Higher Levels Of Mental Distress Research Articles

Psychosocial Factors Affecting Mental Well-Being of Dental Students: A Qualitative Study

INTRODUCTION: Dental students often faced high levels of mental distress which contributed to lower mental well-being. This has a negative impact on their health and academic performance. Many previous studies focused on students who were already in a 'diseased' state with little focus on students who are well but at risk of developing poor mental well-being. A better understanding of the factors affecting the mental well-being dental students is needed. This study was aimed to explore the factors associated with mental well-being of dental students and to identify steps to promote their mental well-being. MATERIALS & METHODS: In this qualitative study, individual interviews were conducted among undergraduate dental students using semi-structured interview guide. The interviews were recorded, transcribed via verbatim and analyzed using thematic analysis. RESULTS: The analysis revealed three main themes; i) Impression of dentistry, ii) Stressors and iii) Mental health experience. CONCLUSION: Undergraduate dental students often experienced low mental well-being due to the stressors they faced. Identifying the factors that influenced the mental well-being of dental students would allow for early intervention and fostering of mental well-being among dental students.

COVID-19 and worker mental distress.

This analysis posits that COVID-19-related worker mental distress may be different for those continuously employed and for those who faced temporary job loss. Mental distress during COVID-19 is characterized using two nationally representative surveys, the American Trend Panel (ATP) and the Household Pulse Survey (HPS). Using a probit model, we examine workplace perceptions for the mentally distressed in the ATP sample. We use graphical analysis to identify barriers to seeking mental healthcare using the 2021-22 HPS sample. In October 2020, the probability of mental distress increased between 7.1 and 9.1 percentage points in response to worsening work-life balance, lowered job security, lowered work productivity and lowered work satisfaction. Workers' perception of advancement denial and poor connectivity with coworkers increased the probability of mental distress by 3.0-5.8 percentage points. In October 2021, over 40% of workers who had experienced job loss reported mental distress as compared to 20% of those with jobs. Only 25% of those with mental distress sought counseling. These high levels of mental distress continued into October 2022. Mitigation strategies for worker mental health should include prosocial nudges, attention to employment history, managerial sensitivity and worker resilience training.

Mental Health in Swiss Veterinary Medicine Students: Variables Associated with Depression Scores

Mental health and wellbeing in veterinary students have become an important area of study, given the high levels of mental distress compared to other professions. Although research has identified poor mental health of veterinary students, few studies have examined positive factors such as self-compassion, which can have a favorable effect on mental health. The aim of this study was to examine self-reported symptoms of depression and factors influencing this construct, such as loneliness, self-compassion, and various demographic aspects in Swiss veterinary students. A sample of 374 Swiss veterinary students completed online measures including a demographic questionnaire, the Center for Epidemiological Studies Depression Scale-Revised (CESD-R), a short form of the University of California Loneliness Scale (UCLA-9), and the short form of the Self-Compassion Scale (SCS-SF). Results showed that 54.3% of the students were above the CESD-R cut-off score for depression, indicating a higher likelihood to suffer from depression. Results from the backward selection linear regression showed loneliness to be a risk factor, while self-compassion and rural upbringing were protective of depression. Findings suggest that Swiss veterinary students are highly burdened and may benefit from interventions aimed at reducing loneliness and improving self-compassion.

A Cross-Sectional Study of the Prevalence and Determinants of Common Mental Health Problems in Primary Care in Switzerland.

Objective: This study investigated the prevalence of the most common mental health symptoms in a large primary care patient population and characterized their determinants. Methods: Data came from a 2015-16 cross-sectional study of a primary care population in Switzerland. An investigator presented the study to patients in waiting rooms, and 1,103 completed a tablet-based questionnaire measuring stress in daily life, sleep disorders and anxiety and depressive symptoms. Diagnoses and treatments were recorded. Results: Moderate-to-high anxiety and depressive symptoms concerned 7.7% of patients; 27.6% felt stressed at least once a week; 17.2% had severe sleep disorders. Sociodemographic determinants were associated with psychiatric symptoms: female sex, young age, and frequency of consultations with a GP. Participants taking psychotropics had high levels of mental distress. Conclusion: Even though most patients were regularly monitored by their GP, a significant number of mental health problems were found. GPs should be provided with concrete tools to manage these patients better. Collaboration with mental health specialists should be encouraged in primary care settings.

