Distress Scale Research Articles

Type D Personality and Psychological Distress: A Correlational Study among Coronary Heart Disease Patients

The study aimed to explore the relationship between type D personality and psychological distress in coronary heart disease patients. It was proposed that people having type D personality are more likely to have psychological distress, which ultimately leads to coronary heart disease. One hundred fifty heart disease patients were included in the test of the hypotheses. There were 90 men and 60 women aged 45 years and above from different heart disease hospitals took part in the study. For data collection, along with the consent form and demographics sheet, Two scales were used i-e., A 14-item Type D Personality Scale was used to measure the Type D Personality, and a 10-item Psychological Distress Scale was used to assess the Psychological Distress among the selected sample. Statistical analysis showed that there is a significant relationship between type D personality and psychological distress among coronary heart patients. Furthermore, results also revealed that there were no significant differences found among men and women developing heart diseases in relation to type D personality and psychological distress. Heart diseases are increasing day by day, and they are reported as the “leading cause of death” all over the world. The current research focused on the association of type D personality and psychological distress among heart patients to highlight that both of these variables prevailed among the chosen sample.

Effect of a 4-Week Telerehabilitation Program for People With Post-COVID Syndrome on Physical Function and Symptoms: Protocol for a Randomized Controlled Trial.

COVID-19 has led to significant morbidity and mortality globally. Post-COVID sequelae can persist beyond the acute and subacute phases of infection, often termed post-COVID syndrome (PCS). There is limited evidence on the appropriate rehabilitation for people with PCS. The aim of this study is to evaluate the effect on exercise capacity, symptoms, cognition, anxiety, depression, health-related quality of life, and fatigue of a 4-week, twice-weekly supervised pulmonary telerehabilitation program compared with usual medical care for people with PCS with persistent respiratory symptoms. The study will be a multi-site randomized controlled trial with assessor blinding. Participants with confirmed previous COVID-19 infection and persistent respiratory symptoms who attend a post-COVID respiratory clinic will be randomized 1:1 to either an intervention group of 4weeks, twice-weekly pulmonary telerehabilitation or a control group of usual medical care. Participants in the control group will be invited to cross-over into the intervention group after the week 4 assessment. Primary outcome: exercise capacity measured by the 1-minute sit-to-stand test. Secondary outcomes: 5 repetition sit-to-stand test; Montreal Cognitive Assessment; COVID-19 Yorkshire Rehabilitation Scale; Chronic Obstructive Pulmonary Disease Assessment Test; 36-Item Short-Form Health Survey; Hospital Anxiety and Depression Scale; Fatigue Severity Scale; and the Kessler Psychological Distress Scale. Outcomes will be collected at baseline, after 4-weeks intervention or control period, after intervention in the cross-over group, and at 12-month follow-up. Research into effective rehabilitation programs is crucial given the substantial morbidity associated with PCS and the lack of long-term data for COVID-19 recovery. A short-duration pulmonary telerehabilitation program, if effective compared with usual care, could inform practice guidelines and direct future clinical trials for the benefit of individuals with persistent respiratory symptoms post-COVID.

Psychological responses to the COVID-19 pandemic and situational impact: A network analysis in Hong Kong residents

BackgroundThe COVID-19 pandemic has had situational impacts and induced various psychological responses among residents. The present study aims to analyze the network structure of psychological responses to the pandemic and their relationships with situational impact, resilience, and well-being through a network approach. MethodsAn online survey recruited 1122 residents (mean age = 32.5 years, 65.4 % female) in Hong Kong from October 2020 to October 2021. The participants completed the Mental Impact and Distress Scale: Psychological Response (MIDc-PR) and other validated measures. Gaussian graphical modeling was conducted in R to identify the central MIDc-PR symptoms and their bridge linkages with situational impact, resilience, and well-being. ResultsIn the MIDc-PR network, the central symptoms were ‘Routine’ and ‘Images’ for Anticipation and ‘Tense’ and ‘Lonely’ for Modulation, with 12 bridge edges between the two clusters. In the combined network, the MIDc-PR nodes showed 12 bridge edges with situational impact, particularly in the health domain. ‘Concerned’, ‘Sleep’, and ‘Lonely’ showed negative linkages with resilience; ‘Unmotivated’ and ‘Trapped’ showed negative linkages with well-being. The network models showed good levels of stability and did not differ significantly in network structure and global strength across gender and age groups. LimitationsThe cross-sectional study design only allowed undirected associations in the network and could not model the within-subject effects. ConclusionsThe study findings contributed to the literature by elucidating the network structure of psychological responses to the pandemic. The central and bridge symptoms have clinical implications as potential targets for future interventions.

