Higher GHQ Scores Research Articles

Screening for psychological distress in childhood and mental health-related hospital attendance among young adults

ObjectivesThe prevalence of mental disorders is high and increasing among children and young people. Investigating the relationship between self-reported poor mental health and mental health service utilisation can provide evidence on the benefits of universal screening, but longitudinal data is rare. ApproachData from a nationally representative English cohort (Next Steps) were linked to NHS Hospital Episode Statistics. GHQ-12 assessed psychological distress in Next Steps at age 15; participants were followed until their first mental health-related hospital presentations or were censored at the end of the study (age 27). Cox proportionate hazard models with survey weights estimated associations. ResultsOut of 4058 young people included in the analyses, 19% reported high levels of distress at age 15. During the 12-year follow-up, 5.3%, 2.9% and 2.7% of the participants had at least one mental disorder, drug/alcohol misuse and self-harm presentation, respectively, and 4.2% had a mental health treatment. Higher GHQ-12 scores were associated with mental disorder presentations (HR=1.10, 95% CI:1.04-1.16), and mental health treatments (HR=1.14, 95% CI:1.08-1.20). Associations were weaker for young people living in deprived areas, or if their main parent had lower education. ConclusionsAdolescent psychological distress predicts subsequent hospital attendance in young adulthood, but there are treatment gaps in service utilisation among more disadvantaged individuals. Detecting youth with mental health difficulties through universal screening, may facilitate early intervention, improve life-course outcomes, and reduce secondary healthcare use. ImplicationsLinked cohort and administrative data can improve our understanding on long-term healthcare utilisation and treatment needs.

Comparison of premenstrual symptoms, psychological well-being, and nutritional status between Palestinian women with and without polycystic ovarian syndrome: a case-control study

BackgroundPolycystic ovarian syndrome (PCOS) is a widely seen reproductive and endocrinological disorder. PCOS can exert substantial effects on many aspects of an individual’s life, including reproductive health and psychological well-being. The objective of this study was to assess the nutritional status, premenstrual syndrome, and mental health of women affected by PCOS in comparison to women without PCOS.MethodologyA case-control observational study in Palestine included 100 PCOS patients and 200 healthy women. The collected data included socio-demographic information, medical history, premenstrual syndrome, mental health, nutritional status, and lifestyle. Anthropometric measurement and the Mediterranean Diet Adherence Screener (MEDAS) were used to evaluate the nutritional status. The General Health Questionnaire (12-GHQ) was used to evaluate the state of mental health. Premenstrual syndrome (PMS) severity was evaluated using a validated Arabic premenstrual syndrome questionnaire.ResultsThe study’s findings indicated that there was a statistically significant increase in the three dimensions of PMS among participants with PCOS, p < 0.05. Similarly, PCOS patients demonstrated elevated ratings across all aspects of mental health, p < 0.05. In terms of the other variables, it has been observed that PCOS patients have a notably greater prevalence of perceived sleep disturbances and decreased adherence to the Mediterranean diet. Regression analysis revealed that PCOS is associated with mental health problems indicated by a higher GHQ score (OR: 1.09; 95% CI: 1.03; 1.16, p < 0.05), lower adherence to the MD diet (OR: 0.86; 95% CI: 0.76; 0.98, p < 0.05), and pre-menstrual syndrome, especially the physical symptoms (OR: 1.06; 95% CI: 1.003; 1.12, p < 0.05) after adjusting for age, smoking, waist-hip ratio, and body mass index (BMI).ConclusionThe study has linked polycystic ovary syndrome to negative mental health outcomes and an increased severity of premenstrual syndrome (PMS). Additional investigation is required in order to establish a causal association between polycystic ovary syndrome (PCOS) and lifestyle behaviors within the Palestinian population. Intervention and instructional studies are necessary to investigate the efficacy of management strategies in alleviating the effects of polycystic ovary syndrome (PCOS) on both physical and mental well-being.

Association between lifestyle choices and mental health among medical students during the COVID-19 pandemic: A cross-sectional study.

