GAD-7 Scale Research Articles

Investigating the prevalence and associated factors of depression, anxiety, and loneliness among people with type-2 diabetes in Bangladesh: a community-based study

Diabetes mellitus is a major worldwide health concern. Diabetes has been associated with a number of adverse mental health conditions including depression, anxiety, and loneliness that can negatively impact diabetes outcomes. This study aimed to investigate factors associated with depression, anxiety, and loneliness in people, in the community, suffering with diabetes in Bangladesh. A cross-sectional study was conducted with 600 people with type-2 diabetes (54.83% females; mean age: 52.70 ± 11.56 years) between July and September 2022. Purposive sampling method was used to recruit the participants. A validated semi-structured questionnaire was used to collect demographic and other data. Depression, anxiety, and loneliness were measured using the PHQ-9, GAD-7, and UCLA Loneliness scale, respectively. Bivariate and multivariable linear regression analyses were conducted to ascertain factors that were significantly associated with these mental health conditions. The prevalence of depression, anxiety, and loneliness was 31.17%, 21.83%, and 28.00%, respectively. A lack of formal education, and not taking part in physical activities were significantly associated with all three mental health states. Duration of diabetes and being on medication for high cholesterol were also associated with depression and anxiety. Older age and being widowed were significantly associated with loneliness. This study found that depression, anxiety, and loneliness are prevalent among Bangladeshi people with diabetes, with certain sociodemographic and diabetes-related factors associated with increased risk. The findings emphasize the need for targeted interventions to people within the communities, at grassroot levels in order to improve reduce health inequality, and improve the mental health of people living with diabetes.

Urbanization, loneliness and mental health model - A cross-sectional network analysis with a representative sample

With increasing urbanization, more people are exposed to mental health risk factors stemming from the urban social or physical environment. However, research on the relationship between urbanization and mental health is lacking. This cross-sectional study aimed to explore the relationships of the physical environment (spatial cohesion and urban environment) and social factors (neighborhood cohesion) with mental health (stress, anxiety and depression symptoms) and physical health and the mediating role of loneliness based on the proposed theoretical model. The study was conducted in Metropolis GZM (Silesia, Poland) in a representative sample of 3296 residents (48% women). The measurements used were the PSS-10, GAD-7, PHQ-9, R-UCLA3 and neighborhood cohesion scale. ANOVA results showed that city residents had better mental health indices than residents of villages and small towns. The network approach revealed that urbanization was one of the most influential nodes and played the role of a bridge between all other nodes. The model was confirmed and showed that the relationships between the physical environment and mental health were consecutively mediated by neighborhood cohesion and loneliness. Spatial cohesion related to factors of the physical environment and physical health, while physical health was directly connected to sociodemographic factors and weakly to stress. Anxiety was the strongest risk factor. Mental health can be improved by social and architectural factors, such as strengthening neighborhood cohesion and improving neglected buildings.

Psychological problems among elementary and high school educators in Canada: association with sick days in the prior school year.

Increased sick leave among educators can detrimentally impact students' productivity, and academic achievement. It remains unknown whether the number of sick days taken by educators in the preceding school year correlates with the prevalence or severity of psychological problems among educators in the subsequent school year. This study aimed to examine the number of self-reported sick days taken by educators in three Canadian provinces during the 2021/2022 academic year and its association with measures of stress, burnout, low resilience, depression, and anxiety during the 2022/2023 school year. Data was collected from educators in three Canadian provinces, Alberta, Nova Scotia, and Newfoundland and Labrador, from September 1, 2022, to August 30, 2023. The Maslach Burnout Inventory-Educator Survey (MBI-ES), the Brief Resilience Scale (BRS), and the Perceived Stress Scale were used to assess burnout, resilience, and stress, respectively. Likely Generalized Anxiety Disorder (GAD) and likely Major Depressive Disorder (MDD) were assessed using the Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 scales, respectively. Statistical analysis was conducted using SPSS version 28. A total of 763 subscribers completed all the demographic, professional questions, and clinical scales, giving a response rate of 39.91%. Of these, there were 94 (12.3%) males and 669 (87.7%) females. Educators who reported taking 11 or more sick days in the previous academic year were at least three times more likely to exhibit high stress, emotional exhaustion, likely GAD, low resilience, and likely MDD than educators with no sick days during the preceding year. Similarly, educators with 11 or more sick days had significantly higher mean scores on the GAD-7 scale, the PHQ-9 scale, the PSS-10, the MBI Emotional Exhaustion subscale, and the MBI Depersonalization subscale than those with zero sick days. This study demonstrates a significant association between sick days and the prevalence and severity of high stress, low resilience, burnout, anxiety, and depression among educators. Short-term sick leave can escalate into long-term absences without adequate support for teachers. Governments and policymakers in the education sector must foster a supportive environment that enables teachers to thrive and effectively perform their professional role without taking prolonged sick days, which can undermine student learning and achievement.

