Depression Anxiety Stress Scale Research Articles

Application of DASS-21 in Chinese students: invariance testing and network analysis

BackgroundThe Depression Anxiety Stress Scale-21 Items (DASS-21) is commonly used to assess the mental health of students, but there is a need for further clarification regarding its equivalence, structure, and core items.MethodsWe conducted a confirmatory factor analysis (CFA) on a sample of 7943 Chinese students to examine the performance of the DASS-21 and assess measurement invariance. Additionally, we utilized network analysis to investigate the structure and centrality of students’ mental health.ResultsOur findings revealed a stable three-factor structure for the DASS-21, characterized by high correlations among depression, anxiety, and stress. The DASS-21 demonstrated strict invariance across genders and weak invariance across levels of education. Network analysis indicated that symptoms of depression, anxiety, and stress form clusters, with some symptoms exhibiting strong correlations with each other.ConclusionOur study highlights a substantial interrelation among depression, anxiety, and stress, revealing a structurally clustered pattern. Network analysis underscores the interconnectedness and centrality of these symptoms, recommending a shorter version of the DASS, and emphasizing the imperative for targeted interventions aimed at improving the psychological well-being of students.

Keadaan Psikologis Mahasiswa Kedokteran Gigi Universitas Sumatera Utara yang Sedang Melaksanakan Pembelajaran Daring

This study aims to identify the characteristics of students during online learning, as well as evaluate their state and level of stress, anxiety, and depression using the Depression Anxiety and Stress Scale (DASS). This research is a descriptive survey research, namely to find out the psychological state of students of the Faculty of Dentistry, University of North Sumatra who are carrying out online learning using the depression anxiety stress scale questionnaire (DASS-42) which consists of stress, anxiety, and depression. This research was conducted at the Faculty of Dentistry, University of North Sumatra which is located in Medan City, North Sumatra Province. This research was carried out from June 2021 to July 2021. Results, In terms of anxiety, 74.5% did not have difficulty swallowing, and moderate anxiety was the highest (31.2%). For depression, 66.8% did not feel that their lives were meaningless, with normal depression being the highest (50.6%). Stressors include learning tasks (72.5%), unavailability of practical tools (64.4%), limited internet quota (61.1%), and boredom with online learning (48.2%).

Psychological stress impact neurotrophic factor levels in patients with androgenetic alopecia and correlated with disease progression.

Androgenetic alopecia (AGA) is a common form of hair loss that can be influenced by psychological factors. To investigate the impact of mental stress on neurotrophic factors in patients with AGA and correlate the findings with the progression of AGA. A total of 120 patients with AGA were analyzed in this study, which were divided into a non-stress group (n = 30) and a stress group (n = 90) on the basis of the presence or absence of psychological stress confirmed by Depression Anxiety Stress Scale-21 scale. The baseline demographic characteristics, serum cortisol levels, hair growth parameters, neurotrophic factors, and AGA progression scores between the non-stress and stress groups were compared. Correlation analyses were conducted to assess the relationships among stress, neurotrophic factors, hair loss progression, and AGA progression. This study revealed significantly higher cortisol levels throughout the day in the stress group than in the non-stress group. The stress group exhibited lower levels of nerve growth factor, brain-derived neurotrophic factor, and glial cell line-derived neurotrophic factor and higher expression levels of neurotrophin (NT)-3 and NT-4 than the non-stress group. Hair parameters indicated lower hair diameter, decreased hair density, and more severe AGA grading in the stress group, whereas follicle count and terminal/vellus hair ratio showed no significant differences between the two groups. After 1 year of treatment with 5% minoxidil, efficacy was observed to be lower but AGA progression was notably more pronounced in the stress group than in the non-stress group. Disease progression was positively correlated with high stress and NT-4 levels. This study provides compelling evidence of the influence of mental stress on neurotrophic factors and its correlation with the progression of AGA. The findings underscore the need for a comprehensive approach to the management of AGA that considers the physiological and psychosocial aspects. Further research is warranted to validate the findings and explore targeted therapeutic interventions for individuals with stress-related AGA.

Burden, Anxiety, and Depression Among Caregivers of Parkinson's Disease Patients.

