Higher Degree Of Psychological Distress Research Articles

Consequences of the COVID-19 pandemic on the mental health of nurses in the Spanish out-of-hospital Emergency Service

ObjectiveTo analyse the impact of the COVID-19 pandemic on the mental health of nurses in Spanish out-of-hospital Emergency Services, identifying predictor factors of greater severity. MethodA multicentre cross-sectional descriptive study was designed, including all nurses working in any Spanish out-of-hospital Emergency Services between 01/02/2021 and 30/04/2021. The main outcomes were the level of depression, anxiety and stress assessed through the DASS-21 scale. Sociodemographic, clinical, and occupational information was also collected. Univariate and multivariate analyses were conducted to determine possible associations between variables. ResultsThe sample included 474 nurses. 32.91%, 32.70% and 26.33% of the participants had severe or extremely severe levels of depression, anxiety and stress, respectively. Professionals with fewer competencies to handle stressful situations, those who had used psychotropic drugs and/or psychotherapy on some occasion before the pandemic onset, or those who had changed their working conditions presented more likelihood of developing more severe levels of depression, anxiety and/or stress. ConclusionNurses in Spanish out-of-hospital Emergency Services have presented medium levels of depression, anxiety and stress during the pandemic. Clinical and occupational factors have been associated with a higher degree of psychological distress. It is necessary to adopt strategies that promote professionals’ self-efficacy and mitigate the triggers of negative emotional states.

Health and Wellbeing of Regional and Rural Australian Healthcare Workers during the COVID-19 Pandemic: Baseline Cross-Sectional Findings from the Loddon Mallee Healthcare Worker COVID-19 Study—A Prospective Cohort Study

Background: Coronavirus 19 (COVID-19) has created complex pressures and challenges for healthcare systems worldwide; however, little is known about the impacts COVID-19 has had on regional/rural healthcare workers. The Loddon Mallee Healthcare Worker COVID-19 Study (LMHCWCS) cohort was established to explore and describe the immediate and long-term impacts of the COVID-19 pandemic on regional and rural healthcare workers. Methods: Eligible healthcare workers employed within 23 different healthcare organisations located in the Loddon Mallee region of Victoria, Australia, were included. In this cohort study, a total of 1313 participants were recruited from November 2020–May 2021. Symptoms of depression, anxiety, post-traumatic stress, and burnout were measured using the Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder-7 (GAD-7), Impact of Events Scale-6 (IES-6), and Copenhagen Burnout Inventory (CBI), respectively. Resilience and optimism were measured using the Brief Resilience Scale and Life Orientation Test—Revised (LOT-R), respectively. Subjective fear of COVID-19 was measured using the Fear of COVID-19 Scale. Results: These cross-sectional baseline findings demonstrate that regional/rural healthcare workers were experiencing moderate/severe depressive symptoms (n = 211, 16.1%), moderate to severe anxiety symptoms (n = 193, 14.7%), and high personal or patient/client burnout with median total scores of 46.4 (IQR = 28.6) and 25.0 (IQR = 29.2), respectively. There was a moderate degree of COVID-19-related fear. However, most participants demonstrated a normal/high degree of resilience (n = 854, 65.0%). Based on self-reporting, 15.4% had a BMI from 18.5 to 24.9 kgm2 and 37.0% have a BMI of 25 kgm2 or over. Overall, 7.3% of participants reported they were current smokers and 20.6% reported alcohol consumption that is considered moderate/high-risk drinking. Only 21.2% of the sample reported consuming four or more serves of vegetables daily and 37.8% reported consuming two or more serves of fruit daily. There were 48.0% the sample who reported having poor sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI). Conclusion: Regional/rural healthcare workers in Victoria, Australia, were experiencing a moderate to high degree of psychological distress during the early stages of the pandemic. However, most participants demonstrated a normal/high degree of resilience. Findings will be used to inform policy options to support healthcare workers in responding to future pandemics.

Quantitative sensory testing, psychological profiles and clinical pain in patients with psoriatic arthritis and hand osteoarthritis experiencing pain of at least moderate intensity.

