect of subtypes of childhood maltreatment on PTSD symptom severity in an adult trauma sample. 160 adults (90 women; Mage = 33.73, SD = 10.86) were recruited from the emergency department at a Level-1 trauma center in southeastern Wisconsin after experiencing a traumatic injury. Experiences of childhood maltreatment and sleep were self-reported at 2-week and 3-month posttrauma, respectively. PTSD symptoms were clinically assessed 6 months later. Sleep disturbances 3-month posttrauma mediated the effect of emotional abuse, physical neglect, and emotional neglect on PTSD symptom 6 months after the traumatic injury. The effect of sexual and physical abuse on PTSD symptoms was not significantly mediated by sleep disturbances. These findings highlight the differential impact of subtypes of childhood maltreatment on PTSD symptoms, the mechanistic role of sleep, and the need to consider early life adversity when assessing adult posttrauma experiences. These results also suggest that interventions aimed at improving sleep quality might improve PTSD symptoms in those who have experienced childhood maltreatment and a subsequent traumatic injury in adulthood. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Mental Health Needs, Barriers, and Receipt of Care Among Transgender and Nonbinary Adolescents

PurposeTransgender and nonbinary youth disproportionately experience adverse mental health outcomes compared to cisgender youth. This study examined differences in their mental health needs and supports, barriers to care, and receipt of mental health care. MethodsThis study examined cross-sectional data from 43,339 adolescents who completed the California Healthy Kids Survey, 4% (n = 1,876) of whom identified as transgender and/or nonbinary. Chi-square test and t-test were used to compare mental health needs and supports, resilience, and barriers to and receipt of care experienced by transgender and nonbinary youth compared to cisgender youth. ResultsTransgender and nonbinary youth were significantly more likely to experience chronic sadness/hopelessness (74% vs. 35%) and consider suicide (53% vs. 14%) and less likely to report resilience factors (school connectedness: mean score 3.12 vs. 3.52). Transgender and nonbinary youth were significantly less likely to be willing to talk to teachers/adults from school (12% vs. 18%) or parents/family members (21% vs. 43%), but more willing to talk to counselors (25% vs. 19%) regarding mental health concerns. Transgender and nonbinary youth were significantly more likely to select being afraid (48% vs. 20%), not knowing how to get help (44% vs. 30%), or concern their parents would find out (61% vs. 36%) as barriers to seeking mental health care, yet reported slightly higher odds of receiving care when needed (odds ratio: 1.2). DiscussionTransgender and nonbinary youth are more likely to report mental health concerns and barriers to seeking care than cisgender youth. Increasing access to care is critical for this population.

Supportive and non-supportive social experiences following suicide loss: a qualitative study

BackgroundSuicide bereavement entails profound social stressors, including stigma and communication barriers, which can impair social support for suicide loss survivors (SLS). Despite recognized benefits of empathetic interactions, social support, and self-disclosure in mitigating adverse mental health outcomes after suicide loss, we lack a comprehensive understanding of the factors influencing perceived social support among SLS within their broader social environments. To address this gap, our study explores the diverse social experiences of SLS beyond their immediate circles. Specifically, we identify characteristics that define both supportive and non-supportive social experiences of SLS, as well as the facilitators and barriers to social support in the context of suicide bereavement.MethodsIn 2022, we conducted structured online individual interviews with a diverse sample of 18 SLS in Germany. We analyzed these interviews using qualitative content analysis.ResultsWe examined the social experiences of SLS across three phases and social contexts: (1) the immediate aftermath of the loss; (2) during bereavement practices; and (3) over time. Our findings show that proactive responses and personalized mourning rituals significantly enhance SLS’ sense of community support, while encounters characterized by avoidance or intrusive curiosity lead to feelings of isolation. Over time, supportive interactions often emerge from peers with similar experiences, promoting openness and shared vulnerability. Conversely, superficial engagement, along with experiences of others depersonalizing and avoiding conversations about the loss, contribute to a sense of marginalization.ConclusionsOur findings highlight the importance of proactive engagement and open dialogue, calling for societal and communicative shifts toward inclusive and compassionate approaches in addressing suicide loss. This study underscores the need for comprehensive strategies that enhance both suicide and grief literacy and address the taboo and stigma surrounding suicide, ultimately fostering supportive social environments for SLS.

Are community-based interventions effective at improving mental health outcomes in refugee children and adolescents in high-income countries?