Untangling the association between COVID-19 health literacy, trust in the pandemic response, and mental distress, during the COVID-19 pandemic in Ireland: a repeated cross-sectional study

BackgroundThe impact of the COVID-19 pandemic on rates of mental distress is well described. However, the contribution of poor health literacy and low levels of trust in state institutions to mental distress is less well defined. This study aimed to assess the impact of COVID-19 health literacy and trust in the pandemic response (Trust) on mental distress during the COVID-19 pandemic in Ireland. MethodsWe did this nationally representative cross-sectional survey of adult Irish residents during three study periods: from May 26 to June 17, 2020 (n=947); from July 1 to July 23, 2020 (n=995); and from Sept 5 to Sept 28, 2020 (n=972). Participants were contacted using random-digit-dialling and interviewed by a professional market research organisation (Ipsos MRBI’ about 80% via mobile phone, 20% via landline). Mental distress was assessed by the Patient Health Questionnaire Anxiety Depression Scale (PHQ-ADS), for which a score of 10 or higher indicated mental distress. Heath literacy and trust were each assessed with three questions, which defined three categories: low, moderate, and high (appendix). Descriptive analysis and multivariate (MVA) Poisson regression were conducted in STATA17, Incidence Rate Ratios (IRR) are reported. Findings2914 participants completed the survey across three study periods (median age 46 years, 1510 [51·8%] women, 1401 [48·1%] men, three [0·1%] non-binary). 804 (27·6%) of 2914 participants experienced mental distress (n=804). More women experienced mental distress than men (508 [34%] of women vs 294 [21%] of men). Mental distress was inversely associated with age (from 43% in those aged <30 years [n=232/539] to 19% in those aged >70 years [n=66/349]). Most participants had high health literacy (n=2,530, 86·8%). While health literacy was positively and significantly associated with trust, it was not associated with mental distress and it was therefore excluded from the MVA. Level of trust was captured for 2693 adults; 42·2% participants reported low trust (n=457) or moderate trust (n=679). The prevalence of mental distress was inversely associated with trust; increasing from 24% in those with high trust (n=374/1557), 30% in those with moderate trust (n=202/679), to 36% in those with low trust (n=166/457). In MVA higher rates of mental distress were associated with low trust (IRR 1·45, 95% CI 1·20–1·75; p=0·000) and moderate trust (IRR 1·24, 1·04–1·47, p=0·016) compared with high trust when adjusted for age, sex, employment status, and income,. InterpretationIn Ireland, low levels of trust in the COVID-19 pandemic response were associated with higher levels of mental distress. Although poor health literacy was associated with low levels of trust, it was not independently associated with mental distress. Inference on the nature and direction of causal effects must be cautious given the cross-sectional study design. FundingHealth Research Board.

Examining influential factors in newly diagnosed cancer patients and survivors: Emphasizing distress, self-care ability, peer support, health perception, daily life activity, and the role of time since diagnosis.

This study investigates the complex interrelationships between peer support, mental distress, self-care abilities, health perceptions, and daily life activities among cancer patients and survivors while considering the evolving nature of these experiences over time. A cross-sectional survey design is employed, utilizing de-identified data from the National Cancer Institute's 2022 nationally representative dataset, which comprises responses from 1234 participants, including 134 newly diagnosed patients undergoing cancer treatment. Partial least squares structural equation modeling is employed for data analysis. The results reveal that peer support significantly reduces mental distress and positively influences the perception of self-care abilities and health perceptions among cancer patients and survivors. Additionally, the study finds that mental distress negatively affects daily life activities and self-care abilities. This means that when cancer patients and survivors experience high levels of mental distress, they may struggle with everyday tasks and find it challenging to care for themselves effectively. The research also shows that mental distress tends to decrease as time passes since diagnosis and health perceptions improve, highlighting the resilience of cancer patients and survivors over time. Furthermore, the study uncovers significant moderating effects of age, education, and income on the relationships between daily life activity difficulties, perception of self-care ability, and perception of health. In conclusion, this research provides a comprehensive understanding of the intricate associations between the variables of interest among cancer patients and survivors. The findings underscore the importance of peer support and targeted interventions for promoting well-being, resilience, and quality of life in this population, offering valuable insights for healthcare providers, researchers, and policymakers. Identifying moderating effects further emphasizes the need to consider individual differences when designing and implementing support systems and interventions tailored to the unique needs of cancer patients and survivors.

