Clinical Levels Of Depression Research Articles

Characterization of chronic pain, pain interference, and daily pain experiences in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.

Although survivors of childhood cancer are at an increased risk, little is known about the prevalence of chronic pain, associated interference, and daily pain experiences. Survivors (N = 233; mean age = 40.8 years, range 22-64 years; mean time since diagnosis = 32.7 years) from the Childhood Cancer Survivor Study completed pain and psychosocial measures. Survivors with chronic pain completed 2-week, daily measures assessing pain and psychological symptoms using mHealth-based ecological momentary assessment. Multivariable-modified Poisson and linear regression models estimated prevalence ratio estimates (PR) and mean effects with 95% confidence intervals (CI) for associations of key risk factors with chronic pain and pain interference, respectively. Multilevel mixed models examined outcomes of daily pain and pain interference with prior day symptoms. Ninety-six survivors (41%) reported chronic pain, of whom 23 (24%) had severe interference. Chronic pain was associated with previous intravenous methotrexate treatment (PR = 1.6, 95% CI 1.1-2.3), respiratory (PR = 1.8, 95% CI 1.2-2.5), gastrointestinal (PR = 1.6, 95% CI 11.0-2.3), and neurological (PR = 1.5, 95% CI 1.0-2.1) chronic health conditions, unemployment (PR = 1.4, 95% CI 1.0-1.9) and clinically significant depression and anxiety (PR = 2.9, 95% CI 2.0-4.2), as well as a diagnosis of childhood Ewing sarcoma or osteosarcoma (PR = 1.9, 95% CI 1.0-3.5). Higher pain interference was associated with cardiovascular and neurological conditions, unemployment and clinical levels of depression and/or anxiety, and fear of cancer recurrence. For male, but not female survivors, low sleep quality, elevated anxiety, and elevated depression predicted high pain intensity and interference the next day. A substantial proportion of childhood cancer survivors experience chronic pain and significant associated interference. Chronic pain should be routinely evaluated, and interventions are needed.

Characterization of chronic pain, pain interference, and daily pain experiences in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.

Although survivors of childhood cancer are at an increased risk, little is known about the prevalence of chronic pain, associated interference, and daily pain experiences. Survivors (N = 233; mean age = 40.8 years, range 22-64 years; mean time since diagnosis = 32.7 years) from the Childhood Cancer Survivor Study completed pain and psychosocial measures. Survivors with chronic pain completed 2-week, daily measures assessing pain and psychological symptoms using mHealth-based ecological momentary assessment. Multivariable-modified Poisson and linear regression models estimated prevalence ratio estimates (PR) and mean effects with 95% confidence intervals (CI) for associations of key risk factors with chronic pain and pain interference, respectively. Multilevel mixed models examined outcomes of daily pain and pain interference with prior day symptoms. Ninety-six survivors (41%) reported chronic pain, of whom 23 (24%) had severe interference. Chronic pain was associated with previous intravenous methotrexate treatment (PR = 1.6, 95% CI 1.1-2.3), respiratory (PR = 1.8, 95% CI 1.2-2.5), gastrointestinal (PR = 1.6, 95% CI 11.0-2.3), and neurological (PR = 1.5, 95% CI 1.0-2.1) chronic health conditions, unemployment (PR = 1.4, 95% CI 1.0-1.9) and clinically significant depression and anxiety (PR = 2.9, 95% CI 2.0-4.2), as well as a diagnosis of childhood Ewing sarcoma or osteosarcoma (PR = 1.9, 95% CI 1.0-3.5). Higher pain interference was associated with cardiovascular and neurological conditions, unemployment and clinical levels of depression and/or anxiety, and fear of cancer recurrence. For male, but not female survivors, low sleep quality, elevated anxiety, and elevated depression predicted high pain intensity and interference the next day. A substantial proportion of childhood cancer survivors experience chronic pain and significant associated interference. Chronic pain should be routinely evaluated, and interventions are needed.

