Symptoms Of Common Mental Disorders Research Articles

Dysphonia Screening in Firefighters and Associated Factors

ObjectiveTo verify the likelihood of dysphonia in firefighters and its relationship with individual and occupational factors and mental health. MethodThis cross-sectional observational study with 442 firefighters collected data on sociodemographic, occupational, and lifestyle aspects and screening for common mental disorders. Individuals were divided into two groups: those slightly likely and those moderately/highly likely to have dysphonia, according to the Brazilian Dysphonia Screening Tool. The questionnaire’s items addressed their sex, age, race, marital status, education, work schedule, administrative or field activity, alcohol consumption, smoking, and common mental disorders. Those who answered "yes" to the question about having a hoarse voice were considered to have dysphonia with an indication for clinical voice assessment. The suspicion of a common mental disorder was measured with the SRQ-20 Self Report Questionnaire. Data were subjected to descriptive and association analysis. Statistical tests were performed assuming a significance level of 5%. ResultsThe moderate/high likelihood of dysphonia was 6.12%. Most firefighters were males (90.31%), aged over 30 (52.47%), multiracial (44.39%), living with a partner (61.39%), and with a bachelor’s or higher degree (42.35%). Individuals self-declared as Black or multiracial had a higher percentage of dysphonia (8.10%). Black and multiracial individuals were approximately 2.5 times more likely to pass the dysphonia screening than Whites and other races. Individuals with symptoms of common mental disorders were also 2.7 times as likely to have dysphonia. ConclusionThe results of the study show that Black and multiracial firefighters and those with symptoms of common mental disorders were moderately/highly likely to have dysphonia. Firefighters with the highest likelihood of having dysphonia are indicated for clinical voice assessment to confirm the diagnosis.

Post COVID-19 syndrome among 5248 healthcare workers in England: longitudinal findings from NHS CHECK

ObjectivesThe objectives of this study were to examine post COVID-19 syndrome (PCS) among healthcare workers (HCWs) in England and explore risk factors for the condition.MethodsData were collected by National Health...

Screening for common mental disorders in people with epilepsy in Goma, in the Democratic Republic of the Congo: A cross-sectional study

Objectives: Epilepsy is a chronic neurological disease that is highly susceptible to a variety of mental health problems due to its enormous biological, social, and psychological burdens. The purpose of this study was to determine the prevalence and identify risk factors for common mental disorders (CMDs) in people with epilepsy (PWEs) in Goma, in the Democratic Republic of the Congo (DRC). Material and Methods: This is an analytical cross-sectional study conducted at the Neuropsychiatric Hospital Center in Goma (DRC) from March to April 2022, involving 302 PWEs. A questionnaire was administered to collect socio-demographic data, personal and family history, clinical features, and management of epilepsy. CMDs were assessed using the self-report questionnaire-20. Bivariate analysis was performed, followed by multivariate analysis, and variables with P < 0.05 in the final model were considered as risk factors associated with CMDs. Results: The study included 302 PWEs, of which 56.9% were men, and the mean age was 28.4 ± 11.0 years. CMDs were present in 39.1% of the participants. The presence of CMDs was significantly associated with having five or more seizures in the month preceding the survey (adjusted odds ratio [aOR] = 3.8; 95% confidence interval [CI]: 1.7–8.3) and having medical co-morbidities (aOR = 3.1; 95% CI: 1.5–6.4). Conclusion: The prevalence of CMDs in PWEs was high (39.1%), suggesting that this is a public health issue. Therefore, early detection and recognition of CMD symptoms should be a routine activity when managing PWEs.

A scoping review of the literature on the application and usefulness of the Problem Management Plus (PM+) intervention around the world.

