GHQ Scores Research Articles

Impact of psychological distress on mortality in Spain. The importance of early detection and treatment of mental disorders

BackgroundMental health problems account for 14% of mortality worldwide. The aim of this study was to evaluate the association between psychological distress and mortality in the Spanish adult population. MethodsData came from a longitudinal study in population ≥15 years of age (n=21,005) who participated in the 2011-12 Spanish National Health Survey, which was linked to mortality records as of December 2020. Mental health was assessed with the GHQ-12, defining psychological distress as a dichotomous variable using a GHQ-12 score ≥3 as the cutoff point. Using Poisson regression, standardized mortality rate ratios (SRR) were estimated for all-cause, cardiovascular disease, and tumor-related mortality, adjusting for sociodemographic variables, lifestyles, and comorbidities. ResultsThe standardized overall mortality rate in individuals with and without psychological distress was 14.58 and 10.90 per 1000 person-years, respectively, estimating an SRR of 1.34 (95%CI: 1.19–1.50). The SRR for tumor-related mortality was 1.17 (95%CI: 0.90–1.53), and cardiovascular-related mortality was related to higher distress (GHQ-12 ≥ 4): SRR of 1.22 (95%CI: 0.98–1.51). Among psychological distressed individuals, the overall mortality SRR for those with a previous mental disorder diagnosis was 1.18 (95%CI: 0.91–1.53) versus 1.34 (95%CI: 1.18–1.54) for those without such diagnosis (p for interaction=0.067). Similarly, distressed participants taking prescription drugs for mental disorders had a lower mortality risk than those not taking them (p for interaction=0.016). ConclusionsIndividuals with psychological distress had a higher risk of overall-, cardiovascular disease- and tumor-related mortality. This association was higher among participants not previously diagnosed with a mental disorder and those not taking medication for mental issues.

Factors influencing the mental health status of support nurses and their workload during the COVID-19 epidemic.

The authors used the National Aeronautics and Space Administration Task Load Index (NASA-TLX) and general health questionnaire to analyze the factors influencing the mental health status and the workload of support nurses during the COVID-19 epidemic. The authors conducted a cross-sectional survey of 349 support nurses in April-October 2022. Using QuestionStar, a powerful online survey tool, the authors administered surveys to the participants, collected data on the mental health status and workload of support nurses, and analyzed the influencing factors based on the collected data. A total of 316 questionnaires were successfully collected, with an effective rate of 98.75%. The proportion of support nurses with mental health problems was 25% and the value of the NASA-TLX questionnaire was: M±SD 68.91±7.28 pts. Multi-factor analysis revealed that the number of children, family support, and nursing support location were the influencing factors of mental health status, while the multivariate analysis revealed that the presence of symptoms, nursing support location, support work type, and total 12-item General Health Questionnaire (GHQ-12) score were the influencing factors of the workload of support nurses. Compared to their counterparts in the plains, nurses working in isolated plateau regions who were caring for children and lacked family support, were more likely to have mental health issues. There was a positive correlation between the changes in GHQ-12 and NASA-TLX scores of the study participants. Compared to their counterparts in the plains and the tropical regions, nurses working in plateau regions had a heavier workload. As part of the follow-up measures to prevent and treat patients impacted by the COVID-19 epidemic, it is important to improve the mental health evaluation, consultation, and treatment of the support nurses to guarantee the high quality of the first-line support work. Int J Occup Med Environ Health. 2023;36(6)761-72.

Cross-sectional study to assess the psychological morbidity of women facing possible miscarriage.

Threatened miscarriage is a common complication of pregnancy. This study aimed to assess psychological morbidity in women with threatened miscarriage, with the goal of identifying early interventions for women at risk of anxiety or depression. Women in their first trimester attending an Early Pregnancy Assessment Clinic were recruited between July 2013 and June 2015. They were asked to complete the 12-item General Health Questionnaire (GHQ-12), the Beck Depression Inventory (BDI), Spielberger's State Anxiety Inventory State form (STAI-S), the Fatigue Scale-14 (FS-14), and the Profile of Mood States (POMS) before consultation. They were also asked to rate anxiety levels before and after consultation using a visual analogue scale (VAS). In total, 1390 women completed the study. The mean ± standard deviation of GHQ-12 (bi-modal) and GHQ-12 (Likert) scores were 4.04 ± 3.17 and 15.19 ± 5.30, respectively. Among these women, 48.4% had a GHQ-12 (bi-modal) score ≥4 and 76.7% had a GHQ-12 (Likert) score >12, indicating distress. The mean ± standard deviation of BDI, STAI-S, and FS-14 scores were 9.35 ± 7.19, 53.81 ± 10.95, and 2.40 ± 0.51, respectively. The VAS score significantly decreased after consultation (P<0.001). Compared with women without a history of miscarriage, women with a previous miscarriage had higher GHQ-12, BDI, and POMS scores (except for fatigue-inertia and vigour-activity subscales). A higher bleeding score was strongly positively correlated with GHQ-12 (Likert) score. There were weak correlations between pain score and the GHQ-12 (bi-modal) ≥4, BDI >12, and POMS scores (except for confusion-bewilderment subscale which showed a strong positive correlation). Women with threatened miscarriage experience a considerable psychological burden, emphasising the importance of early recognition for timely management.