Chronic pain is the hallmark symptom of joint diseases. This study examined the differences in quantitative sensory testing between patients with psoriatic arthritis (PsA), hand osteoarthritis (hand-OA) and a pain-free control group and differences between patients with and without concomitant fibromyalgia (cFM). All patients and pain-free controls were assessed using pressure pain thresholds (PPT), temporal summation of pain (TSP), conditioned pain modulation (CPM) and clinical pain intensities. Psychological distress was assessed with the Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, and Pittsburgh Sleep Quality Index. Disability was assessed with the Health Assessment Questionnaire and pain quality with the painDETECT questionnaire. cFM was identified using the revised 2016 American College of Rheumatology diagnostic criteria. Patients with hand-OA (n = 75) or PsA (n = 58) had statistically significant lower PPTs and CPM, greater TSP, and higher scores of psychological distress (p < 0.05) than controls (n = 20). Patients with cFM (58%) had higher scores of depression (p = 0.001), anxiety (p = 0.004), catastrophizing (p = 0.012), disability (p < 0.001), higher painDETECT score (p = 0.001), TSP (p = 0.027), and reduced sleep quality (p = 0.021) when compared to patients without cFM. Patients with hand-OA and PsA exhibited signs of pain sensitization and a higher degree of psychological distress and disability than pain-free individuals. Patients with cFM had greater TSP, painDETECT score, disability, catastrophizing, and reduced sleep quality, than patients without, indicating greater degree of pain sensitization, psychological burden, and disability. This paper shows that a significant proportion of patients with hand osteoarthritis and psoriatic arthritis with moderate pain intensity have significantly increased signs of pain sensitization and markers of psychological distress. A large proportion of these patients fulfil the criteria for concomitant fibromyalgia and these patients show even greater propensity towards pain sensitization and psychological distress.

Associations between psychological distress, early adverse experiences, and choice of avatars in an immersive virtual world

IntroductionVirtual reality environments (VREs) are an emerging modality consisting of computer-generated worlds. Players in VREs can choose to create representative avatars. Such choices may reflect beliefs related to identity and psychological functioning. The aim of the present study was to examine associations between psychological distress, exposure to adverse childhood experiences, and choice of avatar in an immersive virtual environment. MethodsWe recruited 436 participants in a VRE. Participants completed the Early Traumatic Inventory Self Report-Short Form and the Brief Symptom Inventory. We evaluated between-group differences (selection of child avatar, parent avatar, or “other” avatar, the control group) in psychological distress and traumatic childhood experiences. ResultsIndividuals who selected child avatars experienced a higher degree of psychological distress and childhood trauma, especially sexual abuse, as compared to individuals who selected other avatars. Individuals who selected parent avatars were more likely to have experienced psychological distress as compared to controls. DiscussionAvatar choice may reflect users’ identities and psychological functioning. VREs may provide safe environments for a “do over” of adverse childhood experiences. Future research should explore VREs as venues to treat trauma and psychological distress.

Psychological distress in infertile women: the role of quality of marital relationships and self-compassion

Infertility is a common disease. At least 10–15% of women deal with infertility in some way. Infertile women suffer from a higher degree of psychological distress compared to fertile women. This study aims to identify the role of the quality of marital relationships and self-compassion in psychological distress in infertile women. The participants were 400 women who were referred to fertility clinics in Iran over a two-year period. Questionnaires containing Demographic Questionnaire, Psychological Distress Scale (DASS), Marital Quality Scale (MQS) and Self-Compassion Scale (MCS). The results showed that predictor variables explain a total of 29.9% of the variance of psychological distress in infertile women. The quality of marital relationships (p = 0.001 and β = −0.49) and self-compassion (p < 0.05 and β = −0.08) can negatively predict the psychological distress of infertile women. Considering that the significant role of the quality of marital relationships and self-compassion in the psychological distress of infertile women has been confirmed; therefore, interventions that focus on the quality of marital relationships and self-compassion may be effective and should be used as a resource to combat psychological distress in infertile women.

Psychological Distress in South African Healthcare Workers Early in the COVID-19 Pandemic: An Analysis of Associations and Mitigating Factors.