Psychological impacts of COVID-19 on Vietnamese health workers over the prolonged restricted COVID-19 responses: a cross-sectional study

ObjectiveWe assessed the psychological impact posed by COVID-19 and its associated factors on the healthcare workforce nationwide during the peak of Vietnam’s fourth outbreak.DesignA cross-sectional study.SettingOur study was conducted in...

Inpatients in substance use treatment with co-occurring psychiatric disorders: a prospective cohort study of characteristics and relapse predictors

BackgroundThe characteristics of substance use disorder (SUD) inpatients with co-occurring psychiatric disorders (COD) have been scantly described in the extant literature. This study investigated psychological, demographic and substance use characteristics in these patients, along with predictors of relapse 3 months post-treatment.MethodsProspective data from a cohort of 611 inpatients were analyzed for demographics, motivation, mental distress, SUD diagnosis, psychiatric diagnoses (ICD-10) and relapse rate at 3 months post-treatment (retention rate = 70%).ResultsCompared to patients without COD (n = 322), those with COD (n = 289) were younger, had higher mental distress, lower education and higher likelihood of no permanent residence. The relapse rate was also higher in patients with COD (39.8%) relative to patients without COD (26.4%) (OR = 1.85, 95% CI: 1.23–2.78). The relapse rate was particularly high for patients with COD who were diagnosed with cannabis use disorder (53.3%). Multivariate analysis revealed that among patients with COD, relapse was more likely for individuals with a cannabis use disorder (OR = 2.31, 95% CI: 1.34-4.00), and less likely for older ages (OR = 0.97, 95% CI: 0.94-1.00), females (OR = 0.56, 95% CI: 0.33–0.98) and for those with higher intrinsic motivation (OR = 0.58, 95% CI: 0.42–0.81).ConclusionThis study showed that among SUD inpatients, those with COD had relatively persistent high levels of mental distress and an increased risk of relapse. Enhanced measures aimed at COD patients’ mental health problems during the inpatient stay, along with close and personalized follow-up after discharge from residential SUD treatment may reduce the probability of relapse in this group.

Stress, depression, and anxiety among undergraduate nursing students in the time of a pandemic.

Emerging literature reports on the challenges faced by nursing students internationally during the pandemic as they continue their education. The aim of this mixed methods study was to examine stress, depression, and anxiety among undergraduate nursing students at a Canadian university during the pandemic. Stress and coping and trauma theories informed this study. Mixed methods included an online questionnaire composed of the Depression Anxiety Stress scales (DASS), sociodemographic data, and quality of life items with open-ended questions. Sample included 280 participants. Mean scores for depression and stress were in the mild level, for anxiety in the moderate level; 24 , 37 and 23 % of the sample had scores of severe or extremely severe for depression, anxiety, and stress respectively. Written comments reflected the impact on participants' relationships, motivation, struggles with remote learning, perceived heavy workloads, and impact on health and self-care, while some described positive experiences, including improved study habits. Uncertainty, isolation, sudden and ongoing changes with program delivery and a variety of psychosocial losses, helped to explain the distress many shared. The disconnect between reported levels of use of mental health services and the higher levels of mental distress raises the question of access to and use of these services. The importance of developing and maintaining effective coping, including a support system, and committing to healthy self-care during challenging times was reinforced. This difficult time for nursing students emphasized the need to ensure attention to student well-being and mental health during their foundational educational experiences.

Mental distress links with physical activities, sedentary lifestyle, social support, and sleep problems: A Syrian population cross-sectional study.