Reliability and validity of facial expression recognition in the screening of generalized anxiety disorder

IntroductionAnxiety disorder is one of the most prevalent mental disorders in China. However, there are obvious subjective factors in the current assessment of anxiety disorders, which may lead to certain diagnostic errors. The identification and diagnosis of anxiety disorders can be further improved if objective biological indicators are added in the assessment process. The current research validates facial expression recognition as a screening tool to assist in detecting generalized anxiety disorder. MethodsBased on the International Affective Picture System, we constructed an aided diagnostic experimental paradigm and recorded their facial expression. The split-half reliability was displayed by the Pearson correlation heatmap. The paradigm, GAD-7 and HAMA scales were administered to 60 generalized anxiety disorder patients and 60 matched healthy controls to evaluate the criterion-related validity. Additionally, we conducted a diagnostic study by using MINI as a gold standard and calculated ROC analysis to examine the screening performance of the facial expressions. ResultsThe heatmap showed very high correlations (r > 0.60, PS < 0.05) along the diagonal of the square heatmap (from the bottom left corner to the top right). The Pearson correlation coefficients between the GAD-7, HAMA and seven facial expressions ranged from −0.35(neutral, P < 0.01) to 0.34(angry, P < 0.01). The intergroup effects of neutral, anger and fear emotions were statistically significant (F = 18.893, P < 0.001; F = 20.535, P < 0.001; F = 9.091, P = 0.003). ROC analysis showed AUC for neutral, angry and scared facial expressions were 0.723, 0.792 and 0.727 respectively. ConclusionThis study constructed a tool for auxiliary screening of GAD patients and provided an objective automatic facial expression recognition method to assist psychological diagnosis.

Quantifying Psychological Distress: Prevalence of Anxiety and Depression of 136 Participants using GAD-7 and PHQ-9 Scales

Quantifying Psychological Distress: Prevalence of Anxiety and Depression of 136 Participants using GAD-7 and PHQ-9 Scales

A comparison of the mental health impacts and resilience of healthcare workers in rural Manitoba during the COVID-19 pandemic

Drawing on resilience research in rural studies, this study examined the mental health experiences of frontline healthcare workers during two stages of the COVID-19 pandemic in rural Manitoba, Canada. Data were collected using online surveys from May to June 2020 (n = 137) and from May to June 2021 (n = 219). The surveys assessed symptoms of anxiety and identified strategies and barriers to addressing mental health concerns. Most respondents exhibited clinical symptoms of anxiety as measured by the GAD-7 scale. Respondents mostly accessed informal supports, such as family and friends, in the first survey in 2020, and a broader mix of informal and formal supports in the 2021 survey. In both surveys, numerous barriers to accessing formal mental health support were identified. Our findings suggest that although some degree of resilience in the face of the pandemic was prevalent in rural areas, there is a need for accessible professional and peer mental health support for frontline healthcare workers. The research also highlights the importance of context and resources in sustaining the healthcare workforce in rural areas as part of the pandemic response.