Changes in mental health among Chinese university students before and during campus lockdowns due to the COVID-19 pandemic: a three-wave longitudinal study.

The campus lockdown due to the COVID-19 pandemic has adversely affected mental health among university students. However, the heterogeneity in responses to campus lockdown is still poorly known. We collected three-wave prospective data on university students' mental health in Shanghai, China, in 2022: (i) in February before the pandemic; (ii) in April at the initial COVID-19 campus lockdown; and (iii) in May amidst the citywide lockdown. Overall, 205 university students completed sociodemographic questionnaires, the General Health Questionnaire-12 items (GHQ-12), and the Depression, Anxiety and Stress Scale-21 items (DASS-21). Generalized estimating equations were used to examine the longitudinal changes in mental health and symptoms of depression, anxiety, and stress. Latent class mixed models (LCMM) were constructed to identify distinct trajectories. Multinomial regression models were used to identify factors associated with status variation patterns. Mean GHQ-12 scores were 8.49, 9.66, and 11.26 at pre-pandemic and lockdown T1 and T2, respectively (p < 0.001). Mean scores for depression, anxiety, and stress were (5.96, 10.36, and 8.06, p < 0.001), (7.13, 6.67, and 7.16, p = 0.243), and (9.83, 7.28, and 11.43, p < 0.001), respectively. Changing trends of numbers of participants with clinical symptoms were consistent with those of mean scores. LCMM fitted three distinct trajectory classes, respectively, for GHQ-12, depression and anxiety symptoms, and four classes for stress symptoms. Participants with fair or poor peer relationships were more likely to belong to vulnerable trajectories concerning depression, anxiety, and stress symptoms. This study proves heterogeneity in mental health of university students in response to pandemic campus lockdown and highlights the necessity for identifying vulnerable groups to provide targeted support in future pandemics.

Psychiatric morbidity among patients suffering from Vitiligo.

Vitiligo is a chronic acquired, stigmatizing disease characterized by discoloration of skin and mucous membranes. Patients suffering from this condition suffer from a lack of confidence and psychological stress. To assess depression, anxiety, and social anxiety among patients suffering from vitiligo. This hospital-based cross-sectional, observational, descriptive study was carried out in a tertiary care center on 100 patients suffering from vitiligo, who were consecutively enrolled after informed consent from the outpatient department (OPD) of the dermatology department. Permission was obtained from the institutional ethics committee Diagnosis of vitiligo was made by two consultants from the department of dermatology. Sociodemographic variables were recorded in the sociodemographic form. The General Health Questionnaire-12 (GHQ-12) was applied to all 100 patients. Patients who scored >3 on GHQ-12 were further subjected to the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), and Social Interaction Anxiety Scale. Results were statistically analyzed on SPSS-22.0 (IBM, Armonk, USA). Of all the patients, 55% (n = 55) had a GHQ score >3 (i.e., Psychiatric morbidity was present in 55% of patients.). Out of 50 patients in the age group of 18-25 years, 41 patients in the age groups of 26-35 years, and 9 patients in the age groups of 36-45 years, 22 (44%), 17 (42.1%), and 6 patients had psychiatric morbidity, respectively. Of the total number of patients, 46% had depression according to the HAM-D scale. Of all the patients, 18% had mild, 22% had moderate, and 6% had severe depression. Age-wise analysis showed that out of 50 patients in the age group of 18-25 years, 41 patients in the age group of 26-35 years, and 9 patients in the age group of 36-45 years, 22 (44%), 20 (48.7%), and 4 patients had depression, respectively. Of the patients who had depression, 39% were male and 58% were female. On HAM-A, 47% of the patients had anxiety; 33% had mild, 12% had moderate, and 2% had severe anxiety. Age-wise analysis showed that out of 50 patients in the age group of 18-25, 41 patients in the age group of 26-35 years, and 9 patients in the age group of 36-45 years, 20 (40%), 23 (56.1%), and 3 patients had anxiety, respectively. On SIAS, 36% of the patients had social anxiety. Out of 50 patients in the age group of 18-25 years, 41 patients in the age group of 26-35 years, and 9 patients in the age group of 36-45 years, 23 (46%), 9 (7.8%) and 4 patients had social anxiety, respectively. According to gender-wise distribution, 17% of male and 63% of female patients had social anxiety. A high prevalence of anxiety, depression, and social anxiety has been observed in this present study. Therefore, importance should be given to psychiatric evaluation of such patients and, if required, necessary interventions should be undertaken to improve their quality of life.

