Elevated Levels Of Depression Research Articles

Food insecurity among graduate students: prevalence and association with depression, anxiety and stress.

The impact of food insecurity on mental health has not yet been examined in graduate students, a population widely considered at elevated risk for financial strain and negative mental health outcomes. This study aimed to derive initial prevalence estimates of food insecurity in a sample of current graduate students at a large state university and to elucidate the relationship between food insecurity and depression, anxiety and stress in this sample. Cross-sectional online survey including the US Household Food Security Survey Module: Six-Item Short Form and the Depression, Anxiety, and Stress Scales (DASS-21). University in the northeastern region of the USA. Two hundred sixty-three graduate students. In the present sample, 59·7 % of participants reported high/marginal food security, 18·5 % reported low food security and 21·8 % reported very low food security. Graduate students with very low food security reported significantly greater depression (η2 = 0·09), anxiety (η2 = 0·10) and stress (η2 = 0·10), compared with those with low food security and high food security (all P's < 0·001). Food insecurity occurred in nearly half of the graduate students surveyed, and very low food security was associated with elevated levels of depression, anxiety and stress. Findings highlight the need to address food insecurity and associated elevated mental health problems present among graduate students.

Immediate and Long-Term Effects of an 8-Week Digital Mental Health Intervention on Adults With Poorly Managed Type 2 Diabetes: Protocol for a Randomized Controlled Trial.

BackgroundDiabetes is a leading cause of years of life lost and accounts for approximately one-fourth of health care dollars spent in the United States. Many of these costs are related to poor medication adherence and lack of self-care behaviors and are thus preventable. Depression, which is more prevalent among people with diabetes than in the general population, predicts poorer management of one’s diabetes, whereas positive affect predicts engaging in more positive health behaviors. Consequently, interventions that improve depression and positive affect may also improve diabetes-related outcomes among people with diabetes. Although preliminary research on the impact of such interventions among people with diabetes is promising, these studies focused primarily on in-person interventions, have had small samples, and lack long-term follow-up.ObjectiveThis study aims to examine the short- and long-term effects of a digital therapeutic platform focused on mental health among adults with poorly managed type 2 diabetes and elevated levels of depression.MethodsThis is a randomized controlled trial in which adults with a type 2 diabetes diagnosis, elevated hemoglobin A1c (HbA1c) levels (≧7), and moderate to severe depressive symptoms will be randomly assigned to a positive emotion regulation skills intervention group or a sham digital intervention with only psychoeducational content. The study will take place over 14 months, including the 8-week intervention (or control) delivered via a digital therapeutic platform (Happify Health) and follow-up assessments at 3, 6, and 12 months postintervention. Throughout the intervention and for 1 week at each postintervention follow-up, participants will complete daily assessments of diabetes-related distress, diabetes regimen adherence, and mood. Our primary outcome, HbA1c, will be self-reported every 3 months throughout the study. Secondary and exploratory outcomes will be assessed at baseline; at 8 weeks; and at 3, 6, and 12 months postintervention.ResultsRecruitment is expected to begin in June 2020. Participants will begin the study as they are recruited and will finish in waves. The final wave of data collection from the 8-week intervention is expected for winter 2020, with the completion of the 12-month follow-up in winter 2021.ConclusionsAlthough previous research suggests that in-person psychological interventions have promising effects on both psychological and physical outcomes among adults with diabetes, digital interventions can be advantageous because they are easily scalable and reduce many barriers that prevent people from seeking treatment. This trial will provide important information about the effects of a digital mental health intervention among adults with type 2 diabetes, assessing both short- and long-term effects of this intervention on HbA1c, depressive symptoms, and other diabetes-specific outcomes. If successful, this may introduce a scalable intervention that would help reduce some of the preventable costs associated with diabetes.Trial RegistrationClinicalTrials.gov NCT04068805; https://clinicaltrials.gov/ct2/show/NCT04068805.International Registered Report Identifier (IRRID)PRR1-10.2196/18578

Gender Comparison of Psychological Comorbidities in Tinnitus Patients - Results of a Cross-Sectional Study.