Given the high rates of common mental disorders and limited resources, task-shifting psychosocial interventions are needed to provide adequate care. One such intervention developed by the World Health Organization is Problem Management Plus (PM+). This review maps the evidence regarding the extent of application and usefulness of the PM+ intervention, i.e. adaptability, feasibility, effectiveness and scalability, since it was introduced in 2016. We conducted a scoping review of seven literature databases and grey literature from January 2015 to February 2024, to identify peer-reviewed and grey literature on PM+ around the world. Out of 6739 potential records, 42 met the inclusion criteria. About 60% of the included studies were from low- and middle-income countries. Findings from pilot/feasibility trials demonstrated that PM+ is feasible, acceptable and safe. Results from definitive randomised controlled trials at short-term follow-up also suggested that PM+ is effective, with overall moderate-to-large effect sizes, in improving symptoms of common mental health problems. Although PM+ was more effective in reducing symptoms of common mental disorders, it was found to be costlier compared to usual care in the only study that evaluated its cost-effectiveness. Our findings indicate that PM+, in its individual and group formats, can be adapted and effectively delivered by trained helpers to target a wide range of common mental health concerns. More effectiveness and implementation evidence is required to understand the long-term impact of PM+, its cost-effectiveness and scalability, and moderators of treatment outcomes such as gender and delivery formats.

The Role of Social Support in Perinatal Mental Health and Psychosocial Stimulation.

Social support refers to the help someone receives emotionally or instrumentally from their social network. Poor social support in the perinatal period has been associated with increased risk for symptoms of common mental disorders, including depression and posttraumatic stress symptoms (PTS), which may impact parenting behavior. Whether social support impacts parenting behaviors, independent of mental health symptomatology, remains unclear. Among N=309 participants of the Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT Trial), a large perinatal depression and anxiety treatment trial, we explored the relations between perceived social support, perinatal depressive and PTS symptoms, and psychosocial stimulation provided by the parent in their home environment. Social support was measured at baseline using the Multidimensional Scale of Perceived Social Support (MSPSS). Perinatal depressive symptoms were measured by the Edinburgh Postnatal Depression Scale (EPDS) and PTS symptoms were measured by the Abbreviated PTSD Checklist (PCL-6) at baseline, 3-, and 6-months post-randomization. Psychosocial stimulation was assessed by the Home Observation Measurement of the Environment (HOME) when the infant was between 6 to 24 months. Using stepwise hierarchical regressions, we found: (1) perceived social support at baseline significantly predicted both depressive and PTS symptoms at 3-months post-randomization, even when controlling for baseline depressive and PTS symptoms; and (2) while neither depressive nor PTS symptoms were significantly associated with psychosocial stimulation, perceived social support at baseline was a significant predictor. Clinical implications regarding treatment of perinatal patients are discussed.

Association between antenatal common mental disorders symptoms, and adverse obstetric and perinatal outcomes: A community-based prospective cohort study in Eastern Ethiopia

BackgroundMaternal common mental disorders have broad implications for maternal and child mental and physical health that may have a long-lasting social and economic impact. This study aimed to assess the association between symptoms of antenatal common mental disorders and obstetric and perinatal outcomes in Eastern Ethiopia. MethodsA community-based prospective cohort study was conducted and a total of 1011 randomly selected pregnant women were followed up from February 1, 2021, to January 30, 2022. The modified Poisson regression model with a robust variance was fitted to examine the effect of the symptoms of antenatal common mental disorders on obstetric and perinatal outcomes. ResultsAntenatal common mental disorders (SRQ ≥ 6) were presented among 390 (38.58 %) pregnant women. In the final multivariate Poisson regression model, women with antenatal common mental disorders symptoms had an increased risk of some pregnancy complications (ARR = 1.65, 95 % CI: 1.59, 1.84). In the current study, symptoms of antenatal common mental disorders increased also the risk of preterm birth (ARR = 1.71; 95 % CI: 1.20, 2.42) and low birth weight (ARR = 1.93; 95 % CI: 1.36, 2.74). LimitationThe indirect effects of some potential mediators and moderators were not assessed in this study. ConclusionThe study found a high rate of symptoms of antenatal common mental disorders and adverse obstetric and perinatal outcomes. Antenatal common mental disorders symptoms may have considerable effects on individual and combined pregnancy complications and adverse perinatal outcomes.