While the global COVID-19 pandemic has been widely acknowledged to affect the mental health of health care workers (HCWs), attention to measures that protect those on the front lines of health outbreak response has been limited. In this cross-sectional study, we examine workplace contextual factors associated with how psychological distress was experienced in a South African setting where a severe first wave was being experienced with the objective of identifying factors that can protect against HCWs experiencing negative impacts. Consistent with mounting literature on mental health effects, we found a high degree of psychological distress (57.4% above the General Health Questionnaire cut-off value) and a strong association between perceived risks associated with the presence of COVID-19 in the healthcare workplace and psychological distress (adjusted OR = 2.35, p < 0.01). Our research indicates that both training (adjusted OR 0.41, 95% CI 0.21–0.81) and the reported presence of supportive workplace relationships (adjusted OR 0.52, 95% CI 0.27–0.97) were associated with positive outcomes. This evidence that workplace resilience can be reinforced to better prepare for the onset of similar outbreaks in the future suggests that pursuit of further research into specific interventions to improve resilience is well merited.

Relationship Between Perceived Stress and Psychological Distress Facing Nursing Students in College of Nursing Gombe, Nigeria

The paper is to examine relationship between perceived stress, and psychological distress facing nursing students in College of Nursing, Gombe state. The research design was correlation design. A Research question and one Null hypothesis was formulated to guide the study. The population was all nursing students of the College of nursing Gombe. The entire students were used without any sampling; this is because the students were not too large to be managed. ‘perceived stress scale, and ‘Kessler Psychological Distress Scale’ were adapted and used as Instruments for data collection. Two experts from the department of Educational Foundation Abubakar Tafawa Balewa University, Bauchi validated the two instruments. The internal consistency of the instruments showed Cronbach’s alpha of 0.75 for Emotional Intelligence scale, and 0.64 for Psychological Distress scale respectively. Two hundred and twenty-five (225) nursing students participated in the study. Male = 34 and female =191 (n=225). Ethics approval was obtained from the College Management. Research Question was analyzed using mean and standard deviation, Pearson’s Correlation, was used to address the Hypothesis. The findings of the study revealed that, most of the participants had high level of perceived stress, and were experiencing high degree of psychological distress. Positive correlation was found between perceived stress, and Psychological Distress; it was concluded that the higher the level of perceived stress, the higher experiencing psychological distress among Nursing students. Therefore, it is recommended that further exploration to better understanding of the interrelationships of perceived stress, Psychological distress and coping strategies to help develop students’ perceived stress and coping strategies is needed. Inclusion of strategies to enhance perceived stress management in the nursing curriculum which may be beneficial to Nursing Students as this can help to improve their academic and clinical performance.

Factors Associated With Longitudinal Psychological and Physiological Stress in Health Care Workers During the COVID-19 Pandemic: Observational Study Using Apple Watch Data.

BackgroundThe COVID-19 pandemic has resulted in a high degree of psychological distress among health care workers (HCWs). There is a need to characterize which HCWs are at an increased risk of developing psychological effects from the pandemic. Given the differences in the response of individuals to stress, an analysis of both the perceived and physiological consequences of stressors can provide a comprehensive evaluation of its impact.ObjectiveThis study aimed to determine characteristics associated with longitudinal perceived stress in HCWs and to assess whether changes in heart rate variability (HRV), a marker of autonomic nervous system function, are associated with features protective against longitudinal stress.MethodsHCWs across 7 hospitals in New York City, NY, were prospectively followed in an ongoing observational digital study using the custom Warrior Watch Study app. Participants wore an Apple Watch for the duration of the study to measure HRV throughout the follow-up period. Surveys measuring perceived stress, resilience, emotional support, quality of life, and optimism were collected at baseline and longitudinally.ResultsA total of 361 participants (mean age 36.8, SD 10.1 years; female: n=246, 69.3%) were enrolled. Multivariate analysis found New York City’s COVID-19 case count to be associated with increased longitudinal stress (P=.008). Baseline emotional support, quality of life, and resilience were associated with decreased longitudinal stress (P<.001). A significant reduction in stress during the 4-week period after COVID-19 diagnosis was observed in the highest tertial of emotional support (P=.03) and resilience (P=.006). Participants in the highest tertial of baseline emotional support and resilience had a significantly different circadian pattern of longitudinally collected HRV compared to subjects in the low or medium tertial.ConclusionsHigh resilience, emotional support, and quality of life place HCWs at reduced risk of longitudinal perceived stress and have a distinct physiological stress profile. Our findings support the use of these characteristics to identify HCWs at risk of the psychological and physiological stress effects of the pandemic.