Parkinson's disease (PD) is a disabling neurodegenerative movement disorder. Most PD patients are looked after by caregivers who are close to them regardless of their relationship. Caregivers may experience a notable impact on their mental health as they dedicate a significant amount of time to the patient while observing the progression of the disease. The aim of this study was to evaluate the level of burden, depression, anxiety, and stress among caregivers of PD patients. We conducted a cross-sectional analysis between July and September 2023 among caregivers of PD patients following in the Movement Disorders Clinic at King Khalid University Hospital in Riyadh, Saudi Arabia, and through the Saudi Parkinson's Society. The data collection was done anonymously through an electronic self-administered questionnaire. Caregiver burden was assessed by using the validated Arabic version of the Zarit Burden Interview (ZBI) scale, and the Depression Anxiety Stress Scale (DASS) was used to assess the presence and level of anxiety and depression. There were 118 caregivers (53.39% female, 33.9% aged between 35- 45 years, and 73.73% were sons/daughters) caring for 118 patients (57.63%, male, 38.98% aged between 66- 76). The ZBI score was highest among sibling caregivers. Moreover, burden scores were higher among those who provided care more frequently than others. Our study revealed that PD caregivers face a high risk of care burden, especially those who are siblings and spend longer periods in patient care. Additionally, female caregivers reported higher rates of depression, anxiety, and stress.

Impulse Control Deficits and Loneliness/Depression

This study aimed to assess the prevalence of problematic internet use (PIU) among Brazilian adults and its cognitive and emotional factors. A total of 294 individuals (144 men, 149 women, 1 undisclosed) aged 18 to 55 years (M=29.31, SD=7.99) participated, completing various instruments: a sociodemographic and internet use questionnaire, the generalized problematic internet use scale (GPIUS-2), the online cognition scale (OCS), the depression anxiety stress scale-21 (DASS-21), and the difficulties in emotional regulation scale (DERS). The prevalence of PIU was 17.4% (n=49). Younger participants reported higher rates of PIU. GPIUS-2 scores positively correlated with DERS and DASS-21 subscales. Network analysis highlighted impulse control deficits and loneliness/depression as key factors associated with PIU, with anxiety indirectly related through stress. These findings highlight the link between emotional difficulties and PIU, suggesting the need for guidelines to promote healthier internet use.

Impact of daily physical activity level on mental health and quality of life in substance use disorders patients

ABSTRACT Background Substance use disorders patients often exhibit low levels of physical activity. However, the daily level of physical activity appears to significantly impact the patient’s rehabilitation process. Methods This study analyses the daily level of physical activity (International Physical Activity Questionnaire-Short Form) in a group of 125 patients undergoing rehabilitation, and its relationship with levels of mental health (Depression Anxiety Stress Scale) and quality of life (Short Form Health Survey). Additionally, gender differences in all measured variables were analyzed. Results The results show a strong correlation between daily physical activity and levels of mental health (ρ>0.787), as well as a moderate correlation between physical activity levels and quality of life (ρ:0.406–0.586). Furthermore, when analyzing gender differences, women exhibited lower levels compared to men in physical activity (p < 0.001), mental health (p < 0.05), and different quality of life indicators (p < 0.05). Conclusion The results of this study indicate that the level of daily physical activity could influence the quality of life and mental health of patients during the rehabilitation process. Therefore, rehabilitation treatments should include strategies to increase patients’ daily physical activity levels. Furthermore, considering the gender disparities identified, additional studies are warranted in this field.

Study on the sports biomechanics prediction, sport biofluids and assessment of college students’ mental health status transport based on artificial neural network and expert system

Based on the theories of artificial neural networks and expert systems, this study constructs a model for assessing the sports biomechanics’ mental health of college students using artificial neural networks and expert systems. It assesses the sports biomechanics’ mental health status of college students who had their yoga classes suspended during the COVID-19 pandemic. Meanwhile, A mobile questionnaire was used to collect information on students’ personal circumstances, sport biofluids and yoga exercise routines, as well as data from the Depression Anxiety Stress Scales (DASS-21). This study presents a novel approach to assessing the intersection of sports biomechanics and mental health by employing Artificial Neural Networks (ANNs) and expert systems. Unlike previous research in this domain, this study offers an extensive review of the literature, highlighting both the distinctive contributions of ANNs and expert systems and the existing gaps in current methodologies. Similarly, a univariate analysis method was utilized to quantitatively assess the impact of yoga interventions and other factors on college students’ sports biomechanics and mental health. Building on this analysis, an artificial neural network (ANN) model was developed to predict mental health outcomes and sport biofluid conditions. The model focused on evaluating the significance of various variables, with particular attention to the contribution of yoga exercise routines. In short, this approach aims to enhance the understanding and support for utilizing yoga interventions to improve college students’ mental health within the context of sports biomechanics, especially in the post-pandemic era. The findings should make an important contribution to the field of integrating ANNs with expert systems and sports biomechanics improves mental health prediction accuracy.