The mental health and well-being implications of a mesothelioma diagnosis: A mixed methods study

PurposeMesothelioma is an incurable, asbestos-related cancer with a poor prognosis. There is scant evidence about the mental health and well-being impacts on patients and carers living with the illness. This study aimed to investigate mesothelioma's impact on mental health and well-being and the scale of mental health conditions in patients and informal carers. MethodsA mixed-methods design was used: a cross-sectional survey of mesothelioma patients and informal carers plus semi-structured interviews with patients and carers. The survey used validated scales collecting data on mental health aspects of mesothelioma: the EQ5D to assess health-related quality-of-life; the Hospital Anxiety and Depression scale; the PCL-5 to assess Posttraumatic Stress; and the Posttraumatic Growth Inventory. The datasets were integrated during analysis. Results96 useable survey responses were received. A clinical level of depression was reported by 29 participants (30.21%), of anxiety by 48 (50%), of posttraumatic distress disorder by 32 (33.33%), and of posttraumatic growth by 34 (35.42%). Carers had worse scores than patients. Three main themes were developed from interviews with 10 patients and 11 carers: ‘Prognosis’, ‘Support from services’, and ‘Social connections and communication’. ConclusionsHealthcare professionals delivering a mesothelioma diagnosis require regular training in communication skills plus updating in current treatment options, so they provide an appropriate mix of realism and hope. Better signposting to mental health support is needed for patients and carers. Our introduction of posttraumatic growth into the mesothelioma literature is novel. We recommend specialist nurses are trained to recognise, understand, and foster posttraumatic growth.

Patient, family caregiver, and economic outcomes of an integrated screening and novel stepped collaborative care intervention in the oncology setting in the USA (CARES): a randomised, parallel, phase 3 trial

The current standard of care of screening and referring patients for treatment for symptoms, such as depression, pain, and fatigue, is not effective. This trial aimed to test the efficacy of an integrated screening and novel stepped collaborative care intervention versus standard of care for patients with cancer and at least one of the following symptoms: depression, pain, or fatigue. This randomised, parallel, phase 3 trial was conducted in 29 oncology outpatient clinics associated with the UPMC Hillman Cancer Center in the USA. Patients (aged ≥21 years) with any cancer type and clinical levels of depression, pain, or fatigue (or all of these) were eligible. Eligible family caregivers were aged 21 years or older and providing care to a patient diagnosed with cancer who consented for this study. Patients were randomly assigned (1:1) to stepped collaborative care or standard of care using a central, permuted block design (sizes of 2, 4, and 6) stratified by sex and prognostic status. The biostatistician, oncologists, and outcome assessors were masked to treatment assignment. Stepped collaborative care was once-weekly cognitive behavioural therapy for 50-60 min from a care coordinator via telemedicine (eg, telephone or videoconferencing). Pharmacotherapy for symptoms might be initiated or changed if recommended by the treatment team or preferred by the patient. Standard of care was screening and referral to a health-care provider for treatment of symptoms. The primary outcome was health-related quality of life in patients at 6 months. Maintenance of the treatment benefits was assessed at 12 months. Participants included in the primary analysis were per intention to treat, which included patients missing one or both follow-up assessments. This trial was registered with ClinicalTrials.gov (NCT02939755). Between Dec 5, 2016, and April 8, 2021, 459 patients and 190 family caregivers were enrolled. 222 patients were assigned to standard of care and 237 to stepped collaborative care. Of 459 patients, 201 (44%) were male and 258 (56%) were female. Patients in the stepped collaborative care group had a greater 0-6-month improvement in health-related quality of life than patients in the standard-of-care group (p=0·013, effect size 0·09). Health-related quality of life was maintained for the stepped collaborative care group (p=0·74, effect size 0·01). Patients in the stepped collaborative care group had greater 0-6-month improvements than the standard-of-care group in emotional (p=0·012), functional (p=0·042), and physical (p=0·033) wellbeing. No adverse events were reported by patients in either group and deaths were considered unrelated to the study. An integrated screening and novel stepped collaborative care intervention, compared with the current standard of care, is recommended to improve health-related quality of life. The findings of this study will advance the implementation of guideline concordant care (screening and treatment) and has the potential to shift the practice of screening and treatment paradigm nationwide, improving outcomes for patients diagnosed with cancer. US National Cancer Institute.

Cross-sectional survey evaluating the psychological impact of the COVID-19 vaccination campaign in patients with cancer: The VACCINATE study.

