Depression Anxiety Stress Scale Scores Research Articles

Eating Attitudes, Stress, Anxiety, and Depression in Dietetic Students and Association with Body Mass Index and Body Fat Percent: A Cross-Sectional Study.

University students face challenges impacting psychology and dietary choices. The present work examined the association between eating attitudes, stress, anxiety, and depression to body mass index (BMI) and body fat percentage in Dietetics students. Respondents completed the Eating Attitudes Test-26 (EAT-26), the Depression Anxiety Stress Scales (DASS), a validated Food Frequency Questionnaire, and the Hellenic Physical Activity Questionnaire (HPAQ). Anthropometry and a bioimpedance analysis were performed. The EAT-26 score was 11 (8-16) and the DASS score was 20 (11-36) (medians and interquartile ranges). Disordered eating was detected in 20% of men and 15% of women. Depressive symptomatology was detected in 30% of males and 23% of females, anxiety in 35% of males and 40% of females, and stress in 29% of males and 35% of females. EAT-26 and DASS scores were highly correlated (r = 0. 0.221, p = 0.001). The EAT-26 oral control subscale (B = 0.430, SE = 0.184, p = 0.026) was positively correlated with BMI in men in the models, adjusted for age, physical activity, and Mediterranean Diet Score, while no association was documented for % body fat. The DASS depression score was not related to BMI in multi-adjusted models. In conclusion, disordered eating, depression, stress, and anxiety are present in this sample of university students. The relationship between disordered eating and BMI needs consideration in programs targeting overweight or underweight in Dietetics students.

Perceived Social Stigma, Family Support and Mental Health Issues in Individuals Living with HIV/AIDS

Background: In Pakistan, the HIV/AIDS epidemic is compounded by significant socio-economic challenges and a pervasive stigma that undermines effective treatment and prevention strategies. The psychological impacts of HIV/AIDS, such as anxiety, depression, and stress, further complicate disease management, affecting patients' willingness to adhere to treatment and disclose their status. Objective: This study aimed to assess the prevalence of mental health issues among individuals living with HIV/AIDS in Pakistan and explore the relationships between perceived social stigma, family support, and mental health outcomes. Methods: A cross-sectional study was conducted involving 150 diagnosed HIV/AIDS patients from Nankana Sahib and Faisalabad districts. Participants were selected using purposive sampling. Data were collected through validated Urdu versions of the Depression Anxiety Stress Scales (DASS), a discrimination scale, and a family support scale. Statistical analysis was performed using SPSS version 25, focusing on descriptive statistics, correlation coefficients, and linear regression models. Results: The results indicated that the mean scores for depression, anxiety, and stress were significantly high at 66.6980 ± 17.56598. A strong positive correlation was observed between perceived discrimination (DISC) and DASS scores (r = 0.890, p < 0.01), while perceived family support (PFS) was negatively correlated with DISC scores (r = -0.166, p = 0.043). Regression analysis showed that increased family support significantly mitigated mental health issues, reducing the mean stress, anxiety, and depression scores among participants. Conclusion: The study highlights the critical role of family support in reducing mental health issues among HIV/AIDS patients in Pakistan. Enhancing family involvement and reducing social stigma could improve treatment adherence and overall health outcomes.

Prevalence of mental illness among women in an urban slum area of Jaipur: A cross- sectional study

Gender has been described as a critical determinant of mental health and mental illness. Depression is not only the most common women's mental health problem, but may be more persistent in women than men.To assess the burden of depression, anxiety and stress among women residing in urban slums of Jaipur and also to assess the factors affecting them. A community based cross-sectional study was conducted in an urban field practice area among women aged 18-59 years with calculated sample size of 503. Depression Anxiety Stress Scale (DASS)-21 questionnaire was used to capture the primary outcomes—depression, anxiety, and stress. Data was analyzed using SPSS and MS Excel. The statistical significance was evaluated at 95% confidence level. The difference in proportions was compared using Chi-square test and p-value <0.05 was considered significant. In our study, the overall, the prevalence of anxiety, stress and depression was 38.22%, 9.11%, and 18.61%, respectively which ranged from mild to extremely severe. There were meaningful correlations between probable factors like physical inactivity, poor sleep and generalized pain and DASS scores obtained by the participants. The study showed that the prevalence of anxiety was higher compared to other DASS symptoms. The DASS symptoms were poorly associated to demographic characteristics of the study participants although amongst the separated and widowed females there was significant statistical association.

