Mood Changes Research Articles

THE EFFECT OF PARENTS’ ROLE AND SCHOOL CLIMATE ON ACADEMIC STRESS OF MADRASAH ALIYAH’S STUDENTS IN RURAL AND URBAN AREA

Adolescence is a period of transition from childhood to adulthood and is characterized by a storm-and-stress period influenced by conflict and mood swings, making adolescents vulnerable to stress. One form of stress commonly experienced by adolescents is academic stress. This study aims to analyze the effect of adolescent characteristics, family characteristics, parents' roles, and school climate on the academic stress of Madrasah Aliyah students in rural and urban areas. This research was conducted in five schools representing each sub-district: MA Mathlaul Anwar Barengkok, MA Mathlaul Anwar Cidokom, MA Al-Mukhlisin Ciseeng, MAN 1 Kota Bogor, and MAN 2 Kota Bogor. This study involved 180 students (86 rural and 94 urban students) selected using a purposive sampling. Data analysis included correlation tests, regression tests, and independent t-tests. The study showed that adolescent girls had higher academic stress than boys. The dimensions of support and pressure significantly positively affected academic stress. However, the frequency and school climate dimensions were not found to influence academic stress in this study. Keywords: academic stress, parent’s role, pressure, school climate, support

Premenstrual Syndrome: An Overview of the Review Analysis, and Potential Role of Herbal and Dietary Supplements

: A premenstrual syndrome is a group of regular physiological, mental, emotional, and behavioral symptoms that appear periodically in the luteal phase of the menstrual cycle, and they vanish quickly with the beginning of menstruation or a few days afterward. Thus, severe premenstrual syndrome (PMS) affects 5–8% of women; the majority of these individuals also match the factors for premenstrual dysphoric disorder (PMDD). Premenstrual syndrome typically includes physical problems like headache, tiredness, indigestion, insomnia, nausea, and breast tenderness as well as symptoms associated with emotions (mood swings, anxiousness, and aggressiveness). Although the true mechanism of PMS is unknown, a number of theories point to increased sensitivity to typical hormonal changes and imbalances in neurotransmitters. A multidisciplinary team using an integrative holistic approach in the direction of an individualized strategy gradually manages PMS. The first phase entails educating women about PMS, self-screening, herbs like St John’s Wort, chaste berry, saffron; ginkgo biloba; chamomile, evening primrose, turmeric and so on, various nutrition supplements as Vitamin B6; calcium; magnesium and lifestyle adjustments like dietary modifications; exercise; yoga; sleep hygiene. The second step involves implementing various relaxation therapies, cognitive behavioral therapy (CBT), stress reduction techniques, and acupuncture. The available treatment as various drugs like SSRIs; serotonergic antidepressants; anxiolytics and hormonal therapy that are used currently to treat PMS, exhibits unwanted side effects. Therefore, this issue and other similar gynecological conditions have been discussed and managed with herbal medicines and other natural solutions in this comprehensive piece of work.

Differences in university experiences, support seeking, and mental well-being in Australian university students according to bereavement status

In Australia, nearly half of university students report high levels of distress during their studies. Bereavement increases a student’s risk of mood changes, eating disorders, suicide, poorer academic achievement, and attrition. We used an online, quantitative, cross-sectional survey to investigate the prevalence of bereaved students in Australian universities and differences between bereaved and non-bereaved university students’ mental well-being, university connectedness, current grade average, and support experiences. Findings indicated 22.3% of students experienced bereavement in the previous 24 months. Bereaved students had higher ratings of perceived social support than non-bereaved peers. There were no significant differences in mental well-being, grade averages, and university connectedness once sex, living arrangements, enrolment type (full/part-time), and religious affiliation were controlled. Bereaved students who continued their studies showed resilience and a preference for social support. Findings present a rationale for universities to harness resources to support bereaved students throughout their studies to promote engagement and retention.

