Background Mental Health Problems Research Articles

Intentions and barriers to help-seeking in adolescents and young adults differing in depression severity: cross-sectional results from a school-based mental health project

BackgroundMental health problems, such as depression, have a high prevalence in young people. However, the majority of youths suffering from depression do not seek professional help. This study aimed to compare help-seeking behavior, intentions and perceived barriers between youthswith different levels of depressive symptoms.MethodsThis cross-sectional study is part of a large-scale, multi-center project. Participants were n = 9509 youths who were recruited in German schools and completed a baseline screening questionnaire. Based on their depressive symptoms, youths were allocated to the following three subgroups: (a) without depressive symptoms, (b) with subclinical symptoms, (c) with clinical symptoms (measured by PHQ-A). Quantitative analyses compared previous help-seeking behavior, help-seeking intentions and perceived barriers (Barriers questionnaire) between these subgroups. An additional exploratory qualitative content analysis examined text answers on other perceived barriers to help-seeking.ResultsParticipants were mostly female (n = 5575, 58.6%) and 12 to 24 years old (M = 15.09, SD 2.37). Participants with different levels of depressive symptoms differed significantly in help-seeking behavior, intentions and perceived barriers. Specifically, participants with clinical depressive symptoms reported more previous help-seeking, but lower intentions to seek help compared to participants without symptoms (all p < 0.05). Participants with subclinical depressive symptoms reported a similar frequency of previous help-seeking, but higher intentions to seek help compared to participants without symptoms (all p < 0.05). Perception of barriers was different across subgroups: participants with clinical and subclinical depressive symptoms perceived the majority of barriers such as stigma, difficulties in accessibility, and family-related barriers as more relevant than participants without depressive symptoms. Across all subgroups, participants frequently mentioned intrapersonal reasons, a high need for autonomy, and a lack of mental health literacy as barriers to help-seeking.ConclusionsYouths with higher levels of depressive symptoms are more reluctant to seek professional help and perceive higher barriers. This underlines the need for effective and low-threshold interventions to tackle barriers, increase help-seeking, and lower depressive symptoms in adolescents and young adults differing in depression severity.Trial registrationDRKS00014685.

A two-pronged approach to understanding reciprocity and mental health relationship in developing countries: evidence from young informal construction workers in Nigeria

BackgroundMental health problems disproportionately affect young people in developing countries. However, there is limited research on help-seeking behaviours and the social support systems that improve mental wellbeing among vulnerable youth populations.ObjectiveThis mixed-methods study aimed to examine the relationship between social support reciprocity and mental health among young informal construction workers in Nigeria, a population at high-risk for occupational and socioeconomic stressors.MethodsA cross-sectional survey was administered to 686 informal workers to measure reciprocity, mental health-related quality of life, and covariates. In-depth interviews with 32 participants provided qualitative context.ResultsQuantitative analyses showed 25% of participants reported poor mental health. Reciprocity positively predicted mental health after controlling for covariates. Qualitative findings revealed reciprocity occurs directly between individuals as well as indirectly through trade unions and religious groups. Indirect exchanges through groups helped address limitations of direct support due to limited resources.ConclusionsThis study fills important gaps in understanding how social relationships impact mental health in developing country contexts. Findings emphasize the role of collective action and community-based support systems in promoting mental wellbeing among vulnerable populations. Insights can inform culturally relevant, systems-level mental health interventions.

Adolescent boys’ experiences of mental health and school health services - an interview study from Norway

BackgroundMental health problems among adolescents is a global challenge. During the transition to adolescence, physiological, psychological, and social changes occur, leading to increased vulnerability. Thus, adolescent boys are less likely to seek help for mental health problems, which makes them an undetected group. The aim of this study was to gain a deeper understanding of adolescent boys’ experiences of mental health and school health service.MethodsAn inductive, qualitative design was chosen using three focus group interviews and three individual interviews. The study included 18 adolescent boys in 7th grade, in a school located in a medium-sized municipality in Norway. The interviews were analysed with qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) were followed in this study.ResultsThe overall theme “barriers towards seeking help”, and three categories— navigating stigma and privacy concerns; perceptions of self-responsibility; and lacking knowledge of mental health problems and help-seeking—described the adolescent boys experiences. The awareness and willingness to seek help were present, but there are barriers preventing the adolescent boys from acting on that willingness.ConclusionsLack of knowledge and a non-permissive culture for mental health problems among adolescents contributes to decreased help-seeking behaviour among adolescent boys. The school health service is the most related health service for adolescents and should focus on being available and strengthening empowerment and mental health literacy through the development and implementation of interventions to promote mental health.