RELIABILITY, VALIDITY, AND FACTOR STRUCTURE OF THE 12-ITEM GENERAL HEALTH QUESTIONNAIRE (GHQ-12) AMONG STUDENTS AT CAN THO UNIVERSITY OF MEDICINE AND PHARMACY

Background: Stress in medical education has been inevitable among medical students. The prevalence of mental health problems among medical students is increasing, requiring a reliable tool for accessing assessments. The General Health Questionnaire (GHQ-12), designed to screen for mental disorders and psychological stress, is a promising tool. Although the factor structure of GHQ-12 has been studied internationally, it is still unclear in Vietnam. Objectives: To evaluate the reliability, validity, and factor structure of the Vietnamese version of the GHQ-12 questionnaire. Materials and method: An analytic cross-sectional study of the online Microsoft survey on 1763 students majoring in medicine, traditional medicine, and preventive medicine at Can Tho University of Medicine and Pharmacy from May 2022 to May 2023. Results: Samples in the study comprised 1763 respondents, out of whom male respondents were 42.8%, and female respondents were 57.2%. The average age was 22.62 with the highest proportion being the age group 18-29 years old (95.7%). Our research subjects were mainly studying medicine (86.5%), and the remaining disciplines included Traditional Medicine (8.1%) and Preventive Medicine (5.4%). The average GHQ-12 score was 16.22 points with the mean score obtained on item 5 (1.74) being the highest, indicating that most students were under strain. Cronbach's alpha coefficient of 0.893 showed an appropriate level of confidence. A two-factor structure with nine categories of “negative items” (2, 5, 6, 9, 10) and “positive items” (1, 3, 4, 8) had a cumulative variance of 60.175% drawn from the study. Conclusions: The Vietnamese version of GHQ-12 has enough reliability and validity to assess the mental health of medical students. The results indicated that students had higher-than-average scores, meaning poorer mental health. Furthermore, the study revealed a two-factor structure with nine categories including “negative items” and “positive items” with a cumulative variance of 60.175%. The two-factor structure suggests that GHQ-12 can be a multidimensional measure.

Impact of informal care on the mental health of caregivers during the COVID-19 pandemic.

Informal care can affect the mental health of caregivers. The COVID-19 pandemic precipitated many people into informal care. Little is known about the longitudinal effect of informal care throughout the pandemic. We investigate changes in mental health in relation to changes in informal care between July 2020 and September 2021. Using data from Understanding Society, we applied fixed-effects modelling to assess mental health variations associated with changes in caregiving among 13557 participants (50430 observations). Hours of weekly care were categorized as 0, 1-19, ≥20. Mental health was measured using the General Health Questionnaire (GHQ-12) as a continuous score and a binary indicator. Main analyses were stratified by gender. Compared to when delivering 0hours care/week, the GHQ-12 scores of women providing care for 1-19hours/week were 0.46 points higher (95%CI: -0.11, 1.09), while their mental health scores were 0.99 higher (95%: 0.08, 1.90) when caring for ≥20hours/week. Changes on the binary GHQ-12 measure were only evident for women when providing ≥20hours of weekly care. These changes were not substantial among men. Informal care adversely impacted the mental health of women carers during the COVID-19 pandemic. Support programmes for informal carers should focus on alleviating caregiving loads in women.