BackgroundIn the last decades, research focused on gender-related features in patients with tinnitus has often led to controversial results. The complex clinical picture of tinnitus patients often consists of an interdependent relationship between audiological symptoms and co-occurrent psychological disorders, which can complicate the diagnostic evaluation.MethodsTherefore, we studied 107 patients with tinnitus, investigating their psychological comorbidities in the light of gender differences. All patients were evaluated with ENT/audiological and psychological examination to consider presence/absence, type and gender distribution of psychopathological comorbidities. Patients completed questionnaires on tinnitus distress (Tinnitus Handicap Inventory, THI), anxiety (Beck Anxiety Inventory, BAI), depression (Beck Depression Inventory, BDI), metacognition (Metacognition Questionnaire-30, MCQ-30) and worry (Penn State Worry Questionnaire). The influence of gender on the relationship between tinnitus distress and psychological comorbidities was investigated with simple moderation analyses using the SPSS PROCESS macro.ResultsThe total sample included 65 male and 42 female patients (60.7 vs. 39.3%), matched for age and duration of tinnitus. We found no significant differences for tinnitus distress (THI total score, THI subscales) and MCQ-30 subscales, except for the control over thoughts, where men showed significantly higher scores than women (p = 0.045). Also, in our sample women showed significantly higher values for depression (BDI total score, p = 0.019), anxiety (BAI total score, p = 0.010) and worries (PSQW total score, p = 0.015). Moderation analyses revealed a significant influence of gender on the relationship of tinnitus distress with depression: higher scores of tinnitus distress were associated with significantly elevated levels of depression amongst men. No further gender influences could be observed in our sample.DiscussionIn conclusion, our results indicate general gender differences for psychological comorbidities in tinnitus patients, with women reporting more depression, anxiety and worries. Men, on the other hand, showed a higher need to control their thoughts. Additionally, our results indicate that men might have more coping problems with increasing levels of tinnitus distress, leading to increased depressive symptoms. Nevertheless, several gender related aspects in tinnitus patients remain unclear, thus warranting the need future studies in this field.

COVID-warriors: Psychological impact of the severe acute respiratory syndrome coronavirus 2 pandemic on health-care professionals

Background: The COVID-19 pandemic, caused by the Severe Acute Respiratory Syndrome Corona Virus 2 (SARS CoV-2) has the potential to affect the mental health of health-care professionals in several adverse ways, owing to a multifactorial, unprecedented volley of evolving factors. It may contribute to the elevated levels of depression, anxiety, and worry among the personnel on the frontline, who are often affected by medical and psychosocial factors, including pre-existing illness, scarcity of resources, uncertainty of outcome, prolonged working hours, lack of consensus, prevalent societal misbeliefs, prevailing stigma, and a constant threat to safety. Aim: The aim of this study was to screen health-care professionals for symptoms of depression, anxiety, and worry during SARS CoV-2 pandemic. Methods: In this cross-sectional study, a questionnaire was designed based on Patient Health Questionnaire-9, generalized anxiety disorder-7. It was disseminated through web-based and mobile-based social networks, thereby keeping in line with the social distancing and lockdown protocols. Results: Two hundred and fifty-seven participants were included in the study. Anxiety and depression were present in 23% (n = 59) and 16.8% (n = 43) of participants, respectively, most cases being mild in intensity. Nearly 56.4% (n = 145) of the participants reported that they were worried about COVID 19 pandemic, major cause of worry being risk of family and friends to be infected by COVID 19. About 40.9% (n = 105) participants reported sleep disturbances. Nearly 33.5% (n = 86) of participants reported increase in their smoking/alcohol consumption during lockdown. Conclusions: A significant proportion of health-care professionals experienced worry, sleep disturbances, anxiety, and depressive symptoms. Having clear guidelines, policies and procedures, training on infection control measures, occasional drills and being able to maintain communication with family members while in quarantine can go a long way in reducing worry and psychological impact of pandemic on health-care professionals.

The desire for children among adult survivors of childhood cancer: Psychometric evaluation of a cancer-specific questionnaire and relations with sociodemographic and psychological characteristics.