Evaluation of the mental health status of intensive care unit healthcare workers at the beginning of COVID-19 pandemic.

During pandemic periods, mental health issues are highly prevalent, particularly among healthcare workers who are at a higher risk of developing psychiatric disorders. The aim of this study is to evaluate the mental health status of the intensive care unit (ICU) healthcare workers, who play a vital role in managing the COVID-19 pandemic, in terms of the quality of sleep, levels of depressive and anxiety symptoms, stress and to determine the factors that affect their mental health. The research was conducted in April 2020 and incorporated a total of 79 participants working in an university hospital ICUs in Turkey. Pittsburgh Sleep Quality Index (PSQI), Depression Anxiety Stress Scale 42 (DASS-42), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were applied. Among the participants, 58 individuals comprising 73.4% of the cohort were working in the ICUs, managing patients infected with COVID-19. Those working in ICUs with COVID-19 patients had significantly higher DASS-S, BAI, and BDI scores. Doctors' BDI scores were significantly lower compared to both nurses and other healthcare workers. Participants exhibiting COVID-19 symptoms manifested significantly higher BAI scores in compared to those without such symptoms. Healthcare workers involved in ICUs with COVID-19 patients were more significantly affected psychologically, doctors had lower depressive symptoms as compared to other healthcare workers. In addition, individuals with COVID-19 symptoms demonstrated significantly higher levels of anxiety. The findings of our study emphasize the significance of providing psychological support to healthcare workers throughout pandemics.

Association of macronutrient intake, physical activity, anxiety, and depression with sleep quality among Iranian male adolescents

BackgroundAdolescence is a unique stage of life accompanied by physiological and psychological modifications, along with stress, confusion, and depression.Materials and methodsThe present descriptive-analytical cross-sectional research was done on 267 male adolescents who studied at high schools in Zanjan, Iran. Demographic characteristics questionnaires, a 48-item food frequency questionnaire, a short version of the International Physical Activity Questionnaire (IPAQ), the Depression Anxiety Stress Scale (DASS-21), and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data.ResultsThe mean ± standard deviation (SD) of age, weight, height, and sitting time was 15.94 ± 0.91 years, 68.53 ± 15.28 kg, 1.75 ± 0.06 m, and 449.25 ± 322.06 min, respectively. The study results showed that students with poor sleep quality showed a higher rate of depression than those with good sleep quality in the high and low physical activity groups (p < 0.05). The stress, depression, and anxiety scores significantly correlated with sleep quality in the physical activity groups (p < 0.05). The structural equation model analysis results showed that mental health directly affected sleep quality; this association was significant in the low physical activity group.ConclusionWe found that sleep quality was independently related to mental health in young Iranian men. However, dietary intake was not a significant predictor of mental health or sleep quality. More studies are required to evaluate the association between dietary intake and sleep quality in adults.

Heterogeneity in the association between social support and mental distress in old-age retirees – a computational approach using longitudinal cohort data