The association between higher education attendance and common mental health problems among young people in England: evidence from two population-based cohorts

It is unclear whether young people who attend higher education are at increased risk of common mental disorders, compared with those who do not attend. We aimed to investigate whether higher education attendance was associated with increased symptoms of common mental disorders (depression and anxiety) in young people before, during and after attendance. For this cohort study, we used two cohorts-the Longitudinal Studies of Young People in England (LSYPE1: N=4832, 55·8% [2696 of 4832] students; LSYPE2: n=6128, 50·7% [3104 of 6128] students), beginning in 2004 for LSYPE1 and 2013 for LSYPE2. Both cohorts were designed to be nationally representative, with schools in England as the primary sampling unit. Symptoms of common mental disorders were assessed with the General Health Questionnaire (GHQ-12) before (age 14-17 years for both cohorts), during (age 18-19 years for LSYPE2), and after (age 25 years for LSYPE1) higher education. We assessed differences in GHQ scores using unadjusted and confounder adjusted linear regression. At ages 18-19 years (LSYPE2), mean GHQ-12 scores were 12·0 (SD 6·4) among students and 11·6 (SD 6·8) among non-students (adjusted mean difference 0·36, 95% CI 0·05 to 0·68; p=0·024). In LSYPE1, young people who attended higher education at ages 18-20 years had higher symptoms of common mental disorders at ages 16-17 years than those who did not (0·60, 0·30 to 0·90). However, after higher education (age 25 years for LSYPE1), there was no evidence of a difference-mean GHQ-12 scores were 11·4 (SD 5·5) among those who had attended and 11·7 (SD 6·4) among those who had not attended (-0·25, -0·66 to 0·16; p=0·23). We found evidence that students had more symptoms of common mental disorders than non-students at ages 18-19 years, albeit the effect size was small and there was no evidence of a longer-term difference at the age of 25 years. Department for Education.

Patients’ experiences of a suppoRted self-manAGeMent pAThway In breast Cancer (PRAGMATIC): quality of life and service use results

PurposeTo describe trends and explore factors associated with quality of life (QoL) and psychological morbidity and assess breast cancer (BC) health service use over a 12-month period for patients joining the supported self-management (SSM)/patient-initiated follow-up (PIFU) pathway.MethodsParticipants completed questionnaires at baseline, 3, 6, 9 and 12 months that measured QoL (FACT-B, EQ 5D-5L), self-efficacy (GSE), psychological morbidity (GHQ-12), roles and responsibilities (PRRS) and service use (cost diary).Results99/110 patients completed all timepoints; 32% (35/110) had received chemotherapy. The chemotherapy group had poorer QoL; FACT-B total score mean differences were 8.53 (95% CI: 3.42 to 13.64), 5.38 (95% CI: 0.17 to 10.58) and 8.00 (95% CI: 2.76 to 13.24) at 6, 9 and 12 months, respectively. The odds of psychological morbidity (GHQ12 >4) were 5.5-fold greater for those treated with chemotherapy. Financial and caring burdens (PRRS) were worse for this group (mean difference in change at 9 months 3.25 (95% CI: 0.42 to 6.07)). GSE and GHQ-12 scores impacted FACT-B total scores, indicating QoL decline for those with high baseline psychological morbidity. Chemotherapy patients or those with high psychological morbidity or were unable to carry out normal activities had the highest service costs. Over the 12 months, 68.2% participants phoned/emailed breast care nurses, and 53.3% visited a hospital breast clinician.ConclusionThe data suggest that chemotherapy patients and/or those with heightened psychological morbidity might benefit from closer monitoring and/or supportive interventions whilst on the SSM/PIFU pathway. Reduced access due to COVID-19 could have affected service use.

Feasibility and Effectiveness of an Intervention to Reduce Intimate Partner Violence and Psychological Distress Among Women in Nepal: Protocol for the Domestic Violence Intervention (DeVI) Cluster-Randomized Trial.

