Greater Psychological Distress Research Articles

The impact of COVID-19 pandemic on the psychological well-being among health care workers: A 6-month cohort longitudinal survey study.

IntroductionHealth care workers (HCW) have been identified as a risk group to suffer psychological burden derived from Coronavirus Disease 19 (COVID-19) pandemic. In addition, possible gender differences in the emotional reactions derived from COVID-19 pandemic have been suggested in this population. The aims of the study were to explore the impact of COVID-19 as well as possible gender differences on mental health status and suicidality in a cohort of HCW.Materials and methodsOne thousand four hundred and thirty-two HCW responded to an online survey including sociodemographic, clinical, and psychometric tests in May 2020 while 251 HCW answered in November 2020. Mental health status was measured by General Health Questionnaire 28 (GHQ-28) in both time periods.ResultsHCW informed of a worsening in somatic symptomatology over the follow up period. Gender differences were found in all GHQ-28 dimensions as well in the total score of the questionnaire. Post hoc analyses displayed significant interaction between the time and gender in somatic and anxiety dimensions as well as in GHQ-28 total score. Stress produced by COVID-19 spreading and the feeling of being overwhelmed at work resulted the main predictors of psychological distress although each domain is characterized by a specific set of predictors.ConclusionsSomatic reactions represent the most sensitive dimension over the follow-up period. Moreover, women are characterized by a greater psychological distress at the beginning, although these differences tend to disappear over time. Finally, a complex network of factors predicted different dimensions of psychological distress, showing the complexity of prevention in high-risk populations facing major disasters.

Promoting well-being in the face of a pandemic: the role of sense of coherence and ego-resilience in the relationship between psychological distress and life satisfaction.

COVID-19 has impacted negatively on the lives and academic activities of university students. This has contributed to increasing levels of psychological distress among this population group. Intrinsic and contextual factors can mediate the psychological impact of the pandemic. The study focuses on sense of coherence and ego-resilience as potential protective factors on indices of psychological distress and life satisfaction. Participants were undergraduate students (N = 337) at a South African university who completed six self-report questionnaires, namely, the Beck Hopelessness Scale, the University of California Los Angeles Loneliness Scale, the Center for Epidemiological Studies Depression Scale, the Sense of Coherence Scale, the Ego-Resilience Scale, and the Satisfaction with Life Scale. To examine the direct and mediating effects of sense of coherence and ego-resilience on psychological distress, structural equation modeling was used. Compared to previous research, greater psychological distress was found in the current sample. Moreover, while the hopelessness-life satisfaction relationship was only partially mediated by protective factors, the depression-life satisfaction relationship was fully mediated by sense of coherence and ego-resilience. The direct association between ego-resilience as well as sense of coherence and life satisfaction was significant, suggesting that these factors have a health-sustaining role.

Factors Facilitating or Creating Barriers to Returning to Work in Head and Neck Cancer Patients Within the First 6 Months After Treatment.

Head and neck cancer (HNC) patients who are unable to return to work after completing treatment might face financial loss and reduced self-esteem. The aim of this study was to identify factors influencing a return to work in HNC cancer patients in the first 6 months after treatment. This cross-sectional study examined HNC patients who completed treatment from the outpatient radiation department of a single cancer center in northern Taiwan. Patients were assessed according to psychological distress, patient-perceived health status, barriers to returning to work, and facilitators of returning to work. Of the 106 HNC patients surveyed, 54.7% successfully returned to work. Barriers to returning to work included poor self-perception of health, greater psychological distress, and age ≥50 years. Patients who had higher psychological distress, returned to work after start of the pandemic, or received reconstruction surgery were less likely to experience a positive environment facilitating a return to work.

The Effects of Cognitive Behavioral Therapy with Biofeedback Therapy on the Quality of Life, Anxiety, Depression and Somatic Symptoms in Patients with Dyssynergic Defecation: A Randomized Controlled Trial.