SUMMARYMultiple epidemiological studies have shown an increased prevalence of adverse mental health outcomes in refugee populations and have highlighted children and adolescents to be particularly at risk. This commentary considers a Cochrane Review examining the efficacy of community-based interventions at improving the mental health of refugee children and adolescents in high-income countries. The review concludes that community-based interventions are ineffective at improving mental health in such populations. Notably, the data are limited by significant risk of bias and a small sample size. This article aims to critically appraise this systematic review, extrapolate implications for current practice and identify avenues for further research.

The association between psychological distress, abusive experiences, and help-seeking among people with intimate partner violence.

Intimate partner violence (IPV) is a serious public health problem associated with countless adverse physical and mental health outcomes. It places an enormous economic and public health burden on communities. The aim of this study was to examine the associations between psychological states (such as depression or hopeless) and help-seeking experiences of IPV survivors after experiencing IPV, based on the Allegheny County Health Survey (ACHS). Data from 2015 to 2016 Allegheny County Health Survey with N = 8,012 adults were analyzed. The 6-item version of the Kessler Psychological Stress Scale, located in Module 11 of the ACHS questionnaire, was used to measure psychological stress in participants. Module 12 of the ACHS questionnaire collected information on participants' experiences of intimate partner violence and help-seeking in the past 12 months. Descriptive statistical analysis, Pearson's chi-square or two sample independent t-tests statistical analysis, and multivariate binary logistic regression models were used to analyze the relationship between IPV experience and psychological distress. A total of 212 of the 8,012 participants had IPV experience, with age, marital status, education, income, and race significantly different from those without IPV experience. The psychological stress of participants feeling hopeless (OR = 2.02, 95% CI = 1.37-2.99), restless or fidgety (OR = 1.83, 95% CI = 1.27-2.65), perceiving everything was an effort (OR = 1.55, 95% CI = 1.08-2.22) and worthless (OR = 1.49, 95% CI = 1.01-2.20) was associated with the IPV experience. Help-seeking behaviors of IPV survivors were associated with psychological distress, such as hopelessness (OR = 6.71, 95% CI = 1.38-32.60). This study explored the association between IPV experience, help-seeking and psychological distress, and the need to expand community support. It is necessary to implement targeted interventions, enhance training of professionals, and promote the identification of early IPV cases as well as collaboration between healthcare and social support departments to reduce the occurrence of IPV or psychological distress following IPV.

Parental Experiences of Supporting the Mental Health of Their LGBTQA+ Child

Young people who are lesbian, gay, bisexual, trans, queer or questioning, asexual and other diverse genders and sexualities (LGBTQA+) are at greater risk of adverse mental health outcomes and suicide, with additional barriers to accessing safe and affirming physical and mental health services in comparison to the general population. Parents of LGBTQA+ young people who are supportive and accepting can take on additional responsibilities and an active role in supporting young people, and more information is needed to understand how parents support LGBTQA+ young people in times of acute mental health difficulties (including suicide risk) and what parents experience while navigating support systems. It is imperative these experiences are better understood to inform other parents, clinicians and service providers alike. We aimed to develop a nuanced understanding of the experiences of Australian parents of LGBTQA+ young people in providing support during times of acute distress and suicidal crisis. We utilized an exploratory qualitative design using semi-structured one-on-one interviews with 11 parents. We provide clinically useful recommendations, with the aim of aiding enhanced parental support for LGBTQA+ young people, given this population’s unique needs.

Social support, distress, stress, anxiety, and depression as predictors of suicidal thoughts among selected university students in Bangladesh.

This study examines the association of perceived social support with suicidal thoughts among a young adult sample of university students and estimates the degree to which perceived stress, distress, anxiety, and depression may explain the association. A cross-sectional survey was conducted from June to September 2022 among 642 students, selected using the probability proportional to size procedure, at a large university in Bangladesh. We used the Multidimensional Scale of Perceived Social Support (MSPSS) to measure support. The Impact of Events Scale-Revised (IES-R), the Perceived Stress Scale (PSS-10), the Generalized Anxiety Disorders (GAD-7) scale, and the Patient Health Questionnaire (PHQ-9) were used to assess distress, stress, anxiety, and depression. The association between social support and suicidal thoughts was examined using multivariable logistic regression models. Mediation analyses were carried out using the Karlson, Holm, and Breen (KHB) method. We found that perceived social support was associated with lower odds of suicidal thoughts after controlling for other variables (adjusted odds ratio = 0.94; 95% confidence interval = 0.92-0.96). Mediation analysis showed that, after adjusting for potential confounders, the mediating effects among the total effect of perceived social support on suicidal thoughts were 56.1%, 20.8%, 22.5%, 38.8%, and 50.9% for all mental disorders together and four specific adverse mental health outcomes, i.e., perceived distress, stress, anxiety, and depression, respectively. This study demonstrates that perceived social support reduces the likelihood of suicidal thoughts among university students, and mental disorders have a partial mediating effect on the association. Suicide prevention and mental health promotion efforts among university students should consider encouraging students to build and strengthen a strong social support network.