Foot Reflexology for Managing Menopausal Symptoms in Women: A Systematic Review and Meta-Analysis

Background: Menopause can cause a variety of unpleasant symptoms, such as hot flashes, night sweats, mood swings, and sleep disturbances. Although hormone replacement therapy is frequently utilized to help manage these issues, long-term use of this treatment approach carries certain potential risks. Objective: This study aims to examine the effects of foot reflexology, a type of massage therapy that focuses on applying pressure to specific reflex points on the feet, on menopausal symptoms (primary outcome) and anxiety, fatigue, and depression (secondary outcomes). Methods: A systematic electronic search for relevant studies was conducted in PubMed, Scopus, Web of Science, the Cochrane Library, SID, Magiran, and Google Scholar until September 21, 2023. In addition to the electronic database searches, manual searches were also performed. This manual search process included scanning the reference lists of the included studies and handsearching key journals in the topic area. The risk of bias was assessed via the RoB 2.0 and ROBIN-I tools. Heterogeneity was evaluated via the I² statistic, and in cases of high heterogeneity, a random effects model was used instead of a fixed effects model. Subgroup analyses were performed for the primary outcome on the basis of menopausal symptoms (vasomotor/psychosocial/physical/sexual). The certainty of evidence was assessed via the GRADE approach. Results: A total of 186 articles were retrieved from database searches, and an additional 9 articles were identified through manual searches. Ultimately, 8 studies were included in the systematic review, and 6 studies were included in the meta-analysis. The meta-analysis revealed that foot reflexology had a significant effect on menopausal symptoms, with an average reduction of 3.41 points on the associated measurement scale (95% confidence interval (CI): -4.81 to -2.01; low-certainty evidence). It also significantly reduced fatigue, with an average reduction of 5.84 points (95% CI: - 11.61 to -0.06; very low-certainty evidence). However, there was no significant impact on anxiety (SMD: -0.89, 95% CI: -1.96--0.18; very low-certainty evidence) or depression (SMD: -0.73, 95% CI: -1.80--0.34; very low-certainty evidence) compared with the control group. Conclusion: The present study demonstrated that the use of foot reflexology as a nonhormonal and noninvasive intervention led to a significant reduction in menopausal symptoms and fatigue among women. Given the limited number of studies available in this area and the low to very low-level certainty of the evidence for the desired outcomes, further research with appropriate methodologies to ensure accurate conclusions in this field is strongly recommended.

Neuroplasticity Alterations Induced by Isotretinoin use in RARA Gene Polymorphism is Associated with Increased Risk of Depression and Suicidal Ideation in Patients with Vitamin D Deficiency: A Systematic Review and Meta-Analysis

Rationale: Isotretinoin is widely used for severe acne treatment, but concerns have emerged regarding its potential association with depression and suicidal ideation. Previous studies have produced mixed findings, necessitating a comprehensive evaluation of the evidence. This systematic review and meta-analysis aim to clarify the association between isotretinoin use and the onset of depression or suicidal ideation, focusing on genetic predispositions, particularly in patients with vitamin D deficiency. Objectives: This review assesses the risk of depression and suicidal ideation in patients treated with isotretinoin for severe acne compared to those not using isotretinoin. A secondary focus is placed on identifying specific genetic factors, such as polymorphisms in the RARA and LEP genes, that may predispose patients to these psychiatric side effects. Eligibility Criteria: Randomized controlled trials (RCTs), cohort studies, and case-control studies comparing isotretinoin users to non-users were included. Exclusion criteria included studies that lacked a comparator group or did not report psychiatric outcomes (depression or suicidal ideation). Outcomes: The primary outcome was the incidence of depression or suicidal ideation among isotretinoin users compared to non-users. Secondary outcomes examined the influence of genetic polymorphisms, specifically in the RARA and LEP genes, on the risk of developing psychiatric side effects. Risk of Bias: Risk of bias was assessed using the Cochrane Risk of Bias tool for randomized trials and the Newcastle-Ottawa Scale for observational studies. The overall quality of the included studies was moderate to high. Synthesis Methods: A random-effects meta-analysis was performed to pool odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic, and sensitivity analyses were conducted to ensure the robustness of the findings. Included Studies: Fifteen studies were included, comprising 3 randomized controlled trials, 7 cohort studies, and 5 case-control studies, with a total of 8,000 isotretinoin users and 10,000 non-users. The studies were conducted in diverse clinical settings with a follow-up range of 6 months to 5 years. Synthesis of Results: The pooled analysis demonstrated a significant association between isotretinoin use and an increased risk of depression (OR: 1.3, 95% CI: 1.1–1.5, p < 0.05). Specific genetic polymorphisms, particularly in the RARA and LEP genes, were identified as potential risk factors for developing depression among isotretinoin users, particularly in patients with concurrent vitamin D deficiency. Conclusions: Isotretinoin use is associated with an increased risk of depression, particularly in individuals with specific genetic polymorphisms such as RARA and LEP. Clinicians should consider conduct precision medicine genetic testing testing for these polymorphisms before initiating isotretinoin treatment and closely monitor patients for psychiatric alterations, mood changes, especially those with with vitamin D deficiency or genetic predisposition to depression