Background: Dyssynergic defecation (DD) is a major cause of chronic functional constipation. Patients with DD have greater psychological distress and impaired health-related quality of life compared with the general population. This study aimed to evaluate the effectiveness of cognitive-behavioral therapy (CBT) combined with biofeedback therapy (BFT) on the quality of life, anxiety, depression and physical symptoms in patients with DD. Methods: This randomized controlled trial (IRCT20141115019957N2) was conducted on 45DD patients who were referred to the Rehabilitation Clinic of Iran University of Medical Sciences in 2017. The convenience sampling method was used to select the participants and then they were randomly allocated into three equal groups using RANDBETWEEN function in Excel. The first group received a combination of BFT&CBT and also standard-of-care therapy (SoCT). The second group was treated with BFT and SoCT, and the third group received only SoCT. The patients were assessed by digital rectal examination and the Short Form-36, Spielberger Anxiety, Beck Depression and Constipation Scoring System questionnaires before and after the treatment.The data were analyzed by SPSS-22, ANOVA, ANCOVA and Chi-Square tests. Results: Patients who received both CBT&BFT had significant improvement in symptoms of constipation, depression, and anxiety.Furthermore, BFT and CBT&BFT groups are valued equivalent only on the mental component of SF36 and the total SF36 questionnaire. But the physical component was significantly different, favoring CBT&BFT (p< 0.001). In CBT&BFT group,67%of patients reached the relaxed stage. In contrast, no patient reached the relaxed neither in BFT nor in SoCT. Conclusion: According to our study, patients with unfavorable responses to BFT may become better if CBT is added to their treatment plan.

A mixed-methods approach to psychological help-seeking in Muslims: Islamophobia, self-stigma, and therapeutic preferences.

Muslims living in the United States (MLUS) report high mental health stigma. They also underutilize professional psychological help, despite experiencing rising Islamophobia and comparatively poorer mental health. In line with double stigma, we examined whether MLUS who perceived greater Islamophobia also experienced greater self-stigma of seeking help, and whether this was related to negative help-seeking attitudes. We also assessed therapist demographic and treatment modality preferences and explored how they related to risk factors for low help-seeking. Utilizing a representative sample of 350 MLUS (50% women, 33% immigrants) acquired via a Qualtrics panel aggregate, we assessed a path model of help-seeking attitudes to determine the direct and indirect effects of perceived Islamophobia via self-stigma and psychological distress. Therapist and treatment preferences were examined via multiple regression models and analysis of variance (ANOVAs). Open-ended responses were coded through content analysis. Perceived Islamophobia was associated with greater psychological distress and also indirectly related to negative help-seeking attitudes via greater self-stigma. Therapists of a similar background, therapy in a mosque-setting, group therapy, and imam collaboration were more appealing to MLUS who were at risk for low help-seeking. Among MLUS, perceived Islamophobia may present a dual risk-simultaneously increasing psychological distress and indirectly leading to negative attitudes toward help-seeking via higher self-stigma. Conversely, for MLUS at risk for low help-seeking, accessible community-based treatments and treatment with a Muslim or race/ethnicity-matched therapist may facilitate help-seeking behaviors. Future work may determine whether addressing double stigma within Muslim communities (e.g., Islamophobia and self-stigma) may improve psychological help-seeking. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Trajectories of Pain Severity and Interference Among Adolescent and Young Adults With Cancer: A Microlongitudinal Study.

Cancer-related pain is a pervasive concern among adolescent and young adults (AYA) with cancer and is an emerging long-term health concern. Few studies have examined the complex contributions to pain among AYA. We aimed to fill a gap by (1) identifying subgroups of AYA with distinct patterns of pain severity and interference over time and (2) explore possible predictors of these patterns. Daily text messages over a 9-week period were used to model group-based trajectory analyses of pain severity and interference by identifying subgroups of AYA who experience common patterns of changes in pain. Demographic, medical, physical symptom burden, and psychological distress were examined as possible predictors of these patterns. AYA were on average 16.93 years old and 2.5 years since diagnosis. Subgroups of AYA were identified for pain severity and interference over time: high variability (37.7%; 37.7%, respectively), consistent high pain (35.8%; 18.9%, respectively), and consistent low pain (26.4%; 43.4%, respectively). AYA with greater psychological distress were more likely to belong to the high consistent pain severity and interference groups. AYA with greater physical symptoms were more likely to belong to the high consistent pain interference group. No significant associations between demographic/medical characteristics and trajectory subgroups were found. AYA with elevated physical and psychological symptoms were more likely to experience high consistent pain severity and pain interreference over time. Interventions aimed at reducing pain through focusing on teaching AYA how to alleviate physical symptoms and teaching coping skills to manage psychological distress may be beneficial.