Associations between recorded loneliness and adverse mental health outcomes among patients receiving mental healthcare in South London: a retrospective cohort study.

Loneliness disproportionately affects people with mental disorders, but associations with mental health outcomes in groups affected remain less well understood. A cohort of patients receiving mental healthcare on 30th June 2012 was assembled from a large mental health records database covering a south London catchment area. Recorded loneliness within the preceding 2 years was extracted using natural language processing and outcomes were measured between 30th June 2012 until 30th December 2019, except for survival which applied a censoring point of 6th December 2020 according to data available at the time of extraction. The following mental healthcare outcomes: (i) time to first crisis episode; (ii) time to first emergency presentation; (iii) all-cause mortality; (iv) days active to service per year; and (v) face-to-face contacts per year. Loneliness was recorded in 4,483 (16.7%) patients in the study population and fully adjusted models showed associations with subsequent crisis episode (HR 1.17, 95% CI 1.07-1.29), emergency presentation (HR 1.30, 1.21-1.40), days active per year (IRR 1.04, 1.03-1.05), and face-to-face contacts per year (IRR 1.28, 1.27-1.30). Recorded loneliness in patients with substance misuse problems was particularly strongly associated with adverse outcomes, including risk of emergency presentation (HR 1.68, 1.29-2.18) and mortality (HR 1.29, 1.01-1.65). Patients receiving mental healthcare who are recorded as lonely have a higher risk of several adverse outcomes which may require a need for higher service input.

The Social Context of Pregnancy, Respectful Maternity Care, Biomarkers of Weathering, and Postpartum Mental Health Inequities: A Scoping Review.

Background: Mental health disorders are the number one cause of maternal mortality and a significant maternal morbidity. This scoping review sought to understand the associations between social context and experiences during pregnancy and birth, biological indicators of stress and weathering, and perinatal mood and anxiety disorders (PMADs). Methods: A scoping review was performed using PRISMA-ScR guidance and JBI scoping review methodology. The search was conducted in OVID Medline and Embase. Results: This review identified 74 eligible English-language peer-reviewed original research articles. A majority of studies reported significant associations between social context, negative and stressful experiences in the prenatal period, and a higher incidence of diagnosis and symptoms of PMADs. Included studies reported significant associations between postpartum depression and prenatal stressors (n = 17), socioeconomic disadvantage (n = 14), negative birth experiences (n = 9), obstetric violence (n = 3), and mistreatment by maternity care providers (n = 3). Birth-related post-traumatic stress disorder (PTSD) was positively associated with negative birth experiences (n = 11), obstetric violence (n = 1), mistreatment by the maternity care team (n = 1), socioeconomic disadvantage (n = 2), and prenatal stress (n = 1); and inverse association with supportiveness of the maternity care team (n = 5) and presence of a birth companion or doula (n = 4). Postpartum anxiety was significantly associated with negative birth experiences (n = 2) and prenatal stress (n = 3). Findings related to associations between biomarkers of stress and weathering, perinatal exposures, and PMADs (n = 14) had mixed significance. Conclusions: Postpartum mental health outcomes are linked with the prenatal social context and interactions with the maternity care team during pregnancy and birth. Respectful maternity care has the potential to reduce adverse postpartum mental health outcomes, especially for persons affected by systemic oppression.

The Impact of Social Stigma on the Mental Health of LGBTQ Community

LGBTQ+ community people experience and worries of sexual stigma that affects their mental health. This study investigates the relationship between social stigma and mental health outcomes among LGBTQ+ individuals in India. Utilizing data from a diverse sample of 400 participants, comprising males, females, and non-binary/genderqueer individuals, gathered through an online questionnaire, the research examines the impact of social stigma variables including Rejection, Inferiority, Support Loved Ones and Social Perception Isolation and Loneliness Emotional Resilience parameters such as Unhappiness, Nervousness, and Suicidal Thoughts. Statistical analyses, conducted using SPSS, reveal moderate to moderately strong correlations between experiences of social stigma and adverse mental health outcomes, highlighting the urgent essential for targeted interventions toward reduce stigma then enhance rational healthiness support within LGBTQ+ communities in India and beyond. These findings underscore the importance of fostering inclusive environments and tailored interventions to promote the well-being of LGBTQ+ individuals. Keywords: LGBTQ+, Social Stigma, Mental Health, Queer

Childhood maltreatment and resting-state network connectivity: The risk-buffering role of positive parenting.