IntroductionMental health is recognized as a critical component of public health Given the close relationship between mental health and life style and the importance of students as valuable human resources, the present study aimed at determining the relationship between life style and mental health among medical students in Sousse during COVID-19 pandemic.MethodsWe conducted a cross-sectional observational study in university students from the first to the fifth grade of the Faculty of Medicine of Sousse during the academic year 2020/2021. Data were collected anonymously via an online questionnaire published on the Facebook groups of each grade, on december 2020. The online survey consisted of three sections. The first one aimed to collect sociodemographic information. The second section of the survey addressed recent lifestyle choices and the third one assessed psychological distress using the French version of 12 items of The General Health Questionnaire (GHQ-12). The significance level was considered 0.05.ResultsOverall 147 were studied. Using the bimodal scoring, the total score was between 0 and 12, to evoke psychiatric disorders, we set the threshold of 4. For our sample, the median scale was 7 [4-9], and more than half of the students (68%; n = 100) had a score higher than 4. Psychiatric disorder was significantly more frequent in female students (73.3% vs 42.3%; p = 0.002). Higher GHQ-scale was found in younger students, foreigners, students who need more than 30 minutes to get to the faculty, unemployed students, and students of fifth grade. However, differences were not statistically significant. Regarding lifestyle choices, we found that physical inactivity, no smoking habits, no alcohol use, no illicit substance use, other substance use, changing in eating habits, and absence of coping methods of stress were higher in students with psychiatric disorders. However, this association was statistically significant only for physical activity (p = 0.016). The results of the regression analysis suggest female gender as an independent predictor of high GHQ-12 scores. Practicing physical activity was found as protective factor for psychiatric disorders.ConclusionConsidering the vital role of medical students in providing and promoting community health, the need for more detailed planning and interventions to improve their life style and mental health is essential.

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A study on Mental Health assessment among the Resident doctors, House surgeons during the Corona virus Disease-2019 pandemic in Mamata Medical CollegeIntroduction:Medical students and health care professional are more anxious and depressed than their peers, and the prevalence of various mental health problems is on the raise. The corona virus disease 2019 (COVID-2019) pandemic has had far-reaching psychosocial consequences on the medical professionals.Aims and objectives:The aim of this study is to assess the mental status of Resident doctors and House surgeons at Mamata medical college during COVID -19 Pandemic and lockdown.Materials and methods:A questionnaire-based, cross-sectional study. General health questionnaire with 28 items (GHQ-28) was adapted to GoogleForms and circulated among healthcare professionals from MamataMedical College, Khammam.Results:This study included 105 medical professionals including House surgeons and Resident doctors practicing in different clinical departments, working at Mamata Medical college, khammam,Telangana. Mean age for the study sample is 25.28years, there were 43 male and 62 female at total of 105 medical professionals out of which 17 were male House surgeons and 35 female house surgeons, 26 were male residents and 27 female residents. In this study 70 participants have scored >23 GHQ score. Females were shown to have higher GHQ score >23 than the male participantsConclusion:Mental health issues are very common among medical professionals, which may be aggravated now during the COVID-19 pandemic. The factors such as uncertainty caused by pandemic, female sex were associated with greater mental health issues.

Depressive symptoms in men immediately after birth

ObjectiveDepression is the second leading cause of morbidity worldwide. This study aimed to assess the prevalence and associated risk factors of paternal postpartum depressive symptoms (PPD). MethodsIn a cross-sectional study, via a stratified random and convenience sampling method 591 couples who were referred to Mazandaran primary health centers between 2 and 8 weeks postpartum were recruited from March to October 2017. Couples were screened for depressive symptoms using Edinburgh Postnatal Depression Scale (EPDS). Fathers provided information on socio-demographic characteristics, life events, neonatal stressor, perceived stress (Perceived Stress Scale), social support (Multidimensional Scale of Perceived Social Support), and general health status using General Health Questionnaire (GHQ-12) as well. Data was analyzed using multiple logistic regression. ResultsOverall, 93 fathers (15.7%) and 188 mothers (31.8%) reported depressive symptoms above the cut-off EPDS score of 12. In the multiple logistic regression model, older age, maternal depressive symptoms, higher GHQ-12 scores and increased recent life events were related to paternal PPD. A significant inverse association was found between number of children and paternal PPD. ConclusionDepressive symptoms especially in first-time fathers following the birth of a child are not uncommon. Creating opportunities for men to access special health care services, parental education to help adapting to parenthood, screening programs, and psychiatric/psychosocial interventions to decrease suffering of depression for both depressed parents are recommended.