Psychological Wellbeing, Dyadic Adjustment, and Parental Stress among Spanish Families during the COVID-19 Outbreak.

Due to COVID-19, many countries, like Spain, imposed lockdown on the entire population to prevent the virus from spreading. The purpose of this exploratory study is to investigate the severity of psychological symptoms, dyadic adjustment, and parental stress of parents during the first three weeks of the outbreak. It also aims to identify several risk factors that contribute to this distress. A total of 727 parents completed a form on an online platform with sociodemographic data, BSI- 18, EAD-13, and the Spanish version of the PPS. Linear regression analyses were used to explore the significant associations between the sample characteristics (sociodemographic variables and their lockdown circumstances) and parents’ psychological symptoms, dyadic adjustment, and parenting stress level during the COVID-19 epidemic. Most parents maintained good emotional, personal, conjugal, and family stability; however, female gender, not living with the partner, having a child with a mental disorder and were unable to balance the work and family lives were significantly associated with greater psychological distress. Being receiving psychiatric or psychological treatment has also been associated with poorer psychological and partner adjustment during the outbreak. It is essential to continue researching the impact of lockdowns on families so that, both the government and public health authorities, can offer resources to the most vulnerable families.

Employment and disability among young Australians and associations with psychological distress during the COVID-19 pandemic

BackgroundEmerging global data indicates that the employment status and mental health of young people is being adversely impacted by the COVID-19 pandemic. However, little research has focused on young people with disabilities, despite their lower pre-pandemic employment rates and poorer mental health. We quantified the association between employment status and mental health among young Australians, and tested for effect modification by disability status. MethodsLinear regression analysis of Wave 9 (October–December 2020) of the Longitudinal Study of Australian Children (LSAC) assessing the association between employment status (employed, unemployed) on psychological distress (Kessler-10) and including an interaction term for employment status and disability. ResultsThe association between employment status and psychological distress differed by disability status. Young adults with disabilities had higher adjusted mean K10 scores indicating greater psychological distress both when they were employed (mean 22.99, 95% CI 21.41, 24.58) and unemployed (mean 29.19, 95% CI 25.36, 33.03) compared to their peers without disabilities (employed mean 18.72, 95% CI 17.75, 19.70; unemployed mean 20.45, 95% CI 18.60, 22.29). ConclusionYoung Australians in general may benefit from additional supports to improve their employment and mental health outcomes. Young people with disabilities may particularly benefit from targeted supports to gain and maintain employment and improve mental health.

Why Is Non-suicidal Self-injury More Common in Women? Mediation and Moderation Analyses of Psychological Distress, Emotion Dysregulation, and Impulsivity

Objective Non-suicidal self-injury (NSSI) appears to be more common among women than men, though the underlying reasons for this remain unclear. In a community sample of young adults (N = 996, aged 18–33) assessed during the COVID-19 pandemic, we investigated alternative explanation for the NSSI prevalence gap: are women more likely to experience the feelings which lead to NSSI as a coping strategy, or does this prevalence gap result from differences in how men and women respond to distress? Methods Cross-sectional mediation and moderation analyses tested how self-reported psychological distress (K10), emotion dysregulation (DERS), and impulsivity (UPPS-P) may contribute to a higher prevalence of NSSI among women. Results Women were twice as likely as men to report past-year NSSI (14.47% versus 7.78%, OR = 2.00, 95% CI [1.29, 3.13]). Women reported significantly higher psychological distress and significantly lower sensation seeking and positive urgency than men. Psychological distress partially statistically mediated the relationship between gender and past-year NSSI. Gender did not significantly moderate associations between psychological distress, emotion dysregulation, or impulsivity and past-year NSSI. Past-year NSSI prevalence did not significantly decrease with age and we found no significant age by gender interaction. Conclusions Greater levels of NSSI in young women are partly explained by their greater levels of psychological distress, but not by differences in how men and women respond to this distress. Given similar levels of psychological distress, emotion dysregulation, and impulsivity, women and men are similarly likely to experience NSSI. Highlights Women aged 18–33 were significantly more likely to report past-year NSSI than men Women’s greater psychological distress contributed to their higher NSSI prevalence Variables investigated here were similarly associated with NSSI in men and women

Religious/spiritual struggles and well-being during the COVID-19 pandemic: Does "talking religion" help or hurt?