BackgroundMental distress among retirees and older people is a severe public health challenge, and information on new risk groups is needed. This study aims to identify subgroups of old-age retirees with varying associations between low social support and mental distress by applying model-based recursive partitioning (MOB).MethodsWe used the Helsinki Health Study follow-up survey data of old-age retired former municipal sector employees of the City of Helsinki, Finland. Phase 1 data were collected in 2000–2002, when all participants were employed, Phase 2 in 2007, Phase 3 in 2012, Phase 4 in 2017, and Phase 5 in 2022 (n = 4,466, 81% women). Social support and covariates were measured at each Phase 1–5 and the outcome, mental distress (Depression Anxiety Stress Scales [DASS-21]) was measured at a single occasion, during Phase 5. The three subscales and the common factor of general distress were analysed separately. An approach rooted in computational statistics was used to investigate risk factor heterogeneity in the association of low social support and mental distress. MOB combines decision trees with regression analysis to identify subgroups with the most significant heterogeneity among risk factors.ResultsMedian (IQR) general distress score from DASS-21 was 5.7 (3.0, 9.0), while Social Support Questionnaire number-score (SSQN) was 1.5 (1.15, 2.05). The primary effect modifier for the association between social support and general distress was education (p < 0.001). Those with high education had a different association of low social support and general distress than those with low or medium education. Additionally, the subgroup with low and medium education had a significant effect modification for age (p = 0.01). For the association between low social support and depressive symptoms, the moderating effect of education was dependent on gender, as men with medium–high education had the weakest association, while for women with medium–high education the association was strongest.ConclusionsOur results suggest that stratification by sociodemographic variables is justifiable when investigating risk factors of mental distress in old-age retirees. The incongruent association of low social support and depressive symptoms in men with medium–high education compared to women with medium–high education is a promising target for confirmatory research.

Sensitivity analysis of human error in the steel industry: exploring the effects of psychosocial and mental health risk factors and burnout using Bayesian networks.

Human error and the high rates of fatalities and other occupational accidents in the steel industry are of significant global relevance. The aim of this study was to investigate the effect of psychosocial, mental health, and burnout risk factors on human error probabilities in an industrial environment using Bayesian networks. This cross-sectional study was conducted in 2023. The participants were 252 employees of a steel company. Error probabilities related to the tasks of participants were estimated using the Human Error Assessment and Reduction Technique (HEART). Other data was collected using a survey that consisted of demographic information, the Maslach Burnout Inventory, Depression Anxiety Stress Scales, and a short version of the Copenhagen Psychosocial Questionnaire. A theoretical model was drawn in GeNIe academic software (version 2.3). The results showed that all the studied variables were able to significantly affect the distribution of human error probabilities. Considering a distribution of 100% for the high state of these variables, the results showed that the greatest increases in error probability were related to two burnout dimensions: emotional exhaustion (29%) and depersonalization (28%). All the variables, with a probability of 100%, increased the probability of high human error probabilities by 46%. The most important variables in terms of their effect on human error probabilities were burnout dimensions, and these variables also had a mediation effect on the psychosocial and mental health variables. Therefore, preventive measures to control human error should first focus on managing the risks of burnout in workers. This, in turn, can also reduce the effect of psychosocial risk factors and mental health problems on human error in the workplace.

The impact of cancer prevention education on the mental health of college students based on the difference-in-differences method.

Cancer, as the second leading cause of death worldwide, poses significant challenges to human health and socio-economic development. In recent years, the incidence of cancer has shown a trend toward younger populations, drawing attention to cancer prevention education among college students. However, research on the specific impact of cancer prevention education on the mental health of college students is limited. This study aims to explore the impact of cancer prevention education on the mental health of college students, revealing the mediating role of disease awareness and the moderating roles of psychological resilience and cultural differences. A difference-in-differences (DID) approach was used, involving 1,670 freshmen from a Chinese university, divided into an experimental group (n = 835) and a control group (n = 835). The experimental group received a semester-long cancer prevention education program. Data were collected monthly from November 2022 to June 2023 using the Depression Anxiety Stress Scales (DASS-21) and a custom Disease Awareness Scale. The study found a significant improvement in mental health scores among the experimental group, with an average increase of 14.738 points on the DASS-21 scale (p < 0.001), representing a 23% reduction in stress, anxiety, and depression levels compared to the control group. Disease awareness in the experimental group improved by 17%, as measured by the Disease Awareness Scale, with a mediation effect of 3.563 points (p < 0.001). Furthermore, psychological resilience and cultural differences moderated the impact of the education program, with those scoring higher in resilience showing an additional 8% improvement in mental health scores (moderation effect = 0.892, p < 0.001), and cultural differences accounting for a 5% variance (moderation effect = 0.756, p < 0.001) in the outcomes. This study demonstrates that systematic and scientific cancer prevention education has a significant positive impact on the mental health of college students. Universities should promote comprehensive and personalized health education strategies to improve disease awareness, foster psychological resilience, and emphasize cultural differences, thereby enhancing the overall physical and mental health of college students and promoting their holistic development. This finding provides important empirical support and theoretical basis for the design and implementation of health education in universities.