Differentiating the relationships between traditional and new media use and sleep quality during the COVID-19 pandemic: roles of psychological distress and age.

Numerous studies have consistently demonstrated a decline in sleep quality during the COVID-19 pandemic. The primary objective of this study is to explore the impact of engaging with pertinent epidemic information through the media amid the COVID-19 crisis on individuals' sleep quality and the underlying mechanisms through which this influence operates. An online cross-sectional study design was employed. A total of 1,063 British adults (36.2% males; M age = 38.85, SD age = 13.36, ranging from 18 to 77 years old) participated in the study and completed our questionnaires, which included media usage frequency during the pandemic, the 10-item Kessler Psychological Distress Scale (K10), the Insomnia Severity Index (ISI), and the Ten-item Personality Inventory (TIPI). Pearson's correlation analyses indicated that there was no significant correlation between COVID-19-related traditional media use (television, radio, newspaper) and psychological distress or sleep quality. However, exposure to information related to COVID-19 through new media use (Facebook, Tik Tok, Twitter) was correlated with greater psychological distress and poorer sleep quality. A moderated mediation analysis showed that psychological distress fully mediated the relationship between new media use and poor sleep, which was moderated by age, with the association between psychological distress and poor sleep quality being stronger among older adults. Exposure to information of COVID-19 via new (but not traditional) media use deteriorated sleep quality through greater psychological distress, and this relationship was stronger among older adults.

Psychological distress among healthcare professionals in Mbarara, following the 2022 Ebola Virus Disease outbreak in Uganda: a mixed methods study

BackgroundThe 2022 Ebola Virus Disease (EVD) outbreak occurred at a time when Uganda was still battling the social and psychological challenges of the COVID-19 pandemic; placing health care professionals (HCPs) at a much higher risk of developing psychological distress. Psychological distress among HCPs can cause decreased workplace productivity and ineffective management of their patients. The current study aimed to investigate and understand psychological distress among HCPS in Mbarara city in Southwestern Uganda following the 2022 EVD outbreak.MethodWe enrolled 200 HCPs through convenient sampling from one private and one public health facility in Mbarara city in Southwestern Uganda, in a cross-sectional convergent parallel mixed method approach where qualitative and quantitative data were collected concurrently. Quantitative data, utilizing the Kessler Psychological Distress (K10) Scale, provided us with a quantitative measure of the prevalence of psychological distress among HCPs, and were analyzed using STATA version 16. Qualitative data, on the other hand, offered deeper insights into the nature, perceptions, and contextual factors influencing this distress, and were analyzed using emergent theme analysis.ResultsThe prevalence of psychological distress was 59.5% and it was higher among females (63.9%) compared to males (36.1%). HCPs vividly expressed distress and anxiety, with heightened suspicion that every patient might be an EVD carrier, creating a pervasive sense of unsafety in the workplace. However, the outbreak had an educational affect where concerns about the announcement of another EVD outbreak were diverse, with HCPs expressing anxiety, despair, and dissatisfaction with the country’s management of potential outbreaks.ConclusionHigh levels of psychological distress were experienced by HCPs in Southwestern Uganda as a result of the 2022 EVD pandemic. HCPs express a wide range of feelings, such as dread, anxiety, despair, pessimism, and discontent with the way the outbreaks are handled throughout the nation. We recommend implementation of comprehensive psychosocial support programs tailored to the unique needs of HCPs, including counseling services, stress management workshops, and peer support networks.

Application of the path analysis model to evaluate the role of distress, mental health literacy and burnout in predicting self-care behaviors among patients with type 2 diabetes

IntroductionMental complications of diabetes are one of the main obstacles to the implementation of self -care behaviors that have been less studied. Therefore, this study was conducted to survey the effective factors in predicting burnout and self-care behaviors among patients with type 2 diabetes.MethodsIn this Path analysis, 1280 patients with type 2 diabetes were selected from Mashhad (Iran) in 2023 to 2024. Four scales, the mental health literacy (MHL) scale, diabetes burnout scale, diabetes distress scale, and self-care behavior scale were used for data gathering. AMOS software checked the direct and indirect paths between the variables.ResultsIn the path analysis, variables of MHL and diabetes distress predicted 25% variance of diabetes burnout (R2 = 0.25), and diabetes distress (total effect = 0.491) had the greatest impact on predicting diabetes burnout. Variables of MHL, diabetes distress, and diabetes burnout predicted 12% variance of Self-care behaviors (R2 = 0.12) and MHL (total effect = -0.256), age of onset of diabetes (total effect = 0.199), and diabetes burnout (total effect = − 0.167) had the greatest impact on prediction of self-care behaviors.ConclusionMHL could reduce diabetes distress and burnout and eventually promote self-care behaviors among patients with type 2 diabetes. Therefore, screening and identifying psychological problems (such as distress and burnout) and designing interventions to increase MHL can ultimately increase the health of patients with diabetes.