BackgroundResearch to date has suggested that religion might be a source of comfort and strength in times of crisis brought about by the COVID-19 pandemic, but it may also be a form of stress if spiritual struggles are experienced. We posit the discussion of religious and spiritual matters as a potential feature of religious life that may be helpful or harmful for dealing with the impacts of spiritual struggles.PurposeThis study has two objectives. First, we assess the association between religious/spiritual struggles and both perceptions of psychological distress and self-rated health, affording attention to the prevalence of religious struggles during this time. Second, drawing from social penetration theory, we consider both the potential helpful and harmful role of discussing religion with friends and family members for the well-being of those experiencing various degrees of religious/spiritual struggles.MethodsUsing data from a nationally representative sample of Americans collected in January 2021, nearly a year after the onset of the pandemic (N = 1,711), we conduct a series of OLS and ordinal logistic regression models.ResultsResults suggest that religious/spiritual struggles were somewhat common among Americans during COVID-19 and were associated with greater psychological distress and worse perceived self-rated health during the pandemic. In the context of high R/S struggles, both psychological distress and perceived self-rated health were more favorable when religious and spiritual matters were discussed very frequently, several times a week or more. Unlike for psychological distress, however, we found no evidence that discussion of religious matters in the face of greater R/S struggles exacerbated their ill effect on health. Supplemental analyses showed that these findings are not being driven by religious denominational differences across our focal variables.Conclusions and implicationsEncouraged by discussions of faith with close network confidants, people experiencing R/S struggles might seek help in the form of counseling in both secular and/or religious settings. Exploring potential resilience factors, such as religious discussion, may help inform broader or more local strategies aimed at economic recovery. Our results therefore invite future investigation into the role of religious coping in mitigating the health effects of pandemic hardship.

Different than Your Mother's Pain: Postsurgical Pain Modulation by Psychosocial Factors among Younger and Older Breast Cancer Patients

Younger age is a risk factor for worse outcomes following breast cancer surgery, including acute pain, development of persistent post-surgical pain, physical symptoms (arm disability), and greater psychological distress (depression). The biopsychosocial model of pain emphasizes the importance of considering the psychosocial context of pain experience, in addition to biological factors (age). Potentially, younger women's worse psychosocial adjustment after breast cancer surgery may explain their greater pain-related functional disability. We investigated the longitudinal relationship between age and pain-related functioning three months post-surgery among women with breast cancer. Further, we examined whether early postoperative psychosocial distress, reported two weeks postoperatively, mediated the association between age and subsequent pain-related functioning. This prospective, observational longitudinal study recruited women (N:161, age:54, range: 26-81) undergoing breast cancer surgery. Validated psychosocial assessments (anxiety, depression, sleep disturbance) were assessed two weeks postoperatively, and impact of surgical pain on cognitive/emotional and physical functioning was assessed three months postoperatively. Bivariate correlations tested associations among age, psychosocial factors, and pain-related functioning. Parallel mediation analyses tested whether the relationship between age and pain-related functioning three months postoperatively was mediated by psychosocial factors reported two weeks postoperatively. Younger age was significantly associated with greater impact of pain on cognitive/emotional and physical functioning. Younger age was associated with greater severity of depressive and anxiety symptoms, and greater sleep disturbance (ps<.001). The association between younger age and greater impact of pain on cognitive/emotional functioning was mediated by greater severity of anxiety. The association between younger age and greater impact of pain on physical functioning was mediated by greater sleep disturbance. Findings suggest that anxiety and sleep disturbance that occur early after breast cancer surgery may help explain greater chronic pain-related functional disability in younger patients. Anxiety and sleep disturbance are potentially modifiable, to some degree, with behavioral interventions, making them potential perioperative therapeutic targets. Grant support from NIH/NIGMS: K23 GM110540.