Intimate partner violence (IPV) disproportionately affects people in low-and middle-income countries (LMICs), such as Nepal. Women experiencing IPV are at higher risk of developing depression, anxiety, and posttraumatic stress disorder. The shortage of trained frontline health care providers, coupled with stigma related to IPV and mental health disorders, fuels low service uptake among women experiencing IPV. The Domestic Violence Intervention (DeVI) combines the Problem Management Plus counseling program developed by the World Health Organization with a violence prevention component. This study aims to implement and evaluate the feasibility, acceptability, and effectiveness of DeVI in addressing psychological distress and enabling the secondary prevention of violence for women experiencing IPV. A parallel cluster-randomized trial will be conducted across 8 districts in Madhesh Province in Nepal, involving 24 health care facilities. The study will include women aged 18-49 years who are either nonpregnant or in their first trimester, have experienced IPV within the past 12 months, have a 12-item General Health Questionnaire (GHQ-12) score of 3 or more (indicating current mental health issues), and have lived with their husbands or in-laws for at least 6 months. A total sample size of 912 was estimated at 80% power and α<.05 statistical significance level to detect a 15% absolute risk reduction in the IPV frequency and a 50% reduction in the GHQ-12 score in the intervention arm. The health care facilities will be randomly assigned to either the intervention or the control arm in a 1:1 ratio. Women visiting the health care facilities in the intervention and control arms will be recruited into the respective arms. In total, 38 participants from each health care facility will be included in the trial to meet the desired sample size. Eligible participants allocated to either arm will be assessed at baseline and follow-up visits after 6, 17, and 52 weeks after baseline. This study received funding in 2019. As of December 29, 2022, over 50% of eligible women had been recruited from both intervention and control sites. In total, 269 eligible women have been enrolled in the intervention arm and 309 eligible women in the control arm. The trial is currently in the recruitment phase. Data collection is expected to be completed by December 2023, after which data analysis will begin. If the intervention proves effective, it will provide evidence of how nonspecialist mental health care providers can address the harmful effects of IPV in resource-constrained settings with a high burden of IPV, such as Nepal. The study findings could also contribute evidence for integrating similar services into routine health programs in LMICs to prevent IPV and manage mental health problems among women experiencing IPV. ClinicalTrials.gov NCT05426863; https://clinicaltrials.gov/ct2/show/NCT05426863. DERR1-10.2196/45917.

The Impact of Sexual Violence on Quality of Life and Mental Wellbeing in Transgender and Gender-Diverse Adolescents and Young Adults: A Mixed-Methods Approach.

Transgender (trans) and gender-diverse (GD) adolescents and young adults have remained largely invisible in health research. Previous research shows worse outcomes in health indicators for trans and GD people, compared to cisgender controls. Research on the impact of sexual violence focuses on mainly cisgender female adult victims. This study assessed the impact of sexual violence on the quality of life (QoL) and mental wellbeing (GHQ-12) among trans and GD adolescents and young adults, while taking into account the possible role of gender nonconformity in sexual violence and mental wellbeing. An online, anonymous survey and interviews/focus groups were conducted between October 2021 and May 2022 in Belgium. Multiple analyses of covariance (ANCOVAs) were used to assess the associations between sexual violence, mental wellbeing, and gender nonconformity, while controlling for different background variables (gender identity, sexual orientation, age, economic vulnerability, etc.). The interviews and focus groups were used to validate associations between variables that were hypothesized as important. The quantitative sample consisted of 110 respondents between 15 and 25 years old, with 30 trans respondents (27.3%) and 80 GD respondents (72.7%). A total of 73.6% reported experiences with sexual violence over the past two years (n = 81). The mean QoL score was 5.3/10, and the mean GHQ-12 score was 6.6/12. Sexual violence was not significantly associated with QoL (p = 0.157) and only marginally significantly associated with GHQ-12 (p = 0.05). Changing one's physical appearance to conform to gender norms, out of fear of getting attacked, discriminated against, or harassed was significantly associated with QoL (p = 0.009) and GHQ-12 (p = 0.041). The association between sexual violence and changing one's physical appearance to conform to gender norms was analyzed, to assess a possible mediation effect of sexual violence on mental wellbeing. No significant association was found (p = 0.261). However, the interviews suggest that sexual violence is associated with changing one's physical appearance, but this association is not limited to only trans and GD victims of sexual violence. Non-victims also adjust their appearance, out of fear of future sexual victimization. Together with the high proportion of sexual violence, as well as the lower average QoL and higher average GHQ-12 scores among trans and GD adolescents and young adults, compared to general population statistics, this highlights the need for policy makers to create more inclusive environments.

Predictors of Burden in Carers of Patients with Impulse Control Behaviors in Parkinson's Disease.