Association between personality type and patient-reported outcomes (PRO) in patients with atrial fibrillation

BackgroundAtrial Fibrillation (AF) is known to be associated with a negative emotional state. Patient-reported outcomes (PROs) are important tools for evaluating the endpoints of AF management. This study aims to examine the correlation between personality types and PROs in patients with AF.MethodsAll included subjects were newly diagnosed with AF fewer than one month, and their personality types were assessed using the Eysenck Personality Questionnaire (EPQ). Quality of life (QoL) was measured using the Atrial Fibrillation Effect on Quality of Life (AFEQT) questionnaire. Anxiety and depression were assessed using the General Anxiety Scale (GAD-7) and the 9-item Patient Health Questionnaire (PHQ-9), respectively. We constructed stepwise linear regression analyses for factors related to the QoL and emotional state in patients with AF.ResultsA total of 531 AF patients completed the survey and were categorized into four groups based on their personality types. Of these patients (mean age: 67.12 ± 10.93 years, 50.28% male), 357 (67.23%) had paroxysmal AF, and 16.95% (n = 90) had a sanguine personality. Compared to patients with other personality types, those with a sanguine personality had the highest average AFEQT scores (P < 0.001) and the lowest scores of GAD-7 and PHQ-9 scales (P < 0.05). Furthermore, multiple linear regression analyses suggested that sanguine personality was also independently associated with better QoL and emotional states (P < 0.05).ConclusionThere is a significant association between the personality types and PROs in AF patients.

Relationship Between Postpartum Care Practices and Mental Health Outcomes: Understanding the Impact on Maternal Well-Being

Introduction: Postpartum depression (PPD) is a major mental health condition affecting mothers during the first year postpartum, often beginning within the initial six weeks. The purpose of the study was to assess the relationship between postpartum care practices and their effects on maternal mental health outcomes. Aim of the study: The aim of the study was to evaluate the relationship between postpartum care practices and their effects on maternal mental health outcomes. Methods: This prospective observational study included 130 postpartum women aged 18-45, recruited from the outpatient and inpatient departments of BSMMU and Dhaka Medical College, Dhaka, from July 2020 to June 2021. Women were eligible if they were within six months postpartum and provided informed consent. Data were collected through face-to-face interviews using structured questionnaires, including the EPDS and GAD-7 scales. Analysis was performed using SPSS software version 22.0. Result: The majority of patients, 83 (63.85%), are in the ≥30 age group, have completed primary school, 92 (70.77%), and are Muslim, 104 (80.00%). For pre-pregnancy BMI, 58 (44.62%) of patients had a normal BMI. Parental support was available to 111 (85.38%) of patients. Regarding mental health outcomes, 74 (56.92%) of patients scored within the normal range on the Edinburgh Postnatal Depression Scale (EPDS). Conclusion: The study concludes that comprehensive postpartum support systems are crucial for reducing maternal depression and anxiety, highlighting the need for targeted interventions and systematic screening in postpartum care to improve mental health outcomes.

A Mixed Methods Exploration of Young Women's Agency and Mental Health during COVID-19 in Low-Income Communities in Mumbai, India.

Adolescent girls and young women (AGYW) in India face additional health inequities compared to their male peers, as gender norms constrain agency for prevention and self-care. The onset of the COVID-19 pandemic and associated lockdowns deepened health inequities and often worsened mental health, but the impacts on agency are unclear. This exploratory sequential mixed methods paper examined mental health and COVID-19 elements that exacerbated or mitigated adverse consequences for AGYW in low-income communities in Mumbai. We conducted semi-structured interviews with AGYW (aged 15-25 years; N = 60) and adults (parents, healthcare providers, community-based organization representative; N = 30). We administered a structured survey to AGYW (N = 150) to assess health concerns, depression and anxiety symptoms (using the PHQ-8 and GAD-7 scales), and experiences during COVID-19. We analyzed qualitative data using the constant comparative approach in Atlas.ti, and quantitative data using R and SPSS. Qualitative data revealed that AGYW faced stressors and had limited agency during lockdowns due to limited access to education, financial insecurity, and community violence. Quantitative data indicated that limited agency in the context of COVID-19 was significantly associated with depression and anxiety. Financial resources to address COVID-19 created new employment and leadership opportunities for AGYW to become COVID educators and preschool teachers; participation in these opportunities was associated with less anxiety. Pandemic stress was difficult for low-income AGYW in Mumbai. Mitigating programs for COVID-19 control helped address acute needs and enable capabilities. Exploring similar themes among a broader population of youth can help design strategies and opportunities for young people in low-income communities during health emergencies.

Having any mental health condition before the COVID-19 pandemic as a risk factor of COVID-19 contagion during the first year of pandemic: A Spanish adult cohort.