Moral foundations, moral emotions, and moral distress in NICU nurses.

Background: Moral distress is common in neonatal intensive care unit (NICU) nurses. Purpose: The purpose of this study was to evaluate the relationships between NICU nurses' moral foundations, moral emotions, and moral distress. Research design and method: This is an observational cross-sectional self-report questionnaire study. Participants and research context: One hundred and forty-two (24%) of 585 Level 3-4 NICU nurses completed pen-and-paper self-report measures of moral foundations (harm, fairness, ingroup, authority, and purity) (Moral Foundations Questionnaire-20), proneness to self-conscious moral emotions (guilt and shame) (modified Personal Feelings Questionnaire-2), and moral distress (futile care, compromised care, and untruthful care) (modified Revised Moral Distress Scale). Ethical considerations: Participation was voluntary and anonymous. The ethics committees of the participating hospitals approved the study protocol (HREC Reference: LNR/18/SCHN/316). Results: Non-parametric statistical analyses showed medium to large correlations between moral foundations and moral emotions. Moral foundations and moral emotions had trivial to small correlations with moral distress. Using a liberal p-value of <.10 for statistical significance because of the small sample size, harm (rs = 0.22) and fairness (rs = 0.16) predicted futile care, ingroup predicted compromised care (rs = 0.19) and untruthful care (rs = 0.15), and purity predicted untruthful care (rs = 0.15). Guilt-proneness predicted futile care (rs = 0.15). Shame-proneness did not predict moral distress. Conclusion: The correlations between moral foundations and moral emotions were significant. Moral foundations and guilt-proneness predicted one or more dimensions of moral distress. The smaller than expected effect sizes may have been owing to how moral foundations, moral emotions, and moral distress were conceptualized and measured, or to moral disengagement, including NICU nurses' possible reluctance to countenance aversive but morally warranted feelings of guilt and especially shame. Understanding the nature of these relationships may complement the efforts of NICU administrators, educators, counsellors, and nurses themselves to mitigate moral distress.

Sexual dysfunction in migraine-affected women: A prospective cross-sectional controlled study

IntroductionFemale sexual dysfunction (FSD) is a common health problem that is inadequately investigated in Arabic countries, especially Saudi Arabia. AimTo assess the prevalence and trace predictors of FSD in Saudi women who suffered from migraine headaches comparable to healthy women. Patients and methodsA prospective cross-sectional, controlled study involved 400 Saudi women complaining of migraine (Case Group) and another 400 healthy-looking Saudi women (Control Group) during three months; from January 1st, to March 31st 2023, in Jeddah city, Saudi Arabia. Data was collected by using a pre-structured Female Sexual Function Index (FSFI) questionnaire, Female Sexual Distress Scale (FSDS), Migraine Screen Questionnaire (MS-Q), with an evaluation of the severity of pain by Visual Analogue Scale (VAS), and its impact on daily activity by using both; Headache Impact Test (HIT-6) and Migraine Disability Assessment (MIDAS) Questionnaire. ResultsA total of 800 Saudi women were recruited. Their ages ranged from 18 to 45 years old. Women with abnormally low FSFI scores were 375 (93.75 %) out of 400 with migraine and 85 (21.25 %) out of 400 without migraine. The lowest FSFI scores were mainly for desire (2.75 ± 1.05) and arousal domains (3.0 ± 1.12) followed by sexual satisfaction (3.25 ± 1.30) and orgasmic domains (3.5 ± 1.15). The foremost predictive factor behind low FSFI scores and associated FSD in our study was migraine (P < 0.00001). Additional predictors of statistical significance were low educational level (P < 0.01), urban residency (P < 0.02), high parity (P < 0.02), chronic illness such as diabetes (P < 0.01), and bad habits such as smoking (P < 0.03) ConclusionA significant correlation exists between migraine and female sexual dysfunction (FSD). Desire and arousal dysfunctions were the most significantly affected domains followed by satisfaction and orgasmic problems.