Spinal cord stimulation in severe cases of complex regional pain syndrome: A retrospective cohort study with long-term follow-up.

Complex regional pain syndrome (CRPS) is a debilitating pain condition often resistant to standard treatment modalities. In these cases, spinal cord stimulation (SCS) can be an option, but the effect on CRPS remains disputed. We aimed to assess the long-term effect of SCS on CRPS. We retrospectively analysed 51 CRPS patients implanted with an SCS system at the University Hospitals in Aarhus or Odense, Denmark, with a median follow-up time of 4.4years. Primary outcomes were pain intensity on a numeric rating scale (NRS) and the Patients' Global Impression of Change (PGIC). Secondary outcomes were patient satisfaction, work status, consumption of pain medication, the Major Depression Inventory (MDI), Pain Catastrophizing Scale (PCS) and quality of life (QoL) measured using the Short-Form Health Survey (SF-36). For each outcome measure, baseline data were compared to the latest collected data point. A significant pain relief was found with a mean reduction in NRS score of 2.4 (95% CI: 1.7-3.0, p<0.0001). 68.8% reported 'much improved' or 'very much improved' on the PGIC scale. 87.5% would choose SCS again for the same outcome. A significant beneficial impact was found on MDI score, PCS, SF-36 summary scores and consumption of tricyclic antidepressants, antiepileptic drugs and opioids. No statistical effect was found on work status. Pain intensity, depression, pain catastrophizing, pain medication use and QoL were significantly improved after SCS implantation, with high patient satisfaction rates in CRPS patients. This study supports the continued use of SCS in the treatment of severe CRPS. This study presents detailed data from a large, well-characterized cohort of Danish CRPS patients treated with SCS, analyzing several outcome measures. The results serve to document SCS as an effective treatment for severe CRPS and expands the cumulative level of evidence in favor of its use. Additionally, analysis of preoperative patient characteristics suggests that SCS treatment should not be withheld in patients with a high degree of psychological distress or high consumption of analgesics.

Study Profile of the Tohoku Medical Megabank Community-Based Cohort Study.

BackgroundWe established a community-based cohort study to assess the long-term impact of the Great East Japan Earthquake on disaster victims and gene-environment interactions on the incidence of major diseases, such as cancer and cardiovascular diseases.MethodsWe asked participants to join our cohort in the health check-up settings and assessment center based settings. Inclusion criteria were aged 20 years or over and living in Miyagi or Iwate Prefecture. We obtained information on lifestyle, effect of disaster, blood, and urine information (Type 1 survey), and some detailed measurements (Type 2 survey), such as carotid echography and calcaneal ultrasound bone mineral density. All participants agreed to measure genome information and to distribute their information widely.ResultsAs a result, 87,865 gave their informed consent to join our study. Participation rate at health check-up site was about 70%. The participants in the Type 1 survey were more likely to have psychological distress than those in the Type 2 survey, and women were more likely to have psychological distress than men. Additionally, coastal residents were more likely to have higher degrees of psychological distress than inland residents, regardless of sex.ConclusionThis cohort comprised a large sample size and it contains information on the natural disaster, genome information, and metabolome information. This cohort also had several detailed measurements. Using this cohort enabled us to clarify the long-term effect of the disaster and also to establish personalized prevention based on genome, metabolome, and other omics information.

Cyberbullying Involvement and Psychological Distress among Chinese Adolescents: The Moderating Effects of Family Cohesion and School Cohesion.

Cyberbullying and its consequences is a little-investigated public health issue. We investigated the correlations between cyberbullying involvement, either being a victim or being a preparator, and psychological distress among a group of Chinese adolescents. A representative sample of 4978 students from Jiangsu province covering all types of pre-college schools was surveyed using a stratified sampling method. Both being a victim and being a perpetrator correlated with higher degrees of psychological distress, and the former’s effect is stronger. Family cohesion and school cohesion are protective factors of psychological distress, but only family cohesion plays a moderating effect between cyberbullying involvement and distress. Moreover, the positive correlations between cyberbullying involvement and psychological distress become non-significant when the interactions are included in regression models. Last but not least, female students and students in a higher grade or students with worse academic performance have higher degrees of distress. Our study reveals that, instead of school cohesion, family cohesion is more important to mitigate the psychological impact of cyberbullying involvement and eventually heal the trauma.