Quality of life of critical care nurses and impact on anxiety, depression, stress, burnout and sleep quality: A cross-sectional study

ObjectivesTo investigate how anxiety, depression, stress, burnout, and sleep quality impact on Quality of life of critical care nurses. BackgroundSeveral studies reported that critical care nurses are exposed to a high risk of anxiety, depression, burnout, stress, and sleep quality, but we do not know the impact of critical care nurses. DesignA cross-sectional study. MethodsWe have included all critical care nurses working in the intensive care unit for at least six months. Data were collected from December 1, 2021, to March 18, 2022. We evaluated the critical care nurses using the Depression Anxiety Stress Scale (DASS), Maslach Burnout Inventory scale, Pittsburgh Sleep Quality Index and Nurse Quality of Life. The primary endpoint is Quality of Life. Associations were tested using multivariate modelling. ResultsA total of 140 critical care nurses were included. Multivariate regression showed the relation between emotional QoL and emotional exhaustion and DASS total score [OR = 0.14; 95% CI (0.03–0.73); p = 0.019 and OR = 3.64; 95% CI (1.07–12.32); p = 0.038, respectively]. Personal accomplishment and DASS total score have a direct relationship on quality of work-life [OR = 0.21; 95% CI (0.05–0.82); p = 0.024 and OR = 4.18; 95% CI (1.01–17.33); p = 0.049, respectively]. ConclusionsThe physical quality of life is not optimal in critical care nurses, while burnout and the DASS score directly impact the emotional and work-life quality of life. Implications for clinical practiceOur research has highlighted the importance of detecting the quality of life of critical care nurses. The nurses should take proper care of their health by adopting the right health behaviours to create correct work conditions and increase the quality of care for critically ill patients.

The Relative Effectiveness of Bilateral and Unilateral Electrode Placement in Electroconvulsive Therapy (ECT) in Patients With Major Depressive Disorder: A Retrospective Cohort Study.

Background This study is focused on the comparative efficacy of bilateral and unilateral electroconvulsive therapy (ECT) on depressive symptoms in patients at the Perth Clinic for the period from 2016 to 2021. Methods This was a retrospective cohort study of 485 patients who received ECT treatment. The expected improvements in depressive symptoms were evaluated by the Depression Anxiety Stress Scale(DASS)assessment tool filled out by the patients on admission and discharge from the hospital. Only the depression score of the DASS scale was utilised for this research. Results The results suggested that both electrode placements resulted in a significant improvement in depressive symptoms. The positive response rates for the bilateral and unilateral electrode placements were 78.3% and 71.6%, respectively. There was no difference between males and females in the average DASS score at discharge for bilateral and unilateral electrode placements. Conclusions This study confirmed that the results obtained at the Perth Clinic are similar to the existing international research results on the same topic. Bifrontal and unilateral ECT electrode placements are equally efficacious in improving depressive symptoms in patients suffering from major depressive disorder (MDD).

Plasma marker ACTH, cortisol, and beta-endorphins profile on pregnant women as targeted marker of approach for antenatal depression

Background: Antenatal depression is a frequent mental disorder with much less attention, and most women remain undiagnosed. Altered hypothalamic-pituitary-adrenal (HPA)-axis function mediates maternal depressive symptoms and has been widely reported. The present research aimed to determine the plasma marker HPA-axis including Adrenocorticotropic hormone (ACTH), cortisol, and beta-endorphin, as a suitable representation of mental health in pregnancy by evaluating the psychometric properties. Methods: Therefore, we examined a case-control study of 216 Bontang pregnant women. Psychological measures were conducted during the 27th week of pregnancy, including the Patient Health Questionnaire-9 (PHQ-9) assessment and Depression Anxiety Stress Scale (DASS). Blood samples were collected for plasma ACTH, Cortisol, and beta-endorphins assay as a marker of the HPA axis profile. Data were analyzed Stata for Mac version 14 (StataCorp, USA). Results: our finding showed that DASS scores correlated with PHQ-9 (r=0.79), ACTH (r=0.22), and beta-endorphin (r=54). PHQ-9 score significantly related to ACTH (r=0.27), cortisol (r=0.36) and beta-endorphin (r=0.71). Women with the highest DASS score and PHQ-9 depression scores at 27 weeks of pregnancy had significantly lower baby birth weight (P=0.000) than those women whose stress improved to or normal state. Plasma ACTH, cortisol, and beta-endorphin concentrations were significantly higher in pregnant women with antenatal depression compared to normal pregnancy (p<0.01). All effects remain without controlling unwanted pregnancy. Conclusion: Our study demonstrates a role for circulating ACTH in regulating maternal cortisol secretion and a significant correlation between the HPA-axis profile and antenatal depression at 27 weeks of pregnancy.