Magnitude of psychological distress and associated factors among war survivor women in Northern, Ethiopia, 2022: a community-based cross-sectional survey

BackgroundCivilian war and internal conflicts increase the incidences of mental health conditions among war survivors. It is crucial to assess war-related psychological consequences in war-affected areas in Ethiopia to intervene in the future. Thus, this study aimed to determine the magnitude of psychological distress and associated factors of psychological distress among war survivor women in Northern, Ethiopia.MethodsA community-based cross-sectional survey was conducted, and 1596 war survivor women were recruited to participate using a face-to-face interviews with a census sampling technique from May 1–30, 2022. The psychological distress was assessed using a Kessler psychological distress scale (K10). Bi-variable and multi-variable logistic regression analyses were used, and variables with a p-value less than 0.05 in the multivariable analyses were considered statistically significant.ResultIn this study, the response rate was 100% and the prevalence of psychological distress was 44.90% at a 95% CI: (42.40, 47.40). Psychological distress was significantly associated with the education of ability to read and write (AOR = 2.92; 95% CI: 2.12, 4.01), primary education and above (AOR = 3.08; 95% CI: 2.09, 4.54), housewife (AOR = 5.07; 95%CI: 2.64, 9.74), farmer (AOR = 8.92; 95%CI: 4.03, 19.70), emotional violence (AOR = 1.52; 95%CI: 1.05, 2.18), physical violence (AOR = 3.85; 95%CI: 2.37, 6.26) and sexual violence (AOR = 3.25; 95%CI: 1.98, 5.33) whereas being separate was protective for psychological distress (AOR = 0.38; 95%CI: 0.16, 0.92).ConclusionThe prevalence of psychological distress was found to be high. Therefore, women who are housewives, married, farmers, educated, and who have experienced violence must be the focus of governmental and private collaborative interventions to prevent war-related psychological morbidity and mortality.

(118) ORGASM AND HEART RATE VARIABILITY IN FEMALE BREAST CANCER SURVIVORS: RESULTS FROM A PSYCHOPHYSIOLOGY STUDY

Abstract Introduction Over 70 % of female breast cancer survivors suffer from sexual dysfunction. Sexual dysfunction can cause great amounts of stress and negatively impact overall health and well-being. Most studies focus on sexual arousal disorders and hypoactive sexual desire disorders. The research on orgasm in this specific group is limited. A better understanding of sexual function in breast cancer patients may yield potential targets for new treatment strategies for sexual dysfunction in this population. Low heart rate variability (HRV) has been shown to be predictive of erectile dysfunction and female sexual arousal as well as orgasm frequency. Reduced HRV and low cardiac vagal tone have previously been reported in breast cancer survivors during the first year post-treatment. If HRV is a reliable indicator of female sexual dysfunction, it could be used to assess and monitor it in a clinical setting. Objectives This study aimed to explore whether there is a link between HRV and both, sexual arousal and the ability to orgasm. We were expecting to find a difference in HRV between breast cancer survivors and healthy controls as well as orgasmic and anorgasmic women. Methods Participants were prescreened during a telephone interview. We included 40 premenopausal breast cancer survivors currently on hormonal treatment with an age range of 29 to 57 years (M = 43.5, SD = 6.4) and 20 healthy controls with an age range of 22 to 35 (M = 27.6, SD = 3.2). The vaginal pulse amplitude, heart rate variability (SDNN), subjective sexual arousal and self-reported number of orgasms were assessed in response to audiovisual sexual stimuli and vibrotactile clitoral stimulation in breast cancer survivors and healthy controls. Validated patient-reported outcome measures were used to assess sexual dysfunctions (Female Sexual Function Index, Female Sexual Distress Scale − Desire/Arousal/Orgasm), sexual self-esteem (Sexual Self-Esteem Inventory-Short Form), health-related quality of life (Patient-Reported Outcomes Measurement Information System 29 (PROMIS-29) profile questionnaire). Results Breast cancer survivors showed lower sexual function, health-related quality of life, sexual self-esteem and higher sexual distress than healthy controls. Preliminary results show a difference in baseline HRV scores between healthy controls and breast cancer survivors. However, this finding is likely due to age differences between our two groups and not cancer treatment effects. We could find no apparent differences in baseline HRV between anorgasmic and orgasmic women. Further analyses on the predictive value of HRV during sexual arousal for orgasm occurrence will be conducted. Conclusions Our data did not corroborate either of our hypotheses related to baseline HRV. For the evaluation of HRV as a predictor for orgasm occurrence, further exploratory analyses will follow. More research on the physiological parameters of sexual dysfunction is needed to reveal underlying mechanisms and find targets for future therapies.