Variation in symptoms of common mental disorders in the general population during the COVID-19 pandemic: longitudinal cohort study.

A significant rise in mental health disorders was expected during the COVID-19 pandemic. However, referrals to mental health services dropped for several months before rising to pre-pandemic levels. To identify trajectories of incidence and risk factors for common mental disorders among the general population during 14 months of the COVID-19 pandemic, to inform potential mental health service needs. A cohort of 33 703 adults in England in the University College London COVID-19 Social Study provided data from March 2020 to May 2021. Growth mixture modelling was used to identify trajectories based on the probability of participants reporting symptoms of depression (Patient Health Questionnaire-9) or anxiety (Generalised Anxiety Disorder-7) in the clinical range, for each month. Sociodemographic and personality-related characteristics associated with each trajectory class were explored. Five trajectory classes were identified for depression and anxiety. Participants in the largest class (62%) were very unlikely to report clinically significant symptom levels. Other trajectories represented participants with a high likelihood of clinically significant symptoms throughout, early clinically significant symptoms that reduced over time, clinically significant symptoms that emerged as the pandemic unfolded and a moderate likelihood of clinically significant symptoms throughout. Females, younger adults, carers, those with existing mental health diagnoses, those that socialised frequently pre-pandemic and those with higher neuroticism scores were more likely to experience depression or anxiety. Nearly 40% of participants followed trajectories indicating risk of clinically significant symptoms of depression or anxiety. The identified risk factors could inform public health interventions to target individuals at risk in future health emergencies.

Prevalence of chronic conditions and multimorbidity among healthcare workers in Zimbabwe: Results from a screening intervention.

The burden of non-communicable diseases (NCDs) in southern Africa is expanding and is superimposed on high HIV prevalence. Healthcare workers are a scarce resource; yet are vital to health systems. There are very limited studies on the burden of chronic conditions among healthcare workers in Africa, and none exploring multimorbidity (≥2 chronic conditions). We describe the epidemiology of infectious (HIV) and non-communicable chronic conditions, and multimorbidity, among Zimbabwean healthcare workers. Healthcare workers (≥18 years) in eight Zimbabwean provinces were invited to a voluntary, cross-sectional health-check, including HIV, diabetes, hypertension and mental health screening. Statistical analyses described the prevalence and risk factors for multimorbidity (two or more of HIV, diabetes, hypertension or common mental disorder) and each condition. Missing data were handled using multiple imputation. Among 6598 healthcare workers (July 2020-July 2022) participating in the health-check, median age was 37 years (interquartile range 29-44), 79% were women and 10% knew they were living with HIV. Half had at least one chronic condition: 11% were living with HIV, 36% had elevated blood pressure, 12% had elevated HbA1c and 11% had symptoms of common mental disorder. The overall prevalence of multimorbidity was 15% (95% CI: 13-17%); 39% (95% CI: 36-43%) among people aged 50 and older. Whilst most HIV was diagnosed and treated, other chronic conditions were usually undiagnosed or uncontrolled. Limiting our definition of multimorbidity to two or more screened conditions sought to reduce bias due to access to diagnosis, however, may have led to a lower reported prevalence than that found using a wider definition. Half of healthcare workers screened were living with a chronic condition; one in seven had multimorbidity. Other than HIV, most conditions were undiagnosed or untreated. Multisectoral action to implement contextually relevant, chronic disease services in Africa is urgently needed. Specific attention on health workers is required to protect and retain this critical workforce.

Network analytical investigation of relationships between symptoms of common mental disorders among refugees and asylum seekers in Türkiye.