Numerous studies suggest that subjects suffering from a mental health condition before the COVID-19 pandemic were at higher risk of contagion, but mostly are cross-sectional or retrospective. The BIOVAL-D-COVID-19 is a longitudinal cohort study design with 922 subjects who full filled two evaluations from an online survey of Spanish residents before and during the pandemic. Mental health conditions assessed were: Major Depressive Episode (MDE), Generalised Anxiety Disorder (GAD), Suicidal Thoughts and Behaviours (STB) and subthreshold of panic and bipolar disorder (BD). Mental health screening instruments used were: the Spanish version of the Composite International Diagnostic Interview (CIDI) version 3.0 for the evaluation of MDE, the GAD-7 scale to evaluate GAD; STB was evaluated with four items from the CIDI questionnaire. Panic Disorder and BD were screened from a modified and self-reported version of the CIDI. A bivariate plus five logistic regression models were developed for each mental health condition adjusted by socio-demographic variables; employment status; general and physical health; comorbidity; and including all previous variables and the other mental health conditions. We found in bivariate model that MDE; GAD and STB were statistically significant risk factors of contagion of COVID-19. The logistic regression models developed reveal that having a previous GAD (aOR 3.30 1.31-8.31) or STB (aOR 2.16 CI 95% 1.01-4.62) was statistically significant associated with COVID-19 contagion, independently of all variables included. MDE was not a risk factor of contagion when it was adjusted by comorbidity (aOR 0.99 CI 95% 0.47-2.09). It is recommended to detect those subjects with previous GAD or STB as vulnerable groups of infection to reduce contagion rates.

Altered serum interleukin-17A and interleukin-23A levels may be associated with the pathophysiology and development of generalized anxiety disorder

In recent times, the pathogenesis of generalized anxiety disorder (GAD) and the influence of pro- and anti-inflammatory cytokines on it have garnered considerable interest. Cytokine research, especially Th-17 cytokine research on GAD patients, is limited. Here, we aim to assess the role of interleukin-17A (IL-17A) and interleukin-23A (IL-23A) in the pathophysiology and development of GAD. This investigation included 50 GAD patients and 38 age-sex-matched healthy controls (HCs). A psychiatrist diagnosed patients with GAD and assessed symptom severity using the DSM-5 and the GAD-7 scales. The serum concentrations of IL-17A and IL-23A were determined using commercially available ELISA kits. GAD patients exhibited elevated levels of IL-17A (77.14 ± 58.30 pg/ml) and IL-23A (644.90 ± 296.70 pg/ml) compared to HCs (43.50 ± 25.54 pg/ml and 334.40 ± 176.0 pg/ml). We observed a positive correlation between disease severity and cytokine changes (IL-23A: r = 0.359, p = 0.039; IL-17A: r = 0.397, p = 0.032). These findings indicate that IL-17A and IL-23A may be associated with the pathophysiology of GAD. ROC analysis revealed moderately higher AUC values (IL-23A: 0.824 and IL-17A: 0.710), demonstrating their potential to discriminate between patients and HCs. Also, the sensitivity values of both cytokines were relatively higher (IL-23A: 80.49% and IL-17A: 77.27%). According to the present findings, there may be an association between peripheral serum levels of IL-17A and IL-23A and the pathophysiology and development of GAD. These altered serum IL-17A and IL-23A levels may play a role in directing the early risk of developing GAD. We recommend further research to ascertain their exact role in the pathophysiology and their performance as risk assessment markers of GAD.

Analysis of Parental Stress and Anxiety Symptoms during COVID-19 Pandemic in Khulna City

Abstract Introduction: The COVID-19 pandemic tremendously increases mental health risk among parents due to extreme anxiety and stress. This study focuses on examining the variables related to parental stress and anxiety amid the COVID-19 epidemic. Methods: A cross-sectional survey was conducted among 118 parents in three wards (18, 27, and 28) of Khulna city, Bangladesh. Parental stress and anxiety during the COVID-19 pandemic were measured using the GAD-7 and PSS-10 scales. Socioeconomic and demographic data were also collected from households. The association between stress and anxiety and their contributing factors was analyzed using the Chi-square test and binary logistic regression. Results: The results showed that 27.5% of parents aged over 40 years and 35.6% of those who faced unemployment during COVID-19 experienced severe stress and anxiety. The regression analysis results confirmed this result. Furthermore, educational status, type of family, marital status, and total household income were found to be significant factors affecting parental stress and anxiety symptoms. The study demonstrated a significant impact of COVID-19 on elderly parents. Conclusions: These findings suggest that COVID-19 has significantly impacted elderly parents. Therefore, the study highlights an urgent need for mental health support to assist this vulnerable group in urban areas of Bangladesh.