The COVID-19 pandemic has profoundly impacted on cancer patients' psychological well-being and clinical status. We assessed the levels of anxiety, depression, and distress and the attitude towards COVID-19 vaccination in cancer patients, accepting vaccination at the Verona University Hospital and Camposampiero Hospital in the Veneto region. Self-reported questionnaires were administered to patients undergoing COVID-19 vaccination between March and May 2021 (first and second dose). Twenty-seven items were investigated: i) demographics/clinical characteristics; ii) anxiety, depression, and distress (Hospital Anxiety and Depression Scale-HADS-and Distress Thermometer-DT); iii) four specific items regarding awareness about infection risks, interference with anticancer treatments, and vaccine side effects. Sixty-two and 57% of the patients who accepted to be vaccinated responded to the survey in the two participating Hospitals, respectively. Mean age was 63 years (SD: 12 years; range 19-94 years), women were slightly more prevalent (57.6%), most participants were married (70%), and either worker or retired (60%). Borderline and clinical levels of anxiety were recorded in 14% and 10% of respondents; borderline and clinical levels of depression in 14% and 8%; and moderate and severe distress levels in 33% and 9%. Overall, there was high confidence that vaccination would reduce the risk of contracting COVID-19 (70%), which would make patients feel less worried about contracting the infection (60%). Fear that vaccine-related side effects would interfere with anticancer treatment and/or global health status was low (10% and 9% for items 3 and 4, respectively) and significantly associated with baseline levels of anxiety, depression, and distress at multivariate analysis. Results did not differ between the Verona and Camposampiero cohorts. During the COVID-19 vaccination campaign, adult cancer patients demonstrated high levels of confidence towards vaccination; baseline levels of anxiety, depression, and distress were the only significant predictors of reduced confidence.

Psychological impact of COVID-19 vaccination in patients with cancer: The VACCINATE study.

e24207 Background: Measures adopted to contain COVID-19 may impact cancer pts' psychological well-being and clinical status. We assessed the psychological status and attitude towards COVID-19 vaccination in adult cancer pts who accepted vaccination at the University and Hospital Trust of Verona and Camposampiero Hospital in the Veneto region. Methods: A self-reported questionnaire was administered to pts undergoing the first and second dose of COVID-19 vaccination in the context of the vaccination campaign promoted by the Veneto Oncology Network (Rete Oncologica Veneta - ROV) between March and May 2021. Overall, 27 items were investigated: i) demographics/clinical characteristics; ii) psychological status (Hospital Anxiety and Depression Scale - HADS - and Distress Thermometer - DT); iii) awareness about infection risks, interference with anticancer treatments, and vaccine side effects. Results: Overall, only 2.5% of the invited active oncological population refused COVID-19 vaccination. Data collected in both Verona and Camposampiero (1089 and 286 respondents, respectively) demonstrated borderline and clinical levels of anxiety in 14% and 10% of pts, borderline and clinical levels of depression in 14% and 8% of pts; and moderate and severe distress levels in 33% and 9% of pts, respectively. No significant differences between the two sites and between the first and second dose were observed, with the exception of significantly lower levels of distress at the time of the second dose administration at the Camposampiero site. In the Verona cohort, clinical anxiety was significantly more frequent in breast cancer and rare tumor pts (17.5% and 21.4%, respectively; p= 0.005); no significant associations were found for depression and distress. Overall, there was high confidence that vaccination would reduce the risk of contracting COVID-19 (70%), which would make pts feel less worried about contracting the infection (60%); among pts with borderline and clinical depression levels, there was less confidence that vaccination would "make [them] feel less worried to contract COVID-19" ["Not at all" or "Only a little" in 16.2% and 20% of pts with borderline and clinical depression levels, respectively, as opposed to 6.6% among pts with normal depression levels (p = 0.005)]. Fear that vaccine-related side effects would interfere with anticancer treatment and/or global health status was low (10% and 9% for items 3 and 4, respectively) and significantly associated with baseline psychological status at multivariate analysis. Similar results were obtained in the Camposampiero cohort. Conclusions: During the COVID-19 vaccination campaign, adult cancer pts demonstrated high levels of confidence towards vaccination; baseline psychological status was the only significant predictor of reduced confidence.