Forcibly displaced people, such as refugees and asylum-seekers (RAS), are at higher risk of mental disorders, mainly post-traumatic stress disorder (PTSD), depression and anxiety. Little is known about the complex relationships between these mental disorders among culturally and linguistically diverse RAS. To investigate this, the present study applied a novel network analytical approach to examine and compare the central and bridge symptoms within and between PTSD, depression and anxiety among Afghan and Syrian RAS in Türkiye. A large-scale online survey study with 785 Afghan and 798 Syrian RAS in Türkiye was conducted in 2021. Symptoms of PTSD (the short form of Post-Traumatic Stress Disorders Checklist [PCL-5]), depression and anxiety (Hopkins Symptoms Checklist-25) [HSCL-25]) were measured via self-administrated validated instruments. We conducted network analysis to identify symptoms that are most strongly connected with other symptoms (central symptoms) and those that connect the symptoms of different disorders (bridge symptoms) in R Studio using the qgraph package. Overall, Afghans and Syrians differed in terms of network structure, but not in network strength. Results showed that feeling blue, feeling restless and spells of terror or panic were the most central symptoms maintaining the overall symptom structure of common mental disorders among Afghan participants. For Syrian participants, worrying too much, feeling blue and feeling tense were identified as the central symptoms. For both samples, anger and irritability and feeling low in energy acted as a bridge connecting the symptoms of PTSD, depression and anxiety. The current findings provide insights into the interconnectedness within and between the symptoms of common mental disorders and highlight the key symptoms that can be potential targets for psychological interventions for RAS. Addressing these symptoms may aid in tailoring existing evidence-based interventions and enhance their effectiveness. This contributes to reducing the overall mental health burden and improving well-being in this population.

Ab. No. 46 Impact of Sports Injury on Mental Wellbeing of University Level Athletes

Introduction: Sports injury is an injury that occurs during athletic activities or physical exertion. Exceptional level of effort and striving for perfection close to psychological limits increases the possibility of sports injury. A sports injury can take a toll on an athlete’s emotional wellbeing. Athletes respond to injuries in very different ways, exhibiting a wide range of cognitive, emotional, and behavioral responses. Therefore, it is crucial to understand those responses to examine the symptoms of common mental disorders and general psychological stress depending upon the severity of injury among athletes. The study aims to investigate symptoms of common mental disorders and psychological stress about the severity of injury among athletes. Methods: A total of 100 male and female athletes were selected from Punjabi University, Patiala. The study population included athletes from 18-28 years of age. All subjects were evaluated through Likert scale, Depression anxiety stress scale (DASS-21) and Perceived stress scale (PSS). Result: Overall, majority of athletes were experiencing symptoms of at least one of the mental-health problem assessed. Injured athletes had higher level of symptoms of anxiety, depression (r = 0.823, p = 0.00) and perceived stress (r = 0.776, p = 0.001) compared with Likert scale as analyzed via Pearson’s Correlation. Conclusion: The results indicated that athletic injury negatively impacts the mental wellbeing of athletes.

Transdiagnostic Psychological Interventions for Symptoms of Common Mental Disorders Delivered by Non‐Specialist Providers in Low‐ and Middle‐Income Countries: A Systematic Review and Meta‐Analysis

There is a treatment gap for Common Mental Disorders (CMDs) such as anxiety, depression, and post‐traumatic stress disorder (PTSD), as well as non‐specific psychological distress (NPD) in low‐ and middle‐income countries (LAMIC), due to the lack of available clinicians and locally appropriate interventions. Task‐shifting using non‐specialist providers (NSP) and transdiagnostic approaches may address this. Transdiagnostic approaches can be effective at treating CMDs and NPD in high‐income countries (HIC), but currently, there is no comprehensive synthesis of evidence regarding their effectiveness in LAMICs. This review addressed this gap by examining the effectiveness of transdiagnostic psychological interventions for symptoms of CMDs and NPD delivered by NSPs in LAMICs. Three databases were searched (Embase, PsycInfo, and PubMed). Hedge’s g’s were calculated using random‐effect models to correct for small sample bias. Twenty‐one transdiagnostic interventions across 20 studies were included. Moderate reductions at posttreatment were found in psychological distress (g = −0.64; 95% CI: −0.81 to −0.46), symptoms of anxiety (g = −0.61; 95% CI: −0.80 to −0.42), depression (g = −0.59; 95% CI: −0.75 to −0.44), and PTSD/trauma (g = −0.38; 95% CI: −0.59 to −0.16), with significant small reductions maintained at follow‐up ranging from 13 to 26 weeks for NPD (SMD = − 0.37; 95% CI: −0.57 to −0.17), anxiety (g = − 0.41; 95% CI: −0.91 to 0.09), depression (g = −0.38; 95% CI: −0.59 to −0.16), and trauma symptoms (g = −0.23; 95% CI: −0.42 to −0.05). These findings are important and suggest that transdiagnostic approaches delivered by NSPs are effective at treating symptoms of CMDs and NPD in LAMICs. Future research should consider comparing task‐shifting approaches with disorder‐specific interventions and explore the effectiveness of longer sessions across various mental health conditions.