The Influence of Perinatal Psychological Changes on Infant Neurodevelopment in Shanghai, China: A Longitudinal Group-based Trajectory Analysis

ObjectiveThis prospective cohort study, conducted at the Fenglin Community Health Service Center (FCHC) in Xuhui District, Shanghai, aimed to investigate the impact of maternal psychological status on offspring neurodevelopment. MethodsA total of 430 mother-child pairs were included, with pregnant women enrolled between February 18, 2020, and April 19, 2021. Face-to-face interviews and electronic data collection on demographic characteristics, health conditions and medical history were employed at various stages of pregnancy and postpartum. Maternal depression and anxiety were assessed using the PHQ-9 and GAD-7 scales, while offspring neurodevelopment was measured at six months using the Ages and Stages Questionnaire 3rd Edition (ASQ-3). In statistical analyses, group-based trajectory modeling (GBTM) was employed to identify the latent groups for maternal psychological trajectories, including depression and anxiety, and logistic regression was used to explore associations between maternal psychological trajectories and offspring neurodevelopment, adjusting for potential confounders. ResultsFive latent trajectory groups were identified for both depression and anxiety, exhibiting distinct patterns over time. Results indicated that maternal psychological trajectories were associated with various domains of offspring neurodevelopment, including communication, problem-solving, personal-social, and gross motor skills. Specifically, mothers in trajectory groups characterized by the highest level of depression or anxiety showed increased odds of offspring neurodevelopmental delays compared to reference groups. ConclusionOur findings underscore the importance of maternal mental health during the perinatal period and highlight the potential implications for offspring neurodevelopment. Further research is warranted to elucidate underlying mechanisms and inform targeted interventions to support maternal mental well-being and optimize offspring outcomes.

Effects of Questionnaire-Based Psychological Survey Methods on the Evaluation Results in a Patient Cohort

Objective To assess the influences of self-and interviewer-administered methods on the scores of anxiety and depression questionnaires among the patients with sports injuries.Methods A total of 532 participants with sports injuries treated in the Sports Medicine Center of West China Hospital,Sichuan University from November 2022 to May 2023 were included.They were randomly assigned to either the interviewer-administered group (n=270) or the self-administered group (n=262) to complete the generalized anxiety disorder (GAD-7) and the patient health questionnaire (PHQ-9) scales.The total scores and prevalence rates of anxiety and depression were compared between the two groups.Results There was no statistically significant difference in gender,occupation,or surgical site between the two groups (all P>0.05).The self-administered group had higher scores of GAD-7 and PHQ-9 scales than the interviewer-administered group (P<0.001,P<0.001).A greater proportion of participants in the self-administered group than in the interview-administered group met the criteria for mild to moderate anxiety and depression (P<0.001,P=0.002).The prevalence rates of moderate to severe anxiety (GAD-7≥10) and depression (PHQ-9≥10) showed no statistically significant difference between the two groups (P=0.761,P=0.086).Conclusion This study demonstrates that the participants in the self-administered group are more likely to report mild to moderate symptoms of anxiety and depression than those in the interviewer-administered group.

Comparison of death anxiety symptoms between generalized anxiety disorder and somatization disorder in geriatric patients attending a psychiatric outpatient clinic for the first time

Somatic complaints are among the important complaints frequently seen in Generalized Anxiety Disorder (GAD) and Somatic Symptom Disorder (SSD). Death anxiety has also increased significantly with the Covid-19 pandemic, especially in the elderly population. In this study, we compared the difference of the death anxiety level among patients with GAD, SSD and healthy controls.This cross-sectional study which was carried out in Artvin State Hospital's Psychiatric Outpatient Clinic included 59 participants (GAD = 21, SSD = 18, HC = 20). Three groups were subjected to detailed psychiatric examination by the same psychiatrist. Subsequently, anxiety, somatic symptoms and death anxiety were assessed using standardized tools (GAD-7, Templer Death Anxiety Scale, Somatic Symptom Scale).The GAD-7 Scale mean of the GAD group was significantly higher than SSD (p = 0.001) and Healthy Control (HC) (p = 0.001) groups. Death anxiety and Somatic Symptom levels in GAD and SSD groups were significantly higher than in healthy controls. (GAD, p = 0.001; SSD, p = 0.001) with no significant difference between GAD and SSD groups (p = 1). Healthy controls exhibited significantly lower scores in the three scales mean scores compared to the SSD and GAD groups (p = 0.001).Irrespective of specific psychiatric diagnoses, these findings highlight elevated death anxiety in the elderly, underscoring the need for tailored mental health interventions.