Modulation of Heart Rate Variability in Stressed Medical Students Via Breathing Exercise

Background: Stress in medical students is a global concern. Stress disturbs the sympathovagal balance and affects heart rate variability, a sign of healthy cardiovascular homeostasis. Various strategies have been used globally to combat stress and its effects. Aim: To determine how blowing balloon exercise modulatesheart rate variability (HRV) in stressed medical students. Methodology: A pretest-posttest quasi-experimental study wasconducted among stressed medical students at Islamic international medical college Rawalpindi Pakistan. Sixty students diagnosed with moderate stress were enrolled based on Depression Anxiety Stress Scale (DASS) Proforma. The study population was selected by simple random sampling via the balloting method among the stressed medical students. Study participants underwent a supervised blowing balloon exercise.Before and after a supervised blowing balloon exercise, the participants' pulmonary function tests, electrocardiograms, and DASS scores were measured. Participants' ECGs and pulmonary function tests were recorded viaPower lab (A.D. Instruments, model yam 4/25T, South Wales, Australia). Results: Blowing balloon exercise resulted in a significant reduction of DASS score (p<0.001) and significant improvement in pulmonary function tests (p<0.001). Among Heart rate variability parameters, the participants' standard deviation of successive N-N intervals, high-frequency components, and high-frequency normalized units significantly increased (p<0.05) after blowing balloon exercise. Heart rate, low-frequency normalized units, and the ratio of low-frequency normalized value to high-frequency normalized value were significantly reduced (p<0.05) after blowing balloon exercise. Conclusions: Blowing balloon exercise enhances medical students' heart rate variability and pulmonary function tests while reducing their stress levels. This cost-effective and easy exercise can be performed by stressed students without any time or place barrier. Keywords: Anxiety, Breathing Exercise, Depression, Heart Rate Variability, Stress, Sympathovagal Balance.

Psychological assessment in infertility: A systematic review and meta-analysis.

Infertility is a prevalent worldwide health issue and is defined by the World Health Organization (WHO) as a global health problem. Considering the importance of the psychological dimensions of infertility, various measurement tools have been used to measure the variables involved in infertility, of which the most widely used are the following: the Symptom Checklist 90 (SCL90), the Brief Symptom Inventory (BSI), the State-Trait Anxiety Inventory Form (STAI), and the Depression Anxiety Stress Scale (DASS). Therefore, given the problems of infertile people in terms of psychological dimensions, the aim of this meta-analysis was to assess the psychological assessment score in infertility. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, we applied an online database with no time restriction. Data were gathered using a random-effect model to estimate the standard mean difference (SMD) for the evaluation of the strength of association analyses. Our data demonstrated a significant higher SCL90 score (CI SCL90: 0.96, 0.34-1.57, heterogeneity: 94%, p heterogeneity < 0.001), and a non-significant higher DASS score (CI Anxiety : 0.82, -0.14 to 1.79; CI Depression : 0.8, -0.28 to 1.87; and CI Stress : 0.82, -0.24 to 1.88). It is essential to seek for strategies to help infertile patients overcome their infertility-related psychological problems.

The Effects of Psychoeducational Interventions Based on Mindfulness on Depression, Anxiety, and Stress Outcomes of Older Adults

People of the older ages are now the growing segment of the general population. Despite the individual diversities, older adults are perceived as associated with poor social and emotional functions. The present study aims to examine the effects of mindfulness-based psychoeducational interventions on the depression, anxiety, and stress outcomes of older adults. Thus, it highlights the significance of continuous research in the field of gerontology and awareness and offers suggestions for future research. In the study, the Pearson correlation research method is conducted. The target group consists of older adults aged 60 and over. Grandparents with grandchildren aged 0-6 who attend a pre-school in Bayrampaşa district of Istanbul province constitute the participants. According to repeated measures ANOVA analysis, DASS (Depression Anxiety Stress Scale) scores show a significant difference between before and after Mindfulness Training.

