Distress In Persons Research Articles

Coping, perceived environmental exposure control and mental distress in persons with symptoms attributed to environmental factors in a general population survey

Coping, perceived environmental exposure control and mental distress in persons with symptoms attributed to environmental factors in a general population survey

“I can't cry on cue”: Exploring distress experiences of persons with sickle cell

Persons with sickle cell disease exhibit high levels of distress, which has been documented with validated measures. However, there has been little qualitative investigation of the sources of distress in the lives of persons with sickle cell or the strategies they use to manage different sources of distress. Our study sought to: (1) identify sources of distress for persons with sickle cell, (2) explore management strategies for different sources of distress, (3) inform content development of the future mobile phone application, and (4) incorporate patient voices in the design and development phases of the future mobile phone application. In this manuscript, we present findings for the first objective. Using convenience sampling, we recruited participants with sickle cell (n = 11) from a home visit program at The Ohio State University Wexner Medical Center between February and July 2021. One team member conducted one-on-one semi-structured interviews with participants. We coded and analyzed all transcripts. Participants identified clinical encounters in the emergency department and intermediate care center to manage acute pain flares as the most profound source of distress. Our analysis identified four themes: (1) Pain has performative features, (2) Stigma and racism surround care, (3) Sickle cell is a neglected disease, and (4) Participants lack control over their pain management plan. Researchers may wish to consider how these settings can foster distress, and providers may wish to adopt participant recommendations to reduce distress associated with seeking pain treatment in acute care settings.

"Relationships, Very Quickly, Turn to Nothing": Loneliness, Social Isolation, and Adaptation to Changing Social Lives Among Persons Living With Dementia and Care Partners.

Persons with dementia and their care partners have known risks for loneliness and social isolation throughout the disease trajectory, yet little is described about social lives in a population heterogeneous for disease stage, syndrome type, and setting. We conducted a secondary analysis of qualitative interviews from multiple studies to triangulate responses from a cohort of persons with dementia (n = 24), and active (n = 33) or bereaved (n = 15) care partners diverse in setting, dementia type and stage, and life experience. Interviews explored challenges related to social lives and were analyzed thematically. Persons with dementia were on average 80 years old (range: 67-94), 38% female, and 78% diagnosed with Alzheimer's dementia; care partners were on average 67 years old (range: 40-87) and 69% female. We identified 3 primary themes. First, dyads lost external social networks due to complex factors, including discomfort of surrounding social networks, caregiving responsibilities, and progressive cognitive deficits. Second, care partners described disruptions of meaningful dyadic relationships due to progressive cognitive and functional deficits, leading to loneliness and anticipatory grief. Third, adaptive strategies centered on care partners facilitating shared social activities and programs addressing caregiver burden. An overarching theme of disease-course accumulation of barriers to social interactions and constant adaptations was present in all themes. Isolation and loneliness are a shared experience and source of distress for persons with dementia and care partners. Results can inform interventions tailored to individual needs and disease stages of dyads that enhance social connectedness.

Identifying pain and distress in non-verbal persons with intellectual disability: Professional caregivers’ and parents’ attitudes towards using wearable sensors

BACKGROUND: Persons with severe intellectual disability (ID) may be non-verbal and unable to communicate pain or distress. Consequently, painful conditions may go undetected, and non-verbal persons with ID may not receive adequate care and treatment. OBJECTIVE: This study aims to explore how professional caregivers and parents identify pain and distress in non-verbal persons with ID, and their attitudes towards using wearable sensors to identify pain and distress in daily life situations. METHODS: Exploratory, mixed method study. Caregivers (83) answered an online questionnaire, and professional caregivers (18) and parents (7) were interviewed. RESULTS: Professional caregivers and parents recognise pain and distress from observations and behavioural signs that are often equivocal. They experience that this is inadequate to reliably detect pain and distress in non-verbal persons with ID. Professional caregivers and parents’ express frustration and fear that painful conditions may remain untreated. They are positive towards using wearable sensors on condition that sensors do not infringe on user autonomy and privacy. CONCLUSIONS: There is a need for sensors and methods that can objectively identify pain and distress and ensure adequate treatment, that may improve quality of life of non-verbal persons with ID.