No Effects of Omega-3 Supplementation on Kynurenine Pathway, Inflammation, Depressive Symptoms, and Stress Response in Males: A Placebo-Controlled Trial

Background: Increased inflammation and heightened physiological stress reactivity have been associated with pathophysiology of depressive symptoms. The underlying biological mechanisms by which inflammation and stress may influence neurogenesis are changes in the kynurenine (KYN) pathway, which is activated under stress. Supplementation with n-3 polyunsaturated fatty acids (n-3 PUFAs) has anti-inflammatory properties and can increase stress resilience. Whether n-3 PUFAs alter KYN stress response is unknown. Objectives: This placebo-controlled study investigated the effect of n-3 PUFAs on KYN metabolism, inflammation, depressive symptoms, and mood. Moreover, stress-induced changes following a laboratory stressor have been assessed. Methods: In this placebo-controlled study, 47 healthy male adults received either 4g n-3 PUFAs per day (Omega-3 group) or a placebo (Placebo group) for 12 weeks. Results: A significant group-by-time interaction was found for the inflammatory markers gp130 (F = 7.07, p = 0.011), IL-6R alpha (F = 10.33, p = 0.003), and TNF_RI (F= 10.92, p = 0.002). No significant group-by-time interactions were found for KYN metabolites, depressive symptoms, and mood (except for Hedonic tone (F = 6.50, p = 0.014)), nor for stress-induced changes in KYN metabolites and mood following a laboratory stressor. Conclusions: Overall, increased n-3 PUFA levels in healthy men ameliorate inflammatory markers but do not ameliorate KYN metabolism, depressive symptoms, mood, or KYN metabolism and mood following a stress induction. This study was registered at ClinicalTrials.gov with the identifier NCT05520437 (30/08/2022 first trial registration).

Acceptability and Scalability of a Meditation App Among Adolescents With Type 1 Diabetes Mellitus.

Background Adolescents with type 1 diabetes mellitus (T1DM) experience stress from general life stressors and diabetes-specific stressors. This stress manifests in a range of ways, such as mood swings, heightened frustration, strained familial relationships, and difficulties in T1DM self-management, which then leads to worse health outcomes. There is small to moderate evidence that frequent use of mental health applications (MHapps) improves mental and physical health outcomes. Meditation apps may help reduce some of the stress associated with living with T1DM. This study explores the acceptability and scalability of a self-guided, smartphone-based meditation app, the Healthy Minds Program (HMP) app, among adolescents with T1DM using the Unified Theory of Acceptance and Use of Technology. Methods Eight adolescents ages 15-19 were recruited from a pediatric clinic in a Midwestern state and introduced to the HMP app. After using the HMP app for one week, they were invited to participate in three successive focus group meetings. During the meetings, they shared their perspectives on the content, navigation, and acceptability of the HMP app and strategies to introduce and scale app utilization among adolescents with T1DM. Researchers conducted conventional content analysis using a hybrid coding approach. Data was managed and analyzed using NVivo 10 (Lumivero, Denver, Colorado, USA). Findings Participants believed that the HMP app has the potential to enhance their stress management, mood, and coping abilities when dealing with the challenges of T1DM management. They found the app enjoyable and easy to use but expressed concerns about time constraints as a potential barrier. To address this, they shared recommendations for facilitating app uptake and usage. Conclusions This study's results provide an in-depth understanding of how positively this subset of adolescents with T1DM viewed the HMP app. The participants also offered valuable suggestions that can promote the adoption and sustained use of MHapps by adolescents living with T1DM.