Acceptance of smart sensing, its determinants, and the efficacy of an acceptance-facilitating intervention in people with diabetes: results from a randomized controlled trial.

Mental health problems are prevalent among people with diabetes, yet often under-diagnosed. Smart sensing, utilizing passively collected digital markers through digital devices, is an innovative diagnostic approach that can support mental health screening and intervention. However, the acceptance of this technology remains unclear. Grounded on the Unified Theory of Acceptance and Use of Technology (UTAUT), this study aimed to investigate (1) the acceptance of smart sensing in a diabetes sample, (2) the determinants of acceptance, and (3) the effectiveness of an acceptance facilitating intervention (AFI). A total of N = 132 participants with diabetes were randomized to an intervention group (IG) or a control group (CG). The IG received a video-based AFI on smart sensing and the CG received an educational video on mindfulness. Acceptance and its potential determinants were assessed through an online questionnaire as a single post-measurement. The self-reported behavioral intention, interest in using a smart sensing application and installation of a smart sensing application were assessed as outcomes. The data were analyzed using latent structural equation modeling and t-tests. The acceptance of smart sensing at baseline was average (M = 12.64, SD = 4.24) with 27.8% showing low, 40.3% moderate, and 31.9% high acceptance. Performance expectancy (γ = 0.64, p < 0.001), social influence (γ = 0.23, p = .032) and trust (γ = 0.27, p = .040) were identified as potential determinants of acceptance, explaining 84% of the variance. SEM model fit was acceptable (RMSEA = 0.073, SRMR = 0.059). The intervention did not significantly impact acceptance (γ = 0.25, 95%-CI: -0.16-0.65, p = .233), interest (OR = 0.76, 95% CI: 0.38-1.52, p = .445) or app installation rates (OR = 1.13, 95% CI: 0.47-2.73, p = .777). The high variance in acceptance supports a need for acceptance facilitating procedures. The analyzed model supported performance expectancy, social influence, and trust as potential determinants of smart sensing acceptance; perceived benefit was the most influential factor towards acceptance. The AFI was not significant. Future research should further explore factors contributing to smart sensing acceptance and address implementation barriers.

The epidemiology of major depression among adults in Norway: an observational study on the concurrence between population surveys and registry data – a NCDNOR project

BackgroundMental health problems, and major depression in particular, are important public health issues. Following trends in the prevalence of major depression is difficult because of the costs and complications of diagnostic interviews and general population self-report health surveys. Scandinavian countries, however, have several central, population-based health registries. We aimed to investigate how well these registries capture the epidemiology of major depression in the population.MethodsIn two Norwegian regional surveys of general population health, each repeated after 10 years, responders were asked to report depressive symptoms using the Hopkins Symptom Checklist (HSCL) or the Hospital Anxiety and Depression Scale (HADS). Data were linked to three central health registries capturing contact with primary care, specialist care and prescriptions for antidepressants, to investigate how well these registries reflected self-reported depressive symptoms.ResultsMost responders scored low on Hopkins Symptom Checklist (HSCL) and the Hospital Anxiety and Depression Scale (HADS), but 10% and 13%, respectively, scored above cut-off, with only minor changes between the two survey times. Females scored higher than males. Older people scored lower than younger, and a social gradient was visible. Around 12% of those who scored above the cut-off on either scale were recorded in the central health registries during the following year. This correlation was highest in primary care data, followed by prescription data and lowest in specialist care. Females were more often recorded in registries (p < 0.001), as were younger people (p < 0.001).ConclusionsThere was a strong association between scores on screening for major depression in the general population surveys and being recorded in central health registries. There was a low sensitivity of these registries. and there was some variation in how sensitive the central health registries were in picking up depression, especially for males and older people. However, the stability of the measures over time suggests we may get an impression of the prevalence of major depression in the general population by using data from the central health registries. A combination of primary care data, prescription data and specialist care data have a higher sensitivity.