Help-seeking behaviors for mental health problems in medical students: Studies in Thailand and India

To compare the rate of help-seeking from mental health professionals (MHPs) and other sources of help for mental health problems of medical students in Thailand and India, and explore factors associated with help-seeking from MHPs. Cross-sectional survey-based study was conducted in two medical schools in Thailand and India. Students were asked to rate their preferences for each source of help on a Likert-scale basis. Mental health status was measured by the General health questionnaire-12 (GHQ-12). Attitudes and stigma toward mental illness were collected using the Mental illness clinician's attitude scale: medical student version or MICA v2. 593 students participated in the survey. The percentage of students who chose to seek help from any source was lower in Thailand than in India. 81 % of students in India site chose to seek help from MHPs, compared to 66 % in Thailand site. The risk factors for avoiding seeking help from MHPs in Thailand were history of alcohol use (OR = 1.88, p = .014) and total GHQ score (OR = 1.11, p = .006), whereas having GHQ score ≥ 2 was a significant risk factor in India (OR = 2.20, p = .044). Total MICA score, which reflected overall attitude toward mental illness, was not associated with seeking help from MHPs. The rate of help-seeking behaviors for mental health problems and factors associated differed between medical students in Thailand and India. A high GHQ score was a common risk factor of not seeking help from MHPs in both countries.

Association between nutritional level, menstrual-related symptoms, and mental health in female medical students.

ObjectiveResearch suggests that medical students as well as women are at greater risk of depression compared to the general population and men. This suggests that female medical students are crucial targets requiring specific monitoring for mental health disorder prevention and intervention. However, little is known regarding the risk factors for poor mental health among this population. Therefore, we investigated whether menstrual symptoms and nutritional status are associated with psychological distress in Japanese female medical students.MethodsThis cross-sectional study assessed 326 female medical students who attended a school medical check-up, which included blood sampling in 2018. The levels of psychological distress were evaluated using the Japanese General Health Questionnaire (J-GHQ)-30. We defined high GHQ scores as GHQ-30 ≥7. We checked dysmenorrhea levels and assessed menstrual symptoms according to the presence of premenstrual syndrome (PMS). Dysmenorrhea was evaluated according to quartiles of the sum of the Menstrual Distress Questionnaire (MDQ). PMS was assessed using the Premenstrual Symptoms Questionnaire (PSQ). We evaluated levels of serum albumin, hemoglobin, ferritin, and lipid metabolite as nutritional factors. A multivariate logistic regression analysis was used to identify the association between menstrual-related symptoms or nutritional factors and the levels of psychological distress.ResultsA total of 45 female medical students (15%) experienced psychological distress. Serum albumin levels were associated with psychological distress, while lipid metabolite levels were not. The intensity of dysmenorrhea and the presence of PMS were associated with psychological distress, independent of nutritional status.ConclusionBoth menstrual symptoms and nutrition markers were associated with the levels of psychological distress in Japanese female medical students. School doctors and nurses can help improve the mental health of young female medical students by encouraging a healthy diet and checking for the presence of menstrual symptoms.

Roles of cyberbullying, sleep, and physical activity in mediating the effects of social media use on mental health and wellbeing among young people in England: a secondary analysis of longitudinal data