Long-term childhood cancer survivors (CCS) are less likely to become parents than their peers of the same age. Previous research has suggested that besides fertility, this outcome is shaped by psychosocial factors such as emotional motives toward having a child. Drawing from a sample of CCS with survival times >25 years, we present the validation of a questionnaire assessing cancer-specific reproductive motives and concerns. We evaluated the cancer-specific version of the Leipzig Questionnaire of Motives to have a Child (LKM-C) in a register-based sample of adult CCS (N = 632, 31% had children, 44.5% women). We conducted a confirmatory factor analysis and tested associations with sociodemographic characteristics and psychological symptoms (PHQ-9, GAD-2). The questionnaire showed good item discrimination parameters and reliability (α = 0.86). The two-factorial structure was confirmed with the independent scales "return to normalcy" and "illness-related worries (child's/own health)." On average, CCS reported more motives in favor of a child than worries (P < .001; d = 1.12). Favorable attitudes were associated with the presence of a partnership and children, stronger current desire for a child, and fewer depressive symptoms. Worries were associated with an unfulfilled desire to have a child and elevated levels of depression and anxiety symptoms. The LKM-C offers a brief measure of parenthood motivations in long-term CCS. Having a child signifies return to normalcy, health, fulfillment of life perspectives, and enrichment of the partnership. Less intense worries included illnesses of the child and concerns regarding one's own health. The questionnaire could inform follow-up care, psychotherapy, and fertility treatments.

DEPRESSION AND COGNITIVE DECLINE OF OLDER ADULTS IN THE TRANSITION TO WIDOWHOOD

This study examined the trajectories of depression and cognitive function in the transition to widowhood and investigated the temporal and causal relationship between these two closely related constructs. Respondents were 1,822 widowed adults aged 51 to 91 from a restructured data set (Wave 3 to Wave 12) of the Health and Retirement Study. The results of cross-lagged panel analysis indicated a bidirectional relationship between depressive symptoms and cognition decline, but the effects of cognitive impairment at earlier time points on later depression were larger than the effects of previous depressive symptoms on later cognition. The latent growth curve analysis showed that the cognitive function declined over time, whereas the initial level of depressive symptoms first increased following widowhood and gradually decreased over time. Significant negative associations were found between the initial levels of depression and cognitive function (p < .001) and between the rates of change of these two variables (p = .025). Older adults tended to have lower initial level of cognitive function and they showed faster cognitive decline over time. Female respondents were more likely to report more depressive symptoms and higher cognitive function. White respondents were more likely to report fewer depressive symptoms and higher levels of cognitive function. Higher levels of education were protective for one’s cognitive function but not for depressive symptoms. The study highlighted the reciprocal relationship between depression and cognitive function following widowhood and pointed out that accelerated cognitive decline may precede elevated levels of depression.

Depression and anxiety among HIV-positive men who have sex with men and men who have sex with women in China

ABSTRACTChina is experiencing an emerging HIV epidemic among men who have sex with men (MSM). Minority stress theory posits that marginalized populations experience additional stress, which influences experiences of psychological distress and health outcomes. This study aimed to understand psychological distress of MSM relative to men who have sex with women (MSW) in an urban Chinese setting. Cross-sectional survey data were collected from 162 HIV-positive Chinese men receiving HIV treatment at Beijing’s Ditan Hospital. Multiple linear regression with imputation was used to identify correlates of psychological distress. Relative to MSW, MSM were younger, more educated, and less likely to be in a relationship or have children. While both groups reported clinically elevated levels of depression and anxiety, sexual behavior was not associated with either outcome. Higher endorsement of depression symptomology was associated with worse reported physical health (β = −1.37, p < .05) and greater endorsement of maladaptive coping (β = 2.39, p < .05), whereas higher endorsement of anxiety symptomology was associated with greater endorsement of adaptive coping (β = 0.78, p < .05), diminished physical health (β = −0.86, p < .05), and a high school or greater level of education (β = 4.13, p < .05). These findings suggest that interventions targeting coping strategies may address psychological distress among HIV-positive Chinese men.

PECULIARITIES OF PSYCHOLOGICAL STATUS IN PATIENTS WITH FUNCTIONAL DYSPEPSIA: POSTPRANDIAL DISTRESS SYNDROME

Among all causes of epigastric pain or burning, early satiety, bothersome fullness, the most common one is functional dyspepsia (FD). Analysis of psychological peculiarities of patients with FD becomes one of the key problems. The aim: To compare the level of anxiety, depression, and social functioning of patients with postprandial distress syndrome (PDS), patients with epigastric pain syndrome (EBS), and healthy volunteers. This cross-sectional study was conducted in adult patients with FD (58 patients with PDS and 37 patients with EPS) and healthy volunteers (30 persons). Patients’ social functioning was assessed with the 36-Item Short Form Health Survey (SF-36). Anxiety and depression levels were measured with the Hospital Anxiety and Depression Scale (HADS). Patients with PDS showed significantly lower rates of physical functioning (p=0.0002), role physical (p=0.003), bodily pain (p=0.0001), general health (p=0.0001), vitality (p=0.0001), and social functioning (p=0.0003), in comparison with healthy volunteers. This group also showed significantly lower rates of general health (p=0.041), and social functioning (p=0.048), as compared to patients with EPS. FD led to an increase in anxiety levels regardless of the type of disease as compared with healthy volunteers (p=0.024). Patients with PDS had elevated depression levels compared to patients with EPS (p=0.023) and healthy volunteers (p=0.001). Each type of FD has a certain impact on the social functioning, anxiety and depression levels. Patients with PDS manifested significant differences in the psychological state as compared to patients with EPS, and healthy volunteers.