Effects of Cell Phone Dependence on Mental Health Among College Students During the Pandemic of COVID-19: A Cross-Sectional Survey of a Medical University in Shanghai.

ObjectiveTo investigate the effects of cell phone dependence (CPD) on mental health among undergraduates during the COVID-19 pandemic and further identify the determinants that may affect their mental health in China.MethodsThe data were collected from 602 students at a medical school in Shanghai via an online survey conducted from December 2021 to February 2022. The Mobile Phone Addiction Index (MPAI) and Depression Anxiety Stress Scale (DASS) were applied to evaluate CPD and mental health, respectively. Independent sample t-test and one-way analysis of variance (ANOVA) were employed to compare the means of continuous variables among categorical groups. Correlations between continuous variables were detected using Pearson's correlation analysis. Univariable and multivariable logistic regressions were employed to identify the determinants of mental health.ResultsAmong the 402 eligible students, 73.88% were women with an average age of 20.19 ± 2.36 years. On average, the DASS score was 32.20 ± 11.07, the CPD score was 36.23 ± 11.89, and the cell phone use duration was 7.67 ± 3.61 h/day. CPD was found to have a negative effect on mental health among college students in Shanghai. Additionally, cell phone use duration, age, being senior students, faculty-student relationship, insomnia, tobacco use, obesity, and life satisfaction were clarified as contributing factors to mental health among college students.ConclusionHigh degree of CPD could have a negative effect on college students' mental health, which might lead to some psychological problems. Appropriate actions and effective interventions are highly needed to prevent severe psychological injuries among college students in China.

The Silent Cry of Healthcare Workers: A Cross-Sectional Study on Levels and Determinants of Burnout among Healthcare Workers after First Year of the Pandemic in Turkey.

Although the acute phase of the pandemic is over, healthcare workers continue to face challenges. The aim of this study was to determine burnout levels and possible related psychological processes such as psychological flexibility, moral injury, and values among healthcare workers after the first year of coronavirus disease 2019 (COVID-19) pandemic. A cross-sectional study was performed using an online survey distributed through social networks. A sample of 124 front line healthcare workers working during the pandemic, between January and April 2021, were included in the study. Multiple linear regression was used to identify predictors of all 3 burnout dimensions (emotional exhaustion, depersonalization, and lack of personal accomplishment). While 51.6% of healthcare workers experienced high levels of emotional exhaustion, 75.8% of them were found to have experienced high levels of lack of personal accomplishment. On the contrary, 81.5% of the participants reported low levels of depersonalization. Emotional exhaustion was predicted by total Depression Anxiety Stress Scale score (P = .004) and total Moral Injury Events Scale score was the only predictor of depersonalization (P = .051). Predictors of lack of personal accomplishment were the number of days worked in COVID-19 (P = .001), total Moral Injury Events Scale (P=0.004), Valuing Questionnaire (VQ)-Obstruction (P = .009), and total Depression Anxiety Stress Scale score (P = .002). On the other hand, psychological flexibility did not predict any sub-dimension of burnout. Healthcare workers had high levels of burnout after 1 year with the pandemic. Our findings highlight the importance of factors such as moral injury, values, and emotional distress which need to be taken into consideration to develop future interventions to treat and prevent burnout in healthcare workers.

Negative emotional symptoms during COVID19 confinement: The relationship with reading habits