Reported side effects from hormonal contraceptives among those seeking abortion care versus contraceptive services.

We aim to describe and compare the prevalence of subjective side effects associated with hormonal contraceptive use among reproductive healthcare users seeking either abortion care or contraceptive services. This substudy derives from a previously reported cross-sectional survey involving 1006 users of public reproductive healthcare services in the Helsinki metropolitan area in Finland. We included all 813 respondents with a history of hormonal contraceptive use (mean age 27 years, IQR 24-33 for abortion care; 24 years, IQR 19-30 for contraceptive services). The study followed STROBE guidelines. Altogether 400 respondents sought abortion care, while 413 sought contraceptive services (counselling, prescription renewal, symptoms and/or dissatisfaction with their contraceptive method). Combined oral contraceptives and progestin-only pills were the most used methods in both groups. Respondents seeking abortion care reported contraception-associated weight changes, sex-related problems, mood changes, and acne more frequently than those seeking contraceptive services (p-value<0.05 for all). Some 52% of respondents seeking abortion care reported mood changes compared with 29% of those seeking contraceptive services, with a crude OR of 2.7 (95% CI 2.00 to 3.57). After adjustment, the OR for reporting mood changes among respondents seeking abortion care was 1.5 (95% CI 1.05 to 2.23). Mood changes associated with hormonal contraceptive use were the most frequently reported side effect among all respondents. These findings suggest a need for individualised counselling on mood-related side effects as mood changes may contribute to higher discontinuation rates.

Reducing Synaptic Plasticity Decreases Resilience to Depression and Anxiety in an ASCL1 Mouse Model

Synaptic plasticity, the ability of synapses to strengthen or weaken over time in response to activity, plays a crucial role in the brain’s adaptability and function. This paper examines the impact of synaptic plasticity on resilience to depression and anxiety in an ASCL1 mouse model. By studying the molecular and cellular mechanisms of synaptic changes, how these changes affect behavioral outcomes related to stress and emotional regulation analysis. Through the research and findings of this paper, a deeper understanding of the relationship between the enhancement of synaptic plasticity and mood changes, and provide more treatment ideas for depression and emotion-related diseases.

Autonomic response and attachment style in disruptive mood dysregulation disorder

Background: Disruptive mood dysregulation disorder (DMDD) is characterised by severe emotion regulation difficulties, particularly anger and irritability, in children. Despite the impact of attachment on emotional and behavioural regulation, the link between attachment style and DMDD is under-researched.Aim: This study investigated whether attachment style and parasympathetic regulation differentiate the response profiles to frustrating conditions between children diagnosed with DMDD and controls.Setting: Participants were assessed at schools in Johannesburg, Gauteng, South Africa.Methods: Thirty participants were divided into two matched groups (nDMDD = 15; nControl = 15) and assessed. Respiratory sinus arrhythmia (RSA) and heart period were measured during an Affective Posner Task, inducing frustration. Attachment style was assessed using the Attachment Style Classification Questionnaire for children. Parents of children with DMDD completed a social interaction problems questionnaire.Results: The DMDD group showed a higher prevalence of avoidant attachment style (p = 0.013) compared to controls. Both groups displayed adaptive vagal withdrawal and recovery during the task (p = 0.005; p = 0.021). Controls had significantly higher heart period throughout the assessment (game 1: p = 0.006; game 2: p = 0.013; game 3: p = 0.007). In the DMDD group, lower vagal tone during frustration correlated with more social interaction problems (p = 0.049).Conclusion: The study demonstrates a potential link between attachment style and altered physiological state in children with DMDD.Contribution: The findings provide insight into possible atypical vagal regulation of the heart and avoidant attachment styles in DMDD, highlighting potential therapeutic and intervention targets.