(066) EXPLORING THE IMPACT OF ALCOHOL ON SEXUAL FUNCTION IN PERIMENOPAUSAL WOMEN

Abstract Introduction Sexual well-being is an important quality of life component to women throughout life, and during menopausal transition and beyond. Female sexual response cycle includes desire, arousal, orgasm, and resolution phases. Female sexual dysfunction (FSD) encompasses all phases of sexual response cycle and can lead to distress for both the woman and her partner and warrant further investigation. Research has indicated both positive and negative associations between alcohol consumption and sexual health, our review goal is to further explore the relationship between alcohol consumption and sexual function in perimenopausal women. Objective We aim to review the current literature regarding the influence of alcohol use on sexual health during the menopausal transition and beyond. Methods The examination of alcohol consumption and its effects on sexual health in menopausal women was performed through reviewing existing literature. The literature search was completed in the Ovid MEDLINE database (1946- Present) in August 2023. 16 articles were identified in the initial search. 12 articles met our inclusion criteria and were independently reviewed by the authors. Results from these articles were summarized. The search was limited to the English language and the last 20 years (2003-current). Keywords included: menopause, pre-menopause, post menopause, perimenopause, alcohol use, alcohol related disorder, and sexual function. Results Seven out of 16 articles reviewed linked a negative association between alcohol consumption and female sexual function. Seven indicated a positive association between alcohol use and sexual function and 2 articles did not reveal an association. The findings of our review indicate a complex relationship of alcohol on women's sexual function. Studies indicating a positive association between mild alcohol consumption (equal or less than 0.21 FL oz. alcohol/day) and improved sexual function. This effect was theorized due to alcohol increasing endogenous estrogen or due to behavioral changes such as disinhibition, influencing sexual activities influenced by alcohol or subjective arousal due to drinking. Additionally, a positive association was seen between increased alcohol consumption and Female Sexual Function Index (FSFI) scores. However no significant influence on Female Sexual Distress Scale scoring was identified which is a key component to FSD. Other studies showed that excessive or prolonged alcohol consumption (more than 1.00 FL oz. alcohol per day) found to be associated with worsening sexual function and can impact all 6 domains on the FSFI (which include: desire, arousal, lubrication, orgasm, satisfaction, and pain) even after abstinence. These findings were reflected in another study that showed women (however not exclusively menopausal) who were seeking treatment for alcohol dependency diagnosis experienced low sexual desire, inability to achieve orgasm and less satisfaction. Initiating alcohol consumption at a younger age, along with an extended and more intense period of dependency, was correlated with a higher likelihood of experiencing increased sexual dysfunction. A meta-Analysis of 7 studies showed increased odds of sexual dysfunction with alcohol consumption. Another study showed that moderate alcohol consumption was found to be an independent risk factor for FSD and Genitourinary syndrome of menopause (GSM) which can lead to FSD. Conclusions The impact of alcohol on sexual health in postmenopausal women is multifaceted, based on varying levels of consumption influencing various aspects of sexual function. This relationship can also be influenced by other factors such as pre-existing sexual problems and the utilization of alcohol as a coping mechanism to reduce anxiety, release stress or to increase sexual behavior through enhancing arousal. A study indicated that menopausal symptoms may trigger a craving for alcohol, leading to increased alcohol consumption. Further research is essential to elucidate the direct and indirect effects of alcohol consumption on sexual dysfunction. In addition, the impact of abstinence from alcohol on sexual dysfunction in postmenopausal women needs to be further explored. Understanding the impact of alcohol consumption on sexual function of postmenopausal women is critical for healthcare professionals, to provide appropriate guidance and interventions. These findings highlight the need for further research and increased awareness regarding the impact of alcohol use on sexual health during in pre-menopausal, peri and postmenopausal women. Disclosure No.

(095) CHRONIC EPIDURAL SPINAL CORD STIMULATION AS A POTENTIAL TREATMENT FOR SEXUAL DYSFUNCTION IN WOMEN WITH SPINAL CORD INJURY