1 plus 1 is more than 2: mental health problems, financial difficulties, and social exclusion in a cross-sectional study of 28,047 general-population adults

BackgroundMental health problems and financial difficulties each increase the risk of social exclusion. However, few large studies representing a broad age range have investigated the combined social effect of having both difficulties. The purpose of this cross-sectional study was to examine associations of mental health problems, financial difficulties, and the combination of both with social exclusion.MethodsThis analysis was based on responses from 28,047 adults (age > 18 years) from the general population participating in The Norwegian Counties Public Health Survey 2019. Respondents answered questions about their financial situation, mental health problems, and social exclusion. Social exclusion was measured as a lack of social support, low participation in organized social activities, low participation in other activities, missing someone to be with, feeling excluded, and feeling isolated. Adjustments for sex and age were made in multivariable logistic regression analyses.ResultsHaving mental health problems or financial difficulties was associated with various measures of social exclusion (odds ratios [ORs] with 95% confidence intervals [CIs]: 1.33 [1.23–1.43] to 12.63 [10.90–14.64]). However, the odds of social exclusion strongly increased for respondents who reported a combination of mental health problems and financial difficulties compared with those who did not report either (ORs [CIs]: 2.08 [1.90–2.27] to 29.46 [25.32–34.27]).ConclusionsHaving the combination of mental health problems and financial difficulties is strongly associated with increased risk for social exclusion, far beyond the effect of either factor alone.

Parenting style and child mental health at preschool age: evidence from rural China

BackgroundMental health problems among children at preschool age are a common issue across the world. As shown in literature, a caregiver’s parenting style can play a critical role in child development. This study aims to examine the associations between a caregiver’s parenting style and the mental health problems (or not) of their child when he/she is at preschool age in rural China.MethodsParticipants were children, aged 49 to 65 months, and their primary caregivers. The primary caregivers of the sample children completed the Parenting Styles and Dimensions Questionnaire, Short Version, the Strengths and Difficulties Questionnaire, and a questionnaire that elicited their socio-demographic characteristics. The level of cognitive development of each sample child was assessed using the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition. Pearson correlation analysis, linear regression analysis, and multivariable regression analysis were used to analyze the data.ResultsThe prevalence of mental health problems among sample children at preschool age was high (31.6%). If a caregiver practices an authoritative parenting style, it was found to be negatively associated with the mental health problems of their child. In contrast, a caregiver’s authoritarian parenting style was positively associated with the mental health problems of their child. Compared to those in a subgroup of primary caregivers that used a combination of low authoritative and low authoritarian parenting style, primary caregivers that used a combination of high authoritarian and low authoritative or a combination of high authoritative and high authoritarian were found to have positive association with child health problems. A number of demographic characteristics were found to be associated with the adoption of different parenting styles.ConclusionDifferent parenting styles (including authoritative, authoritarian, and combination of authoritative and authoritarian) of the sample caregivers had different associations with the mental health problems of the sample children. Parenting programs that aim to improve the parenting styles (favoring authoritative parenting styles) should be promoted in an effort to improve the status of child mental health in rural China.

Breaking down barriers to mental healthcare access in prison: a qualitative interview study with incarcerated males in Norway

BackgroundMental health problems are highly prevalent in prison populations. Incarcerated persons generally come from disadvantaged backgrounds and are living under extraordinary conditions while in prison. Their healthcare needs are complex compared to the general population. Studies have found that incarcerated individuals are reluctant to seek help and that they experience challenges in accessing mental healthcare services. To some extent, seeking treatment depends on the degree of fit between potential users and health services, and actual use might be a better indication of accessibility than the fact that services are available. This study aimed to explore individual and systemic facilitators and barriers to accessing mental healthcare in a prison context.MethodsAn analytical approach drawing on elements of constructivist Grounded theory was the methodological basis of this study. Fifteen male participants were recruited from three prisons in Northern Norway. Data was collected through in-depth interviews on topics such as help-seeking experiences, perceived access to services and availability of health information.ResultsWe found that distrust in the system, challenges with the referral routines, worries about negative consequences, and perceived limited access to mental healthcare were barriers to help-seeking among incarcerated individuals. How prison officers, and healthcare personnel respond to incarcerated persons reporting mental distress could also be critical for their future willingness to seek help. Providing information about mental health and available services, initiating outreaching mental health services, and integrating mental health interventions into treatment programs are examples of efforts that might reduce barriers to accessing services.ConclusionsFacilitating access to mental health services is crucial to accommodate the mental health needs of those incarcerated. This study provides insights into the complex interplay of individual, social and systemic factors that may contribute to the utilization of mental health care among incarcerated persons. We suggest that correctional and healthcare systems review their practices to facilitate access to healthcare for people in prison.