BackgroundCoronavirus disease (COVID19) is an ongoing pandemic, which forced governments across the globe to implement confinement measures to limit the spread of the disease. These measures have impacted the daily life and psychological status of people. However, no studies have examined the relationship between changes in psychological status with reading habits during the COVID19 pandemic. ObjectivesThe study aims at examining the relationship between changes in reading habits and negative emotional states. MethodThe psychological status was measured using the Depression, Anxiety, Stress Scales (DASS). In addition, the participants reported changes in four types of reading experiences during COVID19 confinement. These reading types are specialized, general knowledge, story/novels, and religious material. An internet-based survey was used to collect the data among adults. ResultsA total of 1711 individuals participated in the study. About 60.0%, 55.1%, 60.5% and 61.0% reported participating in scientific, religious, general, and novel reading, respectively. Additionally, the ANOVA revealed differences (p < 0.05) in DASS scores according to the changes in scientific, religious, newspaper, and novel/story reading. Subgroup post hoc comparisons showed that DASS scores were associated with a no-change or increase in all types of reading habits indicating a main effect of emotional state on all types of reading. ConclusionsCurrent results might suggest that the participants who experienced greater negative emotions, tended to either not change or increase their reading habits. Additionally, individuals with lower negative emotion scores reported a decrease in reading during the COVID19 pandemic.

Smoking and nicotine dependence in relation to depression, anxiety, and stress in Egyptian adults: A cross-sectional study.

BACKGROUND:Much research has found that smoking is one of the major risk factors for a variety of physical diseases and mental disorders; however, few studies have been conducted on smoking in Egypt. Furthermore, to the researcher's best knowledge, no study in Egypt has compiled data on smoking prevalence, motives, and levels of nicotine dependency. In order to fill in this gap, the current study has attempted to summarize the situation and construct an accurate picture of smoking in Egypt.MATERIALS AND METHODS:This cross-sectional study included 2000 Egyptian adults in Fayoum through a multistage cluster sampling technique. For data collection, the Socioeconomic Status Scale was deployed. In addition, Depression, Anxiety, Stress Scale (DASS), the Modified Reasons for Smoking Scale (MRSS), and Fagerstrom Test for Nicotine Dependence (FTND) were used. Data analysis performed using SPSS version 22.0. For qualitative data, Chi-square test was used to determine statistical significance. Bivariate Pearson correlation was used to test for the association between quantitative variables.RESULTS:Of the total sample of 2000 adults, 40.4% had anxiety and 24.3% had stress, and 19.5% showed severe to extremely severe level of depression. For MRSS, tension reduction or relaxation was found in 46.5% adults while 9.8% had high level of nicotine dependence. There was a statistically significant association between psychometric disorders, on one hand, and both smoking motivation and nicotine dependence, on the other (P < 0.001). The DASS score had a statistically significant correlation with age, smoking duration, nicotine dependence level, and MRSS subscales.CONCLUSION:Smoking is linked to psychological symptoms and shows a moderate to high level of nicotine dependence, with a higher level of dependency, smoking pleasure, stress reduction/ relaxation, and hand-mouth movement as motives for smoking. Furthermore, there was a correlation between nicotine dependence, on one hand, and depression and stress on the other.

Causes, frequencies, and predictors of relapse in patients with ulcerative colitis on long-term follow-up in a tertiary care hospital of Northern India

Context: Ulcerative colitis (UC) initially thought to be a disease of developed world is equally common in India. Surprisingly, there are very scant data from India. The study was undertaken to find the frequency of relapse and to determine factors predictor of relapse in Indian population. Subjects and Methods: This study was conducted at a tertiary care center of New Delhi for a period of 1 year. Patients were included if they had a diagnosis of UC based on accepted historical, endoscopic, histological, and/or radiologic criteria. Detailed past/present history, baseline clinical examination, dietary details, and psychological analysis using shortened Depression Anxiety Stress Scale score, biochemical tests, inflammatory markers, endoscopic, and histopathological analysis were done at baseline and regular intervals. The outcome was clinical relapse or continued remission. Results: Out of 86 patients screened, 50 patients were included in the study according to inclusion criteria and were followed up. The frequency of relapse was 32%. Univariate analysis showed higher relapse frequency, frequency of steroid received in past, patients on immunomodulator therapy, presence of acute or chronic inflammatory cells on histology, and disease activity at baseline as predictors of relapse. There was no significant difference between anxiety, stress, and depression relapsers and those who maintained remission. On multivariate analysis, disease activity at baseline was the only independent predictor of relapse. Conclusions: Stringent control of disease activity with mucosal healing should be the aim, as mucosal healing is the only predictor for prolonged remission.