Accumbal serotonin hypofunction and dopamine hyperfunction due to chronic stress and palatable food intake in rats

ABSTRACT Feeding is regulated by energy homeostatic and pleasure-induced rewarding signals. Palatable food intake modifies serotonergic (5-HT) and dopaminergic (DA) pathways in nucleus accumbens, inducing neuronal maladaptations that favor hyperphagia for high-energy dense food and consequent obesity. Chronic stress is an environmental condition that increases the preference for palatable food by modulating brain DA and 5-HT metabolism. Objective: To evaluate the association between changes in accumbal 5-HT and DA metabolism and the effects of chronic stress, palatable food intake and their interaction with satiety/hunger condition. Methods: Wistar rats were housed in pairs (non-stressed) or individually (stressed), fed with chow or chocolate milk plus chow (Ch) for 2 weeks (4 groups); then 6 animals/group were 48 h fasted or maintained ad libitum; the rest were fasted and re-fed for 2 h either with chow or Ch. Results: Rats with prolonged high-energy density food intake and re-fed with chow showed reduced 5-HT metabolism, although there was no association with animals’ feeding behavior. In contrast, after re-fed with palatable food, stressed chow-fed rats had increased 5-HT turnover, which decreased in Ch re-fed rats, supporting that palatable food might induce positive mood changes related to high extracellular 5-HT in limbic regions. Discussion: Rats with prolonged palatable food intake exhibited high accumbal DA turnover independently of stress exposure, supporting its relation with the development of high-energy dense food hyperphagia. As accumbal 5-HT and DA metabolism changed due to fasting or re-feeding, alterations could represent the interaction of energy homeostatic and hedonic feeding signaling in animals.

Perceptions of Senior Citizens Regarding the Social Media Impact on Relationship between Parents and Teenagers: A Sociological Case Study in Dera Ghazi Khan

The utilization of social media can have both advantageous and detrimental effects on families, regardless of whether they are in their household or traveling. Elderly individuals in households often observe the impact of social media on their interactions with adults, experiencing a combination of concern and fascination. They express apprehension about the potential harm to family connections caused by the various risks linked with teenagers' use of social media, including cyberbullying, harassment, and fraud. The study aims to understand the sociological implications of social media on family dynamics with objective of, (i) to find out the socioeconomic characteristics of the study participants; (ii) to explore the main cause the social media platforms impact on the relationship between parents and teenagers; (iii) to explore the negative consequences of social media sites on the activities of teenagers; and (iv) how to overcome the negative effect of social media. For this study, a sample of 160 study participants (senior citizens) selected through multistage sampling technique. At first stage 1 Tehsil will be selected randomly, at second stage 4 union councils selected randomly from each tehsil, at third stage 2 villages selected from each union council randomly, at fourth stage 20 study participants selected from each village through convenient sampling technique. Majority more than eighty percent (80.7%) of the teenagers due to excessive usage of social media apps make them aggressive. Majority more than eighty-two percent (82.5%) of the teenagers face depression due social loneliness. Majority more than ninety-one percent (91.9%) of the senior citizens’ availability of internet making them addictive of social media app. Majority more than ninety-two percent (92.5%) of the teenagers after the use of social media app they feel headache, back pain and eyesight problems. Majority more than seventy-one percent (71.9%) of the senior citizens said that usage of social media apps teenagers faced mood swings. Strain relationship between parent’s teenagers was associated with teenager isolation. The time for parents was associated with the feeling of pleasant with social media apps. Habitual of social media app usage was associated with depression in teenagers.

Gray Matter Volume Correlates of Co-Occurring Depression in Autism Spectrum Disorder.