Acceptability, feasibility, and preliminary efficacy of a prenatal walking program for depressed pregnant women

Depression is common during pregnancy, yet pregnant women often do not engage in standard mental health treatments, which is concerning due to negative consequences associated with untreated maternal depression. Given that exercise can help to decrease depressive symptoms, and most pregnant women are able to safely engage in mild to moderate physical activity, physical activity interventions may be helpful in improving mood among pregnant women, even those with clinical levels of depression. In an open trial, we piloted a 10-week prenatal walking intervention in 18 depressed pregnant women (mean age=28.7 years). Participants wore a pedometer daily to track activity and attended 6 brief counseling sessions over the 10-week period. Indicators of acceptability and feasibility were assessed, as were changes in depression, physical activity, and other clinical outcomes. Results suggest that the prenatal walking intervention is feasible and acceptable. No adverse events were observed, and most women (83%) completed the intervention, attending on average 5.5 of 6 intervention sessions. Findings also support preliminary efficacy of the intervention: depression scores were reduced by endpoint, and physical activity levels increased based on self-report and objective measurement. Women also reported lower anxiety, and positive changes in affect at endpoint. Participants reported high satisfaction on a questionnaire. Though preliminary, findings suggest that a lifestyle physical activity intervention could be a valuable strategy to improve mood during pregnancy. Further research is needed to evaluate the intervention in a more rigorous randomized trial. If proven efficacious, this simple, low-cost intervention could be implemented in prenatal care settings.

The Multi-dimensional Assessment of Suicide Risk in Chronic illness-20 (MASC-20): Development and validation

BackgroundWe developed and tested the psychometric properties of the Multi-dimensional assessment of suicide risk in chronic illness-20 (MASC-20), which assess suicidal behavior (SB), and its associated distress in chronic physical illness (CPI). MethodsItems were developed by incorporating inputs from patient interviews, a review of existing instruments, and expert consultations. Pilot testing with 109 patients and field testing with 367 patients with renal, cardiovascular, and cerebrovascular diseases were conducted. We analyzed Time (T) 1 data to select items and T2 data to examine psychometric properties. ResultsForty preliminary items were selected through pilot testing; 20 were finalized from field testing. Optimal internal consistency (α = 0.94) and test-retest reliability (Intra class correlation coefficient = 0.92) of the MASC-20 supported reliability. Good fit of the four-factor model (physical distress, psychological distress, social distress, and SB) from exploratory structural equation modeling demonstrated factorial validity. Its correlations with MINI suicidality (r = 0.59) and the Schedule of Attitudes Toward Hastened Death-abbreviated scores (r = 0.62) indicated convergent validity. Higher MASC-20 scores in patients with clinical levels of depression and anxiety and low health status demonstrated known-group validity. The MASC-20 distress score predicted SB beyond known SB risk factors, supporting incremental validity. A cutoff score of 16 was optimal for identifying suicide risk. The area under the curve was within a moderately accurate range. The sum of sensitivity and specificity (1.66) indicated diagnostic utility. LimitationsMASC-20's applicability to other patient populations and its sensitivity to change requires testing. ConclusionsThe MASC-20 appears to be a reliable and valid tool for assessing SB in CPI.

Wellbeing and mental health outcomes amongst hospital healthcare workers during COVID-19.

Global healthcare systems have been particularly impacted by the COVID-19 pandemic. Healthcare workers (HCWs) are widely reported to have experiencedincreased levels of baseline psychological distress relative to the general population, and the COVID-19 pandemic may have had an additive effect. However, previous studies are typically restricted to physicians and nurses with limited data available on hospital HCWs. We aimed to conduct a cross-sectional, psychological evaluation of Irish HCWs during COVID-19. HCWs across five adult acute level-4 Dublin-based hospitals completed an online survey of wellbeing and COVID-19 experience. There were 1898 HCWs who commenced the survey representing 10% of the total employee base. The sample comprised nurses (33%), doctors (21%), Health and Social Care Professionals (HSCPs) (24%) and 'Other' disciplines (22%), and 81% identified as female. Clinical levels of depression, anxiety and PTSD symptoms were endorsed by 31%, 34% and 28% of respondents, respectively. Professional grouping effects included: nurses reporting significantly greater levels of COVID-19 exposure, infection, COVID-fear, moral injury, and post-traumatic distress; HSCPs were significantly less likely to report mood dysfunction. In terms of gender, males were significantly less likely to report negative pandemic experiences, low resilience, and significantly more likely to endorse 'minimal' depression, anxiety, and traumatic distress. Logistic regression modelling revealed mental health outcomes (depression, anxiety and PTSD symptoms) were associated with increased frontline exposure, fewer career years' experience, elevated pre-pandemic stress, and female gender. To our knowledge, this is the largest evaluation of psychological wellbeing amongst HCWs in acute hospitals in the Dublin region. Our findings have implications for healthcare workforce wellbeing and future service delivery.