Factors affecting self-perceived mental health in the general older population during the COVID-19 pandemic: a cross-sectional study

BackgroundMental health problems among older people are large public health concerns but often go unrecognized and undertreated. During COVID − 19 several restrictions regarding social contacts were launched, primarily for the old. The objective of this study is to investigate which factors that had the main negative affect on mental health in the older population during the pandemic.MethodA cross-sectional cohort study set in Swedish primary care during the pandemic years 2021–2022. The population constitutes of 70–80-years-old, N = 260. Instruments used are Geriatric depression scale 20 (GDS20); Hospital anxiety and depression scale (HADS), and Perceived stress scale 10 (PSS10). Sociodemography and risk factors are explored. Outcome measures are factors independently associated with decreased mental health. Analyses were performed for the group as a whole and with logistic regression models comparing individuals who stated they were mentally affected by the pandemic to individuals who stated they were not.ResultsParticipants who stated they were mentally affected by the COVID − 19 pandemic reported significantly higher levels of anxiety (p < 0.001), depression (p < 0.001), and stress (p = 0.026) compared to those who stated they were not mentally affected. Explanatory regression models of up to 50% showed that following factors were prominent among individuals who reported a decline in their mental health due to the COVID − 19 pandemic (n = 24); impaired social life (OR 20.29, p < 0.001, CI 4.53–90.81), change in physical activity (OR 5.28, p = 0.01, CI 1.49–18.72), perceived family situation (OR 31.90, p = 0,007, CI 2,53–402.42), mild/moderate and high anxiety (OR 4.94, p = 0.034, CI 1.13–21.60, OR 7.96, p = 0.035, CI 1.16–54.53 respectively), and female gender (OR 6.52, p = 0.029, CI 1.22–34.92).ConclusionAnxiety, family situation, social life and change in physical activity were the main factors influencing the 70–80-years-old’s self-perceived mental health during the COVID − 19 pandemic. Long-term effects of social restrictions on mental health in the older population need to be further investigated.

An international comparison of gender differences in mental health among higher-education students during the first wave of the COVID-19 pandemic: a multilevel design

BackgroundMental health problems are a common phenomenon among higher-education students. How these mental health problems manifest themselves appears to differ between male and female students. While the latter group bears a greater risk of developing internalizing problems, with depression being particularly prevalent, these problems manifest themselves in male students mainly via externalizing disorders, with alcohol abuse being the most prevalent. Available cross-national research on students’ mental health during the COVID-19 pandemic, to date, mainly focused on the prevalence of depressive symptoms, thereby ignoring a possible gendered impact of the pandemic.MethodsThe current study used the COVID-19 International Student Well-Being Study, which collected data on students’ mental health during the first wave of the COVID-19 pandemic in 26 countries, and multilevel modeling was applied.ResultsIt finds that, overall, female students reported more depressive feelings, and male students reported more excessive alcohol consumption. The strictness of the governmental containment measures explained a substantial amount of these gender differences in depressive feelings, but not in excessive alcohol consumption.ConclusionsOur study highlights that the COVID-19 pandemic had a gendered impact on students’ mental health. Studies that ignore the gendered impact of the COVID-19 pandemic are therefore limited in scope.

Intention to use a mobile phone to receive mental health support and its predicting factors among women attending antenatal care at public health facilities in Ambo town, West Shoa zone, Ethiopia 2022