Psychological distress and social media usage: A survey among undergraduates of a university in Calabar, Nigeria

Access to social network sites (SNS) is commonplace, especially among young people globally. Cumulatively, long duration of daily exposure may be having effects on psychological health outcomes, including increased and in some cases, decreased risk of depression and anxiety. Despite these potential effects, there is a paucity of literature on patterns and effects of exposure to social media, especially in developing countries where regular mental health screening is generally unavailable. This study aims to assess the psychological effects of Internet/social media usage among undergraduates in Calabar. A descriptive cross-sectional study conducted in the University of Calabar, Nigeria. Multi-staged sampling technique was used to recruit equal proportions of the undergraduate students from five selected Faculties in the University. Internet Addiction Test and General Health Questionnaire-28 were used to measure addiction to Internet and psychological health status of the respondents, respectively. Socio-demographic questionnaire was used to obtain information on demographic and social media characteristics of the respondents. Chi-square and independent t-test were used as inferential statistics, with P value set at 0.05. Four hundred and eighteen (418) respondents completed the questionnaires. The mean age was 21.5 ± 3.6 years. Male:female ratio was 1:0.99. WhatsApp (59.8%) was the most commonly visited social media platform, whereas entertainment (52.2%) was the most common reason for social media use. About one-fifth (20.1%) had moderate-to-severe forms of Internet addiction, whereas one-third (33.1%) were psychologically distressed. Psychological distress was found to be significantly more common among respondents with mild/none, compared with those with moderate-to-severe forms of Internet addiction (P = 0.00). Respondents with moderate-to-severe forms of Internet addiction had significantly lower mean depression and anxiety scores compared with those with mild or no form of addiction (P = 0.00). There is high degree of psychological distress among students, and this was found to be more common among those that were less/not addicted to SNS. Specifically, high degree of Internet addiction may be protecting against the increased risk of depression and anxiety. The implications of these findings on youth counselling and the prevention of mental illnesses in developing countries are discussed in this article.

The Relative Associations of Body Image Dissatisfaction among Psychiatric Out-Patients in Singapore.

Background: Adults with body image dissatisfaction (BID) are more likely to be depressed, anxious, and suicidal when compared to those without intense dissatisfaction over their appearance. The current study aimed to estimate the prevalence and factors associated with BID among out-patients with mental illness in Singapore. Methods: Data was collected from 310 psychiatric out-patients using a self-administered questionnaire. Measurements used were socio-demographic characteristics, Body Mass Index scores, Body Shape Questionnaire, Binge Eating Scale, Eating Attitudes Test, Beck’s Depression Inventory, Beck’s Anxiety Inventory and Alcohol Use Disorders Identification Test. Results: A prevalence of 30.9% of BID was established among psychiatric out-patients in Singapore. Being female, having higher BMI scores, binge eating behavior, eating disorders, and those diagnosed with depression were positively associated with BID. Conclusion: BID is prevalent among those with psychiatric illnesses which could lead to a higher degree of psychological distress and the emergence of eating disorders.

Quality of life and psychological distress in women with recurrent miscarriage: a comparative study

BackgroundThis study aimed to evaluate quality of life and psychological distress in Iranian women with recurrent miscarriage and to compare it in women without miscarriage.MethodsThis was a comparative study of quality of life among women with and without recurrent miscarriage. Cases were selected from patients with complain of recurrent miscarriage and comparison group were selected from women attending to two teaching hospitals for annual screening. Quality of life (QOL) was measured using the 36-Item Short Form Survey (SF-36). In addition the Hospital Anxiety and Depression Scale (HADS) were used to measure anxiety and depression. Comparison was made between two groups using the independent samples t-test and chi-square.ResultsIn all 105 women with recurrent miscarriage and 105 healthy women were studied. The socio-demographic status for both groups was similar. Women with recurrent miscarriage showed a significant higher degree of psychological distress [mean (SD) anxiety score was: 10.6 (2.3) vs. 9.1 (2.2), P < 0.0001; and mean (SD) depression score was: 11.0 (2.3) vs. 9.5 (1.9), P < 0.0001]. In addition women with recurrent miscarriage reported significantly lower level of quality of life in all domains (role physical, general health, vitality, social functioning, role emotional, and mental health, all P values < 0.0001), except for physical functioning (P = 0.06) and bodily pain (P = 0.17).ConclusionThe findings demonstrated that women with recurrent miscarriage reported extensive functional disability, and lower level of well-being compared to women without recurrent miscarriage. The findings have some implications for prenatal care and suggest that appropriate treatment of recurrent miscarriage is essential.