Autism Spectrum Disorder (ASD) involves neurodevelopmental syndromes with significant deficits in communication, motor behaviors, emotional and social comprehension. Often, individuals with ASD exhibit co-occurring depression characterized by a change in mood and diminished interest in previously enjoyable activities. Due to communicative challenges and a lack of appropriate assessments in this cohort, co-occurring depression can often go undiagnosed during routine clinical examinations and, thus, its management neglected. The literature on co-occurring depression in adults with ASD is limited. Therefore, understanding the neural basis of the co-occurring psychopathology of depression in ASD is crucial for identifying brain-based markers for its timely and effective management.Using structural MRI and phenotypic data from the Autism Brain Imaging Data Exchange (ABIDE II) repository, we examined the pattern of relationship regional grey matter volume (rGMV) has with co-occurring depression and autism severity within regions of a priori interest in adults with ASD (n = 44; age = 17-28 years). Further, we performed an exploratory analysis of the rGMV differences between ASD and matched typically developed (TD, n = 39; age = 18-31 years) samples. The severity of co-occurring depression correlated negatively with the rGMV of the right thalamus. Additionally, a significant interaction was evident between the severity of co-occurring depression and core ASD symptoms towards explaining the rGMV in the left cerebellum crus II. The results further the understanding of the neurobiological underpinnings of co-occurring depression in adults with ASD towards exploring neuroimaging-based biomarkers in the same cohort.

Exploring hormone replacement therapy dynamics among menopausal women in Kuala Lumpur – a community based survey

BackgroundWomen may lack awareness of the existence of Hormone Replacement Therapy (HRT), its benefits, and potential drawbacks. Furthermore, they may be uninformed about the treatability of menopausal symptoms. Consequently, there is a need to evaluate the knowledge, attitudes, and practices related to HRT among menopausal women within the Malaysian population. Presently, no studies have reported on the inside, attitudes, and practices regarding HRT among menopausal women in Kuala Lumpur. This study sought to determine the prevalence, knowledge, attitude, and practice (KAP) towards HRT and its association with socio-demographic characteristics of the study population.MethodA cross-sectional study was conducted among menopausal women (n = 404) living in Kuala Lumpur, Malaysia. Data was collected using convenient sampling. This research consists of 5 major parts which are (A) Socio-demographic characteristics of participants, (B) HRT knowledge among respondents, (C) Attitudes towards HRT, (D) Practice of HRT, and (E) Menopausal symptoms. All appropriate data from the project was analyzed using IBM SPSS Statistics Ver 26.ResultsA total of 404 participants were recruited in this survey. Overall, participants had good knowledge (n = 254, 62.9%) and negative attitude (n = 213, 52.7%) towards HRT. The majority of them (83.4%) had never taken HRT. The common menopausal symptoms reported were hot flashes (35.4%), irritability/ mood swings (31.9%), and night sweats (29.2%). There was a significant association between knowledge of menopause and HRT and attitude towards HRT use. Participants (68.7%, n = 103) with poor knowledge of menopause and HRT showed a negative attitude towards HRT (p < 0.01).ConclusionsOverall, the prevalence of HRT use among the respondents is low. 83.4% of them have never taken HRT before. There was a positive correlation between knowledge and attitude towards HRT use. Healthcare systems should educate the public using various educational tools and social media.

What is new on peri- and postmenopause?

Menopause is an increasingly discussed topic in recent years. More women are demanding consultancy and help from their doctors via different channels, be it online or in menopause centers.The term genitourinary syndrome of menopause (GSM) comprises vaginal and urological symptoms such as mucosal dryness, itching and burning, dysuria or bleeding and pain during sexual intercourse. GSM can strongly affect quality of life, is common if estrogen deficiency has lasted for 3 months and can be treated locally with very low doses of the weak estrogen estriol."Not feeling like myself anymore" - symptomatic perimenopause may present with sleep disturbances, mastalgia, mood swings, palpitations, panic attacks, but also entail joint pain, vertigo, headache, and brain fog - even years before menopause and in the presence of still adequate estrogen levels. In an online study, 20% of women in the menopausal transition reported symptoms which they could not explain, and which may cause fears of serious illness. This can lead to extensive medical work-ups if the possibility of perimenopause as the cause is disregarded.(Peri-)menopausal complaints last much longer than previously thought: The Study of women's health across the nation (SWAN) reported longer duration of vasomotor symptoms (median: 11,8 years) in women who were already affected in early perimenopause, while those in whom VMS started only after menopause experienced a shorter duration of symptoms (median: 3,4 years).Female hormones protect women from fatty streaks and hypertension, but menopausal hormone therapy (MHT) has positive effects only if started in the first decade after menopause. The interaction with stress, aging and lifestyle factors is complex.For the treatment of VMS, German and international guidelines list both drug and non-drug or non-prescription options, although there is no clear data on their effectiveness.Fezolinetant, a Neurokinin-3 receptor antagonist, is now available in Germany for the treatment of vasomotor symptoms in postmenopausal women with contraindications or aversion against steroid hormones. It modulates the thermoregulation center in the hypothalamus by blocking the KNDy-neurons. Studies on Elinzanetant, another representative of this class of drugs, are still ongoing.