Impulse control behaviors (ICBs) are problematic, reward-based behaviors, affecting 15% to 35% of patients with Parkinson's disease. Evidence exists of increased carer burden as a result of these behaviors; however, little is known about the variables mediating this effect and their management. To identify factors predictive of carer burden in a cohort of patients with Parkinson's disease with ICBs to enable the development of targeted therapeutic interventions for carers. Data were collected from 45 patients with clinically significant ICBs and their carers, including levodopa equivalent daily dosage, motor and neuropsychiatric symptoms, cognitive function, and ICB severity. Carer burden was quantified by Zarit Burden Interview (ZBI). Univariate analyses were performed using the Spearman rank correlation. Linear regression was used to create a multivariate model for predicting ZBI. Univariate analysis identified significant correlations between ZBI and patient total Neuropsychiatric Inventory (NPI) (r s = 0.50), 4 NPI subscores (agitation/aggression, r s = 0.41; depression/dysphoria, r s = 0.47; apathy/indifference, r s = 0.49; and irritability/lability, r s = 0.38; all P < 0.02), and the carer 28-item General Health Questionnaire (GHQ-28) (r s = 0.52, P < 0.0005). Multivariate linear regression retained total NPI and GHQ-28 scores and were collectively predictive of 36.6% of the variance in the ZBI. Our study suggests that depressive symptoms and aspects of executive dysfunction (apathy and disinhibition) in the patient are potential drivers of carer burden in patients with ICBs. Such findings suggest the presence of executive difficulties and/or mood disturbance should point the clinician to inquire about burden in the caring role and encourage the carer to seek help for any of their own general health problems, which may compound carer burden.

The role of effort-reward imbalance and depressive symptoms in the relationship between long working hours and presenteeism among Chinese village doctors: a moderated mediation model

BackgroundLong working hours and effort-reward imbalance (ERI) among medical workers may contribute to poor mental health and reduced productivity. However, the potential mechanisms among them are not well understood. This study aimed to explore the role of depressive symptoms and ERI in the relationship between long working hours and presenteeism among village doctors.MethodsWe conducted a cross-sectional study in Jiangsu Province, eastern China. 705 village doctors were assessed for working hours, ERI (the Effort-Reward Imbalance Questionnaire, ERI questionnaire), presenteeism (6-item Stanford Presenteeism Scale, SPS-6 Scale), and depressive symptoms (12-item General Health Questionnaire, GHQ-12). A moderated mediation model was used to test the role of depressive symptoms (M), and ERI (W) in the relationship between long working hours (X) and presenteeism (Y).Results45.11% of the village doctors worked more than 55 h per week, and 55.89% were exposed to ERI. The prevalence of depressive symptoms among Chinese village doctors was 40.85%. Long working hours (≥ 55 h per week) were significantly associated with presenteeism behaviors (β = 2.17, P < 0.001). Mediation analysis demonstrated that depressive symptoms (GHQ score > 3) could partly mediate the relationship between long working hours and presenteeism (indirect effect β = 0.64, P < 0.001). Moderated mediation further indicated that the interaction of long working hours and ERI was significantly and positively associated with depressive symptoms, which in turn predicted elevated presenteeism behaviors.ConclusionsDepressive symptoms had a mediating role in the association of long working hours with presenteeism behaviors among Chinese village doctors and ERI augment their negative effects.

General health and its relation to the quality of life and alcohol consumption in a Polish cohort of medical students - preliminary results of POLLEK survey.

First-year students of medicine are at higher risk of stress related to the new environment and study overload. Such factors can play a role and have an impact on their quality of life and general health status which can cause possible problems with alcohol use. The aim of the study is to assess the relationship between mentioned factors in the Polish cohort of first-year medical students. The quality of life has been assessed within the WHOQOL-BREF questionnaire, the general health status was assessed via GHQ28, and alcohol consumption was assessed the by AUDIT questionnaire. Due to the lack of signature informed consent and lack of data, 381 (72%) students out of 525 were included in the final analysis. The majority of the 1-year students were females 68%; (n = 259) vs. 32% (n = 122) males. Half of the students had lowered risk of distress. However, females had a higher risk of having higher scores in GHQ-28 than males. In relation to the assessment of the quality of life, the students with a lower level of distress (<32 points in GHQ-28) had better results in each WHOQOL domain. There was no association between general health status and alcohol use. For the students who had possible problems with alcohol use the OR was 1.15 95% CI (0.73-1.80) and for students who were probably addicted OR was 1.07 95% CI (0.33-3.41). The total quality of life in first-year Polish medical students is relatively high; however, half of them suffer because of distress and around 30% have some alcohol problems. Females are more likely to have higher GHQ-28 scores than males.