There is growing concern about the potential associations between social media use and mental health and wellbeing in young people. We explored associations between the frequency of social media use and later mental health and wellbeing in adolescents, and how these effects might be mediated. We did secondary analyses of publicly available data from the Our Futures study, a nationally representative, longitudinal study of 12 866 young people from age 13 years to 16 years in England. The exposure considered was the frequency of social media use (from weekly or less to very frequent [multiple times daily]) at wave 1 (participants aged 13-14 years) through wave 3 of the study (participants aged 15-16 years). Outcomes were mental health at wave 2 (with high 12-item General Health Questionnaire [GHQ12] scores [≥3] indicating psychological distress), and wellbeing at wave 3 (life satisfaction, feeling life is worthwhile, happiness, and anxiety, rated from 1 to 10 by participants). Analyses were adjusted for a minimal sufficient confounding structure, and were done separately for boys and girls. Cyberbullying, sleep adequacy, and physical activity were assessed as potential mediators of the effects. Very frequent use of social media increased from wave 1 to wave 3: from 34·4% (95% CI 32·4-36·4) to 61·9% (60·3-63·6) in boys, and 51·4% (49·5-53·3) to 75·4% (73·8-76·9) in girls. Very frequent social media use in wave 1 predicted a high GHQ12 score at wave 2 among girls (adjusted odds ratio [OR] 1·31 [95% CI 1·06-1·63], p=0·014; N=4429) and boys (1·67 [1·24-2·26], p=0·0009; N=4379). Persistent very frequent social media use across waves 1 and 2 predicted lower wellbeing among girls only (adjusted ORs 0·86 [0·74-0·99], N=3753, p=0·039 for life satisfaction; 0·80 [0·70-0·92], N=3831, p=0·0013 for happiness; 1·28 [1·11-1·48], N=3745, p=0·0007 for anxiety). Adjustment for cyberbullying, sleep, and physical activity attenuated the associations of social media use with GHQ12 high score (proportion mediated 58·2%), life satisfaction (80·1%), happiness (47·7%), and anxiety (32·4%) in girls, such that these associations (except for anxiety) were no longer significant; however, the association with GHQ12 high score among boys remained significant, being mediated only 12·1% by these factors. Mental health harms related to very frequent social media use in girls might be due to a combination of exposure to cyberbullying or displacement of sleep or physical activity, whereas other mechanisms appear to be operative in boys. Interventions to promote mental health should include efforts to prevent or increase resilience to cyberbullying and ensure adequate sleep and physical activity in young people. None.

Correlates of mental disorders among minority Arab adolescents in Israel: results from the Galilee Study

BackgroundThe Galilee Study is the first large epidemiological study to compare correlates of mental disorders between two Arab Palestinian minority groups of adolescents in Israel.MethodsA two-stage cross-sectional study, carried out between 2012 and 2014, included all 9th grade students from 5 Arab localities, representative of 77% of the Muslim and 100% of Druze citizens in Israel. During the screening stage, 1639 students completed the Strengths and Difficulties Questionnaire in the classroom (response rate = 69.3%). During the follow-up stage, 704 adolescent-mother dyads were interviewed at home; using the Development and Well-Being Assessment, the General Health Questionnaire (GHQ)-12, the Subjective Feeling of Discrimination Index (FDI), and socio-demographic questions (response rate = 84.4%).ResultsPrevalence of any disorder, internalizing or externalizing disorders among Muslim adolescents were 19.2, 15.8 and 4.2%, respectively and among Druze adolescents 10.9, 5.9 and 5.5%, respectively. Muslim adolescents were 3.2 times more likely than Druze adolescents to have an internalizing disorder, while Druze were 2 times more likely than Muslim to have an externalizing disorder. Males were at higher risk than females for externalizing disorders in both populations, though among Druze the risk was more striking. Learning disabilities increased the likelihood of having an externalizing disorder in both populations. Risk factors for internalizing disorders among Muslim adolescents were female gender, a very low socio-economic level, few siblings, LD, high maternal GHQ-12 score and high FDI; and for externalizing disorders, male gender, a relatively low socio-economic level but not the lowest, learning disability and high maternal GHQ-12 score.ConclusionsWe found an association between religion/ethnicity and internalizing and externalizing disorders as well as a strong correlation between religion/ethnicity and socio-economic variables. Therefore, we tend to conclude that not religion per se but the multifaceted socio-cultural and economic factors that characterize religious groups are associated with mental disorders. Very low socio-economic level and feeling discriminated which were traits connected only to Muslim adolescents, were associated with internalizing disorders. When preparing preventive measures aimed at furthering mental health among minority adolescents, authorities should focus on improving the socio-economic status of minorities and reducing institutional and personal discrimination. The educational and mental health establishments could undertake measures to improve resilience and coping strategies of Muslim families living in the most adverse conditions, such as providing special support through the school counseling services and coordinating, at the ministerial levels, school and community health services in order to carry out joint preventive programs and referrals to specialist services when needed.

Prevalence, causes and mental health impact of workplace bullying in the Neonatal Intensive Care Unit environment

ObjectivesThe aim of this study is to examine the prevalence, to report barriers and mental health impact of bullying behaviours and to analyse whether psychological support at work could affect...