Predictors of Psychological Distress among Old Aged

Psychological distress is linked with the lack of social support and loneliness. The Elderly is suffering from many psychological issues and a lack of social support. Often, in old age homes, the lack of immediate friends and family leads them to many issues like loneliness, which affects their mental health. So it is essential to address this issue to provide care and support them. This study aimed to understand the contributing factors of psychological distress and influencing factors of psychological distress, loneliness, religiosity, and social support. The study was conducted on 159 older people (age range 60-90 years) of Thrissur and its neighboring places by employing a convenient sampling technique. The psychological distress scale was used to measure psychological distress The UCLA Loneliness Scale, Perceived Social Support Scale, and Religiosity Scale were used to measure loneliness, perceived social support, and religiosity, respectively. Personal details of the participants, such as age, sex, socio-economic status, marital status, etc., were collected using a personal data sheet. Results revealed that the loneliness and support from the family were highly contributing to predictors of psychological distress, and loneliness and support from friends contributed to depression. Males and females differ on psychological distress and its components, namely anxiety and depression. Moreover, males and females experienced similar religiosity and stress levels, and females experienced higher levels of loneliness than males. As a result of lower support from family, friends, and special person and overall perceived social support, there occurs a higher level of depression. Psychological distress will be high when there is lower social support from family, friends, and special people. Also, when there is greater psychological distress, there will be high loneliness. Older persons will have high religiosity when there is high loneliness. Stress and depression differ between people living in old age homes and Pakal Veedu. Reduction in loneliness occurs when there is a presence of a special person in their life.

COVID-19 job and income loss and mental health: the mediating roles of financial assets and well-being and the moderating role of race/ethnicity

ABSTRACT Prior research shows unemployment has a negative effect on mental health, yet whether this relationship is affected by financial factors is unknown. For example, having money in savings may mitigate the impact of job loss on mental health. We use structural equation modeling with data from the Socio-Economic Impacts of COVID-19 Survey with a nationally representative sample (N = 3,341) to examine COVID-19 related job loss and mental health as partially mediated by liquid assets and Financial Well-Being (FWB) and moderated by race and ethnicity as moderators. More than a quarter (28.34%) of participants said they experienced a job or income loss due to COVID-19, which was associated with greater psychological distress as measured by the PHQ-4. The structural model had excellent fit (RMSEA = 0.021); FWB partially mediated the relationship between job/income loss and mental health (p < .001), accounting for 49% of the total effect. However, liquid financial assets did not partially mediate this relationship. Black participants experienced very different direct and indirect effects. Social workers should assess and intervene concerning financial factors when individuals experience job loss. Job loss is different among Black individuals who face greater challenges related to structural racism yet also have greater resilience.

Health-Related Quality of Life and Psychological Distress in Patients With Hypermobility Type Ehlers-Danlos Syndrome

Patients with Ehlers-Danlos Syndrome, hypermobile type (hEDS) often report a decrease of health-related quality of life (HRQoL), symptoms of anxiety and depression, and show a prevalent incidence of psychiatric disorders. Still, there seems to be a lack of a more thorough analysis addressing the relations between these entities. We studied the HRQoL and its relations with depressive symptoms and subgroups of anxiety in a group of patients with hEDS ( n = 81) compared to a comparison group ( n = 90) of healthy controls (HC). HRQoL was assessed with the RAND 36-item health survey, depressive symptoms were measured with the 21-item Beck Depression Inventory (BDI-II) and State/trait anxiety inventory (STAI) was used to estimate levels of state and trait anxiety. The hEDS group showed significantly lower scores on total HRQoL, on all subscales as well on calculated subgroups of physical and mental HRQoL than the HC group. Depression, state, and trait anxiety scores were significantly higher in hEDS group than in the HC group. However, both state and trait anxiety showed a lower degree of negative associations with social functioning in the hEDS group when compared to the HC group. Patients with hEDS present with a lower HRQoL and greater psychological distress than healthy individuals. These factors play a significant role in the patients’ overall functional capacity and should be noticed when examining and treating patients with hEDS.