Mental diseases are very widespread and difficult to treat, affecting around 12% of the global population in 2019. Since social interaction is crucial to human existence and loneliness has been proven to be a significant predictor of depressive symptoms, it stands to reason that social connection problems would also contribute to depression. Physical inactivity seems to weaken and aggravate insulin tolerance alterations, glucose homeostasis, and plasma triglyceride levels, thereby influencing one's mood and happiness. This suggests that physical inactivity may be a significant risk factor for mental illness. This research contributes to our understanding of the mental health situation in Syria by exploring associations between a set of measurable characteristics that may be adjusted. An online quantitative cross-sectional study was conducted between March and April 2022 in Syria, using a structured questionnaire that assesses data on behaviors of health, health in general, wellbeing, and adult population quality of life. Among 1,224 respondents (371 men and 853 women), women have shown higher levels of mental distress, sleep issues, low engagement in structured activities, and a difficult work environment than men. Women experiencing mental anguish have reported being more sedentary, participating in less scheduled activities, and receiving less social support. There are observable connections between high sedentary time and women experiencing mental distress. The mental health of Syrian women in distress was associated with a lack of participation in both organized activities and physical exercise in their free time. Furthermore, sleep issues and financial troubles were seen in persons with mental diseases of both males and females.

A study on mental distress among the undergraduate students of medical college, Kolkata

Background: Medical students are reported to have high levels of mental distress that includes problems such as anxiety, depression, and stress due to the highly competitive curriculum. In the post-pandemic era with a renewed perspective toward health system and popularization of online classes, current batch of students are exposed to diverse sources of mental distress. Aims and Objectives: Objectives of this study were to find out the socio-demographic and behavioral characteristics, family background and academic profile of the study participants, and to estimate the proportion of different varieties of mental distress among them, and to examine relationship of mental distress with sociodemographic, behavioral and academic profile. Materials and Methods: A cross-sectional observational study was performed on 649 undergraduate students by census method using depression anxiety stress scale-21 items. Results: The study participants are predominantly Hindu, urban, unmarried, hostelites, males from nuclear families and belonging to upper socioeconomic class according to Modified B.G Prasad Socioeconomic Status Scale (January 2022). The proportion of depression, anxiety, and stress among study participants was found to be 49.61%, 58.86%, and 33.13%, respectively. Proportion of mental distress was significantly higher in the age group of 21–24 years. Those who preferred to study more at night were more anxious and stressed. Stress was higher in students with addiction to gadgets too. Participants hailing from rural areas, hostelites, and paying guests were relatively more depressed. Conclusion: There is urgent need for emotional support and provision of personalized counseling for the MBBS students as unchecked mental distress can turn into severe psychological morbidity.

Different Typologies of Gamers Are Associated with Mental Health: Are Students DOOMed?

(1) Background: The inclusion of Internet Gaming Disorder in the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) led to a rapid development of assessment instruments based on the suggested diagnosis. However, previous studies suggest that some of the symptoms in the diagnosis reflect engagement in gaming rather than a disorder or addiction. The aim of the present cross-sectional study was to investigate mental health associations with different typologies of gamers. (2) Methods: Data stemmed from a large national survey of students (SHoT2022) that was conducted between February and April 2022 (N = 59,544). Participants were categorized into non-gamers, recreational gamers, engaged gamers, problematic gamers, and addicted gamers. Logistic regression models adjusted for age were analyzed with and without gender-stratification for mental distress and life satisfaction as dependent variables across gaming categories. (3) Results: The proportion reporting case-level mental distress was lower for recreational gamers compared to non-gamers, indicating fewer mental health problems for recreational gamers. However, after stratifying the analysis by gender, female recreational gamers had higher levels of mental distress compared to female non-gamers, reflecting Simpson's paradox. (4) Conclusions: Future studies investigating mental health and gaming should include a gender perspective.

Physical Activity and Mental Health of Medical Students from Poland and Belarus-Countries with Different Restrictive Approaches during the COVID-19 Pandemic.