Depressive and Anxiety Symptoms in Community-Dwelling Women in Rural Areas of Greece in the Post-COVID-19 Pandemic Era

Background/Objectives: Depressive and anxiety syndromes are associated with elevated disability and are more prevalent in women. Data on the prevalence of depressive and anxiety disorders in the rural context are limited and contradictory. It is relevant to study common mental disorders in rural areas in the most vulnerable population of women, particularly in the post-COVID-19 pandemic era. Methods: This is a cross-sectional study that was conducted in two primary healthcare sites in the rural region of Farsala, Central Greece after the obviation of all restrictive measures that had been posed due to the COVID-19 pandemic. All consecutive female patients that attended the study sites for any non-emergent reason were asked to participate in the study. For the recording of symptoms of depression and anxiety, the self-reported Depression, Anxiety, Stress Scale-21 (DASS-21) was used. Results: The study sample consisted of 129 women. The majority of participants were &gt;50 years, with 27.9% being older adults. A small percentage (13.2%) suffered a chronic physical disease. A large proportion of the sample, slightly exceeding 40%, reported clinically relevant symptoms of anxiety, whereas a lower percentage of women with depressive symptoms was detected (17.1%). Symptoms of anxiety and depression were found to be interrelated, while a number of sociodemographic variables were associated with both, such as older age, education (primary), living status (alone, OR 123.5; 95% CI: 7.3–2098.8 for anxiety; OR 3.5; 95% CI: 1.3–9.8 for depression), employment (not working, (OR 0.157; 95% CI: 0.06–0.41 for anxiety; OR 0.08; 95% CI: 0.01–0.62 for depression) and the history of a chronic disease (OR 33.8; 95% CI: 4.3–264.7 for anxiety; OR 37.2; 95% CI: 10–138.1 for depression). Self-rated financial status was not related to symptoms of anxiety or depression. Conclusions: The study highlights the importance of inquiring for symptoms of depression and anxiety in women attending the rural primary care setting. The use of valid and reliable self-reported instruments that are easy to administrate may be helpful in this regard.

Rasch analysis of the depression anxiety stress scales-21 (DASS-21) in a mild traumatic brain injury sample.

In this study, we evaluated the psychometric properties of the Depression Anxiety Stress Scales 21 items (DASS-21) in a mild traumatic brain injury (mTBI) sample. Treatment-seeking adults (n = 347) were recruited from outpatient rehabilitation services in New Zealand. Dimensionality, reliability, person separation index, and differential item functioning (DIF) of the DASS-21 were examined using Rasch analysis. Initial analysis of the complete 21-item DASS showed poor overall fit due to problems with individual items. Fit to the Rasch model was excellent when treated as three composite scores. The stress subscale demonstrated adequate model fit, dimensionality and good reliability. For anxiety, fit was not good, reliability was unsatisfactory and DIF was evident on one item. When this item was removed, fit to the model was still inadequate as was reliability. DIF was also evident for depression, but when this item was removed, fit to the model was adequate. The DASS-21 is a psychometrically sound measure of distress and stress for adults seeking treatment following mTBI. Ordinal to interval score conversion tables are provided to increase the precision of measurement. When assessing depression in a mTBI population, a 6-item depression subscale is recommended. Caution is advised in using the DASS-21 anxiety subscale alone.

CORRELATION BETWEEN PSYCHOLOGICAL PARAMETERS SUCH AS DEPRESSION, ANXIETY, AND STRESS AND AFFECT SCORE AMONG MEDICAL STUDENTS

Objectives: In the modern era, internet use has turned out to be a significant arena for day-to-day life activities. Proper use of the internet is harmless, but misuse of this tool might lead to disruptions in psychological health and social relationships, yet available reports about the association between internet use and affect are inconsistent. Hence, the objective is to assess and correlate the psychological parameters with the affect score among medical college students using the depression anxiety stress scale (DASS)-21 questionnaire and positive and negative affect schedule (PANAS) scale. Methods: The present study was a cross-sectional study conducted on medical students in the age group of 17–22 years. 150 participants were recruited by random sampling. DASS-21 scale was used to assess depression, anxiety, and stress, consisting of 21 items designed to measure emotional states of depression, anxiety, and stress. PANAS is designed to assess individuals’ positive and negative moods. Results: Pearson’s correlation of these psychological parameters with affect scores had a significant negative correlation with the positive affect score (depression [p=0.003], anxiety [p=0.01], and stress [p&lt;0.04]) and a significant positive correlation with negative affect score (depression [p&lt;0.02], anxiety [p=0.0009], and stress [p=0.01]). Students should be closely monitored with regard to their use of the internet, and also, internet addiction and psychological behaviors can be reduced by providing early counseling and interventional therapy. Conclusion: Awareness about the harmful effects of excessive internet use should be provided so as to enhance the academic performance of students.