BackgroundMental health problems are the most common morbidities of women during the prenatal period. In LMICs mobile phones have been identified as a good vehicle for monitoring individuals with a high risk of mental health conditions. However, evidence is scarce and the purpose of this study was to assess the intention to use a mobile phone to receive mental health support and its predicting factors among women attending antenatal care at public health facilities in Ambo town, Ethiopia 2022.Methods and materialsAn institutional-based cross-sectional study design was conducted from May 20th to June 20th, 2022. A total of 715 prenatal women were included and a systematic random sampling technique was employed. An interviewer-administered structured questionnaire was used. Collected data was exported to SPSS version 25 for the descriptive part, and AMOS 26 structural equation modeling was also used to describe and assess the degree and significance of relationships between variables.ResultsA total of 699 (97.8% response rate) responded to complete all the questionnaires. About 530 (77.3%) 95% CI (74%-80.3%) of women intended to use a mobile phone to receive mental health support. The perceived usefulness has a positive effect on attitude (β = 0.391, p < 0.001) and intention to use (β = 0.253, p < 0.001). The perceived ease of use influences perceived usefulness (β = 0.253, p < 0.001) and attitude β = 0.579, p < 0.001). The intention to use is positively affected by attitude (β = 0.662, p < 0.001).Trust has a positive effect on perceived usefulness (β = 0.580, p < 0.001) and intention to use (β = 0.113, p = 0.005). Subjective norm has a direct positive effect on perceived usefulness (β = 0.248, p < 0.001). Attitude serves as a partial mediator between perceived usefulness and intention to use and a complete mediating role between perceived ease of use and intention to use.ConclusionThe level of intention to use a mobile phone among prenatal women is relatively high and attitude, perceived usefulness, and trust had direct positive effects on intention to use a mobile phone. Therefore, hospitals and healthcare providers should take proactive measures to implement the strategies and policies for providing mobile phone-based mental health support to prenatal women in remote areas.

Impact of psychological distress on mortality in Spain. The importance of early detection and treatment of mental disorders

BackgroundMental health problems account for 14% of mortality worldwide. The aim of this study was to evaluate the association between psychological distress and mortality in the Spanish adult population. MethodsData came from a longitudinal study in population ≥15 years of age (n=21,005) who participated in the 2011-12 Spanish National Health Survey, which was linked to mortality records as of December 2020. Mental health was assessed with the GHQ-12, defining psychological distress as a dichotomous variable using a GHQ-12 score ≥3 as the cutoff point. Using Poisson regression, standardized mortality rate ratios (SRR) were estimated for all-cause, cardiovascular disease, and tumor-related mortality, adjusting for sociodemographic variables, lifestyles, and comorbidities. ResultsThe standardized overall mortality rate in individuals with and without psychological distress was 14.58 and 10.90 per 1000 person-years, respectively, estimating an SRR of 1.34 (95%CI: 1.19–1.50). The SRR for tumor-related mortality was 1.17 (95%CI: 0.90–1.53), and cardiovascular-related mortality was related to higher distress (GHQ-12 ≥ 4): SRR of 1.22 (95%CI: 0.98–1.51). Among psychological distressed individuals, the overall mortality SRR for those with a previous mental disorder diagnosis was 1.18 (95%CI: 0.91–1.53) versus 1.34 (95%CI: 1.18–1.54) for those without such diagnosis (p for interaction=0.067). Similarly, distressed participants taking prescription drugs for mental disorders had a lower mortality risk than those not taking them (p for interaction=0.016). ConclusionsIndividuals with psychological distress had a higher risk of overall-, cardiovascular disease- and tumor-related mortality. This association was higher among participants not previously diagnosed with a mental disorder and those not taking medication for mental issues.

Treatment rates and barriers to mental health service utilisation among university students in South Africa

BackgroundMental health problems are common and impairing among university students, yet only a minority of students with psychological disorders access treatment. Understanding barriers to treatment is integral to planning services, especially in resource constrained settings like South Africa (SA).MethodsData collected across 17 institutions in the online SA National Student Mental Health Survey were used to: (1) estimate 12-month prevalence of common mental health problems and self-harm; (2) estimate the proportion of students receiving treatments for the various mental health problems; (3) explore barriers to treatment; and (4) investigate sociodemographic predictors of treatment mediated through the various barriers endorsed by students with mental health problems. Prevalence analyses were carried out using cross-tabulations and prediction analyses using modified Poisson regression models.ResultsPrevalence of clinically significant mental health problems is high relative to international comparisons, with the prevalence of severe, mild and moderate symptoms of any disorder and/or self-harm of 24.8% (SD = 0.3), 18.8% (SD = 0.3) and 27.6% (SD = 0.4) respectively. Treatment rates were 35.2% (S.E. = 0.6) among students with mental health problems who perceived need for treatment and 21.3% (S.E. = 0.4) irrespective of perceived need. Treatment rates were highest for mood disorders (29.9%, S.E. = 0.6) and lowest for externalising disorders (23.8%, S.E. = 0.5). Treatment rates were much less variable across disorder types among students with perceived need than irrespective of perceived need, indicating that perceived need mediated the associations of disorder types with received treatment. Adjusting for disorder profile, probability of obtaining treatment was significantly and positively associated with older age, female gender, study beyond the first year, traditional sexual orientation, and diverse indicators of social advantage (full-time study, high parent education, and attending Historically White Institutions). Among students with mental health problems, numerous barriers to treatment were reported adjusting for disorder profile, including lack of perceived need (39.5%, S.E. = 0.5) and, conditional on perceived need, psychological (54.4%, S.E. = 1.0), practical (77.3%, S.E. = 1.1), and other (79.1%, S.E. = 1.1) barriers. Typically, students reported multiple barriers to treatment. Differences in perceived need explained the gender difference in treatment, whereas practical barriers were most important in accounting for the other predictors of treatment.ConclusionMental health problems are highly prevalent but seldom treated among SA university students. Although many barriers were reported, practical barriers were especially important in accounting for the associations of social disadvantage with low rates of treatment. Many of these practical barriers are however addressable.