Microaggressions in Clinical Training and Practice.

Microaggressions in Clinical Training and Practice.

207-OR: Intentional Insulin Omission for Weight Loss and Psychosocial Outcomes among Youth with Type 1 Diabetes: Findings from Routine Screening

Introduction: Research has found that up to 31% of youth with type 1 diabetes (T1D) restrict insulin in efforts to lose weight (Wisting et al., 2013), and that restricting or omitting insulin has been linked to higher HbA1c. However, less is known about psychosocial outcomes among youth who omit insulin. The purpose of the current study was to examine associations between intentional omission of insulin to lose or avoid gaining weight and psychosocial outcomes among youth with T1D. Methods: Participants included 54 youth with T1D ages 12-17 (M age = 14.7, 55.6% female) and their caregivers, recruited during routine diabetes clinic visits. Youth and caregivers completed an annual psychosocial screening battery which included the PROMIS® depression and anxiety scales, the Problem Areas in Diabetes measure, and the Diabetes Family Conflict Scale. Youth also answered questions on their intentional omission of insulin to either lose or avoid gaining weight. Analyses were conducted via Pearson’s correlations, t-tests, and Chi-square tests. Results: Intentional omission of insulin to lose or avoid gaining weight was significantly positively correlated with youth-report of depression, anxiety, diabetes distress, and diabetes-related family conflict. Compared to youth who do not intentionally omit insulin, those who do omit insulin were more likely to have clinically elevated levels of depression (p’s &amp;lt; .05). No differences for parent-reported psychosocial outcomes were found. Conclusions: Results reveal that youth who intentionally omit insulin for weight purposes are at risk for poorer psychosocial outcomes, especially depression. Additional research is needed to understand the causal direction of these associations, and to examine the potential role of disordered eating behavior. Results also highlight how psychosocial screening during routine diabetes visits can identify youth and caregivers in need of behavioral health interventions. Disclosure J.L. Papadakis: None. L.M. Anderson: None. A.T. Vesco: None. M.A. Evans: None. J. Weissberg-Benchell: Consultant; Self; Roche Diabetes Care.

Personality & mental health of Greek cosplayers, in relation to postgraduate “mental health” students

ABSTRACTAim of this cross-sectional study is to evaluate personality features and psychiatric symptomatology of the Greek cosplayers, in comparison to a control group of new mental health postgraduate students (NMHPS) at the Technological Educational Institute of Thessaly. Relative literature on cosplayers worldwide is almost non-existent. The psychometric tools used were the HDHQ (Hostility and Direction of Hostility Questionnaire) and the SCL-90-R (Symptoms Check List-90-Revised), on 49 Greek cosplayers and 37 NMHPS. The HDHQ estimates quantity, structure, and direction of hostile mood, which reveals personality characteristics and dimensions. The SCL-90-R detects nine different psychopathological states: somatization, obsessivity-compulsivity, interpersonal sensitivity, depression, anxiety, anger/aggression, phobic anxiety, paranoid ideation, psychotic symptoms. Other data investigated were participants’ demographics and cosplay practice. The statistical analysis was descriptive and inductive; parametric and non-parametric. Greek cosplayers exhibited higher levels of all hostility forms; mainly extroverted, self-criticism & other-criticism, and psychopathological conditions; mainly depression & obsessivity-compulsivity, than the NMHPS. Demographics that increased some form of hostility or psychopathological symptom for the cosplayers were female gender, lower level education, cosplaying >10 characters, while, respectively, marital status and health-care profession for the NMHPS. Greek cosplayers experience significantly more pronounced psychopathological symptoms than the control group. Cosplay probably enhances their sociability and interpersonal relationships development, whose type gets influenced by their personality, alike the degree of chosen cosplay character adoption while in costume. Interest to study mental health, might benefit it. Cosplayers may display dysmorphophobic traits and similarities to people disliking their identity; elevated levels of depression, hostility and self/other-criticism.