COVID-19 pandemic has struck all of us suddenly and unexpectedly; it deprived the society of a sense of control over their lives on different levels. In a short period of time, it led to a number of changes in everyday life of people all over the world. In particular, these changes affected medical staff, who, all of a sudden, were burdened with new work-related responsibilities and duties. This situation may have had a detrimental effect on their mental health. Due to the unpredictability of the COVID-19 pandemic, we attempted to assess its consequences in terms of mental health and physical fitness of university students from countries in which different approaches to these issues were adopted. A total of 779 medical students (374 students from John Paul II University of Applied Sciences (ABNS) in Biala Podlaska, Poland, and 405 students from Yanka Kupala State University of Grodno (YKSUG), Belarus) took part in the survey. Three standardised psychometric tools were used in the study: The Satisfaction With Life Scale (SWLS), The General Health Questionnaire (GHQ-28) and Stress Coping Inventory (Mini-COPE). In addition, the International Physical Activity Questionnaire (IPAQ) was applied. The vast majority of students both from Poland and Belarus demonstrated high levels of physical activity. However, students from ABNS manifested significantly higher levels of physical activity compared to their counterparts from YKSUG. Students from Biala Podlaska had greater satisfaction with life during the COVID-19 pandemic, whereas their peers from Grodno exhibited higher levels of mental distress. The COVID-19 pandemic resulted in a significant exacerbation of mental health issues among medical students. In order to alleviate negative effects of the pandemic, it seems necessary for universities to monitor the physical and mental health state of students and to implement prevention programmes.

Mental Health and Substance Use of Farmers in Canada during COVID-19.

Farmers in Canada faced higher levels of mental distress than the general public prior to the Coronavirus Disease 2019 (COVID-19) pandemic and are generally less likely than the public to seek help. However, the mental health impacts of COVID-19 on farmers in Canada remain unexplored. Our objective was to investigate mental health outcomes among farmers in Canada by gender and within the context of COVID-19. We conducted a national, online, cross-sectional survey of farmers in Canada (February–May 2021). The survey included validated scales of anxiety, depression, perceived stress, burnout (emotional exhaustion, cynicism, professional efficacy), alcohol use, resilience, and questions regarding participants’ perceived changes in these outcomes during the pandemic. Data were also collected on the impact of COVID-19 specific social and economic factors on mental health, help-seeking, and sense of community belonging through the pandemic. Descriptive statistics were summarized, and Chi-square analyses and t-tests were conducted to compare survey results between genders and to data collected in our similar 2016 survey and normative population data. A total of 1167 farmers participated in the survey. Participants scored more severely across scales than scale norms and the general Canadian population during COVID-19. Scale means were consistent between the 2016 and 2021 samples. Most participants with moderate to severe scores for any outcome reported worsening symptoms since the pandemic began. Women fared significantly worse than men across measures. Over twice as many women reported seeking mental health or substance use support during the pandemic than men. Participants rated the mental health impacts of all social and economic factors related to COVID-19 examined significantly (p < 0.05) differently than the Canadian public. The pandemic has negatively impacted the mental health of farmers in Canada and in ways that differ from the general population. National level and gender-specific mental health supports are needed to help improve the mental health of farmers in Canada.

GPs’ identification of patients with mental distress: a coupled questionnaire and cohort study from norwegian urban general practice