Prevalence, persistence, and course of symptoms of depression, anxiety, and stress of mothers and fathers. Results of an 18-year longitudinal study

BackgroundMental health problems in mothers and fathers are common. This longitudinal study analyzed the prevalence, course, and persistence of symptoms of depression, anxiety, and stress over 18 years in parents based on a sample from the Future Family project (N = 316). MethodsAt pre-assessment the children were on average 4.2, the mothers 35.3, and the fathers 38.1 years old. Over time, the parents repeatedly filled out the “Depression, Anxiety, Stress Scales” (DASS). Analyses included descriptive methods, Chi2-tests, binary logistic regression models, and different analytical approaches (number chains, transition probability). ResultsApproximately 6.2 % of mothers and 8.2 % of fathers suffered from borderline clinical or clinically relevant depression (anxiety: 5.4 %/6.3 %, stress: 12.6 %/14.2 %). The largest proportion of the sample was stable healthy over the 18-year period (depression: 89.1 %/86.8 %; anxiety: 90.2 %/86.2 %; stress: 75.3 %/75.7 %), whereas 2.2 % of mothers and 3.9 % of fathers showed chronic symptoms of depression (anxiety: 1.8 %/3.9 %; stress: 5.1 %/9.2 %). The remaining mothers and fathers were distributed among positive, negative, and transient courses. Child's mental health problems and mother's traumatic experiences in childhood were found to be important predictors of maternal chronic symptoms of depression, anxiety, and stress. Based on the selected models, no significant prediction was found for fathers. The average short-term persistence (from one assessment to the next) was 42 % in mothers and 44 % in fathers, the average long-term persistence rates (over 18 years) were somewhat lower (35 %/38 %). ConclusionPrevention programs and psychotherapy should be considered as an effective and economic approach to reduce mothers' and fathers' psychopathology in Germany.

Behind the Curtain: Prevalence of Symptoms of Depression, Generalised Anxiety and Eating Disorders in 147 Professional Dancers from Six Opera Houses or State Theatres

BackgroundMental health problems cover a wide spectrum. Depression and anxiety disorders are the most frequent mental health problem in the general population and in elite athletes. The aim of the present study was to assess the prevalence of symptoms of depression, generalised anxiety disorder and eating disorders in professional dancers, to compare the results between genders and to the general population and to analyse potential determinants.MethodsDuring a pre-season health screening, professional dancers of six German companies answered a comprehensive questionnaire on personal and dancer-specific characteristics, medical history and the Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Questionnaire (GAD-7) and Eating-Disorder-Examination-Questionnaire (EDE-QS).ResultsA total of 82 (55.8%) female and 65 (44.2%) male dancers answered the questionnaire. One in five (20.8%) dancers had at least moderate symptoms of either depression, generalised anxiety disorder or eating disorders. The prevalence of at least moderate symptoms of depression was 11.1% in female and 6.4% in male dancers, of generalised anxiety disorder 16.0% in female and 6.4% in male dancers and of eating disorders 14.8% in female and 6.1% in male dancers. Compared to the general population of the same gender and similar age, the prevalence of at least moderate symptoms of generalised anxiety disorder was significantly higher in both genders. About one in four dancers (26.9%) reported a subjective need for support from a psychotherapist at the time of the screening. The PHQ-9, GAD-7 and EDE-QS sum scores were not related to the size or type of the companies, the age or rank of the dancers, but the PHQ-9 and GAD-7 sum score were significantly related to severity of musculoskeletal pain in the past seven days and to chronic or recurrent symptoms of low mood and generalised anxiety.ConclusionThe prevalence of symptoms of depression, generalised anxiety and eating disorders was high in professional dancers. Routine screening and low-threshold interventions to improve mental health of professional dancers are recommended.