The Psychosocial Considerations for Behaviour Change, Mental Health, and Work-Related Satisfaction in Preregistration Nurses, during Coronavirus Pandemic

The mental health of healthcare workers was affected by physical and psychological challenges during the pandemic. The aim was to study how psychosocial considerations can help manage behaviour change, mental health, and work satisfaction of nurse trainees in the UK during the COVID-19 pandemic in 2021. This cross-sectional study involved ninety-nine students. Participants’ anxiety, fear of the coronavirus, and perceived work satisfaction were measured by GAD-7, FCV19S, and COM-B scales and assessed using descriptive, correlational, and linear regression analysis. The significant zero-order correlations between job satisfaction and fear, anxiety, and psychosocial considerations were significant. They indicated moderate strength that allowed for further inferential development to find the best predictors of job satisfaction. The findings suggested that 50% of trainees showed anxiety above the suggested ≥8 cut-off on GAD-7, and 48% scored high for fear on FCV19S. There was a significant effect between year groups (F (2, 99) = 4.25, p=0.02, η2 = 0.081), with a Tukey post hoc test showing a significant difference between training years 1 and 2 with a p=0.015. A significant linear regression found that psychosocial variables in behaviour change (p≤0.001) and anxiety (p=0.011) were significant factors in job satisfaction, explaining 53.4% of the variance. Conclusion. Satisfaction was associated with higher levels of psychosocial considerations and low levels of anxiety and fear, which adds to previous literature on job satisfaction in nurse education. Future implications must examine ways to alleviate mental health effects and support policies and curricula to address this need.

Stress and Anxiety Levels of International Nursing Students: Case of Northern Cyprus

Introduction: Stress is a multifaceted concept that focuses on changes in the interaction between people and their environment. Stress, which is increasing in developing and rich countries, is one of the biggest problems affcting the health sector, especially universities, and especially nursing practices. Aim: This study aimed to determine the stress and anxiety levels of undergraduate nursing students. Method: This descriptive study was conducted on 223 international nursing students studying at Near East University to determine the stress and anxiety levels of nursing students. Data were collected through online Google Forms using the Generalized Anxiety Disorder - 7 Scale, Perceived Stress Scale and Sociodemographic questionnaire in December 2022 and January 2023. Results: Of the students participating in this study, 182 (81.6%) were female and 41 (18.4%) were male. Students' average Perceived Stress Scale score was 22.00 ± 8.52; Generalized Anxiety Disorder -7 Scale mean score were found to be 7.43 ± 6.43. Perceived Stress Scale average scores vary depending on students' grade point averages and alcohol/substance use while under stress. Generalized Anxiety Disorder - 7 Scale mean scores vary depending on alcohol/ substance use while under stress (p &amp;lt; 0.05). Conclusion: Educational programs should be organized to enable students to cope more effctively with the stressors they encounter. On the other hand, it is recommended to create learning environments that will help alleviate the stress and anxiety that students encounter during the education process.

The role of income inequality as an ecological determinant of mental health: A nation-wide multilevel analysis on an Italian sample.