Exploring associations between positive and negative valanced parental comments about adolescents\u2019 bodies and eating and eating problems: a community study

BackgroundAdolescence is a time of rapid emotional and physical development when foundational self-concepts (including beliefs about one’s weight and shape) are established. Parents are key influencers of adolescent beliefs and behaviours. This study aimed to investigate associations between perceived positive and negative parental comments on weight/shape and eating, with sons’ and daughters’ psychological distress and eating disorder cognitions (EDCs).MethodsA representative mixed-sex sample of 2204 Australian adolescents (12–19 years) from the EveryBODY Study completed an online survey exploring eating behaviours, psychological wellbeing and experiences of parental comments regarding weight, shape and eating behaviours.ResultsCorrelation analyses revealed that adolescents’ reports of perceived positive parental comments on shape/weight were significantly associated with lower psychological distress and EDCs only for daughters. All perceived negative parental comments on shape/weight or eating were associated with greater psychological distress and EDCs for both sons and daughters. In the final model of the regression analysis, only perceived parental negative shape/weight and maternal negative eating comments, adolescent stage and biological sex were significantly associated with EDCs. When known contributors such as BMI percentile and psychological distress were included in the regression model, adolescent stage and perceived negative paternal comments were no longer significantly associated with EDCs.ConclusionsOverall, results show perceived negative comments were associated with poorer adolescent mental health, both their specific EDCs and general distress. Findings highlight the importance of raising awareness of potential negative impacts within family systems of comments around weight/shape and eating in these key formative years.Trial Registration The study was approved by the Macquarie University Human Research Ethics Committee (HREC 5201600312) and the New South Wales Department of Education.

The use of online social media for the recruitment of people living with HIV in Spain and Latin America: Lessons from two studies.

Various barriers make recruiting a difficult task for researchers, especially when recruiting people living with HIV (PLWH) or conducting longitudinal studies. Effective recruitment is crucial to the validity of studies, and in this regard, social media can come to aid, although researchers usually rely on paid advertisements. This paper describes the free social media strategies used for participant recruitment in two studies carried out with PLWH in Spain and Latin America. Study 1 was a cross-sectional study on the validation of two stigma scales with a 1-month retest. Study 2 was a longitudinal study exploring the mental health of newly diagnosed PLWH, with a second assessment after 6months. Facebook posts, Twitter mentions, and discussion forums were used in both studies. Study 2 also recruited participants through a healthcare centre. In Study 1, 5-month recruitment yielded a sample of 458 PLWH, averaging 91.6 surveys/month and a 43% retention rate. In study 2, recruitment took 16months, yielding a final sample of 145 newly diagnosed PLWH, 92 from the healthcare centre (5.75 surveys/month) and 53 from social media (3.31 surveys/month), with 95% and 60% retention rates, respectively. Participants in Study 2 did not differ in sociodemographic characteristics by recruitment method, except for the region of origin and financial difficulty (more diverse origin and greater difficulty emerged in social media participants). Greater psychological distress and lower personal and social resources were also found in social media participants. These data indicate that free social media recruitment is a feasible and effective tool for the recruitment of Spanish-speaking PLWH, although it is best used in combination with traditional methods for newly diagnosed PLWH and longitudinal studies.

Mineurs non accompagnés accueillis au centre psychiatrique d’orientation et d’accueil de l’hôpital Sainte-Anne, Paris

Since its creation, the Psychiatric Guidance and Reception Centre (CPOA) has received and cared for patients aged 16 to 18. Among them, the rate of Unaccompanied Minor Refugees (UMR) has steadily increased, from 10% in 2016 to 12% in 2018. Meeting UMR patients most often occurs at the peak of their crisis, when their personal resources are overwhelmed and when they experience a severe state of psychological suffering. Our objective was to understand who UMR are concerning the particularities and the similarities they could share at clinical and therapeutic levels with other adolescents. We conducted a retrospective and observational cohort study of the 52 UMR received at the CPOA in 2018 in order to draw a portrait of them, to identify the specificities of their care, their guidance and their access to care, and to compare them with other young non UMR patients. UMR we met at CPOA in 2018 were most often boys aged 16 to 17, with limited resources and in great psychological distress. UMR had more suicidal behaviors (19%) than other minor patients (13%), and our results showed more prolonged consultations for UMR than non UMR at the CPOA (44% versus 41%), indicating that the isolated situation of UMRs complicates their ambulatory support. This study also allowed us to question the existence of emergency care specially dedicated to UMR. Although there are few recommendations to date, it seems important to reintroduce time into their care, in order to recreate a unit, which has sufficient place and time for these young patients whose lives are marked by many breakdowns.

Cognitive Outcome 1 Year After Mild Traumatic Brain Injury: Results From the TRACK-TBI Study.