The effectiveness of Problem Management Plus at 1-year follow-up for Syrian refugees in a high-income setting.

Problem Management Plus (PM+) has been effective in reducing mental health problems among refugees at three-month follow-up, but there is a lack of research on its long-term effectiveness. This study examined the effectiveness of PM+ in reducing symptoms of common mental disorders at 12-month follow-up among Syrian refugees in the Netherlands. This single-blind, parallel, controlled trial randomised 206 adult Syrians who screened positive for psychological distress and impaired functioning to either PM+ in addition to care as usual (PM+/CAU) or CAU alone. Assessments were at baseline, 1 week and 3 months after the intervention and 12 months after baseline. Outcomes were psychological distress (Hopkins Symptom Checklist [HSCL-25]), depression (HSCL-25 subscale), anxiety (HSCL-25 subscale), posttraumatic stress disorder symptoms (PCL-5), functional impairment (WHODAS 2.0) and self-identified problems (PSYCHLOPS). In March 2019-December 2022, 103 participants were assigned to PM+/CAU and 103 to CAU of which 169 (82.0%) were retained at 12 months. Intention-to-treat analyses showed greater reductions in psychological distress at 12 months for PM+/CAU compared to CAU (adjusted mean difference -0.17, 95% CI -0.310 to -0.027; p = 0.01, Cohen's d = 0.28). Relative to CAU, PM+/CAU participants also showed significant reductions on anxiety (-0.19, 95% CI -0.344 to -0.047; p = 0.01, d = 0.31) but not on any of the other outcomes. PM+ is effective in reducing psychological distress and symptoms of anxiety over a period up to 1 year. Additional support such as booster sessions or additional (trauma-focused) modules may be required to prolong and consolidate benefits gained through PM+ on other mental health and psychosocial outcomes.

Prevalence and sociodemographic determinants of common mental disorders (CMDs) symptoms in a rural adult population of Haryana, North India.

Common mental disorders (CMDs), including depression, anxiety, and somatoform disorders, affect all stages of life and impact individuals, families, and communities. This study aimed to determine the magnitude of CMDs and their sociodemographic determinants in the adult population of a rural block in North India. A cross-sectional, quantitative, community-based study was conducted among adult residents of a rural block in Haryana, North India, using a multistage random sampling technique. The Hindi version of the General Health Questionnaire (GHQ-12), a well-validated tool, was used to screen participants for CMDs. Scores of 4 or above denoted the presence of CMDs. Bivariate analyses were performed to determine the associations between CMDs and sociodemographic characteristics. Of the 180 residents selected for the study, most were women (60.0%) and aged between 31 and 50 years (52.3%). The prevalence of CMDs symptoms in the study population was 20.0%. The presence of CMDs symptoms was significantly higher among those who were aged 60 years or older [OR=12.33, 95% CI 3.21-47.38], widowed, divorced or separated [OR=7.50, 95% CI 1.09-51.52], illiterate [OR= 6.25, 95% CI 2.84-13.77], had monthly family income below 10,000 INR [OR=3.33, 95% CI 1.54-7.20], had any chronic physical illness [OR=8.28, 95% CI 3.70-18.56] and had a family history of any psychiatric illness [OR=5.56, 95% CI 1.52-19.42]. The burden of CMDs was quite high among adults in rural North India. The presence of CMDs was closely associated with sociodemographic characteristics. Primary care and community-based settings need to screen for, diagnose, and manage CMDs to address this growing problem.