Unraveling the neurobiological foundations of childhood maltreatment is important due to the persistent associations with adverse mental health outcomes. However, the mechanisms through which abuse and neglect disturb resting-state network connectivity remain elusive. Moreover, it remains unclear if positive parenting can mitigate the negative impact of childhood maltreatment on network connectivity. We analyzed a cohort of 194 adolescents and young adults (aged 14-25, 47.42% female) from the Neuroscience in Psychiatry Network (NSPN) to investigate the impact of childhood abuse and neglect on resting-state network connectivity. Specifically, we examined the SAN, DMN, FPN, DAN, and VAN over time. We also explored the moderating role of positive parenting. The results showed that childhood abuse was linked to stronger connectivity within the SAN and VAN, as well as between the DMN-DAN, DMN-VAN, DMN-SAN, SAN-DAN, FPN-DAN, SAN-VAN, and VAN-DAN networks about 18 months later. Positive parenting during childhood buffered the negative impact of childhood abuse on network connectivity. To our knowledge, this is the first study to demonstrate the protective effect of positive parenting on network connectivity following childhood abuse. These findings not only highlight the importance of positive parenting but also lead to a better understanding of the neurobiology and resilience mechanisms of childhood maltreatment.

Optimism in dire times: The buffering role of optimism in the relationship between food insecurity and mental health during the COVID-19 pandemic

Considering the need to gain a deeper understanding of the protective factors associated with coping with food insecurity, specifically in times of severe prolonged stress, the current longitudinal study seeks to examine the role of optimism in the relationship between food insecurity and adverse mental health outcomes during the COVID-19 pandemic. A three-wave longitudinal study involving 1921 Israeli adults was performed during the COVID-19 pandemic. Participants completed questionnaires assessing food insecurity, anxiety, depression, optimism, and socio-demographic characteristics. To explore the relationship between food insecurity and symptoms of anxiety and depression, as well as the moderating role of optimism in this relationship, we employed a set of panel regression models with individual fixed effects. Our results indicate that the degree and change in food insecurity over time were positively associated with both anxiety and depression symptoms, whereas the degree and change in optimism were negatively correlated. Optimism was found to moderate the association between food insecurity and anxiety symptoms over time, but not the association between food insecurity and depression symptoms. A subgroup analysis revealed that optimism moderated the relationship between food insecurity and anxiety and depression for women, but not for men; for married/coupled individuals but not for singles; for non-parents with regard to anxiety, and for parents with regard to depression. Our results highlight the need to practice and enhance optimism in times of great despair, uncertainty, and hardship, especially in situations of food insecurity where tangible change may take time.

Identifying research gaps in climate-related mental health outcomes in North America and Europe: a qualitative framework analysis

BackgroundClimate change and mental health outcomes are two of the most pressing global crises. Despite the increasing global mental health burden, climate-related mental health outcomes research is nascent and isolated, with substantial gaps across regions and disciplines. Connecting Climate Minds is a global initiative connecting researchers, experts, and people with lived experience of adverse mental health outcomes to identify regional research needs and create a community to support improved climate-related mental health outcomes. MethodsWe focused on North America and Europe as part of the global Connecting Climate Minds effort, using semi-structured interviews, focus groups, regional dialogues (ie, discussions between experts in climate health, planetary health, human health, and mental health and with lived experience to discuss the climate threats most affecting their communities, their effects on mental health, and opportunities for action), and a literature review to identify crucial research gaps in climate change and mental health. We collected insights into priorities when addressing mental health outcomes related to climate change in Europe and North America; requirements for effective research, policy, and practice; and encouraging collaboration from a diverse community that included experts, researchers, practitioners from multiple disciplines, indigenous groups, and youth representatives. We used a qualitative framework analysis to identify consensus priorities. FindingsSeveral themes emerged regarding research gaps. First, research into the effects of climate change on mental health is needed (eg, how pre-existing mental health outcomes are affected by climate disaster events, risk factors and protective factors, the effects of climate action or inaction on mental health, and economic costs). Second, investigating connections between climate-related mental health outcomes and Indigenous and other cultural practices (eg, the effects of climate change on Indigenous peoples and practices, cultural variations in mental health responses, and the effectiveness of integrating Indigenous and cultural knowledge into mental health interventions). Third, mixed-methods research is needed to explore the relationships between climate change, global and national economies, and governance and their associations with mental health outcomes. Fourth, evaluating social and cultural connectedness in mental health outcomes and climate change, community-level interventions, and the effectiveness of climate-education programmes that incorporate mental health considerations are research priorities. Finally, understanding how emerging technology can be used to understand climate-related mental health outcomes and use of technology to collect, analyse, and respond to population health data (with ethical considerations). InterpretationConnecting Climate Minds aims to psychologically equip people in Europe and North America to navigate the challenges of a changing climate. Climate-related mental health experts in should collaborate and encourage research and action that are proactive, community-led, and accessible. FundingImperial College London, the Wellcome Trust, and the Planetary Health Alliance via Harvard University.