Post-dengue fatigue syndrome: A comprehensive review of an emerging clinical entity

Post-dengue fatigue syndrome (PDFS) is an emerging clinical entity characterised by persistent, debilitating fatigue and other symptoms following acute dengue infection. This review synthesises current evidence on the epidemiology, clinical features, pathophysiology and management of PDFS. Studies suggest that 20–25% of hospitalised dengue patients may develop PDFS, though population-based incidence is likely lower. Risk factors include older age, female sex and possibly host genetic factors. The hallmark symptom is profound fatigue, often accompanied by musculoskeletal pain, cognitive difficulties, sleep disturbances and mood changes. While some patients recover within weeks, others experience symptoms persisting for months or years. The pathophysiology of PDFS remains unclear but may involve persistent immune activation, hypothalamic-pituitary-adrenal axis dysfunction and autonomic nervous system disturbances. Diagnosis is based on the clinical history and exclusion of alternative causes. Management typically involves a multidisciplinary approach, including patient education, graded exercise therapy, cognitive behavioural therapy and symptomatic treatment. However, evidence for specific interventions is limited. Prognosis is variable, with some patients experiencing prolonged disability. Significant research gaps remain, including the need for standardised diagnostic criteria, biomarkers and controlled trials of potential therapies. As dengue’s global burden increases, further investigation of PDFS is crucial to improve recognition and develop evidence-based treatments for this impactful sequela of dengue infection.

Postpartum anger among low-income women with high rates of trauma exposure.

Few studies have examined anger concerns among postpartum women despite their risk of mood dysregulation. This study examined the performance of the Dimensions of Anger Reactions-5 (DAR-5) scale, a brief screen for problematic anger, in a sample of 1,383 postpartum women in Wisconsin who received perinatal home visiting services. We aimed to analyze the discriminant validity and measurement invariance of the DAR-5, the occurrence of problematic anger symptoms and their co-occurrence with mental health concerns, and the association between elevated anger levels and exposure to potentially traumatic events in childhood and adulthood. Descriptive statistics for anger symptoms and their associations with depression, anxiety, and PTSD were calculated. Psychometric properties of the DAR-5 were assessed via confirmatory factor analyses, and associations between trauma exposure and anger were evaluated as bivariate and partial correlations. Approximately 21% of the sample exhibited problematic anger based on an established DAR-5 cutoff score (≥ 12). Anger symptoms co-occurred with posttraumatic stress disorder (PTSD), depressive, and anxiety symptoms, though the DAR-5 sufficiently distinguished anger from these correlated symptom profiles. The DAR-5 also demonstrated acceptable measurement invariance across levels of trauma exposure. Higher levels of trauma exposure in childhood and adulthood significantly increased the risk of problematic anger even after controlling for PTSD, anxiety, and depressive symptoms, partial pb range:.07-.16. The findings suggest the DAR-5 is a valid brief screen for anger in postpartum women. Increased attention should be paid to elevated anger and the co-occurrence of other mental health concerns following childbirth.

Hormone replacement therapy for menopausal mood swings and sleep quality: The current evidence.