BackgroundMental health problems are one of the leading causes of disease burden worldwide, and are mainly diagnosed and treated in general practice. It is unclear however, how general practitioners (GPs) identify mental health problems in their patients. The aim of this study was to explore how patients’ self-reported levels of mental distress correspond with psychological diagnoses made by their GPs, and associations with sex, age, number of consultations, and somatic symptom diagnoses.MethodsA questionnaire study coupled with retrospective and prospective cohort data from 553 patients aged 16–65 years in six GP offices in Oslo, Norway during 21 months in 2014–2016.ResultsWe found that 73.3% of patients with self-reported high levels of mental distress versus only 13.3% of the patients with low levels of mental distress had received a psychological diagnosis (p < 0.01). We found an increase in number of consultations for the group with high levels of mental distress regardless of having received a psychological diagnosis (p < 0.01). There was also an increase in number of somatic symptoms (p = 0.04) and higher number of females (0.04) in this group. 35% of patients had received one or more psychological diagnosis by their GP. Mean CORE-10 score, being female and a high number of consultations was associated with having received a psychological diagnosis. In the adjusted analyses high CORE-10 score and a high number of consultations still predicted a psychological diagnosis.ConclusionsWe found a clear association between self-reported mental distress and having received a psychological diagnosis amongst the participants, and the probability for being identified increased with increasing levels of mental distress, and increasing number of visits to their doctor. This suggests that GPs can identify patients with high levels of mental distress in general practice in an adequate way, even though this can sometimes be a complex issue.Trial registrationTrial registration The main study was retrospectively registered in ClinicalTrials.gov on August 10 2019 with identification number NCT03624829.

The magnitude of mental distress and associated factors among a school of medicine and college of health sciences students at Debre Markos University, 2021.

Mental distress is a collection of mental health abnormalities characterized by symptoms of anxiety, depression, insomnia, fatigue, irritability, forgetfulness, difficulty in concentrating, and somatic symptoms. It affects society as a whole and no group is immune to mental distress; however, students have a significantly high level of mental distress than their community peers. The study is aimed to assess the magnitude of mental distress and associated factors among a school of medicine and college of health sciences students. To assess the magnitude of mental distress and associated factors among a school of medicine and college of health sciences students at Debre Markos University, 2021. Institution-based cross-sectional study design was employed from March 15-29, 2021. A simple random sampling technique was used to select 475 study participants. A binary logistic regression model was used to identify factors associated with mental distress. Variables with a p-value less than 0.25 in the bivariable analysis were entered into multivariable logistic regression analysis and a P-Value of less than 0.05 was considered as having a statistically significant association. The magnitude of mental distress among students was found to be 35.4%, 95%CI (31%, 40%). Female sex [AOR = 1.95; 95%CI (1.24-3.06)], financial distress[AOR = 1.64; 95%CI (1.062.54)], feeling of insecurity [AOR = 2.49; 95% CI (1.13-3.54)], lack of interest to department [AOR = 2.00; 95%CI (1.75-4.36)] and cumulative grade point average less than expected [AOR = 2.63; 95%CI (1.59-4.37)]were significant variables with mental distress. The magnitude of mental distress was high. Sex, financial distress, feeling of insecurity, lack of interest in the department, and cumulative grade point average less than expected were significant variables with mental distress, so special attention on mental health promotion is required from policymakers, college officials, parents, and other Non-Governmental organizations.

O12 - Multiple birth mental health outcomes throughout pregnancy, delivery and postnatally

While there is awareness that multiple birth pregnancies and postnatal experiences are more challenging generally, little is known of the mental health impacts. To explore multiple birth mothers pregnancy experience and mental health outcomes during pregnancy, following delivery and postnatally. An open online anonymous survey was used to collect data from multiple birth parents, 1006 responses were collected. 713 completed the survey fully, providing very detailed responses to open-ended questions, whilst 293 provided high level responses only. The challenges of a multiple birth pregnancy was associated with high levels of mental distress and mental health problems. 73.3% of respondents noted that they experienced challenges during their pregnancy, and of these, 84.7% cited these challenges as directly impacting upon their emotional or mental health. Despite the challenges, 70% of these respondents did not seek treatment or a diagnosis. At birth, 73.7% of those surveyed had a caesarean delivery and another 2.3% had at least one baby delivered via caesarean. Almost 28% of respondents reporting experiencing a traumatic birth, with over 60% not seeking support or treatment. The heightened risk of postnatal mental health problems and emotional distress is indicated with 69% of respondents experiencing stress, anxiety and/or depression in the postnatal period. In addition, over three quarters (77.5%) experienced feelings of isolation. The results reveal the significantly higher risks of emotional and mental health distress for parents of multiple births. This begins in the antenatal period, and continues at birth and throughout the postnatal period. The results highlight the imperative need for information, screening and early detection, support and treatment. Given the high prevalence of emotional and mental health distress, low rates of help-seeking, and isolation, the need for continued advocacy to support the unique needs of this population group is urgently needed.