Stress-Related Exhaustion, Polygenic Cognitive Potential, and Cognitive Test Performance – A General Population Study

BackgroundWe investigated whether stress-related exhaustion (chronic or short-term, and co-occurring with depression or not) is related to cognitive performance and whether polygenic cognitive potential modifies these associations.MethodsThe participants were from the Young Finns Study (N = 541–1273). Stress-related exhaustion was assessed using the Maastricht Questionnaire, depressive symptoms with the Beck Depression Inventory, and cognitive performance with subtests of the Cambridge Neuropsychological Test Automated Battery, measuring visuospatial learning, reaction time, sustained attention, and executive function. Cognitive performance and depression were assessed in 2011, and exhaustion in 2001, 2007, and 2011. A polygenic score for cognitive potential was calculated based on a GWAS on intelligence.ResultsHigh stress-related exhaustion, especially chronic, was associated with slower reaction time. Only clinical levels of depression were related to slower reaction time. Polygenic cognitive potential did not modify these associations. There were no differences in cognitive performance between individuals with co-occurring exhaustion and depression vs. those with only either condition.ConclusionStress-related exhaustion, especially if chronic, seems to relate to slower reactions. Co-occurring exhaustion and depression may not have additive effects on cognitive performance. High polygenic cognitive potential may not protect from or predispose to harmful effects of exhaustion or depression on reaction time.

Sexual dysfunction, depression, and marital dissatisfaction among Brazilian couples.

Health professionals treating sexual dysfunction and relational dissatisfaction recognize that they are multifactorial phenomena, and depression can be bidirectionally associated with both. The purpose of this study was to investigate sexual dysfunction in heterosexual couples in relation to the quality of their marital relationship and depression symptoms. The sample consisted of 100 heterosexual couples recruited in Brazil. Both partners of each couple completed the Golombok-Rust Inventory of Sexual Satisfaction and the Golombok-Rust Inventory of Marital Satisfaction, which were translated and adapted, and the Beck Depression Inventory, which was validated for the Brazilian population. Both partners completed their questionnaires separately, and the couple's surveys were linked to preserve conjugal data for dyadic analysis. The Actor-Partner Interdependence Model was used to understand how sexual dysfunction in couples is related to depression and relationship quality among and between partners. Sexual dysfunction was found to be strongly associated with dissatisfaction in the relationship (husbands, β = 0.57, P < 0.001; wives, β = 0.60, P < 0.001), and a positive association was found between depressive symptoms and marital dissatisfaction (husbands, β = .32, P < .001; wives β = .40, P < .001). The results suggest that it is important for health professionals to be aware of the dyadic impact of struggles with both sex and the relationship and the presence of depression symptoms in patients who seek care for sexual complaints or depression and who are in a marital relationship. The different results found for men and women may shed light on the biopsychosocial dimensions of human sexuality. When treated as a purely physical experience, sex is myopic. In this study we demonstrated psychosocial aspects associated with gender and sexuality, and the partner's variables were found to have a greater impact on women than they did on the men. A limitation of this study is that the sample is not generalizable as it is not demographically representative of all socioeconomic groups in Brazil. Furthermore, the participants in this sample did not have clinical levels of depression, so the results cannot be extended to couples in which one or both spouses have depressive disorder. It was found that sexual dysfunction is strongly associated with the quality of the couple relationship, and that the quality of relationship plays a mediating role between depression and marital quality, especially for the women.