Determinants of brain drain among physicians in Turkey: Findings from a national exploratory study.

The shortage of physicians in Turkey is a highly critical emergency. In fact, physicians' migration to developing or high-income countries, defined as brain drain, threatens the sustainability of the national healthcare system. This study explored the driving factors associated with Turkish Physicians' brain drain, including high-economic inflation, social-politics, poor-living, equity, violence, and the desire to practice medical activity abroad. A cross-sectional survey of 1,861 Turkish physicians aged 25 to 65 years old was conducted employing the Brain Drain questionnaire, the Depression Anxiety Stress Scale (DASS-21), the Patient Health Questionnaire 9 (PHQ-9), and the Fatigue Assessment Scale (FAS). Significant differences were observed among physicians staying in Turkey versus considering migration to Western countries, regarding their age, gender, marital status, educational level, occupational status, work years, hospital night shifts, income, and cigarette/nargileh smoking habits (all p ⩽ .018). The main reasons for brain drain included transport problems, harassment, low salary, malpractice, bad environment, job insecurity, workload, burnout, treating difficult patients, inadequate postgraduate systems, peer-pressure, health safety concerns, and favoritism in the workplace, as well as stress and depression caused by work overload. In fact, depression, anxiety, stress, fatigue, and burnout varied significantly among the different groups of physicians (all p ⩽ .013). Additionally, key predictors of brain drain were better job opportunities, poor hospital management (in Turkey), job-related stress, dealing with difficult patients, research deficiencies, workload, burnout, transportation issues, short consultation time, low salary, and fatigue. Among the general factors contributing to the brain drain in the Turkish Health System, we identified significant issues related to research deficiencies, compulsory working duties, poor quality of postgraduate, inadequate medical-schools, poor hospital management, and shortage of consultants. Physicians' migration is a major global public health concern, leading to substantial risks for healthcare services, especially in Turkey. Many physicians decide to migrate to work in Western countries.

DEPRESSION IN PERSONS WITH SPIRITIST ENGAGEMENT

Objective: To analyze the factors associated with depression, before and after the COVID-19 pandemic, among people with some Level of Spiritist Engagement (LSE). Method: This is a cross-sectional study that investigated the prevalence of depression in people with LSE, before and during COVID-19. Results: Digital data on sociodemographic profile, mental state, psychological care, and LSE, in addition to the Depression Anxiety Stress Scales (DASS), were collected from 848 people with LSE using the snowball sampling technique. Significant results (p&lt;0.05) showed a high prevalence of severe depression in unemployed individuals (16.2%), those in marital crisis (23.2%), alcohol users and/or smokers (28.6%), those with self-inflicted violence (44.1%); those greatly/totally affected by the "lockdown" (21.3%) and those who perceived their emotional health as poor/very poor (53.6%). Before and during COVID-19, psychiatric follow-up was highly prevalent, especially in mild depression (&gt;60%); and people with some LSE were mainly associated with mild depression (&gt;75%). The pandemic did not significantly change the values associated with severe depression, with a low prevalence of high/very high LSE (2.7% before, 5.0% during COVID-19) compared to low LSE (8.2% before, 9.5% during COVID-19) and very low LSE (10.7% before, 9.9% during COVID-19). Conclusion: Regardless of the pandemic, Spiritism was attractive to people with depression and high/very high LSE was less associated with severe depression. Keywords: Depression. Spiritism. Spirituality. COVID-19.

Effects of traditional Chinese medicine on symptoms of patients with spleen and stomach deficiency-related tinnitus.

