High Levels Of Psychological Distress Research Articles

Secondary analysis of a randomized trial testing community health educator interventions for diabetes prevention among refugees with depression: effects on nutrition, physical activity and sleep

BackgroundRefugees have high levels of psychological distress that hamper lifestyle change efforts. We previously reported that community health educator (CHE) diabetes prevention interventions decreased HbA1c and depressive symptoms among Cambodian-American refugees with depression; this paper reports health behavior outcomes of those interventions.MethodsParticipants were aged 35–75, Khmer speaking, at risk for diabetes, and met study criteria for likely depression by either a) antidepressant medication and/or b) prolonged elevated depressive symptoms. Participants were randomized to one of three CHE interventions: 1) lifestyle intervention called Eat, Walk, Sleep (EWS), 2) EWS plus medication therapy management with a pharmacist/CHE team (EWS + MTM), or, 3) social services (SS; control). Physical activity and sleep were measured with 7 days of actigraphy. Nutrition was measured as carbohydrates as reported in a culturally tailored food frequency questionnaire. Assessments were at baseline, end point (12 months), and follow-up (15 months).ResultsThe n = 188 participants were 78% female, average age of 55 years, half had a household income < $20,000, and modal education was 7.0 years. Individuals in the two treatment groups that received the EWS intervention significantly increased their brown rice consumption (p < .001, Cohen’s d = 0.76) and their moderate-to-vigorous activity (p = .039, d = 0.32). No intervention changed sleep duration, timing, efficiency or wake after sleep onset. Across groups, individuals who increased brown rice consumption, increased vigorous activity and decreased total sleep time variability showed decreased HbA1c, with small effect sizes.ConclusionsCHEs may improve nutrition and physical activity in refugees with depression but more intensive interventions may be required to impact sleep. Improvements in all three behaviors appear to be associated with HbA1c loweringTrial registrationClinicalTrials.gov identifier NCT02502929.

China’s zero-COVID policy and psychological distress: a spatial quasi-experimental design

Abstract Before the Omicron variant ran amok inside China in November 2022, the Chinese central government’s dynamic zero-COVID policy effectively contained the spread of the coronavirus and its variants during multiple waves of outbreaks. However, it was not without cost. This study examines the impacts of stringent lockdown interventions on urban residents’ mental health during the initial outbreak of the Omicron variant in the spring of 2022. Using survey data from 522 respondents within the same neighbourhood and a spatial quasi-experimental design, the results show that strict lockdown interventions are significantly related to higher levels of psychological distress after controlling for observed confounders and that lockdown interventions have further spillover effects on mental health for residents in adjacent residential compounds who are otherwise free. Moreover, the results show that the lack of material supplies and medical care plays a more salient role in explaining lockdown effects on psychological distress than residents’ social interaction and trust levels of COVID-19 policy. Policy and intervention implications are also discussed.

Burnout and perceived stress among Italian physical therapists during the COVID-19 pandemic: a cross-sectional study

ABSTRACT High levels of burnout and psychological distress have been reported for healthcare workers, with seemingly worse outcomes after the outbreak of the COVID-19 pandemic. However, to date, scarce evidence has been gathered about the condition of physical therapists. This cross-sectional study investigated the three burnout dimensions of emotional exhaustion, depersonalization, and personal accomplishment as measured by the Maslach Burnout Inventory (MBI) and assessed perceived stress with the 10-item Perceived Stress Scale (PSS) in a sample of Italian physical therapists with the aim of examining the relationships between these variables and demographic and work-related factors. An anonymous questionnaire was administered to a convenience sample of 671 professionals from the whole nation and associations between burnout, perceived stress, and work-related variables were investigated with descriptive and inferential statistical methods. Overall, 25% of the participants showed high burnout risk (40% scored high on emotional exhaustion, 36% scored high on depersonalization, and 19% scored low on personal accomplishment), whereas 50% reported high levels of perceived stress. Having been exposed to verbal or physical aggressive behaviors at work (OR = 4.06) was associated with high burnout risk, and participants at risk were significantly younger than those showing no burnout risk (d = 0.27). Having a partner (OR = 0.54) and having children (OR = 0.56) were associated on the other hand with reduced burnout risk. Regression models identified weekly working hours (β = 0.16), exposure to aggressive behaviors at work (β = 0.12), and perceived stress (β = 0.66) as significant predictors of emotional exhaustion, gender (β = 0.18), exposure to aggressive behaviors (β = 0.09), and perceived stress (β = 0.37) as predictors of depersonalization, and gender (β=-0.1) and perceived stress (β=-0.35) as predictors of personal accomplishment. In summary, this study found high rates of burnout and psychological distress among Italian physical therapists a year after the outbreak of COVID-19. Significant relations were found between burnout, psychological distress, and both socio-demographic and work-related variables.