Depression and Burnout Levels of Graduate Students in Music

At the end of the undergraduate process, many students dream of graduate school for self-improvement, career, or status. The idea of going to graduate school and the preparations for it are the beginning of a stressful period. The beginning of the courses, the long thesis writing process, and finally, a new scientific product defended is the end of this stressful period. In this process, many students struggle with psychological problems due to poor stress management. The study aims to determine graduate music students' depression and burnout levels. The data collection tools of the correlational survey design study were Beck Depression Scale (BDS) and Maslach Burnout Inventory-Student Scale (MBI-SS). The study group consisted of 236 graduate students in different departments and institutes in the field of music. According to the research results, it was determined that the general depression status of the students was at the level of moderate mood disturbance, and some groups were found to be at the level of clinical depression according to different variables. It was observed that the student's overall burnout levels were at a medium level, while they were at a low level in emotional exhaustion and depersonalization sub-dimensions. While the burnout levels of the students show a significant difference according to having children, educational status, work status, institutes, and departments, there is no significant difference according to gender, marital status, and age.

Conventional and expanded adverse childhood experiences (ACEs) and maternal functioning among low‐income Black mothers

AbstractA paucity of research has examined the individual and cumulative effects of conventional and expanded adverse childhood experiences (ACEs) on maternal functioning, especially among low‐income Black mothers. Using self‐report data from a subsample of Black mothers (N = 157) who participated in a larger study to evaluate the effectiveness of an urban public prekindergarten program in the mid‐Atlantic region of the United States, we examined the prevalence of ACEs and the individual and cumulative effects of conventional (i.e., family trauma and dysfunction) and expanded (i.e., community stressors) ACEs on depression and health among low‐income Black mothers. Findings indicated that Black mothers had more exposure to expanded than conventional ACEs. Hierarchical regression analyses revealed that experience of physical neglect was significantly associated with depression and physical abuse with compromised health, and perceived experience of racism was a predictor of depression and compromised health. More conventional and expanded ACEs were associated with clinical levels of depression and compromised health. Findings highlight the need for more research related to the impact of ACEs, especially expanded ACEs, on mental and behavioural health outcomes. Additionally, our findings indicate the need for more trauma‐informed care to reduce and address the impact of individual and community‐level adversities on low‐income Black mothers.

How Social Experiences Affect Interpretation Bias Among Individuals With Non-clinical Depression: The Role of Ostracism.

BackgroundExtensive knowledge and research indicate that interpretation bias is very common among individuals with sub-clinical and clinical levels of depression. Nevertheless, little is known about the role of social experiences in enhancing interpretation bias. Given the major relevance of social experiences in the context of depression, the present study investigated the role of potential interactions between social experiences and levels of depression symptoms in the interpretation of ambiguous information.MethodSeventy participants underwent a laboratory controlled manipulation either of social ostracism or of overinclusion. Participants completed a computerized task that measured both direct and indirect interpretation bias and reported their level of depression symptoms.ResultsThe findings show that ostracism enhanced interpretation bias when symptom levels were higher, while overinclusion did not. This interaction effect between social ostracism and symptom level was found both for direct and for indirect interpretation bias.ConclusionWhereas previous research showed the existence of interpretation bias among people with symptoms of depression, the present study expands previous knowledge by shedding light on the conditions under which interpretation bias emerges, suggesting that ostracism enhances negative interpretation of ambiguous information when levels of depression symptoms are higher.

Examining the Impact of Digital Components Across Different Phases of Treatment in a Blended Care Cognitive Behavioral Therapy Intervention for Depression and Anxiety: Pragmatic Retrospective Study.