A prospective analysis of physical activity and mental health in children: the GECKO Drenthe cohort

BackgroundMental health problems in young people have become a global health burden. The positive effects of physical activity on mental health in adults are well known but still not clear in children. The aim of this study was to investigate to what extent physical activity in early childhood would affect mental health in middle childhood.MethodsFrom the Dutch GECKO Drenthe birth cohort, 850 children (51.5% boys) were enrolled in this analysis. Physical activity and sedentary time were measured at age 5–6 using ActiGraph GT3X. Mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ) at age 5–6 and age 10–11. Multiple linear regression models were used to estimate the associations between physical activity, sedentary time and SDQ subscales, stratified by gender, adjusting for age, BMI, maternal education level, family size, accelerometer wear time and season, and additionally adjusting for SDQ scores at age 5–6 to take tracking of mental health over time into account.ResultsGreater physical activity volume at age 5–6 was associated with lower peer problems scores at age 10–11 in boys and girls. An increase in MVPA was associated with lower peer problems scores in boys (b = -0.445, -0.713 to -0.176) and girls (b = -0.354, -0.601 to -0.107), however, increased sedentary time was linked to higher peer problems scores in boys (b = 1.18, 0.455 to 1.906) and girls (b = 0.870, 0.191 to 1.550). For hyperactivity, higher levels of physical activity volume and MVPA were associated with higher hyperactivity scores in boys. Increased sedentary time was related to lower hyperactivity scores in boys. Further adjustment for SDQ scores at age 5–6 attenuated associations between physical activity and hyperactivity in boys but hardly changed the relationships with peer problems. No significant associations between physical activity and other SDQ subscales or total difficulties scores were observed, neither in boys nor in girls.ConclusionsChildren who are more physically active at age 5–6 have fewer peer problems at age 10–11, and for boys, greater activity levels at age 5–6 could be an indicator of hyperactivity at age 10–11.

Vulnerable in the end – Longitudinal study among medical students on mental health and personal and work-related resources over a 5.5-year-period

BackgroundMental health problems are common in medical professionals and their development already starts at the undergraduate level. Studies on medical students can replicate higher prevalence for depression and burnout in this group, but they normally compare semester cohorts in an anonymized, cross-sectional approach and without a preventive perspective. MethodsWe surveyed medical students at the beginning and end of their medical curriculum and collected data on burnout, depressivity, work related experience and salutogenesis parameters with validated self-administered questionnaires. Most remarkably we obtained the data from the same 58 individuals after 5.5 years, representing data of the highest quality in order to compare the mental health status at the beginning and the end of our students´ medical curriculum. ResultsOur results not only show a severe exacerbation of physical, mental and emotional burnout in the participants at the end of their studies. The students also do not seem to have sufficient personal (resilience) or social resources (e.g. experience of social support) for coping with their mental health problems around the time of their graduation. ConclusionsOur participants reflect a development of mental health during their medical studies at university that is paving the way to the devastating prevalence of mental disorders and suicide in health professionals. From our results we derive an urgent need to integrate self-care and active coping in the learning goals of medical curricula.

Beyond conventional healthcare for mental health problems: Experiences of existential group conversations

Background Mental health problems (MHP) are a major public health challenge. Conventional healthcare has shown limitation on reducing MHP and there is a call for offering methods beyond healthcare as well as improve access to healthcare. Aims To explore experiences among people having MHP of (i) taking part in existential conversations in groups beyond conventional healthcare and (ii) seeking and receiving conventional healthcare. Materials and methods Four focus group interviews were conducted after finishing existential conversations in groups. Data was analyzed following thematic analysis. Results The theme Access to a community for exploration and acceptance describes communication through impressions and expressions together with others. A reflective perspective on everyday life, describes re-evaluation through reflection. Within the theme Experiences of healthcare related encounters, referring to the second aim, participants recollected feelings of disconnectedness, difficulties verbalizing MHP and dealing with rigid, standardized measures. Conclusion Existential conversations in group may contribute to a more reflected doing in accordance with one’s own values as well as improved mental health literacy. Design and measures within healthcare need to explicitly address MHP and consider individual’s own preferences. Significance This study contributes to understanding of coping with MHP in everyday life from an existential perspective.