Abstract Introduction Spinal cord injury (SCI) is a lifelong condition that affects approximately 294,000 individuals in the United States, with an estimated 17,900 new cases occurring each year. Despite sexual function being reported as a top priority to restore after injury, research on sexual dysfunction after SCI is scarce, especially among people with gynecological anatomy. One major challenge in treating female sexual dysfunction (FSD) after SCI is the heterogeneity of symptoms. Women can have impacted libido, genital sensitivity, lubrication, and/or ability to orgasm. This is further complicated by the comorbidities of bladder and bowel dysfunction, which are also common after SCI. Epidural spinal cord stimulation (eSCS) has emerged as a promising treatment for SCI, demonstrating positive results across various domains for motor-complete patients, including bladder, bowel, and sexual function. Objective The primary objective is to determine if chronic eSCS improves survey-reported sexual function after SCI in women. The secondary objective is to determine if chronic eSCS improves survey-reported bladder and bowel function. Methods Seven female participants who are motor and sensory complete after traumatic SCI with injury levels between cervical (C)6 and thoracic (T)10 were recruited for the study. Participants were implanted with a 16-contact paddle lead epidural spinal cord stimulation at the T11-T12 level and followed for 13 months. The Female Sexual Distress Scale (FSDS), Neurogenic Bowel Dysfunction Score (NBDS), and Neurogenic Bladder Symptom Score (NBSS) were administered monthly. Participants received continuous stimulation over 13 months. A generalized linear model was created for each outcome to examine trends in function over time with an alpha of 0.025 (Bonferroni corrected). Results In the first 6 participants analyzed, we found that sexual distress improves over time (p&amp;lt;0.001) in the largest series of women participants with SCI targeted for restoration of function (Figure 1). One woman reported restoration of orgasm after five years of chronic SCI. Additionally, we found a statistically significant improvement in bowel function as measured by the NBDS with stimulation (p&amp;lt;0.003) from the generalized linear mixed effects fit corresponding to the follow-up visit number. There were no statistically significant trends in the NBSS scores, however, one participant noted that she no longer uses an intermittent catheter to empty her bladder indicating functional improvements that are not captured by the survey. Conclusions Epidural SCS is a promising therapy to improve female sexual function after chronic SCI. Although quantitative surveys remain the most valid and reliable measures of pelvic organ function after SCI, we saw improvements in function that were not captured by the questionnaires. Still, we found significant improvements in validated surveys of bowel function and female sexual distress over time. These high-priority outcomes for women with SCI are potential targets of restoration using commercially available spinal cord stimulation. Disclosure Yes, this is sponsored by industry/sponsor: Abbott. Clarification: No industry support in study design or execution. Any of the authors act as a consultant, employee or shareholder of an industry for: Stim Sherpa.

(094) MEASURES OF FEMALE SEXUAL DISTRESS IN AN EXPLORATORY, PHASE 2B, RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED CLINICAL TRIAL OF SILDENAFIL CREAM, 3.6% FOR THE TREATMENT OF FEMALE SEXUAL AROUSAL DISORDER

Abstract Introduction The diagnosis of female sexual arousal disorder (FSAD) requires that individuals experience clinically significant distress from their symptoms. Pre-trial content validity investigations were conducted by the sponsor to understand how women with FSAD best described their distress associated with this female sexual dysfunction (FSD) diagnosis. Objective Responses to the Female Sexual Distress Scale – Desire, Arousal, Orgasm (FSDS-DAO) survey among healthy premenopausal women enrolled in a Phase 2b, exploratory, randomized, placebo-controlled, double-blind study of Sildenafil Cream, 3.6% for FSAD treatment (NCT04948151). Methods After informed consent, enrollment diagnoses for each participant were established during a one-on-one clinical interview with independent experts. Baseline assessments were measured after a one-month, single-blind, placebo, run-in period. Participants were then randomized to Sildenafil Cream, 3.6% (n=101) versus Placebo (n=99) and used the investigational product (IP) as needed at home for 12 weeks, with monthly in-clinic assessments. The change from baseline at week 12 in question 14 (Q14) of the FSDS-DAO was a co-primary efficacy endpoint. All 15 FSDS-DAO questions begin with “How often did you feel, in the past 30 days” with a Likert score of 0 (Never) to 4 (Always). Results Although changes from baseline at week 12 in FSDS-DAO Q14 responses were not different among active versus placebo users in the intent-to-treat population (p=0.84) or the future target population (women with FSAD only or primary FSAD with secondary hypoactive sexual desire disorder (HSDD)) (p=0.95), responses to several FSDS-DAO questions, showed reduced sexual distress among Sildenafil Cream, 3.6% users (Table 1). While Q14 asked specifically about concerns with sexual arousal, the other 5 questions asked about generalized sexual distress, using verbiage more congruent with pre-trial content validity investigations. Post-trial psychometric validation studies selected question 5 as the most appropriate for measuring sexual distress among this population. Conclusions Data from this exploratory trial support that women with a diagnosis of FSAD only or primary FSAD with secondary HSDD experienced reduced sexual distress after receiving Sildenafil Cream, 3.6%. Disclosure Yes, this is sponsored by industry/sponsor: Dare Bioscience and Strategic Science and Technologies. Clarification: Industry initiated, executed and funded study. Any of the authors act as a consultant, employee or shareholder of an industry for: Dare Bioscience and Strategic Science and Technologies.

Young adult mental health during the United Kingdom’s first COVID-19 lockdown: the benefit of living with parents and siblings

ABSTRACT UK young adults saw sharp mental health declines during the COVID-19 pandemic. This paper examines whether living with siblings helped moderate this negative effect. We compare the outcomes of young adults (age 19), i) who were living with parents and siblings, with ii) those who were living with only parents, and iii) with those who were living away from parents. We used data from the Millennium Cohort Study COVID-19 survey, linked with the mainstage survey (N = 2,578), and captured mental health with: the Shortened Warwick-Edinburgh Mental Well-being Scale and the Kessler-6 Psychological Distress scale. As young men and women may be differently affected by sibling co-residence, we vary living arrangements effects by gender. While average young adult mental health deteriorated during the first national lockdown, there were variations by gender and living arrangements. For young men, living with siblings was associated with improved mental health on both measures during the first COVID-19 lockdown. For young women, living with parents was associated with lower psychological distress than living away from home, but siblings provided no additional benefit. Data from later in the pandemic suggests that, as young adults became more accustomed to social restrictions, the importance of family living arrangements declined.