A Study of the Impact of Psychiatric Distress on Coping Responses and the Levels of Anxiety, Depression, and Suicidal Ideation among Undergraduate Nursing Students

Background: Entering medical professional courses is stressful to students in general and more so in a profession like nursing. Identifying the most effective methods of coping strategies with psychiatric distress may help to reduce mental health issues. This study was conducted to estimate the levels of psychiatric distress, anxiety, depression, and suicidal ideation, and their correlation with coping responses among undergraduate nursing students. Methodology and Participants: Sixty-eight 1st-year BSC nursing students participated in the study. The students were surveyed online using Google Forms. Participants had to fill up five scales: General Health Questionnaire (GHQ-28); Coping response inventory; State-Trait Anxiety Inventory (STAI); Beck Depression Inventory (BDI); and Adult Suicidal Ideation Questionnaire (ASIQ). Results: Thirty-nine students (57.35%) were found to be facing psychiatric distress (GHQ-28 Score &gt;4). Sixteen (23.5%) had moderate depression and 13 (19.1%) had severe depression scores. Psychiatric distress scores were positively correlated with Depression, Anxiety, and Suicidal Ideation scores. A positive correlation was also found between suicidal ideation and anxiety and depression. A significant positive correlation was found between emotional discharge and acceptance/resignation (coping strategies) and GHQ, STAI, BDI, and ASIQ Scores. Positive reappraisal (PR), seeking guidance and support (SG), and problem-solving were the three coping strategies that had negative correlations with psychiatric distress, state anxiety, and suicidal ideation. Conclusion: Psychiatric distress increased depression levels, anxiety as well as suicidal ideation. Emotional discharge was identified as the most commonly used coping response. PR, SG, and problem-solving were the three most effective coping strategies which helped in reducing perceived stress levels.

Revisiting the World’s Strictest COVID-19 Lockdown: Formidable Mental Health Challenges

Abstract Introduction Many nations have implemented lockdowns to prevent and minimize the spread of infections in healthcare settings. However, the impact of lockdown duration on mental health remains controversial. Methods We conducted a retrospective study using online questionnaires to assess the mental health status of the general population during the Shanghai lockdown period from March to May 2022. The mental health of the participants was evaluated by the 12-item General Health Questionnaire (GHQ-12), in which a cut-off score of 12 or more indicated psychological distress. A logistic regression model was used to evaluate the relationship between lockdown duration and mental health. Results Among 2139 participants (mean age: 26.12 years, standard deviation: 6.37, 731 females; 1378 unmarried; 1099 Shanghai residents), approximately 47% reported psychological distress (GHQ-12≥12). Participants exposed to lockdown reported significantly higher GHQ-12 scores (11.93±6.81 vs. 8.73±6.35, p&lt;0.001). In our logistic regression model, participants who experienced the longest lockdown (43–61 days) had a significantly higher risk of psychological distress compared with those who did not (odds ratio: 3.10, 95% confidence interval: 2.06–4.70, p&lt;0.001). Discussion Lockdown duration significantly affects mental health, with longer lockdown duration being associated with worse mental health status. The relationship between lockdown and mental health should not be neglected in case of lockdown in response to future pandemics.

Validation of the Sinhala Version of Tinnitus Handicap Inventory.

Tinnitus is a common and disabling condition that largely remains undertreated in Sri Lanka. Currently, standardized tools that assess and monitor the treatment of tinnitus or the distress it causes are unavailable in either of the two main vernacular languages prevalent in Sri Lanka. The Tinnitus Handicap Inventory (THI) is used internationally to measure tinnitus-induced distress and to monitor treatment efficacy. In this study, we validated the Sinhala version of the THI (THI-Sin). Subjects and. The THI was translated into Sinhala and back translated into English and finalized by independent translators. The THI-Sin questionnaire and the 12-item General Health Questionnaire (GHQ-12) and Visual Analog Scale of tinnitus annoyance (VAS) were administered to 122 adults who visited the otolaryngology clinic of Colombo North Teaching Hospital, Ragama, Sri Lanka. THI-Sin scores showed satisfactory internal consistency (Cronbach's α=0.902) and were significantly correlated with the GHQ-12 and VAS scores. Factor analysis of the THI-Sin confirmed a three-factorial structure, which did not correspond to the original THI subscales. We observed significant reliability and validity of the THI-Sin tool for evaluation of tinnitus-induced handicaps among the Sinhalese-speaking population of Sri Lanka.

Construct validity of the General Health Questionnaire (GHQ-12) in patients with COVID-19 and its demographic and medical correlates.