Income inequality, a pivotal determinant of general and mental health, operates through intricate mechanisms at various geographical scales. While established at country or region levels, the impact of lower-level (municipal or neighborhood) inequality remains inconsistent. This study explores the influence of regional- and municipal-level income inequality on individual psychological distress during the COVID-19 pandemic in Italy, employing a multilevel data analysis. In a post hoc analysis of data from the first wave of the pandemic (March to April 2020), three hierarchical levels were considered: individual participants, municipalities, and regions. Depressive and anxiety symptoms were measured using the PHQ-9 and GAD-7 scales, while the Gini coefficient gauged income inequality at municipal and regional levels. The analysis incorporated demographic variables as potential confounders. The study encompassed 21 regions, 3,900 municipalities, and 21,477 subjects. Income inequality at both regional and municipal levels exhibited associations with distress scores, suggesting independent effects. Notably, higher distress scores were identified in southern regions with elevated inequality, despite a more substantial COVID-19 impact in the north. Findings contribute to existing literature by emphasizing the independent impact of lower-level (municipal) and higher-level (regional) income inequality on population psychopathology. The study supports theories suggesting diverse pathways through which inequality at different levels influences health, such as potential associations with healthcare system dysfunction at the regional level and welfare dysfunction at the municipal level. The observed north-south gradient in distress scores highlights the need for psychosocial interventions to alleviate income inequality, especially in historically disadvantaged southern regions. Future research should explore the nuanced interplay between income inequality and various ecological variables to provide a comprehensive understanding of its health impact.

Factors associated with the presence of depression, anxiety, and substance use in health students from 10 Latin American countries during the COVID-19 pandemic

Introduction. Health science students represented a particularly vulnerable group during the pandemic. Studies in various regions have found a high prevalence of psychopathology, associated with the presence of stressors such as contact with patients, isolation, and financial difficulties. Objective. To determine the stressors for and frequency of depression, anxiety and substance use in Latin American health science students during the COVID-19 pandemic. Method. A questionnaire-based, cross-sectional study was conducted to measure the presence of stressors and determine anxiety and depression symptoms through the PHQ-9 and the GAD-7 scales, and substance use in 777 students from ten countries, from June 2020 to January 2021. Results. The most frequent stressors were having a loved one diagnosed with COVID-19 and being diagnosed with another illness. A total of 54.1% of the sample had depression, and 46.2% had anxiety according to the rating scales cut-off points, while 24.8% reported substance use. Reading or listening to news about the pandemic was the main stressor associated with the presence of psychopathology. Discussion and conclusion. Latin American health science students displayed high frequencies of psychopathology associated with various stressors. It is therefore important to monitor the mental health of this population to prevent low academic performance.

Text4Hope: An e-Mental Health Tool for Mitigating Psychological Symptoms among Young Adults

IntroductionChronic stress, anxiety, and depression can interfere with young adults’ everyday function, academic achievement, and interpersonal relationships. Interventions aimed at preventing the deterioration or possibly onset of these mental disorders among young people are timely.ObjectivesTo assess the impact of a supportive text messaging program (Text4Hope) on the psychological well-being of young adults.MethodsThis study adopted both longitudinal and naturalistic controlled trial designs. Longitudinal study: compared baseline and 6th week outcomes in the same group of young adult subscribers. Naturalistic controlled study: compared clinical parameters in two groups of Text4Hope young adult subscribers: (i) intervention group (IG), subscribers who received once-daily supportive text messages for 6-weeks and completed 6th-week evaluation between 26 April and 12 July 2020, and (ii) control group (CG), subscribers who joined Text4Hope the same time frame, completed a baseline survey and were yet to receive text messages. The prevalence and severity of moderate-high stress, anxiety, and depression was measured using standardized scales. Inferential statistics, including the t-test, McNemar test, chi-square, and binary logistic regression analyses, were used to evaluate the differences in the prevalence and severity of the psychological symptoms.ResultsLongitudinal study: subscribers who completed both the baseline and 6th-week surveys, had significant reduction in the prevalence of moderate-high stress (8%) and likely GAD (20%) from baseline to six weeks. The largest reduction in mean scores was for the GAD-7 scale (18.4%). Naturalistic study: significantly lower prevalence for likely Moderate Depressive Disorder (25.2%) and suicidal thoughts/thoughts of self-harm (48.4%), with a small effect size in the IG compared to CG.Image:ConclusionsTheText4Hope program has been demonstrated as an effective e-mental health tool for mental health support for young adult subscribers. This is particularly encouraging, as young adults have already adapted to SMS text messaging and texting. Therefore, this mode of intervention can be used to supplement existing treatments for psychological problems impacting young adults. In addition, the cost effectiveness and easy scalability of supportive text message interventions mean that policymakers and governments can quickly implement similar programs as part of national youth suicide prevention strategies.Disclosure of InterestNone Declared