Quality of Life and Mental Distress in Patients with Chronic Low Back Pain: A Cross-Sectional Study.

The aim of this study was to examine the levels of health-related quality of life (HRQoL), pain intensity, and mental distress in participants with chronic low back pain (CLBP), and to examine the differences in the HRQoL of participants with respect to mental distress and the correlations of the examined variables. Data were collected from 148 patients using the SF-36 Health Status Questionnaire (SF-36), the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM) questionnaire, and the visual-analog pain scale (VAS). The results indicate poorer self-assessment of physical health (Me = 28.1) compared to mental health (Me = 39.4). Participants with higher levels of mental distress reported significant emotional limitations (p = 0.003), lower energy (p < 0.001), poorer psychological health (p < 0.001) and social functioning (p < 0.001), more pain (p = 0.007), and, ultimately, poorer general health (p < 0.001). The level of mental distress was related to the level of HRQoL, while a correlation with the level of pain of the participants was not found. The study results indicate a connection between the presence of mental distress and almost all aspects of HRQoL in participants with CLBP.

Mental Distress during the COVID-19 Pandemic: A Cross-Sectional Study of Women Receiving the Comprehensive Social Security Allowance in Hong Kong.

Welfare recipients were often considered the least deserving of COVID-related support. Despite the recent attention paid to the impact of COVID-19 pandemic on mental health, few studies have explored the mental distress experienced by welfare recipients. This cross-sectional study on female Comprehensive Social Security Allowance recipients in Hong Kong aimed to explore their level of mental distress and its association with a range of risk factors specific to welfare recipients. Hence, 316 valid cases from a local community center responded to our online survey. We found that 52.3%, 23.4%, and 78% of the participants showed moderate to extremely severe depression, anxiety, and stress symptoms, respectively. A higher level of mental distress was associated with having a psychiatric diagnosis, poorer social, and greater concerns over disciplining children, the living environment, daily expenses and being infected by COVID-19. Unexpectedly, being married, having a permanent residence, and having a job were not significant protective factors for this group. The models explained 45.5%, 44.6%, and 52.5% of the overall variance in the level of depression, anxiety, and stress (p < 0.01), respectively. Our findings have important implications for supporting female welfare recipients during a public health crisis and may help frontline staff and professionals provide prompt assistance to this group in need.

An exploration of mental distress in transgender people in Ireland with reference to minority stress and dissonance theory

Introduction: Internationally mental distress is more prominent in the LGBTI community than the general population. The LGBTIreland study was set up to take stock of this in the Republic of Ireland. This paper reports on the analysis of the transgender group with reference to minority stress theory and cognitive dissonance theory. Method: An online survey was conducted addressing several aspects of mental health and distress that received responses from all groupings (n = 2,264) among which 12.3% (n = 279) identified as transgender. The survey consisted of several validated tools to measure depression, anxiety, stress (DASS-21), coping (CSES), self-esteem (RSES), alcohol and drugs misuse (AUDIT) and a variety of questions addressing demographics, experiential aspects, coping and self-related factors. Data analysis focused on predicting mental distress using DASS-general (composite of depression, anxiety and stress). Results: Transgender participants reported higher levels of mental distress, self-harm, suicidal ideation and attempts, and lower levels of self-esteem in comparison with the LGB groups, as well as the general population. Hierarchical multiple regression showed that 53% of variance in mental distress could be predicted from reduced self-esteem, the experience of harassment and not belonging in school. Furthermore, mental distress was highest among younger participants, those who were ‘not out’, those who had self-harmed and used avoidant coping. There was no significant difference in distress levels among those who had sought mental health support and those who had not. Conclusions: To understand mental distress in transgender people, the minority stress model is useful when taking into account both adverse external (environmental) and internal (cognitive/emotional) factors. The cognitive dissonance mechanism is essential in outlining the mechanism whereby gender incongruence is associated with psychological discomfort, low self-esteem and high mental distress.