Effects of COVID-19 stress, proximity, and adverse childhood experiences on healthcare workers' mental health.

Past research has shown that healthcare workers (HCWs) experience high levels of psychological distress during epidemics and pandemics, resulting in cascading effects that have led to chronically understaffed hospitals and healthcare centers. Due to the nature of their responsibilities and workplace stress, HCWs are among vulnerable groups especially during global health crises. During COVID-19 many healthcare workers reported greater symptoms of anxiety, depression, and COVID-19 related worries. Furthermore, adverse childhood experiences increase vulnerability for psychological conditions, especially during pandemics. This study sets out to (1) investigate the moderating effects of adverse childhood experiences on healthcare workers' COVID-19 related stressors and depression/anxiety symptoms, and (2) investigate the moderating effects of adverse childhood experiences on proximity to the COVID-19 virus and depression/anxiety symptoms. Participants included 438 employed HCWs recruited from academic medical centers and smaller healthcare agencies in northcentral Florida between October to December 2020. Mean age of participants was 38.23 (SD = 11.5) with most of the HCWs being white (72.1%), non-Hispanic (86.8%) and female (82%). Healthcare workers completed several online questionnaires, including the Adverse Childhood Experiences scale, Patient Health Questionnaire, Generalized Anxiety Disorder Scale, a COVID-19 specific worries scale, and a Social Proximity to COVID-19 scale. Healthcare workers experiencing specific COVID-19 worries reported experiencing anxiety and depressive symptoms. A significant positive interaction was seen between childhood adverse experiences globally and COVID-19 worries on anxiety symptoms. A significant positive interaction was observed between childhood maltreatment specifically and COVID-19 worries on depressive symptoms. Additionally, a positive interaction effect was seen between childhood adverse experiences and COVID-19 social proximity for both depression symptoms and anxiety symptoms. Findings from the present study indicate that adverse childhood experiences strengthen the relationship between COVID-19 worry/proximity and negative psychological symptoms. Vulnerable populations such as individuals who have experienced ACEs could benefit from targeted and specific interventions to cope with the collective trauma experienced globally due to COVID-19. As COVID-19 becomes endemic, hospital leadership and authorities should continue addressing COVID-19 worries and HCWs' psychological symptoms through mental health support and organizational interventions.

Sense of danger, sense of country's mastery, and sense of personal mastery as concomitants of psychological distress and subjective well-being in a sample of Poles following Russia's invasion of Ukraine: Prospective analyses.

This study investigated psychological toll of the ongoing war in neighboring Ukraine in a sample of adult Poles (N= 1245). Data were collected online in early February and August 2022. Prospective analyses that accounted for psychological health status assessed before the Russian invasion showed that higher levels of sense of danger due to the war predicted higher levels of psychological distress and lower levels of affect balance close to 6 months after Russia attacked Ukraine. Sense of country's mastery (i.e. beliefs that government, its major institutions, and citizens would effectively cope with various emergencies and crises) served as a protective factor. Likewise, Poles who had confidence in their personal mastery (e.g., beliefs in ability to exercise control over life challenges) exhibited less distress and more subjective well-being. These findings emerged after controlling for sociodemographic factors, the presence of stressful experiences associated with the COVID-19 pandemic, and other life events. Wars dramatically reverberate beyond the borders of the countries involved. People's own sense of mastery and their trust in the resilience of their governmental and public institutions are critical in times of coping with existential security threats and wars.

How did Latinxs near the U.S.-Mexico border fare during the COVID-19 pandemic? A snapshot of anxiety, depression, and posttraumatic stress symptoms.