Exploring the nexus of water insecurity and psychological distress in Windhoek's informal settlements, Namibia.

Water insecurity has long been a pressing issue, particularly in the informal settlements of Windhoek. The current study aims to investigate the relationship between water insecurity and residents' psychological distress in Windhoek's informal settlements. The study draws upon secondary data collected by Future Resilience for African Cities and Lands in 2017. Confirmatory factor analysis was used to establish the relationship between water insecurity, psychological distress, and three manifest variables (source of income, housing type, and household structure). The study findings revealed a positive association between housing type and psychological distress (β = 0.056, p < 0.001). Household structure was negatively associated with psychological distress (β = -0.035, p < 0.001) and water insecurity (β = -0.054, p < 0.001). In addition, a positive association (β = 0.595, p < 0.001) was found between water insecurity and psychological distress, suggesting that water scarcity negatively impacts residents' mental well-being. The study highlights the need to address the issue of water insecurity in informal settlements across Windhoek. This can be achieved by setting measures to make water and essential sanitation services more accessible and affordable to residents in these communities. Such approaches would help mitigate the effect of water insecurity on the psychological distress of persons living in informal settlements and create more resilient and sustainable settlements.

Distress, anxiety, and depression in persons with hereditary cancer syndromes: Results from a nationwide cross-sectional study in Germany.

Persons with hereditary cancer syndromes (carriers) have a higher risk of developing cancer early. They are confronted with decisions regarding prophylactic surgeries, communication within their families, and childbearing. The present study aims to assess distress, anxiety, and depression in adult carriers and identify risk groups and predictors; clinicians can use to screen for particularly distressed persons. N = 223 participants (n = 200 women, n = 23 men) with different hereditary cancer syndromes affected and unaffected by cancer answered questionnaires measuring their distress, anxiety, and depression levels. The sample was compared to the general population using one-sample t-tests. The n = 200 women with (n = 111) and without cancer (n = 89) were then compared and predictors for increased levels of anxiety and depression were identified using stepwise linear regression analyses. 66% reported clinical relevant distress, 47% reported clinical relevant anxiety, and 37% reported clinical relevant depression. Compared to the general population, carriers experienced increased distress, anxiety, and depression. Additionally, women with cancer suffered from more depressive symptoms than those without cancer. Past psychotherapy for a mental disorder and high distress were identified as predictors for increased anxiety and depression in female carriers. The results suggest that the psychosocial consequences of hereditary cancer syndromes are serious. Clinicians could regularly screen carriers regarding anxiety and depression. The NCCN Distress Thermometer can be combined with questions about past psychotherapy to identify especially vulnerable persons. Further studies are needed to develop psychosocial interventions.

Research trends in humanitarian logistics and sustainable development: A bibliometric analysis

Sustainable development (SD) has become a prevalent topic in the logistics discipline. Hence, the attention of researchers to humanitarian logistics (HL) in SD has been increasing. Therefore, the study applied a literature review in a bibliometric methodology, and feasibly reached a total of 112 publications published in world-class journals from the chosen databases. The findings show an increasing trend in the number of studies in this area, and that most of the studies were published in the last three years. Humanitarian Organizations (HOs) have a responsibility to save victims and decrease the distress of persons for SD during difficult times through fast, fair, and safe HL, which is possible through an effective HL operation. This study offers the first bibliometric investigation in the field that could serve as a theoretical reference point for future investigations and as a managerial tool, recognizing the urgent need for a careful understanding of how sustainability can be integrated into HL.

Relationship satisfaction moderates links between poor sleep quality and psychological distress among couples coping with type 1 diabetes