Effects of Web-Based Parent Training on Caregiver Functioning Following Pediatric Traumatic Brain Injury: A Randomized Control Trial.

To examine the effects of a Web-based parenting intervention (I-InTERACT), and an abbreviated version (Express), on caregiver depression, psychological distress, parenting stress, and parenting efficacy following pediatric traumatic brain injury (TBI). Four children's hospitals and 1 general hospital in the United States. 148 caregivers of 113 children aged 3 to 9 years with a moderate to severe TBI. Multicenter randomized controlled trial. Participants were randomly assigned to I-InTERACT, Express, or an active control condition. Caregiver data were collected at baseline and postintervention (6 months later). I-InTERACT (10-14 sessions) and Express (7 sessions) combine live coaching of parenting skills and positive parenting strategies. Center for Epidemiologic Studies Depression Scale (CES-D); Global Severity Index of the Symptom Checklist-90-R (GSI), Parenting Stress Index (PSI), and Caregiver Self-Efficacy Scale (CSES). Analyses revealed no main effects of treatment on caregiver distress (GSI), parenting stress (PSI), or parenting efficacy (CSES). However, analyses examining baseline severity as a moderator found that caregivers with elevated levels of depression in I-InTERACT experienced significantly greater reductions in CES-D scores compared with caregivers in the active control condition. I-InTERACT reduced caregiver depression but no other facets of caregiver psychological functioning. Modifications to the treatment content may be necessary to reduce parenting stress and improve caregiver efficacy.

Why dysfunctional expectations in depression persist - Results from two experimental studies investigating cognitive immunization.

Research has revealed that negative expectations impact depressive symptoms. However, research on the change of dysfunctional expectations in depression is lacking so far. Therefore, the present research aimed to fill this gap by testing the hypothesis that people with the major depressive disorder (MDD), contrary to healthy individuals, maintain their expectations despite experiences that positively disconfirm expectations. Further, it was hypothesized that cognitive immunization (a cognitive reappraisal of the disconfirming evidence) is a mechanism underlying the persistence of expectations. In Study 1, we compared individuals with MDD (N = 58) to healthy individuals (N = 59). Participants worked on the same performance test and received standardized feedback that either confirmed or disconfirmed their initial performance expectations. In Study 2, we investigated the effects of cognitive immunization on expectation change among 59 individuals reporting elevated levels of depression by varying the appraisal of expectation-disconfirming feedback. Results from Study 1 show that in the expectation-disconfirming condition, healthy individuals changed their expectations, whereas individuals with MDD did not. No such difference between the two groups was found for expectation-confirming feedback. Results from Study 2 indicated that varying cognitive immunization impacted expectation change, thus suggesting a crucial role of cognitive immunization in expectation change. These two studies indicated that individuals suffering from depression have more difficulties in changing their expectations after disconfirming experiences than do healthy individuals, and cognitive immunization might be a core mechanism underlying expectation persistence. Therefore, psychotherapeutic interventions should aim to inhibit cognitive immunization processes to enhance expectation change.

Resting-state connectivity and spontaneous activity of ventromedial prefrontal cortex predict depressive symptomology and peripheral inflammation in HIV.

Depression and chronic inflammation are common in persons infected with the human immunodeficiency virus (HIV+). Although depression and response to inflammatory challenge are shown to reflect activity in common neural networks, little is known regarding sub-clinical presentation in persons chronically infected with HIV. The relationship of resting-state functional connectivity (rsFC) between the subgenual anterior cingulate cortex (sgACC) and bilateral amygdala to Beck Depression Inventory-1 (BDI) scores were compared within a group of 23 HIV+ and 23 HIV-negative comparison adults. An interaction was found wherein lower rsFC between the sgACC and both right and left amygdala was associated with higher BDI scores in HIV+ individuals. Total BDI scores and plasma levels of IL-6, IL-8, TNF-α, and IL-10 made available from 10 of the HIV+ patients were regressed upon an index of spontaneous whole-brain activity at rest; i.e., the amplitude of low-frequency fluctuations (ALFFs). Elevated levels of depression and IL-6 were associated with increased ALFF in a cluster of voxels on the medial portion of the ventral surface of the frontal lobe (Brodmann Area 11). Within this sampleof HIV+ individuals lowerrsFC of the sgACC with subcortical limbic regions predictsgreater burden of depressive symptomology whereaselevated activity in the adjacent BA 11 may reflect sickness, indexed by elevated IL-6,and associated depressive behaviors.