The objectives of this study were to develop and establish concurrent validity of a clinically relevant definition of poor cognitive outcome 1 year after mild traumatic brain injury (mTBI), to compare baseline characteristics across cognitive outcome groups, and to determine whether poor 1-year cognitive outcome can be predicted by routinely available baseline clinical variables. Prospective cohort study included 656 participants ≥17 years of age presenting to level 1 trauma centers within 24 hours of mTBI (Glasgow Coma Scale score 13-15) and 156 demographically similar healthy controls enrolled in the Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study. Poor 1-year cognitive outcome was defined as cognitive impairment (below the ninth percentile of normative data on ≥2 cognitive tests), cognitive decline (change score [1-year score minus best 2-week or 6-month score] exceeding the 90% reliable change index on ≥2 cognitive tests), or both. Associations of poor 1-year cognitive outcome with 1-year neurobehavioral outcomes were performed to establish concurrent validity. Baseline characteristics were compared across cognitive outcome groups, and backward elimination logistic regression was used to build a prediction model. Mean age of participants with mTBI was 40.2 years; 36.6% were female; 76.6% were White. Poor 1-year cognitive outcome was associated with worse 1-year functional outcome, more neurobehavioral symptoms, greater psychological distress, and lower satisfaction with life (all p < 0.05), establishing concurrent validity. At 1 year, 13.5% of participants with mTBI had a poor cognitive outcome vs 4.5% of controls (p = 0.003). In univariable analyses, poor 1-year cognitive outcome was associated with non-White race, lower education, lower income, lack of health insurance, hyperglycemia, preinjury depression, and greater injury severity (all p < 0.05). The final multivariable prediction model included education, health insurance, preinjury depression, hyperglycemia, and Rotterdam CT score ≥3 and achieved an area under the curve of 0.69 (95% CI 0.62-0.75) for the prediction of a poor 1-year cognitive outcome, with each variable associated with >2-fold increased odds of poor 1-year cognitive outcome. Poor 1-year cognitive outcome is common, affecting 13.5% of patients with mTBI vs 4.5% of controls. These results highlight the need for better understanding of mechanisms underlying poor cognitive outcome after mTBI to inform interventions to optimize cognitive recovery.

Translated article] Chemotherapy, Alopecia, and Scalp Cooling Systems

Chemotherapy-induced hair loss in cancer is usually temporary but can take a significant emotional toll on patients and lead to treatment refusal in many cases. Although hair loss is usually reversible, regrowth can take months, causing greater psychological distress. Recent years have seen the emergence of cold caps, or scalp cooling systems, designed to prevent or at least reduce chemotherapy-induced hair loss. The results to date are encouraging. We review the evidence on the effects and effectiveness of these systems, which are making their way into routine clinical practice.

Moral injury in Chinese health professionals during the COVID-19 pandemic.

Objective: Caring for patients during the COVID-19 pandemic has placed considerable stress on health care professionals (HCPs), increasing their risk of moral injury (MI) and clinician burnout. The present study sought to examine the prevalence and correlates of MI among physicians and nurses in mainland China during the pandemic. Method: A cross-sectional study was performed via an online survey conducted from March 27, 2020 to April 26, 2020. The 10-item Moral Injury Symptoms Scale-Health Professional version (MISS-HP) was administered along with measures of clinician mental health and burnout. A total of 3,006 physicians and nurses who completed the questionnaire were included in the final analysis. Unconditional logistic regression modeling was performed to determine the associations, including that between COVID-19 patient exposure and the risk of moral injury. Results: MISS-HP scores strongly and positively correlated with depression, anxiety, low well-being, and burnout symptoms. The estimated prevalence of MI in the total sample was 41.3%, 95% confidence interval (CI) [39.3%, 43.0%]. HCPs providing medical care to COVID-19 patients experienced a 28% greater risk of MI than those providing medical care to patients without the coronavirus (odds ratio = 1.28, 95% CI [1.05, 1.56], p = .01). Conclusions: A significant proportion of HCPs in mainland China are at risk for significant MI symptoms as well as mental health problems and burnout during the COVID-19 pandemic. MI symptoms are strongly correlated with higher clinician burnout, greater psychological distress, and lower level of subjective well-being. Effective strategies are needed to address MI and other mental health problems in frontline health care workers treating those with and without COVID-19 disease. (PsycInfo Database Record (c) 2022 APA, all rights reserved).