ObjectivesWe examined links between sleep quality and psychological distress among couples dealing with type 1 diabetes (T1D) across cross-sectional and daily diary methods and investigated whether relationship satisfaction moderated these associations. Methods199 persons with T1D and their spouses completed survey questionnaires reporting their own sleep quality, depressive symptoms, and relationship satisfaction. They also completed 14-day diaries reporting their own sleep quality and negative affect. Multi-level actor-partner interdependence models examined associations between sleep quality and psychological distress. ResultsCross-sectional and daily diary data revealed an association between poorer sleep quality and higher psychological distress for both persons with T1D and their spouses (ie, actor effects). Some partner effects were found. For example, poorer sleep quality of persons with T1D was associated with greater negative affect for spouses (within persons). Relationship satisfaction moderated the effects of sleep quality on psychological distress. For example, participants’ poorer overall daily sleep quality was associated with greater negative affect for those with lower relationship satisfaction but not for those with higher relationship satisfaction (ie, actor effects). In contrast, partners’ poorer overall daily sleep quality was associated with participants’ greater negative affect for those with higher relationship satisfaction but not for those with lower relationship satisfaction (ie, partner-effects). ConclusionLinks between sleep quality and psychological distress occur both within and between persons. Relationship satisfaction moderates the effect of poorer sleep quality on psychological distress in a nuanced way.

Cognitive behaviour therapy in adults with spinal cord injury: A scoping review.

The aim of this study is to report on the extent and range of the research evaluating cognitive behaviour therapy (CBT) in adults with spinal cord injury. Spinal cord injury is a devastating event that can lead to permanent neurologic deficit. Compared with the average person, spinal cord injury (SCI) patients are at twice the risk of developing mood disorders, highlighting vulnerability of SCI patients' mental states which can be easily hurt. CBT is the most commonly used psychosocial intervention. This was a scoping review. Five electronic databases (MEDLINE, CINAHL, EMBASE, PsycINFO and Airiti Library) were searched for articles published between 1990 and 2021. Google Scholar was utilized to search additional articles listed in the reference lists of included articles. Overall, 16 articles met the inclusion criteria, with the majority reporting on CBT, that focused on psychological distress and neuropathic pain. The core concept of intervention included disease identification, cognitive distortion/modification and coping strategies. There were significant knowledge gaps on the interventions' content and effectiveness for psychological distress of persons with SCI. Development of multifaceted cognitive behaviour interventions, especially to strengthen self-identity and to inspire patients' hope, is needed. Further research is required to investigate the long-term effectiveness of CBT.

Dementia Caregiver Surrogate Decision Making Self-Efficacy:Distress, and Quality of Life

We assessed the relationship between caregiver self-efficacy and caregivers’ ratings of care recipient’s health-related quality of life, the severity of neuropsychiatric symptoms, and associated caregiver distress for persons with Alzheimer’s dementia (AD). Methods: The 31-item DEMQOL-Proxy, Neuropsychiatric Inventory (NPI-Q), and the Self-Efficacy for Surrogate Decision-Making scale (SDM-SES) were collected from 26 family caregivers of people with AD expressing care resistant behaviors. We used Spearman correlations to assess relationships between SDM-SES, NPI-Q severity, and NPI-distress and DEMQOL-proxy. Among enrolled caregivers, 14 (54%) were women; mean age was 64.5 years, and 24 (92%) were college-educated. Their care recipients were 61% women, 77 % white, with a mean age of 76 years, and mostly college-educated (88%). Mean scores were DEMQOL-Proxy 91.27 (+/- 14.16), SDM-SES 16.38 (+/- 2.74), NPI-Q Severity score 14.23 (+/- 6.04), and NPI-distress 17.42 (+/-6.90). There were moderate correlations between DEMQOL-Proxy and SDM-SES (r=0.54), NPI severity (r= -0.42) and NPI-distress (r= -0.49). Secondary analysis showed a moderate correlation between SDM-SES and NPI-distress (r= -0.40). We identified associations between caregiver self-efficacy, quality of life, and caregiver distress. A higher baseline SDM-SES was associated with greater health-related quality of life for the care recipient. Lower self-efficacy scores were related to more caregiver distress related to neuropsychiatric symptoms. Higher NPI severity and caregiver distress were associated with lower quality of life for the care recipient. Interventions targeting self-efficacy may promote improved QOL and decrease caregiver distress in AD dyads.

Comorbid obstructive sleep apnea and insomnia and its associations with mood and diabetes-related distress in type 2 diabetes mellitus.