The current study documented levels of anxiety, depression, posttraumatic stress, and COVID-19 fears and impacts among Latinxs living near the U.S.-Mexico border during the COVID-19 pandemic. Participants of this cross-sectional study were 305 Latinx adults living in the Rio Grande Valley (RGV) who completed an online survey between June and November 2020. About half of participants scored above the cut-off for anxiety (50.2%; GAD-7 scores ≥10) and depression (48.8%; PHQ-9 scores ≥10), and more than a quarter of participants showed clinical levels of posttraumatic stress (27.3%; PCL-5 scores ≥31). Latinxs reported on average 22 types of negative pandemic life impacts on the Epidemic-Pandemic Impacts Inventory. Endorsement of mental health symptoms, severity of COVID-19 fears, and COVID-related life impacts varied based on several demographic characteristics including gender, marital status, educational attainment, employment, income, insurance coverage, vulnerability to COVID-19, and essential worker status. Overall, the cross-sectional results of this study revealed that RGV Latinx residents experienced high levels of psychological distress during the pandemic. Results suggest that Latinx women were most affected by the psychological consequences of the pandemic. More research is needed with communities living near the U.S.-Mexico border as they may be particularly vulnerable to mental health problems during the pandemic.

Psychological Distress and Self-Management in CKD: A Cross-Sectional Study

Patients with chronic kidney disease (CKD) not receiving dialysis, including kidney transplant recipients, often experience difficulties regarding self-management. An important barrier for adherence to self-management recommendations may be the presence of psychological distress, consisting of depressive and anxiety symptoms. We investigated relationships between psychological distress and adherence to self-management recommendations. Cross-sectional online questionnaire data as part of the E-GOAL study. Patients with CKD (estimated glomerular filtration rate, 20-89mL/min/1.73m2) were recruited from April 2018 to October 2020 at 4 hospitals in The Netherlands and completed online screening questionnaires. Psychological distress, depressive symptoms, and anxiety symptoms. Dietary adherence, physical activity, medication adherence, smoking, body mass index, and a CKD self-management index (ie, the sum of 5 binary indicators of nonadherence to the recommended self-management factors). Adjusted multivariable regression and ordinal logistic regression analyses. In our sample (N=460), 27.2% of patients reported psychological distress, and 69.8% were nonadherent to 1 or more recommendations. Higher psychological distress was significantly associated with poorer dietary adherence (βadj,-0.13; 95% CI,-0.23 to-0.04), less physical activity (βadj,-0.13; 95% CI,-0.22 to-0.03), and lower medication adherence (βadj,-0.15; 95% CI,-0.24 to-0.05), but not with smoking and body mass index. Findings were similar for depressive symptoms, whereas anxiety was only associated with poorer dietary and medication adherence. Every 1-point higher psychological distress was also associated with a higher likelihood of being nonadherent to an accumulating number of different recommendations (adjusted OR, 1.04; 95% CI, 1.02-1.07). Cross-sectional design, possible residual confounding, and self-report. Many people with CKD experience psychological distress, of whom most have difficulties self-managing their CKD. Given the relationship between psychological distress and adherence to CKD self-management recommendations, behavioral interventions are needed to identify and treat psychological distress as a potential barrier to CKD self-management. This online questionnaire study investigated relationships between psychological distress and self-management among 460 people with chronic kidney disease. Over a quarter of them reported mild-to-severe psychological distress. Alarmingly, 4 out of 5 patients with psychological distress were also nonadherent to 1 or more self-management recommendations, and higher levels of psychological distress were associated with poorer dietary and medication adherence and lower physical activity. Moreover, patients who suffered from moderate-to-severe distress were relatively more often nonadherent to 3 or more recommendations compared with patients with no or mild distress symptoms. So, it seems that psychological distress can be a barrier for self-management. To support patients in managing chronic kidney disease, researchers and health professionals should not overlook patients' mental health.

Children of extremist parents: Insights from a specialized clinical team.

Data on children who grow up with parents adhering to violent extremism is scant. This makes it extremely delicate to inform policies and clinical services to protect such children from potential physical and psychological harm. This paper explores the predicament of children whose caretakers were referred to a specialized clinical team in Montreal (Canada) because of concerns about risks or actual involvement in violent extremism processes. This paper uses a mixed methods concurrent triangulation design. Quantitative data was obtained through a file review (2016-2020). Qualitative data was collected through semi-structured interviews and a focus group with the team practitioners. Clinicians reported the presence of stereotypes in the health and social services network frequently representing religious extremist parents as potentially dangerous or having inappropriate parenting skills while minimizing the perception of risk for parents adhering to political extremism. Children displayed high levels of psychological distress, mainly related to family separation, parental psychopathology, and conflicts of loyalty stemming from familial or social alienation. Training practitioners to be aware of their own personal and institutional bias may help them to understand the predicament of extremist parents' children and implement systemic, trauma and attachment informed interventions.