BackgroundDepression and anxiety incur significant personal and societal costs. Effective psychotherapies exist, such as cognitive behavioral therapy (CBT); however, timely access to quality care is limited by myriad barriers. Blended care therapy models incorporate traditional face-to-face therapy with scalable, digital components of care, expanding the reach of evidence-based care.ObjectiveThe aim of this study is to determine the effectiveness of a blended care CBT program (BC-CBT) in real-world settings and examine the unique impacts of the (1) digital components of care (video lessons and digital exercises) and (2) phase of treatment (early versus late) in decreasing symptoms of anxiety and depression.MethodsThis retrospective cohort analysis included 3401 US-based individuals enrolled in a BC-CBT program, who presented with clinical levels of depression and/or anxiety. The treatment program consisted of regular therapy sessions augmented by clinician-assigned digital video lessons and exercises. A growth curve model incorporating time-varying covariates examined the relationship between engagement with BCT components (ie, therapy sessions, digital video lessons, and digital exercises) during the early (weeks 0-7) and late (weeks 8-15) phases of treatment, and weekly symptom reports on depression and anxiety measures.ResultsOn average, a significant decline in depression and anxiety symptoms was observed during the initial weeks of treatment (P<.001), with a continued, though slower, decline over subsequent weeks (P<.001). Each session completed was associated with significant decreases in anxiety (b=–0.72) and depression (b=–0.83) in the early phase, as well as in the late phase (anxiety, b=–0.47; depression, b=–0.27). Significant decreases in anxiety (b=–0.15) and depression (b=–0.12) were observed for time spent on video lessons (measured in 10-minute intervals) in the early phase of treatment. Engaging with exercises was associated with statistically significant increases in anxiety symptoms (b=0.03) during the early phase of treatment. However, sensitivity analyses examining the effects of exercises in isolation revealed significant decreases in anxiety (b=–0.05) in the early phase, suggesting a potential suppression effect in the larger model.ConclusionsUsing a retrospective cohort design, therapy sessions and digital video lessons were uniquely predictive of improvements in depression and anxiety symptoms, and their effects were modulated based on the phase of treatment (early vs late). Future research should investigate whether other treatment variables, such as therapeutic alliance or familiarity with technology, are related to differential effects on various components of care.

Psychometric Properties of the Korean Version of the Mental Health Professionals Stress Scale.

Background: Job stress of mental health professionals can have a negative impact on them, particularly their psychological health and mortality, and may also affect organizations' and institutions' ability to provide quality mental health services to patients.Aim: This study aimed to: (1) investigate the validity and reliability of the Korean Mental Health Professionals Stress Scale (K-MHPSS), (2) develop K-MHPSS cut-off points to measure clinical depression and anxiety, and (3) examine whether specific stressors vary by area of expertise.Methodology: Data were collected via an online survey over 3 months, from August to October 2020. An online survey using a survey website was administered to volunteers who accessed the link and consented to participate. Data from 558 participants (200 clinical psychologists, 157 nurses, and 201 social workers) were included in the final analysis. Confirmatory and exploratory factor analyses were conducted to examine the factor structure of the K-MHPSS; concurrent validity of the scale was determined by analyzing correlation; internal consistency was determined by Cronbach's alpha coefficient. In addition, ROC curve analysis and Youden's index were used to estimate optimal cut-off points for K-MHPSS; one-way ANOVA was performed to investigate the difference among the three groups.Results: The seven-factor model of the original scale did not be replicated by Korean mental health professionals. The K-MHPSS had the best fit with the six-factor model, which consists of 34 items. Concurrent validity was confirmed, and overall reliability was found to be good. The K-MHPSS cut-off points for depression and anxiety appeared to slightly different by professional groups. Furthermore, nurses and social workers showed significantly higher total scores compared to clinical psychologists, and there are significant differences in subscale scores among professionals.Conclusion: The Korean version of the MHPSS has appropriate psychometric properties and can be used to assess the occupational stress of mental health professionals. It can also serve as a reference point for screening clinical level of depression and anxiety in mental health professionals.

Hopelessness and depressive symptoms in children and adolescents: An integrative data analysis.

Although hopelessness has been linked to depression for centuries, the diagnostic criteria for depression are inconsistent with regard to the status of hopelessness. Most research on hopelessness and depression has focused on adults. The current study examined this relation in children and adolescents. Integrative data analyses with a pooled sample (N = 2466) showed that clinical levels of hopelessness multiplied the odds of having a clinical diagnosis of depression 10-fold. Conversely, not having clinical levels of hopelessness multiplied the odds of endorsing no clinical level of depressive symptoms 28-fold. Moreover, results differed by levels of depression: (a) among youths with clinical levels of depression, hopelessness was associated with six depressive symptoms; (b) among youths without clinical levels of depression, hopelessness was associated with nine depressive symptoms. We found that hopelessness helps to explain the heterogeneity of depressive presentations. Our finding supports the consideration of hopelessness in the diagnosis (if not treatment and prevention) of depression in children and adolescents. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Rays your mental health: for a transformed mindset – a case study of Rahaf Kobeissi