Association of Hyperparathyroidism with Depression and Anxiety Among Chronic Hemodialysis Patients in the Al Baha Region, Kingdom of Saudi Arabia.

Introduction Anxiety and depression are prevalent psychological issues among hemodialysis patients, adversely affecting their well-being and treatment response. The study aims to identify the relationship between these mental health concerns and hyperparathyroidism in chronic hemodialysis patients from the Al Baha Region, Kingdom of Saudi Arabia. Methods This retrospective study included 143 chronic hemodialysis patients aged 18-85 years. Monthly laboratory records for parathyroid hormone (PTH) levels and the Hospital Anxiety and Depression Scale (HADS) for mental health assessment were utilized. Demographic information and the primary causes of end-stage renal disease were obtained through patient interviews. Statistical analyses, including chi-square tests, odds ratio, and significance tests, were performed to assess associations. Results Elevated PTH levels were associated with increased anxiety and depression in hemodialysis patients. Patients with PTH levels >400 pg/ml exhibited higher rates of abnormal HADS scores for anxiety and depression than those with PTH levels <400 pg/ml. Gender differences were evident, with women showing a higher predisposition to anxiety disorders and men having depression. Additionally, patients with PTH levels <150 pg/ml had a significantly higher proportion of the "normal" depression score than those with PTH levels >800 pg/ml. Conclusion The study underscores the association between hyperparathyroidism and adverse mental health outcomes in chronic hemodialysis patients. Maintaining optimal PTH levels plays a crucial role in mitigating anxiety and depression. Gender differences in mental health outcomes highlight the need for tailored interventions. Routine mental health assessments, utilizing tools such as the HADS, are important in the comprehensive care of hemodialysis patients.

Intergenerational trauma transmission through family psychosocial factors in adult children of Rwandan survivors of the 1994 genocide against the Tutsi

Thirty years after the 1994 genocide against the Tutsi in Rwanda, children of survivors are being increasingly documented to be at higher risk compared to their peers for adverse mental health outcomes. However, no studies in Rwanda have empirically explored family psychosocial factors underlying this intergenerational transmission of trauma. We investigated family psychosocial factors that could underlie this transmission in 251 adult Rwandan children of survivors (mean age = 23.31, SD = 2.40; 50.2% female) who completed a cross-sectional online survey. For participants with survivor mothers (n = 187), we found that both offspring-reported maternal trauma exposure and maternal PTSD were indirectly associated with children's PTSD via maternal trauma communication (specifically, nonverbal and guilt-inducing communication), and that maternal PTSD was indirectly associated with children's PTSD, anxiety, and depression symptoms through family communication styles. For participants with survivor fathers (n = 170), we found that paternal PTSD symptoms were indirectly associated with children's anxiety and depression symptoms via paternal parenting styles (specifically, abusive and indifferent parenting). Although replication is needed in longitudinal research with parent-child dyads, these results reaffirm the importance of looking at mass trauma in a family context and suggest that intergenerational trauma interventions should focus on addressing family communication, trauma communication, and parenting.

Association of ever use of e-cigarettes with health and lifestyle variables among young adults: a Canadian health measure survey study.

Our study found that EC use was independently and significantly associated with increased odds of life stress and an indication of poorer QOL. Ongoing surveillance on young EC users is important to measure the long-term impact of vaping on their physical, mental health and quality of life to target for interventions. • E-cigarette use has been associated with high-risk behaviours and adverse mental health outcomes, such as depression and anxiety. • E-cigarette users had significantly higher odds of being physically active and higher amounts of life stress.