Previous research suggests that obstructive sleep apnea (OSA) and insomnia frequently coexist and are prevalent in persons with type 2 diabetes mellitus. This study compared mood and diabetes-related distress among OSA, insomnia, and comorbid OSA and insomnia groups in persons with type 2 diabetes mellitus. A secondary analysis was conducted with baseline data from 2 independent randomized controlled trials evaluating the efficacy of OSA and insomnia treatment. The pooled sample (n = 224) included participants with OSA only (n = 68 [30.4%]), insomnia only (n = 107 [47.8%]), and OSA and insomnia (OSA+insomnia; n = 49 [21.9%]). OSA was defined as an apnea-hypopnea index ≥ 15 events/h; insomnia was defined as an Insomnia Severity Index score ≥ 15. Mood was measured by the Profile of Mood States total and subscale scores; diabetes-related distress was assessed by the Problem Areas in Diabetes questionnaire. One-way analysis of covariance and multivariate analysis of covariance were conducted, controlling for demographic characteristics and restless legs syndrome. The insomnia group had on average significantly higher scores for total mood disturbance (insomnia vs OSA = 45.32 vs 32.15, P = .049), tension-anxiety (insomnia vs OSA = 12.64 vs 9.47, P = .008), and confusion-bewilderment (insomnia vs OSA = 9.45 vs 7.46, P = .036) than the OSA group. The OSA+insomnia group had on average significantly greater diabetes-related distress than the OSA group (OSA+insomnia vs OSA = 40.61 vs 30.97, P = .036). Insomnia may have greater impact on mood disturbance and diabetes-related distress than OSA in persons with type 2 diabetes mellitus. In particular, comorbid insomnia may contribute to greater diabetes-related distress in persons with type 2 diabetes mellitus and OSA. Jeon B, Luyster FS, Sereika SM, DiNardo MM, Callan JA, Chasens ER. Comorbid obstructive sleep apnea and insomnia and its associations with mood and diabetes-related distress in type 2 diabetes mellitus. J Clin Sleep Med. 2022;18(4):1103-1111.

Anxiety, depression, and fatigue in middle-aged and older persons with spina bifida: a cross-sectional study

Purpose To study psychological distress and fatigue among persons with spina bifida (SB) 50 years or older and living in Norway. Methods In 2017, cross-sectional data were collected (n = 30). The Hospital Anxiety and Depression Scale (HADS) and the Fatigue Severity Scale (FSS) were used. Descriptive statistics, non-parametric tests, and Spearman correlations were performed. Relevant information from previous studies on adults with chronic spinal cord injury (SCI) and the general population, were collected for comparison. Results Participants were 18 women and 12 men, mean age 57.5 (SD 5.6), 26 with myelomeningocele, and six with hydrocephalus. Thirty percent scored above the HADS-A- and 20% above the HADS-D thresholds, thus in the same range as previous studies of SB, but higher compared to persons with SCI and norms. HADS-D correlated with pain and FSS scores. Forty percent reported fatigue symptoms (9/15 without hydrocephalus, 3/6 with hydrocephalus). Conclusions The study revealed a high prevalence of fatigue symptomatology among middle-aged and older adults with SB. Symptoms of anxiety and depression were more common than among persons with chronic SCI and norms. SB follow-ups should include awareness of psychological distress and fatigue, and investigate pain and medication side effects among possible influencing factors. IMPLICATIONS FOR REHABILITATION Clinicians treating adult persons with SB should be aware of possible psychological distress and fatigue symptomatology among these patients. We suggest an initial screening for psychological distress and fatigue in persons with SB during follow-up visits and rehabilitation. Interventions to reduce pain may influence levels of psychological distress and/or fatigue in patients with SB. Clinicians should enquire about the effects of medication on fatigue when assessing and prescribing new medications; a thorough medication review helps to assess the benefits and risks.

Complexity of antidiabetic medication regimen is associated with increased diabetes-related distress in persons with type 2 diabetes mellitus

IntroductionDiabetes-related distress is present in a high proportion of people with type 2 diabetes mellitus. We hypothesized that complexity of the antidiabetic medication regimen is a factor that is associated...

A cross-sectional study of financial distress in persons with multimorbidity.