The Impact of Childhood Mental Health and Substance Use on Methylation Aging Into Adulthood

To test whether childhood mental health symptoms, substance use, and early adversity accelerate the rate of DNA methylation (DNAm) aging from adolescence to adulthood. DNAm was assayed from blood samples in 381 participants in both adolescence (mean [SD] age= 13.9 [1.6] years) and adulthood (mean [SD] age= 25.9 [2.7] years). Structured diagnostic interviews were completed with participants and their parents at multiple childhood observations (1,950 total) to assess symptoms of common mental health disorders (attention-deficit/hyperactivity disorder, oppositional defiant disorder, conduct disorder, anxiety, and depression) and common types of substance use (alcohol, cannabis, nicotine) and early adversities. Neither childhood mental health symptoms nor substance use variables were associated with DNAm aging cross-sectionally. In contrast, the following mental health symptoms and substance variables were associated with accelerated DNAm aging from adolescence to adulthood: depressive symptoms (b= 0.314, SE= 0.127, p= .014), internalizing symptoms (b= 0.108, SE= 0.049, p= .029), weekly cannabis use (b=1.665, SE= 0.591, p= .005), and years of weekly cannabis use (b= 0.718, SE= 0.283, p= .012). In models testing all individual variables simultaneously, the combined effect of the variables was equivalent to a potential difference of 3.17 to 3.76 years in DNAm aging. A final model tested a variable assessing cumulative exposure to mental health symptoms, substance use, and early adversities. This cumulative variable was strongly associated with accelerated aging (b= 0.126, SE= 0.044, p= .005). Mental health symptoms and substance use accelerated DNAm aging into adulthood in a manner consistent with a shared risk mechanism. Using data from 381 participants in the Great Smoky Mountains Study, the authors examined whether childhood mental health symptoms, substance use, and early adversity accelerate biological aging, as measured by DNA methylation age, from adolescence to adulthood. Depressive symptoms and cannabis use were found to significantly accelerate biological aging. Models that tested the combined effect of mental health symptoms, substance use, and early adversity demonstrated that there was a shared effect across these types of childhood problems on accelerated aging.

Psychosocial impacts of the COVID-19 pandemic among settled women: A longitudinal study.

to analyze the psychosocial impacts of the COVID-19 pandemic among Brazilian women from rural settlements. this is a quantitative and longitudinal study conducted with 13 settled women. The data were collected between January 2020 and September 2021 using questionnaires on the perception of the social environment (quality of life, social support, self-efficacy), common mental disorder symptoms and sociodemographic aspects. The data were analyzed using descriptive statistics, cluster analysis and variance analysis. intersecting vulnerability conditions were identified that possibly intensified the challenges arising from the pandemic. The Quality of Life physical domain fluctuated differently and inversely according to the mental disorder symptoms. As for the psychological domain, at the end of the segment, an increase over time was identified in the entire sample, as the women's perception was better than before the pandemic. worsening of the participants' physical health deserves to be highlighted and, probably, it can be related to the difficulty accessing health services in this period as well as to the fear of contamination. Despite this, the participants were emotionally resilient throughout the period, including signs of improvement in terms of psychological aspects, suggesting a possible effect of the community organization of the settlement.

Effects of a Self-Guided Transdiagnostic Smartphone App on Patient Empowerment and Mental Health: Randomized Controlled Trial.