Neurologic and Psychiatric Manifestations of Bradykinin-Mediated Angioedema: Old and New Challenges.

Neurologic manifestations have been occasionally described in patients with bradykinin-mediated angioedema. The existing literature is currently limited to case series and case reports mainly described in the hereditary forms (HAE) concerning central nervous system (CNS) involvement. On the contrary, very little is known about peripheral and autonomic nervous system manifestations. CNS involvement in HAE may present with symptoms including severe headaches, visual disturbance, seizures, and various focal and generalized deficits. In addition, a stroke-like clinical picture may present in HAE patients. In turn, some drugs used in patients with cardiovascular and neurologic disorders, such as recombinant tissue plasminogen activator (r-tPA) and angiotensin-converting enzyme inhibitors (ACEI), may produce medication-induced angioedema, resulting in a diagnostic challenge. Finally, most patients with HAE have higher levels of psychological distress, anxiety, and depression. With this review, we aimed to provide an organized and detailed analysis of the existing literature on neurologic and psychiatric manifestations of HAE to shed light on these potentially invalidating symptoms and lay the foundation for further personalized diagnostic pathways for patients affected by this protean disease.

Methamphetamine dependence in Australia–why is ‘ice’ (crystal meth) so addictive?

Australia has one of the highest rates in the world of the use of the crystalline form of methamphetamine, a highly addictive stimulant that is often associated with a chronic, relapsing dependency. Methamphetamine use is associated with both acquisitive and violent offending, which cause substantial personal and societal costs. Whilst the short-term euphoria and stimulation provide a positive reinforcement to methamphetamine use, the aversive states of withdrawing from methamphetamine and the associated craving, which may last up to five weeks into abstinence, underlie the negative reinforcement to continued methamphetamine use. Although many methamphetamine-dependent users experience high levels of psychological distress, it is likely that less than half engage with treatment or support services, and current intervention and treatment programmes have high discontinuation rates. Stigma and discrimination, even from paramedics and health clinicians, are prominent barriers to methamphetamine-dependent users accessing treatment in Australia.

Covid-19's impact on the mental and psychological health of people with autisms: a narrative review

The restrictions on the coronavirus disease (COVID-19) have had a significant emotional impact on the general population and could lead to high levels of psychological distress. Individuals with autism spectrum disorder (ASD) may be more vulnerable in this widespread because of persistent difficulties in social interaction and communication as well as constrained and repetitive patterns of behavior. The goal of this study is to review studies that assess how COVID-19 affects autistic people's psychological and mental health. This study is a narrative review. The subjects included in these studies consisted of individuals with autism, their parents, families and caregivers. The findings revealed that responses to the pandemic varied, with some autistic persons displaying improvements and others demonstrating deterioration in mental health. Variables like biological vulnerability, isolation, and loss of social support, adjustments to household roles and dynamics, and family conflicts all related to reductions in mental health.

Trajectories of psychological distress and social integration in newly resettled refugees: findings from the Building a New Life in Australia longitudinal study

PurposeRefugees are at greater risk of mental illness due to stressors encountered post-resettlement. However, few longitudinal studies have examined the within-person effects of these stressors, especially with respect to social integration. This study aims to examine what factors are associated with psychological distress in a longitudinal sample of refugees resettled in Australia.MethodsThis study used data from three Waves of the Building a New Life in Australia study, collected between 2013 and 2018. The eligible sample included 1881 adult respondents, clustered in 1175 households. We conducted multilevel mixed-effects growth modelling incorporating time-variant and time-invariant covariates with psychological distress, using the Kessler Psychological Distress Scale (K6).ResultsRates of high psychological distress increased across the 5-year follow-up period. Social integration stressors (e.g. discrimination, lower sense of belonging, loneliness, lower English proficiency) were associated with higher levels of psychological distress over time. Refugees reporting loneliness not only had a greater risk of elevated psychological distress at each time point, but the difference in risk increased over each time point. Refugees who were exposed to traumatic events, older, female and of Middle Eastern background were also more likely to report higher levels of psychological distress over time.ConclusionsThese findings highlight the importance of identifying refugees who may encounter difficulties with social integration in the early years of resettlement. Newly arrived refugees may benefit from longer-term resettlement programmes that address post-migratory stressors, particularly with regards to loneliness, to reduce the prevalence of elevated psychological distress during the early years of resettlement.