Alcohol use disorder among healthcare professional students: a structural equation model describing its effect on depression, anxiety, and risky sexual behavior

BackgroundMental health problems such as depression, anxiety and alcohol use disorders are among the leading causes of disability worldwide. Among university students, alcohol use and poor mental health are associated with risky sexual behavior. Given the syndemic occurrence of these disorders most especially in young adults, we describe the relationship between them so as to guide and intensify current interventions on reducing their burden in this population.MethodsThis was a cross-sectional study based on an online survey among healthcare professional university students that captured sociodemographic characteristics, risky sexual behavior, alcohol use disorder, generalized anxiety disorder, and depression. Structural equation modelling was used to describe the relationship between these variables using RStudio.ResultsWe enrolled a total of 351 participants of which 11% (37/351) had Alcohol Use Disorder, 33% (117/351) had depressive symptoms and 32% (111/351) had symptoms of anxiety. A model describing the relationship between these variables was found to fit well both descriptively and statistically [χ2 = 44.437, df = 21, p-value = 0.01, CFI = 0.989, TFI = 0.980, RMSEA = 0.056]. All observed variables were found to fit significantly and positively onto their respective latent factors (AUD, anxiety, depression and risky sexual behavior). AUD was found to be significantly associated with risky sexual behavior (β = 0.381, P < 0.001), depression (β = 0.152, P = 0.004), and anxiety (β = 0.137, P = 0.001).ConclusionAUD, depression and anxiety are a significant burden in this health professional student population and there’s need to consider screening for anxiety and depression in students reporting with AUD so as to ensure appropriate interventions. A lot of attention and efforts should be focused on the effect of AUD on risky sexual behavior and continued health education is still required even among health professional students.

Translation, Adaptation, and Validation of the Malay Version of the Barriers to Access to Care Questionnaire for Assessing the Barriers to Seeking Mental Health Care Among the Health Workforce in the East Coast Region of Peninsular Malaysia.

Background Mental health problems among the health workforce are a significant concern worldwide, including in Malaysia. Unfortunately, some health workforce may perceive various barriers or challenges that prevent them from seeking help. Identifying and addressing these barriers is crucial for enhancing mental health services and support. The Barriers to Access to Care Evaluation (BACE-3) questionnaire is a valuable tool that can be used for assessing these barriers among health workers. However, a validated Malay version is needed. Therefore, this study aims to translate, adapt, and validate the original version of Barriers to Access to Care Evaluation (BACE-3) into the Malay version (MBACE). Methods A rigorous process of translation and adaptation was followed to develop the Malay version of the BACE-3 questionnaire (MBACE). A cross-sectional study was conducted to assess the psychometric properties of the questionnaire, with purposive sampling employed to recruit 188 participants from various job categories, including doctors, nurses, pharmacists, and non-clinical staff, such as health assistants and clerks. The analysis was conducted using the R software version 4.2.2 (R Foundation, Vienna, Austria). Construct validity was determined using confirmatory factor analysis (CFA). To assess the convergent validity, internal consistency, and reliability of the instrument, measures such as the average variance extracted (AVE), composite reliability (CR), and Cronbach's alpha values were calculated. Results During the CFA process, two items with a factor loading less than 0.5 (items 15 and 16) were removed to improve the convergent validity and model fit. The CFA results revealed that the 2-factor model MBACE had good construct validity (root mean square error of approximation (RMSEA) = 0.053; comparative fit index (CFI) = 0.939; Tucker-Lewis fit index (TLI) = 0.934). The internal consistency was supported by Cronbach's alpha values ranging from 0.92 to 0.94 for the stigma factor and non-stigma factor. The average variance extracted (AVE) and composite reliability (CR) values further supported the questionnaire's reliability and convergent validity. Conclusion The translated and adapted 28-item MBACE questionnaire is a valid and reliable tool for assessing the barrier to seeking professional mental health care among the Malaysian health workforce. This instrument has the potential to aid in the development of targeted interventions to promote mental health help-seeking behavior and enhance the well-being of the Malaysian health workforce.