Association between social support and child abuse potential among Japanese mothers

Child abuse is a global public health problem and a serious social issue in Japan. Social support is beneficial for parents faced with childrearing challenges. The aim of this study was to clarify the association between social support and child abuse potential. A cross-sectional study was conducted using a structured questionnaire. The target population was mothers of children at nine public nursery schools. Bivariate and multiple linear regression analysis were performed to examine the effects of socio-demographic, social support and psychological distress factors on child abuse potential. Among 309 mothers, 29 (9.4%) had a high child abuse potential score. Bivariate analysis indicated that mothers with a higher child abuse potential score were more likely to be divorced or unmarried (P<0.001); living in single-female-parent households (P<0.001); have low perceived economic status (P<0.001); have a low level of child care support (P=0.01); have a low Multidimensional Scale of Perceived Social Support (MSPSS) score (P<0.001); and/or a high General Health Questionnaire-12 score (GHQ-12) (P<0.001). Important predictors of child abuse potential among the mothers surveyed included living in single-female-parent households, having low perceived economic status, low MSPSS score, and high GHQ-12 score. Improving approaches that help mothers build social support relationships and ease them into child rearing in a psychologically healthy condition is recommended to prevent child abuse.

Association between passive smoking and mental distress in adult never-smokers: a cross-sectional study

ObjectiveMany studies have suggested exposure to secondhand smoke (SHS) is a risk factor for various somatic diseases, but only few studies based on small sample size or specific groups have...

Assessment of Mental Health among Iranian Medical Students: A Cross-Sectional Study.

More mental morbidities were reported in medical students than their nonmedical peers, which may negatively influence their lives and future career. The aim of this study was to assess the mental health status among medical students of Shiraz University of Medical Sciences. Two hundred and eight 1(st) to 4(th) year Medical students took part in this cross-sectional study. General Health Questionnaire with 28 items (GHQ-28) was used for data collection. We performed descriptive statistics, Mann Whitney U test, one way ANOVA and Tukey's post hoc and Kruskal Wallis H and Chi square test for statistical analysis. The mean age of participants was 20.70 ± 1.14 (mean ± SD) years. More than half of them (54.4%) had total GHQ score above the cut-off point considered as probably abnormal mental health status. Years of education, positive family history and low satisfaction of the medicine discipline affected their mental health. Third and fourth year students had significantly higher mean scores of total GHQ (p-value = 0.009) and anxiety, somatic and social subscales (p-value = 0.001, 0.004 and 0.026). Students with positive family history of mental illness and low satisfaction of field of the study significantly had higher GHQ scores (p-value = 0.012 and < 0.001 respectively). Poor mental health prevalence is high among medical students in Shiraz. Proper changes in educational programs and other effective interventions to raise the students' satisfaction may reduce the effect of other stress reasons and improve their mental health status.

Quality of Life in Heroin Users Attending Substitution Treatment: A Multicenter Study in Italy

Quality of life (QoL) is an important measure to verify the effectiveness of therapy in substance use disorders (SUD). In this cross-sectional, multicenter study QoL has been measured in 1057 heroin dependents attending SerDs (“Servizi per le Dipendenze”, Italian National Health System Services for Addictions) and has been correlated with demographic variables and drug treatment. QoL has been measured by using GHQ-12 (12-item General Health Questionnaire), a self-administered questionnaire whose value is inversely correlated with the QoL. The median value of GHQ-12 in the study population was 12 (interquartile range [IQ] 9 - 18): 640 patients (60.6%) scored 20 points at the GHQ-12, which relates with a bad QoL. Female population showed higher GHQ12 scores when compared to male population (14 [IQ 9 - 19] vs. 12 [IQ 9 - 17], p = 0.03). Similarly, unemployed patients showed higher GHQ12 scores when compared to employed patients (15 [IQ 10 - 20] vs. 12 [IQ 8 - 16], p 20. Results show that most of patients receiving care for heroin dependence at SerDs have a positive assessment of their quality of life, and that being unemployed and having a dual diagnosis are predictors of poor QoL. Besides, data suggest that assuming buprenorphine could be a protective factor for QoL.

Association Between Clinical Signs of Temporomandibular Disorders and Psychological Distress Among an Adult Finnish Population.