Home-Based Physical Activity Program Improves Depression and Anxiety in Older Adults.

Late-life depression and anxiety among older adults is an important public health concern. This study examined the effect of a DVD-delivered exercise intervention on the secondary outcomes of depression and anxiety in older adults and the extent to which physical self-worth mediated the relationship between leisure-time physical activity and depression and anxiety. Older adults (N = 307) were randomized to a 6-month flexibility, toning, and balance DVD (FlexToBa™, FTB) or healthy aging DVD control. Self-reported physical activity and questionnaires were administered at baseline and postintervention. Statistical analyses were conducted in the total sample and in a subsample of participants with elevated levels of depression or anxiety. FTB participants with elevated depression and anxiety symptoms at baseline had significantly greater reductions in depression and anxiety (d = 1.66 and 2.90) than the control condition (d = 0.77 and 0.73). The effect of physical activity on depression and anxiety was partially mediated by increases in physical self-worth in the total sample but not in those with elevated depression or anxiety. A home-based physical activity intervention may be a viable treatment for reducing depression and anxiety in older adults with elevated baseline scores.

Database Analysis of Depression and Anxiety in a Community Sample-Response to a Micronutrient Intervention.

Background: Depression and anxiety are common mental health concerns worldwide. Broad-spectrum multi-vitamin/mineral approaches have been found to alleviate a number of psychiatric symptoms. We investigated the effects of a nutrient intervention program, which includes optimizing vitamin D levels, on depression and anxiety outcomes from community-based program. Methods: We evaluated self-reported health measures of depression and anxiety collected as part of a community-based program focused on optimizing overall health through nutritional supplementation, education and lifestyle advice. Results: Data were collected from 16,020 participants, with measures including European Quality of Life Five Dimensions (EQ-5D) and Targeted Symptoms List (TSL) providing self-reported depression and anxiety. More than 56% of participants were identified as having elevated levels of depression and anxiety at baseline as reported on the EQ-5D. After one year in the program, 49.2% (n = 7878) of participants who reported any level of depression or anxiety at baseline reported improvement at follow-up. Of those who reported severe/extreme depression at baseline (n = 829), 97.2% reported improvement after one year. Regression analyses revealed a significant association of improvement in depression and anxiety with higher vitamin D status (>100 nmol/L) and more strenuous physical activity. Conclusion: Overall, people from the general population who suffer from mood and anxiety problems may benefit from improved nutritional status achieved with nutritional supplements.

A comparative study of the psychological problems of HIV-infected and HIV-uninfected children in a South African sample

ABSTRACTAccording to research children living with HIV experience elevated levels of depression, anxiety, ADHD and disruptive behavioural disorders. Although South Africa’s paediatric population that is infected with the human immunodeficiency virus (HIV) is the largest worldwide, little research has been conducted on their mental health challenges. However, attributing high levels of mental health problems solely to their HIV status can be problematic as there may be other contributory factors. This research explored the mental health problems of HIV-infected children and compared these to the mental health problems of their HIV-unaffected peers from similar backgrounds. Data was gathered from two samples of child and caregiver pairs. HIV-infected children (aged 6–12 years) and their caregivers/mothers (n = 54) were recruited from the Kalafong paediatric clinic where they received medical treatment and routine ART. A comparison group of 113 HIV-uninfected children and their uninfected mothers were recruited from primary care clinics in the same community. Caregivers completed the Child Behaviour Checklist (CBCL) to assess children’s mental health. Children completed the Self-Description Questionnaire (SDQ-I) and the Revised Children’s Manifest Anxiety Scale (RCMAS). The scores of the psychometric sub-scales of the two groups were compared using parametric and non-parametric statistics. HIV-infected children experienced more somatic and affective problems, physiological anxiety, less ADHD and lower self-esteem than HIV-uninfected children in the comparison group, while controlling for age differences. The high levels of mental health problems of both groups of children may be attributed to similar difficult socio-economic circumstances. The fact that most infected children were not aware of their HIV-status could have influenced the results. Mental health services should not be limited to HIV-infected children but should form part of all health care services.