Period of residence in prefabricated temporary housing and psychological distress after the Great East Japan Earthquake: a longitudinal study

ObjectivesPrevious studies have reported that displacement from one’s own home after a natural disaster is associated with a higher degree of psychological distress. The present study investigated the longitudinal association...

Effects of Mindfulness on Psychological Distress and HbA1c in People with Diabetes

Type 2 diabetes mellitus (T2DM) is a prevalent chronic condition that is associated with a high degree of psychological distress. The aim of this study was to evaluate the effectiveness of a novel approach to delivering an intervention of mindfulness practice (IMP) to a patient population with a demonstrated need for psychological support. The novel approach utilised a self-directed audio compact disc (CD) recording of mindfulness practice. In this randomised controlled trial, 67 participants with T2DM (mean age = 59.4, standard deviation = 12.4), attending outpatient clinics, were randomised to an IMP (n = 31) or a control (n = 36) group. Participants completed written questionnaires at baseline and again at 8- and 12-week follow-ups. Primary outcome measures included depression, anxiety and stress (21-item Depression, Anxiety and Stress Scale) and diabetes-specific emotional problems (Problem Areas in Diabetes Survey (PAID)). Secondary outcome measures included diabetes self-management using the Summary of Diabetes Self-Care Activities Scale (SDSCA), systolic and diastolic blood pressure and HbA1c. Participants receiving the IMP reported significant reductions in depression (p = 0.02) and stress (p = 0.03) when compared with the control group. At the 12-week follow-up, there was an overall reduction in depression by 4.1 units and stress by 3.4 units in the IMP group relative to the control group. There was an overall improvement in blood glucose monitoring; however, this was not significant (p = 0.06). HbA1c measures decreased significantly over the 12-week follow-up by 0.48 units (time × group interaction: p = 0.02). The current study has shown that an easily accessible self-directed IMP was effective in improving psychological symptoms of depression and stress, blood glucose monitoring and HbA1c.

Development and validation of the Psychological Abuse Experienced in Groups Scale

The aim of this study is the development and analysis of the psychometric properties of a new instrument to assess the possible psychological abuse experienced in a group setting. The Psychological Abuse Experienced in Groups Scale was administered to 138 people who self-identified as former members of abusive groups. An exploratory factor analysis revealed a common factor, which showed appropriate reliability. The scale scores were correlated with a prior measure aimed to assess group abusiveness, providing evidence of external validity. Participants reported a higher degree of psychological distress than normative samples, and those who requested psychological counseling after leaving the group had suffered group psychological abuse to a greater extent. The scale covers a wide range of subtle and explicit abusive behaviors and overcomes the limitations of previous instruments, being useful in both research and applied settings.

Anxiety and Depression in Patients with Gastrointestinal Cancer: Does Knowledge of Cancer Diagnosis Matter?

Background: Gastrointestinal cancer is the first leading cause of cancer related deaths in men and the second among women in Iran. The present study examine the anxiety and depression in this group of patients and assess whether the knowledge of cancer diagnosis affect their psychological distress. Methods: This was a cross sectional study of anxiety and depression in patients with gastrointestinal cancer attending to the Tehran Cancer Institute, Iran. Anxiety and depression was measured using the Hospital Anxiety and Depression Scale (HADS). Demographic and clinical data also were collected to examine anxiety and depression in the sub-group of patients especially in those who knew their cancer diagnosis and those who did not. Results: 142 patients were studied. The mean age of patients were 54.1 (SD = 14.8). 56% were Male. 52% did not know their cancer diagnosis and their diagnosis was related to esophagus (29%), stomach (30%), small intestine (3%), colon (22%) and rectum (16%). The mean anxiety score was 7.6 (SD = 4.5) and 8.4 (SD = 3.8) for depression. Overall 47.2% and 57% of patients scored high on both anxiety and depression. There were no significant differences between gender, educational level, marital status, cancer site and anxiety and depression scores whereas those who knew their diagnosis showed a significant higher degree of psychological distress [mean (SD) anxiety score: knew diagnosis 9.1 (4.2) vs. 6.3 (4.4) did not know diagnosis, P &lt; 0.001; mean (SD) depression score: knew diagnosis 9.1 (4.1) vs. 7.9 (3.6) did not know diagnosis, P = 0.05]. logistic regression analysis indicated that those who knew their cancer diagnosis showed a significant higher risk of anxiety [OR: 2.7, 95% CI: 1.1–6.8] and depression [OR: 2.8, 95% CI: 1.1–7.2]. Conclusion: Psychological distress was higher in those who knew their cancer diagnosis. It seems that the cultural issues and the way we provide information for cancer patients play important role in their improved or decreased psychological well-being.