BackgroundFinancial distress among persons with multimorbidity is an important topic which has been inadequately addressed to date.ObjectiveWe examined the extent of financial distress among persons with multimorbidity, using data from the 2017 Behavioral Risk Factor Surveillance System (BRFSS).DesignCross-sectional, population-based study.ParticipantsAdults ages ≥ 18 years with multimorbidity.Main measuresLow income and selected social determinants of health that are indicators of financial distress.Key resultsMultimorbidity was more common among those with a household income of less than $15,000 per year (P < 0.001) and among those who were 65 years of age or older (P < 0.001). There was an approximately linear increase in the percentage of individuals who had a household income of less than $15,000 or $25,000 per year with increasing number of morbidities. About one-quarter of individuals who had five or more morbidities had a household income of less than $15,000 per year as compared with 4.49% of individuals with no morbidities (P < 0.001). For all of the social determinants of health examined (Couldn’t pay bills, didn’t have money for food, didn’t have money for balanced meals, didn’t have enough money to make ends meet, and felt this kind of stress), there was an approximately linear increase in the percentage of individuals with an indicator of financial distress with increasing number of morbidities. Further research is needed examining the prevalence and correlates of financial distress in this population as well effective strategies for ameliorating its impact on the health and wellbeing of these persons.

Using the multiple sclerosis resiliency scale to identify psychological distress in persons with multiple sclerosis

BackgroundThe Multiple Sclerosis Resiliency Scale (MSRS) is the first resilience measure that is specific to multiple sclerosis (MS)-related challenges. In order for the MSRS to be a valuable tool for clinicians, it is important to identify what is a meaningful score. As such, this study aimed to examine the MSRS’ ability to identify persons with MS experiencing depression or anxiety symptoms, as determined using clinically significant scores on the Hospital Anxiety and Depression Scale (HADS). MethodsParticipants (n = 884) were persons with MS who were recruited electronically primarily through the North American Research Committee on MS (NARCOMS). In addition to the MSRS, participants completed the HADS, which was used to categorize them into possible depression and anxiety groups using two criteria from the literature: ≥8 and ≥11. Receiver-operating-characteristic (ROC) curves were run to determine the MSRS total and subscale scores’ classification accuracies, with optimal scores for detecting possible depression and anxiety cases determined using the Youden index. ResultsThe MSRS total score's classification accuracy ranged between 86.2% and 92.2% for depression, with scores of 70 and 68 for the ≥8 and ≥11 criteria, respectively. For anxiety, the MSRS total score's classification accuracy ranged between 78.1% and 82.8%, with scores of 72 and 71 for the ≥8 and ≥11 criteria, respectively. The Emotional and Cognitive Strategies subscale had the strongest classification accuracy of all the subscales. ConclusionsThe MSRS can be used to identify persons with MS experiencing mental health difficulties with relatively good classification accuracy, which may help clinicians to triage who needs additional assistance or support.

Parental Attachment Style and Young Persons\u2019 Adjustment to Bereavement

BackgroundPrevious clinical and theoretical work supports the idea that parental attachment style and complicated grief affect young persons’ mental health, but empirical research investigating their impact on young person’s adjustment to bereavement is lacking.ObjectiveThis study investigated the impact of parental attachment style and complicated grief on young person’s adjustment to bereavement. It was hypothesised that a) parental attachment anxiety, avoidance, and complicated grief would moderate the link between bereavement experience and psychological distress in young persons and b) parental attachment style would moderate the link between parental complicated grief and psychological distress experienced by bereaved young persons.MethodThis was a questionnaire-based case control study, involving two participant groups: 133 parents of young persons who had experienced the loss of the loved one and 101 parents of young persons with no bereavement experience.ResultsBereaved young persons experienced greater externalising and internalising problems than the non-bereaved only when they were raised by an anxiously attached parent, but when parental attachment anxiety was low, bereaved children had fewer problems than the non-bereaved. When parental attachment avoidance was low, bereaved children also had fewer externalising problems than the non-bereaved. Among the bereaved, high levels of parental attachment anxiety and attachment avoidance amplified the link between parental complicated grief and child post-traumatic stress, while in the presence of low parental anxiety, complicated grief was negatively associated with an immediate distressing response and numbing-dissociative symptomatology.ConclusionsPsychological vulnerability in bereaved young persons was associated with an insecure parental attachment style.