To evaluate the association between signs of temporomandibular disorders (TMD) and psychological distress in a general population-based sample of Finnish adults. The Health 2000 Survey was conducted in 2000-2001 by the National Institute for Health and Welfare in Finland. Of the sample of adults aged 30 or over (n=8,028), 79% participated in a clinical oral health examination, which included examination of TMD signs. The participants (n=6,155) also completed questionnaires, including the 12-item General Health Questionnaire (GHQ-12), which measured psychological distress. Associations between TMD signs and psychological distress measured by the GHQ-12 were examined in both genders. Statistical measures included chi-square tests, t tests, and logistic regression analyses. The prevalence of the TMD signs (limited opening, clicking, crepitation, temporomandibular joint [TMJ] palpation pain, and muscle palpation pain) was 11.2%, 17.6%, 10.5%, 5.1%, and 18.9% in women, and 6.1%, 12.9%, 5.3%, 2.4%, and 7.2% in men, respectively. High GHQ-12 scores, measured as continuous variables and in quartiles by distress level, were significantly associated with masticatory muscle pain on palpation in both genders (P<.05) and with TMJ pain on palpation in women (P<.05). Additionally, high GHQ-12 scores as continuous were associated with TMJ crepitation in men (P<.05). The logistic regression analyses showed that higher GHQ-12 scores were associated significantly with masticatory muscle pain on palpation both in women (odds ratio [OR]=2.18; 95% confidence interval [CI]=1.6-2.9) and men (OR=2.03; 95% CI=1.3-3.1). TMD signs and psychological distress appear to be associated. However, due to the limitations of the study, the findings can be regarded as preliminary.

Mental health problems and influencing factors in Japanese women 4 months after delivery.

BackgroundPostpartum mental health problems are a major public health issue; however, studies on the mental health status of mothers and its influencing factors between 8 weeks and 1 year postpartum are scarce. Furthermore, it would be necessary to examine the factors influencing mothers’ mental health in order to evaluate their physiological adaptations to the nursing environment.MethodsWe examined the mental health status of postpartum women and the factors influencing poor mental health at 4 months after delivery. A cross-sectional study of 584 postpartum women was conducted. Information on mental health status, delivery, and other factors was collected using a self-administered questionnaire. Women were asked about their age, height, weight, gestational or marital status, whether they were eating regular meals, appetite, frequency of going out, financial difficulty, stressful life events, and history of depression. The Japanese version of the 12-item General Health Questionnaire (GHQ-12) was used to identify potential poor mental health status. Participants with GHQ-12 scores of ≥4 were classified as the high GHQ-12 score group (poor mental health status) and participants with GHQ-12 scores of ≤3 were classified as the low GHQ-12 score group (good mental health status).ResultsForty-five women (7.7%) were classified as having high GHQ-12 scores. Multiple logistic regression analysis revealed that older age, not eating meals regularly, and history of depression were significantly associated with poor mental health. Financial difficulty had a borderline association with poor mental health in this model.ConclusionsThese risk factors might help practitioners identify women at high risk of poor mental health after delivery.

The impact of supportive counselling on women's psychological wellbeing after miscarriage--a randomised controlled trial.

To assess the effectiveness of supportive counselling after miscarriage. Randomised controlled trial. University hospital. Two hundred and eighty women with miscarriage. Women were randomised to receive supportive counselling from a nurse (at diagnosis and 2 weeks later) or routine care. Psychological wellbeing was measured with the General Health Questionnaire (GHQ-12) and Beck Depression Inventory (BDI). Primary outcome measured the proportion of women suffering psychological distress (GHQ-12 score ≥4) at 3 months after miscarriage. Secondary outcomes were GHQ-12 and BDI scores at 6 weeks, 3 and 6 months. There was no difference in the proportion of women suffering psychological distress at 3 months after miscarriage (17.1% in counselling group versus 24.4% in control group; 95% CI -0.034 to 0.177; P = 0.19). However, for the subgroup of women (n = 152) with high baseline GHQ-12 scores, the median GHQ-12 score in the counselling group was significantly lower than the control group at 6 weeks (median score 3 versus 4.5 in counselling and control groups; P = 0.04) and 3 months (median score 1 versus 2.5 in counselling and control groups; P = 0.03). Similarly, for women with high baseline BDI scores (BDI > 12), the proportion for women continuing to score high was significantly lower in the counselling group 6 weeks after miscarriage (33.3 versus 61.1% in counselling group and control group; P = 0.03). Although the results of current study do not justify routine counselling of all women following miscarriage, a supportive counselling programme for selected women with high levels of psychological distress is promising and merits further investigation.