Psychological Distress and the Risk of Withdrawing From Hypertension Treatment After an Earthquake Disaster.

This study examined the association between psychological distress and the risk of withdrawing from hypertension treatment (HTTx) 1 year after the earthquake disaster in the coastal area affected by the Great East Japan Earthquake (GEJE). Using cross-sectional data from 2012, we studied people over 20 years of age living in Shichigahama Town, Miyagi, on the northeastern coast of Japan, which had been severely inundated by the tsunami that followed the GEJE in 2011. A total of 1014 subjects were categorized as in need of HTTx. Withdrawing from HTTx was assessed by using a self-reported questionnaire. Subjects with a higher degree of psychological distress (Kessler-6 [K6] score ≥ 13) exhibited a significantly higher risk of withdrawing from HTTx, compared with subjects with a lower degree of psychological distress (K6 score ≤ 12; odds ratio=4.0; 95% confidence interval: 1.3-10.6, P<0.01). This study indicated that psychological distress is a risk factor for withdrawing from HTTx in post-disaster settings. Our data suggested that the increased risk of withdrawing from HTTx associated with post-disaster psychological distress may underlie the increased prevalence of vascular diseases after the earthquake disaster in coastal areas affected by the tsunami. (Disaster Med Public Health Preparedness. 2017;11:179-182).

A new instrument to predict smoking cessation among patients with chronic obstructive pulmonary disease: an observational longitudinal study of the Trying To Quit smoking questionnaire.

The Trying To Quit smoking questionnaire (TTQ), was developed to measure pressure-filled mental states, use of destructive pressure-relief strategies and ambivalent thoughts about quitting smoking among patients with COPD. The aim of this study was to evaluate whether the TTQ (available in an extended and in a reduced version) can be used to predict smoking cessation outcomes in smokers with COPD. As higher TTQ scores indicate higher degree of psychological distress, we hypothesised that TTQ scores at baseline would be negatively correlated with the probability of making a quit attempt, reducing the intensity of smoking and achieving complete abstinence during the 3 months. Smokers with COPD were recruited during planned or unplanned visits to primary healthcare centres, and 109 completed the TTQ at baseline and 85% participated in the follow-up after 3 months. Logistic regression was used to measure the association between the original (19 items) and the brief (14 item) version of TTQ scores and three outcomes: making at least one quit attempt, reducing the intensity of smoking and achieving complete abstinence. In a primary analysis among all the participants higher total score in the original version of TTQ was significantly associated with a lower probability of quit attempts. In a secondary analysis of subgroups of patients classified according to their readiness to quit, high TTQ scores at baseline were associated with lower probability of complete abstinence among patients not ready to quit (adjusted odds ratio (OR)=0.72; 95% confidence interval (CI)=0.53–0.99). Among patients ready to quit, high score on pressure-filled mental states was associated with lower probability of quit attempts (OR=0.78; 95% CI=0.66–0.94) but with higher probability of reduced smoking (OR=1.32; 95% CI=1.05–1.66). Ambivalent thoughts were associated with lower probability of all outcomes, but estimates were not statistically significant. Destructive coping strategies were inconsistently associated with the outcomes. TTQ in its original version and two of its subscales predicted smoking cessation outcomes in the anticipated direction. Therefore, this instrument may be useful in tailoring smoking cessation counselling for patients with COPD.