Оцінки рівня дистресу, депресії, тривоги та соматизації у ветеранів з ПТСР та легкою черепно-мозковою травмою після 8-тижневого комплексного втручання

Background. Understanding the complex relationships between combat injuries, physical health, and mental health symptoms is critical to meeting the healthcare needs of veterans. The relationship between head injuries, posttraumatic stress disorder (PTSD), and depression among combat-injured service members is unique to modern conflicts but understudied. Research suggests a relationship between PTSD and somatic complaints in veterans, suggesting that PTSD influences somatic complaints through underlying symptoms of depression and anxiety sensitivity. Aims. To investigate the dynamics of distress, depression, anxiety, and somatization in veterans with PTSD and mTBI after an 8-week comprehensive intervention (combining a psychotherapy program with transcranial direct current electrical stimulation (tDCS)). Methods. The data of the initial and repeated examination of 329 veterans from three clinical groups were analyzed: individuals with PTSD (n=109), with mild TBI (n = 112), and with PTSD+TBI comorbid condition (n=108). All patients received standard therapy as well as psychotherapeutic intervention and transcranial direct current electrical stimulation (tDCS). The Four-Dimensional Symptom Questionnaire (4DSQ) was used to assess distress, depression, anxiety, and somatization. The rank correlation between the primary and repeated examination data for each clinical group was also determined. Results. Patients suffering from PTSD or PTSD with mTBI had significantly more symptoms of depression, anxiety, and somatization than patients with mTBI without PTSD. After the therapy, patients from the PTSD and PTSD+mTBI groups experienced a subjective increase in the feeling of distress, which was associated with a reduction of mainly depressive and somatoform symptoms in the respondents of the PTSD+mTBI group, and in patients with PTSD with a decrease of mainly depressive and anxiety symptoms. In contrast, in the patients with TBI, there was no increase in the subjective feeling of distress, and the improvement of the mental state was accompanied by a decrease in the entire investigated spectrum of symptoms - depressive, somatoform, and anxiety. In patients with TBI, a higher level of distress at the primary examination led to a lower level of depression and distress at the repeated examination, and a high somatization score was correlated with its significant reduction under the influence of therapy. In the patients of the PTSD+mTBI group, a high index of somatization at the primary examination was correlated with a subjective increase in distress, but a decrease in somatization itself at the end of therapy. Conclusions. The presence and level of expressiveness of symptoms of distress, depression, anxiety, and somatization in persons with PTSD, TBI, and a combination of these painful conditions are closely related to the effectiveness of the complex intervention, which provides the possibility of differentiated targeted therapy of individual clinical groups of patients.

Neurocircuitry of Contingency Awareness in Pavlovian Fear Conditioning.

In Pavlovian fear conditioning, contingency awareness provides an indicator of explicit fear learning. A less studied aspect of fear-based psychopathologies and their treatment, awareness of learned fear is a common cause of distress in persons with such conditions and is a focus of their treatment. The present work is a substudy of a broader fear-conditioning fMRI study. Following fear conditioning, we identified a subset of individuals who did not exhibit explicit awareness of the CS-US contingency. This prompted an exploratory analysis of differences in "aware" versus "unaware" individuals after fear conditioning. Self-reported expectancies of the CS-US contingency obtained immediately following fear conditioning were used to differentiate the two groups. Results corrected for multiple comparisons indicated significantly greater BOLD signal in the bilateral dlPFC, right vmPFC, bilateral vlPFC, left insula, left hippocampus, and bilateral amygdala for the CS+>CS- contrast in the aware group compared with the unaware group (all p values ≤ 0.004). PPI analysis with a left hippocampal seed indicated stronger coupling with the dlPFC and vmPFC in the aware group compared with the unaware group (all p values ≤ 0.002). Our findings add to our current knowledge of the networks involved in explicit learning and awareness of conditioned fear, with important clinical implications.