Mental disorders impact both individuals and health systems. Symptoms and syndromes often remain undetected and untreated, resulting in chronification. Besides limited health care resources, within-person barriers such as the lack of trust in professionals, the fear of stigmatization, or the desire to cope with problems without professional help contribute to the treatment gap. Self-guided mental health apps may support treatment seeking by reducing within-person barriers and facilitating mental health literacy. Digital mental health interventions may also improve mental health related self-management skills and contribute to symptom reduction and the improvement of quality of life. This study aims to investigate the effects of a self-guided transdiagnostic app for mental health on help seeking, reduced stigma, mental health literacy, self-management skills, mental health symptoms, and quality of life using a randomized controlled design. Overall, 1045 participants (recruited via open, blinded, and web-based recruitment) with mild to moderate depression or anxiety-, sleep-, eating-, or somatization-related psychopathology were randomized to receive either access to a self-guided transdiagnostic mental health app (MindDoc) in addition to care as usual or care as usual only. The core features of the app were regular self-monitoring, automated feedback, and psychological courses and exercises. The coprimary outcomes were mental health literacy, mental health-related patient empowerment and self-management skills (MHPSS), attitudes toward help seeking, and actual mental health service use. The secondary outcomes were psychopathological symptom burden and quality of life. Data were collected at baseline and 8 weeks and 6 months after randomization. Treatment effects were investigated using analyses of covariance, including baseline variables as predictors and applying multiple imputation. We found small but robust between-group effects for MHPSS (Cohen d=0.29), symptoms burden (Cohen d=0.28), and quality of life (Cohen d=0.19) 8 weeks after randomization. The effects on MHPSS were maintained at follow-up. Follow-up assessments also showed robust effects on mental health literacy and preliminary evidence for the improvement of help seeking. Predictors of attrition were lower age and higher personality dysfunction. Among the non-attritors, predictors for deterioration were less outpatient treatment and higher initial symptom severity. A self-guided transdiagnostic mental health app can contribute to lasting improvements in patient empowerment. Symptoms of common mental disorders and quality of life improved faster in the intervention group than in the control group. Therefore, such interventions may support individuals with symptoms of 1 or more internalizing disorders, develop health-centered coping skills, prevent chronification, and accelerate symptom improvement. Although the effects for individual users are small and predictors of attrition and deterioration need to be investigated further, the potential public health impact of a self-guided intervention can be large, given its high scalability. German Clinical Trials Register DRKS00022531; https://drks.de/search/de/trial/DRKS00022531.

Safety, Efficacy, and Ill Intent: Examining COVID-19 Vaccine Perceptions among the New Undervaccinated Moveable Middle in a U.S. Cohort, October 2022.

Individuals who received their primary vaccine series only (with no subsequent booster) may be a new type of "moveable middle" given their receipt of the original COVID-19 vaccination. One population within the moveable middle for whom tailored interventions may be needed is individuals with common mental disorders (CMD). The purpose of this paper is to understand the vaccine perceptions among this new moveable middle-the undervaccinated-and within the undervaccinated to examine the extent to which COVID-19 vaccine perceptions and motivations differ among those with and without symptoms of CMD. Using data from the CHASING COVID Cohort, we examine the relationship between vaccination status, CMD, and vaccine perceptions in the undervaccinated. Among 510 undervaccinated participants who had completed the primary vaccine series but were not boosted, the most common reasons for undervaccination focused on efficacy (not seeing a need for an additional dose, 42.4%; there not being enough evidence that a booster dose is effective, 26.5%; already having had COVID-19, 19.6%). Other concerns were related to safety (long-term side effects, 21.0%; short-term side effects, 17.6%) and logistics (plan to get a booster but haven't had time yet, 18.8%). Overall, the greatest vaccine concerns (over 30%) for the undervaccinated focused on efficacy and safety issues. Symptoms of depression or anxiety were associated with lower levels of vaccine efficacy and greater safety concerns in adjusted models. The implications of our study are that campaigns that are hoping to maximize vaccination uptake should consider focusing on and emphasizing messaging on efficacy and safety issues.