Physical activity to ameliorate the negative mental health effects of COVID-19-induced confinement

Mental health is strongly affected by physical (PA) and sedentary (SA) activity. In the current study, the relationships of PA and sedentary activity (SA) with mental status amid confinement caused by COVID-19 were examined. The study is self-reporting, survey-based, and cross-sectional in design. The study was conducted in Jordan and included 1744 participants (≥18 years old). The participants' mental status was obtained using the Depression-Anxiety-Stress Scale (DASS). The results showed involvement in both PA and SA during COVID-19-induced confinement. The involvement includes walking (77.2%), running (70.3%), cycling (84.9%), swimming (83.1%), sports (82.9%), weightlifting (86.4%), watching TV (79.4%), using electronics (86.3%), and logging to social media (85.1%). Lower DASS scores were associated (p < 0.05) with lower walking, running, and weightlifting but not (p > 0.05) with cycling and swimming PA. Additionally, DASS scores (p < 0.05) were associated with changes in television viewing but not (p > 0.05) with electronics and social media use during confinement. In conclusion, individuals who experienced higher levels of stress, anxiety, and depression were more likely to turn to more PA and less SA. These findings are important and suggest that individuals during confinement find PA a useful strategy to mitigate the negative mental effects of the pandemic.

Mental Health Status and Health-Promoting Lifestyle Behaviors among Call Center Employees

Background: Call center employees experience high levels of occupational stress and other mental health issues. This study aimed to examine the relationship between mental health status and health-promoting lifestyles among call center employees.Methods: A secondary data analysis from a descriptive cross-sectional study of 302 call center employees was conducted. Call center employees were asked to complete the Depression Anxiety Stress Scale (DASS) and the Health Promoting Lifestyle Profile-II (HPLP-II).Results: Participants’ overall DASS score was 23.87±13.98 out of 63. Among the six subscales of the HPLP-II, participants’ highest scores were for interpersonal relations, spiritual growth, and stress management, whereas physical activity had the lowest score. Participants with a severe level of mental health issues (i.e., depression, anxiety, and stress) reported lower levels of health-promoting lifestyle behaviors, especially in the areas of physical activity, spiritual growth, interpersonal relationships, and stress management.Conclusions: As call center service sectors increase in modern industries, so does the need to address the physical and mental health needs of its employees. Healthcare providers and organizations should closely and routinely monitor employee’s levels of depression, anxiety, and stress and develop organizational and health-related policies for the call center sector. Additionally, the development and implementation of health-related interventions to promote healthy lifestyle behaviors is critical for call center employees.

Abstract 13624: Rates of Depression, Anxiety and Stress in Parents of Children With Congenital Heart Disease Using the DASS

Introduction: There have been many studies investigating the rate of mental health disorders for caregivers of children with congenital heart disease (CHD) but the types and timing of evaluation vary. The Cardiac Neurodevelopmental Outcome Collaborative recommends using the Depression Anxiety Stress Scale (DASS) to evaluate parents between 6-36 months of age. The DASS is a self-completed questionnaire that evaluates for depression, anxiety and stress. There has not been a study investigating the use of DASS in parents of children with CHD. Hypothesis: Our hypothesis was that DASS scores would peak initially and improve with time. Methods: This study was a single centered, retrospective review from January 1, 2018 to June 1, 2020. Eligible subjects were parents of CHD patients seen in our Neurodevelopmental clinic who completed the DASS. Demographic data, clinical history of the child and DASS scores were recorded. Cox-regression analysis was conducted using a composite end point of having an abnormal score in any of the three DASS domains, depression, anxiety or stress. Data for mothers and fathers were analyzed separately. Results: 273 mothers and 139 fathers were enrolled. For mothers, elevated scores in each domain were increased at the 12 and 24 months appointments. For fathers, scores for each domain were elevated initially, followed by a decrease before peaking later on. Paternal scores for depression were increased at 36 months and paternal scores for anxiety and stress were increased at 30 months. Increased length of stay for the index surgery was associated with an abnormal DASS score for mothers (B 0.02, p&lt; 0.01) and fathers (B 0.01, p=0.04). Being in a relationship with the father (B -0.8, p&lt;0.01) was associated with freedom of an abnormal DASS score for mothers. Conclusions: Abnormal DASS scores peak at different time points for mothers and fathers. These time points may be critical time points to offer social support for parents. In addition, increased length of stay for the child’s index surgery and the parents being in a relationship are important factors in the development of mental distress in parents.