Parents' Psychological and Decision-Making Outcomes following Prenatal Diagnosis with Complex Congenital Heart Defect: An Exploratory Study.

Background. Parents with a fetus diagnosed with a complex congenital heart defect (CHD) are at high risk of negative psychological outcomes. Purpose. To explore whether parents' psychological and decision-making outcomes differed based on their treatment decision and fetus/neonate survival status. Methods. We prospectively enrolled parents with a fetus diagnosed with a complex, life-threatening CHD from September 2018 to December 2020. We tested whether parents' psychological and decision-making outcomes 3 months posttreatment differed by treatment choice and survival status. Results. Our sample included 23 parents (average Age[years]: 27 ± 4, range = 21-37). Most were women (n = 18), non-Hispanic White (n = 20), and married (n = 21). Most parents chose surgery (n = 16), with 11 children surviving to the time of the survey; remaining parents (n = 7) chose comfort-directed care. Parents who chose comfort-directed care reported higher distress ( = 1.51, s = 0.75 v. = 0.74, s = 0.55; Mdifference = 0.77, 95% confidence interval [CI], 0.05-1.48) and perinatal grief ( = 91.86, s = 22.96 v. = 63.38, s = 20.15; Mdifference = 27.18, 95% CI, 6.20-48.16) than parents who chose surgery, regardless of survival status. Parents who chose comfort-directed care reported higher depression ( = 1.64, s = 0.95 v. = 0.65, s = 0.49; Mdifference = 0.99, 95% CI, 0.10-1.88) than parents whose child survived following surgery. Parents choosing comfort-directed care reported higher regret ( = 26.43, s = 8.02 v. = 5.00, s = 7.07; Mdifference = 21.43, 95% CI, 11.59-31.27) and decisional conflict ( = 20.98, s = 10.00 v. = 3.44, s = 4.74; Mdifference = 17.54, 95% CI; 7.75-27.34) than parents whose child had not survived following surgery. Parents whose child survived following surgery reported lower grief (Mdifference = -19.71; 95% CI, -39.41 to -0.01) than parents whose child had not. Conclusions. The results highlight the potential for interventions and care tailored to parents' treatment decisions and outcomes to support parental coping and well-being. Question: Do the psychological and decision-making outcomes of parents differ based on their treatment decision and survival outcome following prenatal diagnosis with complex CHD?Findings: In this exploratory study, parents who decided to pursue comfort-directed care after a prenatal diagnosis reported higher levels of psychological distress and grief as well as higher decisional conflict and regret than parents who decided to pursue surgery.Meaning: The findings from this exploratory study highlight potential differences in parents' psychological and decision-making outcomes following a diagnosis of complex CHD for their fetus, which appear to relate to the treatment approach and the treatment outcome and may require tailoring of psychological and decision support.

Moral disengagement and academic engagement: the moderating roles of educational anti-mattering and psychological distress

ABSTRACT Research concerning the link between morality and education-related variables is scarce. Thus, the present study addressed this issue by focusing on the connection between moral disengagement and academic engagement and the moderating roles of educational anti-mattering and psychological distress. Our sample comprised 363 university students aged 18 to 29 (M = 20.86, SD = 1.57) from Bachelor’s and Master’s programs. Correlation analysis suggested that academic engagement was negatively associated with psychological distress and educational anti-mattering. Moderation analyses suggested that moral disengagement predicted academic engagement only at high levels of psychological distress (i.e. depression, anxiety, and stress). Educational anti-mattering, however, did not significantly moderate the link between moral disengagement and academic engagement. We discuss the theoretical and practical implications of the results in addressing students’ academic engagement.