Association of a healthy ageing index with health-related outcomes in a multi-ethnic cohort from Singapore

BackgroundThe global population is ageing rapidly and it is important to promote healthy ageing. The Healthy Ageing Index (HAI) is a comprehensive measure of health, but there is limited research on its association with other age-related outcomes. The management of an aging population necessitates considerations even among generally healthy adults, as age-related diseases often remain unaccounted for until later stages of life. This study explores the association of risk factors with HAI and its association with peripheral artery disease (PAD), muscle strength, health-related quality of life (HRQoL), and psychological distress in the Singapore Multi-Ethnic Cohort study.MethodsThis cross-sectional study involved 1909 participants (median (Q1, Q3) age: 53 (48, 60) years and 59.3% females) from Singapore Multi-Ethnic Cohort study. The risk factors of HAI included age, gender, ethnicity, education level, smoking, alcohol consumption, employment, BMI and past medical histories. PAD was assessed using ankle-brachial index (ABI), handgrip strength (HGS), HRQoL with the EQ-5D-5 L questionnaire and psychological distress via the Kessler Psychological Distress Scale (K10). HAI components were assessed using relevant marker tests.ResultsOlder age, Malay and Indian ethnicities, unemployment, high BMI and histories of CHD, hypercholesterolaemia, tumours and TIA/stroke were associated with lower HAI scores indicative of poorer health. Higher HAI scores were associated with females and higher education levels. Lower HAI scores were significantly associated with low ABI, high K10 scores, mobility and anxiety/depression dimensions of EQ-5D-5 L.ConclusionThe most important factors associated with HAI were age, sex, ethnicity, education, unemployment, BMI and a history of health conditions. Lower HAI scores were significantly associated with PAD, lower HRQoL and psychological distress. Thus, the HAI demonstrates promise as an evaluation method for assessing PAD, overall muscle strength and HRQoL in a population-based setting.

Psychological Distress, Coping Strategies and Social Support in Parents of Children with Leukemia

Background: Leukemia poses significant distress for affected children and their families, necessitating extensive parental involvement in care. Parents must manage multiple clinic visits, medication administration, and provide emotional support during treatment, impacting their psychological well-being. Objective: To assess the levels of psychological distress, coping strategies, and social support among parents of children with leukemia. Methods: This analytical cross-sectional study was conducted at Bolan Medical Complex and Cenar Cancer Hospital in Quetta, Baluchistan. A total of 341 parents participated, with data collected via three standardized questionnaires: the Coping Health Inventory for Parents (CHIP), Kessler Psychological Distress Scale (K10), and Multidimensional Scale of Perceived Social Support. Ethical approval was granted by the Khyber Medical University Peshawar. Results: Among the participants, 36.1% were aged 25-35 years; 61.9% were male. Educational levels were 73.9% secondary and 23.8% primary. Psychological distress was reported as moderate by 86%, while 76% utilized fair coping strategies, and 95% experienced medium social support. There was no significant correlation between psychological distress and coping strategies; however, a negative association was noted between social support and psychological distress. Conclusion: The study reveals substantial psychological distress among parents, with prevalent fair coping strategies and medium social support. Enhanced social support is negatively associated with psychological distress, highlighting the need for targeted support interventions.

Clinical Manifestations' Spectrum of Smartphone Addiction: Moving from an Addiction toward a Clinical Syndrome.

Smartphone addiction is an emerging type of addiction in the digital era, characterized by smartphone dependence that negatively affects human health with a wide range of psychological and physical manifestations. This study aimed to evaluate the detailed clinical manifestations of smartphone addiction as a delineated clinical syndrome. A cross-sectional study design was employed to assess smartphone addiction prevalence and its health impacts among Syrian undergraduates using the Smartphone Addiction Scale-Short Version (SAS-SV 2013), the Kessler psychological distress scale (K-6), and a comprehensive assessment of the clinical manifestations frequently linked to smartphone addiction in the literature. Different statistical modeling techniques were applied; a P value of < .05 was considered statistically significant. Of 1532 invited undergraduates, 1401 (91.45%) completed the assessment adequately. Most participants were females (59.7%) and below 23 years of age (73.2%). The prevalence of smartphone addiction was 67.80%; statistically significant smartphone addiction associations were revealed with psychological distress (P < .0001) with odds ratios of 3.308. Most screened physical manifestations also showed a significant association with smartphone addiction. A high prevalence of smartphone addiction was observed with a broad spectrum of associated mental and physical manifestations. As smart device addiction becomes a global health concern, combining the clinical findings reported in the related literature into one clinical identity is necessary to develop a holistic management approach for the delineated clinical syndrome.