The present cross sectional study aimed to evaluate the construct and criterion validity, reliability, and gender and age differences of the 12-item General Health Questionnaire (GHQ-12) among hospitalized patients with COVID-19 in 2020. The criterion validity was assessed via its link with perceived stress, sleep quality, daily life activities, and demographic and medical characteristics. A total of 328 COVID-19 patients (55.8% men; Mage = 50.49, SD = 14.96) completed the GHQ-12, the Perceived Stress Scale (PSS), the Pittsburgh Sleep Quality Index (PSQI), the Activities of Daily Life (ADL)-Katz Scale, and the Lawton Instrumental Activities of Daily Living Scale (IADL). Among 13 factorial models, the three-factor model (successful coping, self-esteem, and stress) was shown to have the best fit. GHQ-12 was positively associated with PSQI, PSS, Hyperlipidemia, psychiatry disorders, hospitalization duration, the change in sleep time, and use of sleeping pills, and negatively correlated with educational level, and the number of family members. The GHQ-12 also had a negative correlation with ADL and IADL in over 60 years of age group. Females scored higher on total GHQ-12 scores, compared to males. Finally, the hospitalization duration was longer for patients over 60 (mean = 8.8 days, SD = 5.9) than patients under 60 (mean = 6.35 days, SD = 5.87). Overall, the findings provided evidence that mental distress in patients with COVID-19 is correlated with high perceived stress, low sleep quality, low ADL and IADL, and a range of demographic features and medical conditions. Designing psychological interventions for these patients that target the aforementioned correlates of mental distress is warranted.

The influence of perceived stress and income on mental health in China and Germany

BackgroundMental health issues affect rich and poor, young and old, and are widespread in Asia as well as in Europe. However, few studies have investigated the influence of perceived stress and income on mental health among general population in China and in Germany. MethodsWe conducted an online survey from December 2021 to February 2022 to investigate how perceived stress and income affect mental health among the general population in China (N = 1123) and in Germany (N = 1018). Accordingly, we used the 10-item Perceived Stress Scale (PSS-10) and the 12-item General Health Questionnaire (GHQ-12). We ran a multiple linear regression model to investigate the relationship between perceived stress, income, and mental health. ResultsOverall, we found that 53.4% participants reported mental health issues (GHQ-12 score ≥12). The proportion of our sample who reported mental health issues was higher in Germany (60.3%) than in China (44.8%). The regression model revealed that a higher perceived stress score was associated with more mental health issues in both countries (b = 0.60, p < 0.01). Individuals with a low income reported poorer mental health in Germany than those in China. Interestingly, the situation was reversed when incomes were high: individuals with a high income reported worse mental health in China than in Germany (b = −0.40, p < 0.01). ConclusionPerceived stress has a negative impact on mental health, while income has differential effects. Mental health promotion programmes may involve teaching stress management, while considering differences in mental health outcomes in developed and developing countries.

Quantification of Epistemic Capacity and Physical Frailty in Chronic Kidney Disease: Koch's Disease Co-infection.

Background Chronic kidney disease (CKD) and tuberculosis (TB) co-infection devastates the affected individual physically and psychologically. Moreover, poor immune status and mental turmoil worsen cognition and quality of life. Hence, studying the cognitive function and quality of life among such patients is necessary. This study aimed to determine the changes in mini-mental state examination (MMSE) score and general health questionnaire (GHQ-12) score at six months from baseline. Methodology This prospective, observational study was conducted at Sriram Chandra Bhanja Medical College and Hospital, India, from February 2020 to December 2021. A total of 40 patients with stage 3-4 CKD and pulmonary TB were assessed with MMSE and GHQ-12 scales at baseline, two, and six months. The study population was grouped as ≤50 and >50 years of age. We used R software (version 4.1.1) for data analysis. Results In total, 40 (69%) of the 58 enrolled participants completed this study. The mean age of the study population was 50.93 ± 9.83 years. The baseline MMSE scores (≤50 years: 20.8 ± 2.1, >50 years: 20.1 ± 1.7, p = 0.17) were increased (≤50 years: 25.4 ± 1.8, >50 years: 22.4 ± 1.6, p = 0.08) at six months. The baseline GHQ-12 scores (≤50 years: 22.8 ± 2.6, >50 years: 23.1 ± 2.8, p = 0.56) were reduced (≤50 years: 17.9 ± 1.9, >50 years: 20.3 ± 2.3, p = 0.14) at six months. Conclusions The study participants' cognitive function and quality of life improved after six months of modified antitubercular drugs. Nevertheless, the intergroup differences were not statistically significant.