The mental labyrinth of postgraduate research: a qualitative study of postgraduate mental health and wellbeing and the impact of the supervisory relationship

AbstractPostgraduate research students (PGRs) experience disproportionately high levels of psychological distress. Many factors contribute to this poor mental wellbeing and relate to each other in complex and dynamic ways. However, the relationship between PGRs and their supervisor(s) is known to strongly affect the wellbeing of the former. This study explores the mental health and wellbeing of PGRs with a focus on the role of the student—supervisor relationship. Using combined qualitative data from a large survey of PGRs and focus groups and reflexive thematic analysis, we found that PGRs experience the overarching process of obtaining a research degree as a mental labyrinth. Three constituent themes were identified: (1) inequity in navigating the labyrinth, (2) the labyrinth as a place of uncertainty and isolation, and (3) supervisors as labyrinth guides, not mental care providers. The results suggest that significant inequities exist which contribute to poorer mental wellbeing in particular subgroups of PGRs, both in general and specifically in relation to the supervisory relationship. Experiences of loneliness and ambiguity around progress were also identified as being detrimental to mental health. Furthermore, although supervisors can be a vital source of support and have a positive influence on PGR mental health, students recognise supervisors cannot reasonably be expected to act as professional mental health care providers and institutions must do more to provide equitable access to mental health support services.

Heavy social media use and psychological distress among adolescents: the moderating role of sex, age, and parental support.

Despite increasing evidence that social media use is associated with adolescents' mental well-being, little is known about the role of various factors in modifying the effect of this association during adolescence. This study examined the association between social media use and psychological distress among adolescents and explored whether sex, age, and parental support moderate this association. Data came from a representative sample of middle and high school students in Ontario, Canada. Cross-sectional analyses included 6,822 students derived from the 2019 Ontario Student Drug Use and Health Survey. Our results showed that 48% of adolescents used social media for 3 h or more per day, and 43.7% had moderate to severe psychological distress, with a higher prevalence among females (54%) than males (31%). After adjustment for relevant covariates, heavy social media use (≥3 h/day) was associated with increased odds of severe psychological distress [odds ratio (OR): 2.01; 95% confidence interval (CI):1.59-2.55]. The association of social media use with psychological distress was modified by age (p < 0.05) but not sex or parental support. The association was stronger among younger adolescents. Heavy social media use is associated with higher levels of psychological distress, with younger adolescents being the most vulnerable. Longitudinal studies are recommended for future research to examine in more depth the role of sex, age, and parental support in the association between social media use and psychological distress to better determine the strength and of the association.

Variations of work engagement and psychological distress based on three working modalities during the COVID-19 pandemic.

With the onset of the COVID-19 pandemic, the rapid spread of the SARS-CoV-2 virus became a global health threat affecting people's mental and physical health, as well as working conditions and modalities. The reorganization of the work environment also affected work engagement and psychological distress levels. This manuscript assesses how work engagement and distress vary according to gender and age across three working modalities. We used a voluntary response sampling strategy to collect data on psychological distress and work engagement between August 2021 and January 2022. Results are from 542 people working in Ecuador during the COVID-19 pandemic. Overall, participants experienced psychological distress; women and younger participants presented higher psychological distress. Regarding engagement, the sample showed average levels of total engagement, average levels of vigor, and high levels of dedication and absorption. Men presented higher levels of total work engagement and vigor. Psychological distress was significantly and negatively correlated with total work engagement scores and its three factors. There were no differences in work engagement according to the different modalities. However, teleworkers reported significantly higher levels of psychological distress than hybrid workers. Findings are discussed considering ideas for decision-makers to explore the benefits of flexible working practices.

Quality of Life (QoL) in Patients with Chronic Inflammatory Bowel Diseases: How Much Better with Biological Drugs?