INFLUENCE OF COMMON MENTAL DISORDERS ON PREGNANT WOMEN

This narrative review addresses the prevalence and implications of Common Mental Disorders (CMDs) in pregnant women, highlighting the need for early detection and intervention. Systematic research across databases identified a high rate of CMDs in pregnant women, with variances across studies, some showing prevalences as high as 57.1%. Symptoms of CMDs are often confused with typical hormonal and emotional changes during pregnancy, making diagnosis and treatment challenging. This review underscores the urgency of clinical approaches and public policies focused on maternal mental health, targeting both the well-being of the mother and the fetus

Toward an integrated approach for mental health and psychosocial support and peacebuilding in North-East Nigeria: programme description and preliminary outcomes from 'Counselling on Wheels'.

Despite theoretical support for including mental health and psychosocial support (MHPSS) with peacebuilding, few programmes in conflict-affected regions fully integrate these approaches. To describe and assess preliminary outcomes of the Counselling on Wheels programme delivered by the NEEM Foundation in the Borno State of North-East Nigeria. We first describe the components of the Counselling on Wheels programme, including education and advocacy for peace and social cohesion through community peacebuilding partnerships and activities, and an MHPSS intervention open to all adults, delivered in groups of eight to ten people. We then conducted secondary analysis of data from 1550 adults who took part in the MHPSS intervention, who provided data at baseline and 1-2 weeks after the final group session. Vulnerability to violent extremism was assessed with a locally developed 80-item scale. Symptoms of common mental disorders were assessed with the Depression, Anxiety and Stress Scale (DASS-21) and Post-Traumatic Stress Disorder Scale (PTSD-8). Data were analysed through a mixed-effect linear regression model, accounting for clustering by community and adjusted for age and gender. After taking part in group MHPSS, scores fell for depression (-5.8, 95% CI -6.7 to -5.0), stress (-5.5, 95% CI -6.3 to -4.6), post-traumatic stress disorder (-2.9, 95% CI -3.4 to -2.4) and vulnerability to violent extremism (-44.6, 95% CI -50.6 to -38.6). The Counselling on Wheels programme shows promise as a model for integrating MHPSS with community peacebuilding activities in this conflict-affected region of Africa.

The association between higher education attendance and common mental health problems among young people in England: evidence from two population-based cohorts

It is unclear whether young people who attend higher education are at increased risk of common mental disorders, compared with those who do not attend. We aimed to investigate whether higher education attendance was associated with increased symptoms of common mental disorders (depression and anxiety) in young people before, during and after attendance. For this cohort study, we used two cohorts-the Longitudinal Studies of Young People in England (LSYPE1: N=4832, 55·8% [2696 of 4832] students; LSYPE2: n=6128, 50·7% [3104 of 6128] students), beginning in 2004 for LSYPE1 and 2013 for LSYPE2. Both cohorts were designed to be nationally representative, with schools in England as the primary sampling unit. Symptoms of common mental disorders were assessed with the General Health Questionnaire (GHQ-12) before (age 14-17 years for both cohorts), during (age 18-19 years for LSYPE2), and after (age 25 years for LSYPE1) higher education. We assessed differences in GHQ scores using unadjusted and confounder adjusted linear regression. At ages 18-19 years (LSYPE2), mean GHQ-12 scores were 12·0 (SD 6·4) among students and 11·6 (SD 6·8) among non-students (adjusted mean difference 0·36, 95% CI 0·05 to 0·68; p=0·024). In LSYPE1, young people who attended higher education at ages 18-20 years had higher symptoms of common mental disorders at ages 16-17 years than those who did not (0·60, 0·30 to 0·90). However, after higher education (age 25 years for LSYPE1), there was no evidence of a difference-mean GHQ-12 scores were 11·4 (SD 5·5) among those who had attended and 11·7 (SD 6·4) among those who had not attended (-0·25, -0·66 to 0·16; p=0·23). We found evidence that students had more symptoms of common mental disorders than non-students at ages 18-19 years, albeit the effect size was small and there was no evidence of a longer-term difference at the age of 25 years. Department for Education.