Learning outcomes This case discussion will enable learners to: demonstrate how the adoption of entrepreneurial leadership could aid the overwhelmed youth to successfully bounce back. Summarize various events and challenges faced. Demonstrate mindful entrepreneurial qualities to be effective. Identify various coping strategies in balancing a commercial viable model with a compassionate approach. Establish a roadmap for a healthy sustainable business model. Case overview/synopsis Ms Rahaf Raef Kobeissi was a 33-year solopreneur, mental health coach and personal development trainer who resided in Dubai. She encountered dilemmas while attempting to offer commercial, as well as empathy and compassion-based services. She tried to strike a balance between her own broken past life challenges and managing her clients’ healing journey. Another challenge was to assess whether she should adopt inductive counseling or deductive counseling principles, especially during a Covid-19 scenario. She needed to ensure a healthy work/life balance to prevent herself from suffering from burnout. Her personal journey to becoming a solopreneur was filled with grief and hardship over the years, which she endured with little support. She had the arduous task of dealing with a series of shocking incidents and events, which pushed her down through the cracks, leading to her attempting to take her own life three times when overwhelmed by tragedy. At the age of 23, Rahaf lost her father to suicide – they found him hanging in his apartment. Her abusive mother had several breakdowns due to severe depression and her drug addict brother accidentally killed his friend in her apartment with an overdose injection. The challenge before her was to strike a reasonable balance between managing the highest levels of clinical depression with suicidal tendencies and finding the right path and purpose for her own life. This was the very reason she chose to battle depression through therapy and bounced back as a stronger and more resilient woman. Complexity academic level This case has been focused on undergraduate and postgraduate-early stage level students pursuing business or psychology programs. Particularly those specializing in entrepreneurial, organizational behavioral and positive psychology courses. Supplementary materials Teaching Notes are available for educators only. Subject code CSS 3: Entrepreneurship.

Informal caregivers of older Muslims diagnosed with cancer: A portrait of depression, social support, and faith.

Islamic population constitute more than 20% of the world population and is growing rapidly. Nevertheless, data concerning informal caregiving to older Muslim patients diagnosed with cancer are scarce. Improving the well-being of caregivers is a vital step to optimal care for the patients themselves throughout the Muslim community and the world. This study focuses on a sample of Palestinian caregivers of older Muslim patients diagnosed with cancer living in East Jerusalem, the West Bank, and Gaza. The study aims to describe the socio-demographic characteristics of the caregivers and to understand their social support, and identify predictors of caregivers' depression. A cross-sectional study of a convenience sample of 99 dyads of Palestinian patients (age ≥65) and their informal caregivers. Depression and social support were measured using the five items of the Geriatric Depression Scale and the Cancer Perceived Agents of Social Support questionnaire. Caregivers were most frequently adult children (52%) or spouses (32%), with male patients cared for by spouses (47.5%) or sons (32%), and female patients by daughters (50%). Clinical levels of depression were reported by 76% of the caregivers and 85% of patients. The significant predictors of caregiver depression were female gender, lower education, lower perceived social support from spouse and family, and higher perceived support from faith. Healthcare providers serving the study population should determine the position and role of the caregiver within the social and family structure surrounding the patients' families. This understanding may facilitate overcoming barriers to effective and meaningful social support.

Burnout Status of Italian Healthcare Workers during the First COVID-19 Pandemic Peak Period.

The pandemic of 2019 coronavirus disease (COVID-19) has burdened extraordinary psychological stress on the healthcare workforce. The present survey aimed to examine the personal resources and psychological symptoms associated with burnout in 933 healthcare workers in Italy during the COVID-19 outbreak period. Sociodemographic and occupational data, depression, anxiety, burnout, and post-traumatic symptoms, as well as psychological well-being, were cross-sectional assessed through an online questionnaire. A considerable part of the sample scored over the clinical levels of depression (57.9%), anxiety (65.2%), post-traumatic symptoms (55%), and burnout (25.61%). Working in the front-line (p < 0.05), being part of the medical staff (p < 0.05), experiencing lower levels of psychological well-being (p < 0.001), and higher levels of post-traumatic symptoms (p < 0.001) independently explained 38% of burnout variance. The healthcare industry, services, and professionals should be aware of the harmful effects of COVID-19 on healthcare workers and take adequate preventive measures.