Testing the Impact of Variations in Administration on the Kessler Psychological Distress Scale (K10).

Self-report measures are useful in psychological research and practice, but scores may be impacted by administration methods. This study investigated whether changing the recall period (from 30 to 7 days) and response option order (from ascending to descending) alters the score distribution of the Kessler Psychological Distress Scale (K10). Participants were presented with the K10 with either different recall periods or different response option orders. There was weak evidence of lower mean K10 scores when using a 7-day recall period than when using the 30-day recall period (B = 1.96, 95% CI [0.04-3.90]) but no evidence of a change in the estimated prevalence of very high psychological distress. Presenting the response options in ascending order did not affect mean scores, but there was weak evidence of reduced prevalence of very high distress relative to the descending order (incidence rate ratio [IRR] = 0.60, 95% CI [0.36-0.98]). These findings suggest that varying the administration method may result in minor differences in population estimates of very high psychological distress when using the K10.

Body image, eating distress and emotional-behavioral difficulties among adolescents in Mbarara, Southwestern Uganda

BackgroundAdolescents frequently have emotional and behavioral difficulties as they struggle with the challenges of transition from childhood to adulthood. Many struggle with issues of body image and eating distress as they deal with the difficult and frequently perplexing changes that occur with puberty. Yet there is surprisingly little research on the emotional and behavioral challenges, as well as body image and eating distress among this sizable population in Uganda. This study sought to assess attitudes and behaviors related to body image and eating distress, as well as emotional and behavioral difficulties among adolescents in Mbarara, Southwestern Uganda.MethodsThis was a cross-sectional study among 788 adolescents aged 13 to 19 years in secondary schools in Mbarara city and Mbarara district in south-western Uganda. The study employed the Body Image and Eating Distress scale to assess attitudes and behaviors about dieting and body shape and the extended version of the Strengths and Difficulties Questionnaire (SDQ) to assess for perceived emotional and behavioral difficulties. Logistic regression was used to identify the association between body image and eating distress and perceived difficulties.ResultsThe prevalence of high body image and eating distress was 10.8% while that of perceived emotional and behavioral difficulties was 45.8%. Some of the adolescents (16.1%) were dissatisfied with their body shape, 24.6% exercised a lot to avoid gaining weight, 15.0% were terrified to gain even a little weight, and 12.1% could not control their eating. More males reported eating large amounts of food at one time (p = < 0.001). Having emotional and behavioral difficulties (aOR: 1.89; 95% CI: 1.18 – 3.02; p = 0.019) and coming from a two-parent household (aOR: 1.79; 95% CI: 1.10 – 2.92; p = 0.019) increased the odds of high body image and eating distress.ConclusionHigh levels of body image and eating distress are linked to behavioral and emotional problems and adolescent’s family structure. Clinicians who treat adolescents should use a holistic care strategy and be aware of the high prevalence and close association between emotional and behavioral difficulties, concerns about weight, and dieting. It is important to encourage parental involvement and support in providing information about mental health issues among adolescents.

Minorities’ Diminished Psychedelic Returns: Gender, Perceived Stigma, and Distress

Because psychedelics have been found to increase psychological traits like openness, mental flexibility, and interpersonal perceptiveness, some researchers believe that psychedelics could help individuals cope with the psychological effects of discrimination. However, it is still unclear whether psychedelic use can help manage the internalized stigma that deters formal mental health treatment. This study investigates the impact of six measures of psychedelic use (MDMA, psilocybin, DMT, ayahuasca, peyote/mescaline, and LSD) on psychological distress (Kessler Psychological Distress Scale) and internalized stigma. The study used data from the National Survey of Drug Use and Health (NSDUH) from 2008 to 2019, with a sample size of 458,372 participants. Ordinary least square regression models were conducted using Stata 18. Gender analysis found that among men, ayahuasca use was linked to reduced stigma perception associated with higher distress. For women, DMT use was linked to reduced stigma perceptions when experiencing higher distress. However, results find that individuals who have used MDMA and psilocybin reported heightened perceptions of stigma associated with increased psychological distress. Among women, MDMA and psilocybin use was associated with a higher perception of stigma when they experienced distress. These findings suggest that, overall, psychedelics may not reduce the impact of distress on the perception of stigma, especially for women.