Anxiety and Depression: A Cross-sectional Survey among Parents of Children with Cancer.

Context:Parents of children with cancer are experiencing high levels of psychological distress. Elevated levels of depression and anxiety following the disclosure of diagnosis affect many aspects of parents’ health.Aims:The aim of this study was to assess anxiety and depression of parents of Iranian children with cancer.Settings and Design:This descriptive-correlational study was undertaken among 148 parents of children with cancer admitted to a pediatric hospital affiliated to Tabriz University of Medical Sciences, Tabriz/Iran.Subjects and Methods:Participants were selected using convenience sampling method. Hospital Anxiety and Depression Scale was used to evaluate patients’ levels of anxiety and depression.Statistical Analysis Used:The data were analyzed using SPSS version 13.0.Results:The study findings showed that the mean anxiety and depression scores were 9.63 ± 3.69 and 8.66 ± 4.59 (range score: 0–21), respectively. Additionally, 41.2% (n = 61) and 32.4% (n = 48) of participants had clinical symptoms of anxiety and depression, respectively.Conclusions:Parents of children with cancer experienced high levels of anxiety and depression. Effective interventions are essential to improve the mental health of parents of children with cancer. These interventions may include mental health screening, psychological counseling, and training programs to cope with the problems caused by the child's disease.

The mediating effect of family cohesion in reducing patient symptoms and family distress in a culturally informed family therapy for schizophrenia: A parallel-process latent-growth model.

Although both patients with schizophrenia and their caregivers report elevated levels of depression, anxiety, and stress (DASS), affective symptoms in patients and family members seldom constitute a primary treatment focus. The present study tested whether a culturally informed family therapy for schizophrenia (CIT-S) outperformed standard family psychoeducation (PSY-ED) not only in decreasing patient schizophrenia symptoms, but also in decreasing individual DASS. Because CIT-S fostered family cohesion throughout treatment, we predicted that increases in family cohesion would mediate treatment effects. Participants included 266 patients and family members nested within 115 families, randomized to the CIT-S or PSY-ED conditions. We specified a series of multilevel latent growth and latent change models to examine direct effects of CIT-S on patient schizophrenia symptoms, individual DASS, and family cohesion over time. Next, we used parallel-process growth models to test the indirect effect of CIT-S on decreasing patient and caregiver psychopathology over time via changes in family cohesion. The CIT-S treatment significantly reduced patient schizophrenia symptoms from baseline to follow-up (γ = -1.72, 95% confidence interval [CI] [-2.83, -0.60]), as well as individual DASS (γ = -4.39, 95% CI [-6.44, -2.34]) from baseline to termination. In line with treatment goals, CIT-S increased family cohesion from baseline to midpoint (γ = 0.93, 95% CI [0.06, 1.80]). The CIT-S-related change in cohesion mediated changes in DASS (γ = -0.87, 95% CI [-1.47, -0.27]), but not patient symptoms. By integrating the family's cultural context into treatment, clinicians may foster family dynamics that enhance treatment outcomes and promote broad improvements in mental health. (PsycINFO Database Record

”I Don’t Believe in Leading a Life of My Own, I Lead His Life”: A Qualitative Investigation of Difficulties Experienced by Informal Caregivers of Stroke Survivors Experiencing Depressive and Anxious Symptoms

ABSTRACTObjectives: Health and social care services are increasingly reliant on informal caregivers to provide long-term support to stroke survivors. However, caregiving is associated with elevated levels of depression and anxiety in the caregiver that may also negatively impact stroke survivor recovery. This qualitative study aims to understand the specific difficulties experienced by caregivers experiencing elevated symptoms of anxiety and depression.Methods: Nineteen semi-structured interviews were conducted with caregivers experiencing elevated levels of depression and anxiety, with a thematic analysis approach adopted for analysis. Results: Analysis revealed three main themes: Difficulties adapting to the caring role; Uncertainty; and Lack of support.Conclusions: Caregivers experienced significant difficulties adapting to changes and losses associated with becoming a caregiver, such as giving up roles and goals of importance and value. Such difficulties persisted into the long-term and were coupled with feelings of hopelessness and worry. Difficulties were further exacerbated by social isolation, lack of information and poor long-term health and social care support.Clinical Implications: A greater understanding of difficulties experienced by depressed and anxious caregivers may inform the development of psychological support targeting difficulties unique to the caring role. Improving caregiver mental health may also result in health benefits for stroke survivors themselves.