Inflammatory bowel diseases (IBDs), including ulcerative colitis (UC) and Crohn's disease (CD), are chronic and disabling diseases that affect patient health-related quality of life (HRQoL). IBD patients are frequently exposed to high levels of stress and psychological distress. Biological drugs have been proven to reduce inflammation, hospitalization, and most of the complications that characterize IBDs; their potential contribution to patients' HRQoL remains to be explored. To evaluate and compare any change in the HRQoL and markers of inflammation in IBD patients undergoing biological drugs (infliximab or vedolizumab). A prospective observational study was conducted on a cohort of IBD patients, aged >18 years, who were prescribed with infliximab or vedolizumab. Demographic and disease-related data at baseline were collected. Standard hematological and clinical biochemistry parameters, including C-reactive protein (CRP), white blood cells count (WBC), erythrocytes sedimentation rate (ESR), and α1 and α2 globulins were measured after a 12-h fast at baseline (T0), after 6 weeks (T1), and at 14 weeks (T2) of biological treatment. Steroid use, disease activity as measured by the Harvey-Bradshaw index (HBI) and partial Mayo score (pMS) for the CD and UC, respectively, were also recorded at each timepoint. The Short Form 36 Health Survey (SF-36), Functional Assessment of Chronic Illness Therapy (FACIT-F), and Work Productivity and Activity Impairment-General Health Questionnaire (WPAI:GH) were administered to each patient at baseline, T1, and T2 to address the study aims. Fifty eligible consecutive patients (52% with CD and 48% with UC) were included in the study. Twenty-two patients received infliximab and twenty-eight received vedolizumab. We noted a significant reduction in the CRP, WBC, α1, and α2 globulins from T0 to T2 (p = 0.046, p = 0.002, p = 0.008, and p = 0.002, respectively). Participants showed a significant decrease in steroid administration during the observation period. A significant reduction in the HBI of CD patients at all three timepoints and a similarly significant decrease in the pMS of UC patients from baseline to T1 were recorded. Statistically significant changes were observed in all questionnaires during follow-up as well as an overall improvement in the HRQoL. The interdependence analysis carried out between the biomarkers and the scores of the individual subscales showed a significant correlation between the variation (Δ) of the CRP, Hb, MCH, and MCV with physical and emotional dimensions of the SF-36 and FACIT-F tools; work productivity loss expressed by some of the WPAI:GH items negatively correlated with the ΔWBC and positively with the ΔMCV, ΔMCH, and Δ α1 globulins. A sub-analysis according to the type of treatment showed that patients receiving infliximab experienced a more pronounced improvement in their HRQoL (according to both SF-36 and FACIT-F) compared with patients receiving vedolizumab. Both infliximab and vedolizumab played an important role in contributing to the improvement of the HRQoL in IBD patients by also reducing inflammation and, consequently, steroid use in patients with an active disease. HRQoL, being one of the treatment goals, should also be assessed when taking charge of IBD patients to assess their clinical response and remission. The specific correlation between the biomarkers of inflammation and life's spheres, as well as their possible role as clinical markers of HRQoL, should be further investigated.

Validation of the distress thermometer score in a geriatric oncology population.

e24030 Background: The geriatric oncology population is uniquely vulnerable to increased levels of psychological distress due to age related challenges such as social isolation, change in lifestyle, and comorbid conditions. In the general population, higher levels of psychological distress have been shown to impact treatment course, quality of life, and survival. The NCCN Distress Thermometer (DT) is a validated fast and effective screening tool for psychological distress, with a cutoff score of 4 yielding optimal sensitivity and specificity in a general cancer population. However, the best cutoff for detecting psychological morbidity in older cancer patients is unclear. In this study, we aim to compare the sensitivity and specificity of various cutoff values for the Distress Thermometer score to predict Geriatric Depression Scale (GDS) score. Methods: Data is derived from 242 geriatric oncology patients from the Senior Adult Oncology Center at Jefferson Health. Using a cutoff of 5 for the GDS as the clinical standard guideline, we use receiver operating characteristic (ROC) curve analysis of the univariable logistic regression model to predict clinical depression. Results: A cutoff DT score of 3.5 was found to be most sensitive and specific (0.66,0.68) for predicting clinical depression (Area Under the ROC Curve (AUC) = 0.70). Multivariable logistic regression including age improved the predictive ability of the DT score to an AUC of 0.75. Conclusions: The increase in AUC with the addition of age indicates the potential use of a composite value of age and DT score to best determine at-risk patients in a clinical setting. While these results indicate the utility of the Distress Thermometer as an effective screening tool in the geriatric oncology population, our findings also suggest that a lower threshold score is advised for clinicians who are hoping to identify older cancer patients who are distressed. Patients who meet the threshold criteria would then be assessed further for triage into appropriate levels of geriatric supportive services.

Long-Term Mental Health Impacts of the Covid-19 Pandemic on University Students in the UK: A Longitudinal Analysis Over 12 Months

ABSTRACT University students in the UK have encountered many challenges as a result of the COVID-19 pandemic. This research aimed to track the mental well-being of a large sample of British university students (n = 554) over a one-year period of the COVID-19 pandemic, capturing data at four time points between May 2020 and May 2021. Overall retention after 12 months was 34.73%. Findings showed the COVID-19 pandemic has caused a significant, negative impact on the well-being of British university students. Students are suffering from prolonged and high levels of psychological distress and anxiety. Levels of flourishing in students are still very low. The different phases of the pandemic appear to have played an influential role in student mental health. The practical implications for higher education and recommendations for future research are discussed.