Acute Response of Stress System in Multiple Sclerosis

Background: It has long been suspected that exposure to stress is a major factor that can increase the risk of Multiple Sclerosis (MS) and exacerbate it, as a stress-related disorder. Therefore, we conducted this study to investigate the response of the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic-adrenal-medullar (SAM) system to acute social stress. Methods: A total of 46 MS patients and 23 age-sex-matched healthy controls were recruited in the study. The Trier Social Stress Test (TSST) was used to induce acute psychosocial stress. We measured salivary cortisol (SC) to evaluate the HPA axis. In addition, electrocardiography (ECG) was recorded to evaluate the SAM system based on the linear and non-linear features of Heart Rate Variation (HRV). Then, SC and HRV were measured before and after the stress exposure. We also used the Depression Anxiety Stress Scale (DASS) and Emotional Visual Analog Scale (EVAS) to conduct the psychometric assessment and evaluate the perceived stress level, respectively. Results: The mean age of the MS group was 35.38 ± 15 years, with a mean disease duration of 7.4 ± 60. Besides, the HC group's mean age was 35.8 ± 9 years. There were no significant differences in demographic features and DASS scores between the two groups. In response to TSST, both MS and healthy individuals showed a significant increase in the SC levels and EVAS scores, as well as changes in the HRV indices. Notably, significant differences were also found between the two groups regarding the basic and post-stress SC levels, EVAS score, and HRV indices. Unlike the HC group, the SC level returned to its baseline after recovery in the MS group, and the sympathetic tone was more sensitive. Conclusions: Our results indicated that both MS and healthy individuals respond to acute stress regarding neuroendocrine assessment; however, patients with multiple sclerosis show some impairments in this response.

Maternal and child factors associated with the health-promoting behaviours of mothers of children with a developmental disability

Background/aimMothers caring for their child or adult with a developmental disability can experience mental health disparity. Protective factors such as healthy behaviours are under-researched. This study investigated relationships between mental health, healthy behaviours, and disability factors. MethodsThe cross-sectional online survey included: Depression Anxiety Stress Scales (DASS); Family Empowerment Scale (FES); Health Promoting Activities Scale (HPAS); and a measure of childhood quality of life (QoL). ResultsAll mothers were raising offspring (aged 3–36 years) with a developmental disability. Fifty-two percent of mothers (N = 81) had a mental health diagnosis. DASS scores were elevated for depression (58 %), anxiety (52 %) and stress (68 %). Mothers participated in health promoting activities infrequently and reported low satisfaction with community health-supporting facilities. Depressive symptoms, maternal empowerment and two indicators of child-related QoL explained 29.7 % of the variance in healthy behaviours. Depressive symptoms were the most important predictor of lack of health promoting behaviours. ConclusionsBetter mental health predicted more frequent participation in health promoting behaviour. Future research might explore the extent to which health promoting behaviours protect mental health. Service changes including family health focused services, and custom designed health promotion or coaching programs may improve the health behaviours of mothers with high care responsibilities.

Art Therapy for Adjustment Disorders in Adolescent with Systemic Lupus Erythematosus (SLE) and Pulmonary Tuberculosis (TB)

This study presents an experimental Single Case-Single Subject ABA design of a 17-year-old female patient suffering from Systemic Lupus Erythematosus (SLE) and Pulmonary Tuberculosis (TB) who experience adjustment disorders. The purpose of this study is to reduce adjustment disorders in the patient with SLE and pulmonary TB by using art therapy. The assessment methods are observation, interviews, and psychological testing tools. Data analysis was carried out using the qualitatively and quantitatively. Quantitative analysis is performed using visual inspection by looking at the comparison of Depression Anxiety Stress Scale (DASS) scores. Initial measurements using DASS showed a level of depression with a score of 26 (severe), anxiety score at 23 (very severe), and stress score at 19 (moderate). Art therapy is given as a therapeutic intervention for the patient. After the therapy was given, there was a decrease in the DASS score with a depression score to 20 (moderate), anxiety score at 19 (severe), and stress score at 17 (mild). The patient also felt moreable to express and control emotions more precisely. These results indicate that art therapy is one of the interventions that can overcome psychological problems in the patient with adjustment disorders.