Tinnitus affects 10%-30% of the population. Recent evidence suggests that tinnitus is associated with spleen deficiency. However, compared with kidney deficiency-related tinnitus, less research has been conducted on the impact of spleen deficiency-related tinnitus. To investigate the clinical efficacy of using Guipi Wan and dietary and lifestyle modification based on traditional Chinese medicine for treatment of patients with spleen and stomach deficiency-related tinnitus. We enrolled 110 patients with spleen and stomach deficiency-related tinnitus who were distributed into treatment (58 cases) and control (52 cases) groups. Tinnitus severity, sleep quality and emotional state were assessed by questionnaires [Tinnitus Evaluation Questionnaire (TEQ); Pittsburgh Sleep Quality Index (PSQI); Depression-Anxiety-Stress Scale-21 (DASS-21)] that were used for analysis in the two groups during the initial and intervention and after. In the treatment group, patients were treated with oral administration of Guipi Wan and consulted for healthy dietary and lifestyle modification. In the control group, patients were only assessed and not treated. At the end of the 6-months, TEQ scores decreased significantly in the treatment group (P = 0.021) but not in the Control group. Significant effects in the treatment group were noted for PSQI total score (P = 0.043) and several PSQI component scores in the treatment group (P < 0.05). After treatment, the DASS-21 scores were significantly reduced in the treatment group (P < 0.05). Guipi Wan combined with dietary and lifestyle modification based on regulating the spleen and stomach can be considered core to the treatment of tinnitus related to spleen and stomach deficiency.

Psychological Status Observation Among the Medical Students using DASS21

Background The psychological disorders like depression, anxiety, and stress seem significantly more prevalent in medical students than in general people nowadays. The medical courses with tedious academic activities raise this mental distress among them. In addition, demographic and biological factors have a citable impact on mental illness. Thus, to analyze these health issues, many studies have been done based on the DASS- Depression Anxiety Stress Scale, where DASS21 comprises 21 questionnaires. Objectives To highlight the correlation between demographic features and DASS21 attributes. Determining the severity of depression, anxiety, and stress in medical students, and observing the percentage-wise relation between preferred features – BMI, Blood Pressure, and Blood Group – and DASS21 attributes. Methods An online survey was conducted on Uttara Adhunik Medical College undergraduate students in November 2023. Students’ demographic data, biological factors information, and responses from DASS21 questionnaires were taken in this survey. Further analysis of results and visual observation has been done through online and offline spreadsheets. Result Following the correlation coefficient test, students’ age and blood pressure negatively relate to DASS attributes; however, BMI is correlated positively with depression, anxiety, and stress. The severe prevalence rate of depression- 59%, anxiety- 72%, and stress- 53%, where females are more affected. The students who belong to the O and B blood groups as well as the overweight and obese students are more affected although most of them are healthier; nevertheless, depressed, anxious, and stressed students are mostly normotensive. Conclusion The present study highlights that most of the undergraduate medical students of UAMC, especially females are suffering from depression, anxiety, and stress issues. These psychological disorders are highly associated with their BMI, Blood Pressure, and Blood Groups. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1149-1158

Adaptation and Validation of the Pet Bereavement Questionnaire (PBQ) for Chinese Population

Despite the increasing prevalence of pet ownership in Chinese societies, standardized tools to assess grief from pet loss remain lacking. Research predominantly focuses on Western populations, creating a gap in understanding pet bereavement in Chinese cultural settings. This study aimed to adapt and validate the Pet Bereavement Questionnaire (PBQ-C) for a Chinese context to create a culturally appropriate assessment tool. A total of 246 participants with companion animal loss experiences were recruited through the university of the research team. They were invited to complete an online survey including the PBQ-C, the Depression subscale of the Depression Anxiety Stress Scales (DASS-21), and the Inventory of Complicated Grief (ICG). Both Exploratory Factor Analysis and Confirmatory Factor Analysis were conducted to examine the psychometric properties of the PBQ-C and the findings supported a three-factor structure—grief, anger, and guilt—aligned with the original PBQ, with three items reassigned to different factors. Despite these adjustments, the PBQ-C demonstrated strong internal consistency, reflecting the reliability of the questionnaire in measuring the same construct across its items; split-half reliability, indicating its ability to produce consistent results when divided into two parts; and concurrent validity, showing that the PBQ-C correlates well with other established measures of grief. The validated PBQ-C provides a culturally sensitive tool for assessing pet bereavement in Chinese society that can promote research and counselling support for this under-researched and under-recognized type of loss of human-animal relationships.