661 Chronotype, Mood, and Diabetes-Related Distress in Adults with Type 2 Diabetes

Abstract Introduction Chronotype refers to an individual’s preferred timing of sleep and wakefulness, which can be classified as ‘normal’ or ‘late’ chronotypes. The purpose of this study was to examine whether late sleep timing was associated with impaired mood and diabetes-related distress in persons with type 2 diabetes (T2D). Methods The study is a secondary analysis of pooled cross-sectional baseline data from two studies of treatment of obstructive sleep apnea (R01-DK96028) and insomnia (K24-NR016685) in persons with T2D. Sleep timing was measured by the bedtime from a 7-day sleep diary. “Normal” sleep timing was defined as bedtime between 9PM to 12AM ≥ 85% per week. “Late” sleep timing as bedtime after 12AM with normal sleep timing &amp;lt; 85% per week. Other sleep variables evaluated were sleep duration, daytime sleepiness (Epworth Sleepiness Scale [ESS]), and OSA severity (apnea-hypopnea index [AHI]). The Profiles of Mood States measured Total Mood Disturbance (TMD) and the subscales of Tension-Anxiety (T-A), Depression-Dejection (D-D), Anger-Hostility (A-H), Vigor-Activity (V-A), Fatigue-Inertia (F-I), and Confusion-Bewilderment (C-B). Diabetes-related distress was measured by the Problem Areas in Diabetes (PAID). Hierarchical multiple regression was performed to determine whether sleep timing was associated with mood and diabetes-related distress. Results The sample (N=296) had 61% with late sleep timing (n=181). Persons with normal vs late sleep timing were similar in age, sex, race, and education (p &amp;gt;.05). Persons with late sleep timing were less likely to be partnered, had shorter sleep duration and greater mood impairment (TMD and T-A, D-D, A-H, C-B subscales) than those with normal timing (all p values &amp;lt;.05); there was no significant difference by sleep timing in PAID scores (p=.256). Hierarchical regression analyses adjusting for demographics (age, sex, race, marital status, education level), clinical (HbA1c, BMI), and sleep variables (sleep duration, ESS, AHI) revealed that late sleep timing was not significantly associated with impaired mood (TMD and subscales) or PAID. However, ESS was statistically significant in predicting greater TMD (β=.310, p &amp;lt;.001), mood subscales (all p-values &amp;lt;.05) and PAID (β =.222, p &amp;lt;.001). Conclusion Daytime sleepiness, not late sleep timing, is a significant sleep-related symptom for increased mood impairment and diabetes-related distress in persons with T2D. Support (if any):

Vision loss, vision difficulty and psychological distress in South Africa: results from SANHANES-1

BackgroundPsychological distress in vision impairments and blindness is a complex issue and a major public health concern. Sudden adjustments in routine lifestyle and career aspirations in such persons culminate in and/or aggravate their level of stress. Yet, psychological distress in persons with visual difficulties and vision loss in South Africa is poorly understood. We investigated the association between psychological distress and self-reported vision difficulties as well as clinician-assessed vision loss using data from the South African National Health and Nutrition Examination Survey (SANHANES-1).MethodsData was analysed on participants aged ≥ 15 years who participated in the SANHANES-1 clinical examinations and interviews. Data on demographic, socio-economic, and health status variables were gathered using a structured questionnaire. Psychological distress was assessed using the Kessler psychological distress scale (K10). Vision assessment was conducted by clinicians adhering to standard protocols as well as by participants’ subjective response to vision-related questions. Vision loss was defined as presenting visual acuity worse than Snellen 6/12 in the better eye. Bivariate and multiple logistic regressions were used to examine the association between vision parameters and psychological distress.ResultsThe analytic sample comprised 6859 participants with mean age of 38.4 years (60.8% females). The prevalence of psychological distress was 19.9%. After adjusting for demographics, socioeconomic, health risk and eye care variables, self-reported myopia (mild adjusted odds ratio [AOR] = 1.9, 95% CI 1.3–2.7; moderate AOR = 2.4, 95% CI 1.6–3.7; severe AOR = 3.6, 95% CI 1.8–7.3) and self-reported hyperopia (mild AOR = 1.7, 95% CI 1.2–2.5; moderate AOR = 2.4, 95% CI 1.5–3.8; severe AOR = 3.5, 95% CI 1.8–6.8) were significantly associated with psychological distress. While psychological distress was higher in patients with clinician assessed vision loss than those with normal vision, the association was not statistically significant after adjusting for confounders (AOR: 1.0, 95% CI 0.7–1.4).ConclusionsPersons who self-reported vision difficulty experienced a higher prevalence of psychological distress. Therefore, comprehensive psychological care is needed for patients with eye disease or vision difficulties as part of a governmental strategy to provide mental health care for all South Africans.