Marked alterations in the normal female hormonal milieu in the perimenopausal period significantly affect women's health, leading to decreased well-being, psychological distress, and impaired quality of life. Common menopausal symptoms include hot flashes, sleep and mood changes, fatigue, weight gain, and urogenital disturbances. Clinicians often neglect mood swings and disrupted sleep, although those can significantly limit the productivity of women and impair their cognitive function and mental health. Evidence-based management should include a personalized, holistic approach to alleviate symptoms and careful consideration of the risks vs benefits of hormone replacement therapy (HRT), with due consideration of personal preferences. A research paper in the recent issue of the World Journal of Psychiatry by Liu et al investigated the role of HRT in altering mood changes and impaired sleep quality in menopausal women, which helps us to understand the benefits of this treatment approach.

Impact of COVID-19 Vaccination on Menstrual Cycle, Quality of Life and Perception on Fertility: A Mixed Methods Study of Women in Delhi-NCR

The COVID-19 pandemic presented extraordinary challenges which led individuals to make global efforts to develop a vaccine that could help battle the spread of the infection. The COVID-19 vaccine came as a sigh of relief for the world, but whilst we assess the positives, we must consider looking into the potential impacts it has had on aspects of health, including female reproductive health. The current study aimed at assessing the potential impacts that COVID-19 vaccination had on menstrual cycles and the perception of women about fertility-related issues following the jab through a comprehensive mixed methods design. A structured survey, using the Menstrual Symptom Questionnaire (MSQ) and WHO Quality of life scale was carried out with a diverse sample (n=500) of women (18-40 years) in the Delhi-NCR region, collecting data on menstrual cycle changes post receiving the Vaccine. Additionally, semi-structured interviews were conducted with a subset of the participants (n=15) to understand the perceptions of women about fertility-related issues following the Vaccine. The study suggests that most of the participants reported facing menstrual concerns such as missed periods, menstrual irregularities, excessive menstrual bleeding and increased cramping on the first day of their period. Through semi-structured interviews, the themes that emerged were fear regarding conception, early menopause, infertility, mood changes, anxiety, fatigue, less pain tolerance and problems with menstrual flow. Alongside, many had low scores on the quality-of-life questionnaire which was understood better through semi-structured interviews. Cognitive distortions were observed among participants while they explained their perceptions of the whole scenario. The study seeks to address a critical topic and fill knowledge gaps to understand the possible health impacts the COVID-19 vaccine has on women’s reproductive health. The study would contribute to creating scientific evidence and valuable insights for the health industry to understand any potential side effects the vaccine could have.

Additive vs. redundant properties of theory in the advancement of weight-control behaviors within community-based obesity treatments in lower- to lower-middle income women

BackgroundObesity is a growing epidemic with non-surgical/non-pharmacological interventions having only nominal and transient effects on excess weight. Those persistent shortcomings are associated with minimal understandings of impacts of treatment-associated changes in psychological variables and their relationships. Women of lower incomes have high rates of obesity and might have increased difficulties accessing evidence-based programs.MethodsWomen with obesity of lower- to lower-middle incomes participated in 6-month community-based treatments in the United States emphasizing either self-regulatory skills development (behavioral methods group: n = 63) or typical education in exercise and healthy dietary practices (education group: n = 48).ResultsThere were significant 6-month improvements in self-regulation, self-efficacy, mood, physical activity/exercise, dietary behaviors, and weight in both groups. All improvements were significantly greater in the behavioral group. Based on the incorporation of multiple behavioral theories, separate multiple regression models were fit for prediction of the weight-loss behavior changes. Stepwise entry of changes in self-regulation, self-efficacy, and mood each significantly contributed to the explained variance in physical activity/exercise change. Change in self-efficacy was most relevant in the prediction of change in dietary behaviors. Change in physical activity/exercise was significantly related to change in dietary behaviors; however, a regression analysis indicated that only physical activity/exercise change was a significant independent contributor to the overall accounted-for variance in lost weight.ConclusionBy incorporating key tenets of social cognitive theory, self-efficacy theory, self-regulation theory, coaction theory, and the mood-behavior model in an additive manner, suggestions and emphases for addressing psychological variables for improved weight-loss behaviors within scalable obesity treatments were advanced.