Caregiver burden mediates between caregiver's mental health condition and elder's behavioral problems among Japanese family caregivers

Objectives: In Japan, the prevalence of depression has been reported to occur among 1 in 4 family caregivers. The purpose of this study was to investigate the self-rated burden associated with mental health conditions among caregivers.Methods: We studied 95 caregivers aged 38–87 years in a cross-sectional study. The General Health Questionnaire (GHQ-12) score of 4 or more was defined as poor mental health.Results: The proportion of caregivers with poor mental health was 24%. Caregivers with a high GHQ-12 score had the number of caregiver burdens increased by 2.5-fold compared to those with a low GHQ-12 score (p = 0.001). The proportion of caregivers with a high GHQ-12 score was significantly higher with an increasing number of behavioral problems among care recipients (p = 0.003). A mediational model was used to identify the underlying mechanism of the relationship between the number of behavioral problems and poor mental health in caregivers. Consequently, we found that mental health conditions in caregivers were associated with both the number of caregiver burdens and behavioral problems among care recipients.Conclusions: It is vital to provide support not only to the caregivers but also to their elderly relatives, paying particular attention to early identification of poor mental health in caregivers so as to administer effective interventions, and to offer useful advice concerning how to deal with behavioral problems.

Malnutrition in early life and adult mental health: Evidence from a natural experiment

As natural experiments, famines provide a unique opportunity to test the health consequences of nutritional deprivation during the critical period of early life. Using data on 4972 Chinese born between 1956 and 1963 who participated in a large mental health epidemiology survey conducted between 2001 and 2005, we investigated the potential impact of exposure to the 1959–1961 Chinese Famine in utero and during the early postnatal life on adult mental illness. The risk of mental illness was assessed with the 12-item General Health Questionnaire (GHQ-12) and eight other risk factors, and the famine impact on adult mental illness was estimated by difference-in-difference models. Results show that compared with unexposed women born in 1963, women born during the famine years (1959–1961) had higher GHQ scores (increased by 0.95 points; CI: 0.26, 1.65) and increased risk of mental illness (OR = 2.80; CI: 1.23, 6.39); those born in 1959 were the most affected and had GHQ scores 1.52 points higher (CI: 0.42, 2.63) and an OR for mental illness of 4.99 (CI: 1.68, 14.84). Compared to men in the 1963 birth cohort, men born during the famine had lower GHQ scores (decreased by 0.89 points; CI: −1.59, −0.20) and a nonsignificant decrease in the risk of mental illness (OR = 0.60; CI: 0.26, 1.40). We speculate that the long-term consequences of early-life famine exposure include both the selection of the hardiest and the enduring deleterious effects of famine on those who survive. The greater biological vulnerability and stronger natural selection in utero of male versus female fetuses during severe famine may result in a stronger selection effect among men than women, obscuring the deleterious impact of famine exposure on the risk of mental illness in men later in life.

Suicidal and help-seeking behavior in Xiamen, south China

The aim of this study is to examine the association between suicidal behavior and mental health status of south Chinese people, and explore the mediating effect of help-seeking behaviors. The study participants were 10,757 persons aged 18 years and older from the mental health survey of Xiamen city. Data on suicidal behavior and help-seeking behavior were collected by trained psychiatric nurses through face-to-face interviews. Mental health status was assessed using the 12-item General Health Questionnaire (GHQ-12). Multiple logistic regression and general linear model were used in statistical analysis. In the entire study sample, 236 study participants reported suicide ideation (2.19%, 95% CI: 1.92-2.47%), and 59 reported at least one suicide attempt (0.55%, 95% CI: 0.41-0.69%). Individuals with suicide attempt and suicide ideation had higher GHQ scores than those without suicidal behavior. The majority of study participants with suicide ideation or suicide attempt did not seek any help (77.5% and 79.7%, respectively). Among participants with suicidal behavior, seeking help from mental health professional was associated with a better mental health status (OR = 4.04, 95%CI: 1.17-10.16). Only a small proportion of individuals with suicide behavior in south China had ever sought help. Seeking help was associated with a better mental health status.