Mental Health Impact Research Articles

How did the depression and anxiety levels of older New Zealanders change during the COVID-19 pandemic?

ABSTRACT There has been widespread concern about the mental health impact of the global COVID-19 outbreak. Fears have been raised that depression and anxiety among older people may have increased in the pandemic, and that adverse health behaviours, such as increased alcohol use and decreased physical activity, may have contributed to the mental health decline. This study aimed to examine changes in depression, anxiety, alcohol use and physical activity scores of people aged 55 and older in New Zealand over the initial months of the pandemic. The sample included 3,171 people who responded to wave 7 (August-November 2018) and wave 8 (June-September 2020) of the Health, Work and Retirement Study. Analyses were carried out using paired t tests and multilevel mediation modelling. There was no evidence of significant changes in depression or anxiety. Alcohol use and physical activity were shown to decrease significantly, albeit to a small degree, and there was evidence of an indirect effect of time on depression via physical activity. These findings suggest a general resilience among older people 3 to 6 months into the pandemic. However, increased attention should be paid to promoting physical exercise among older people, as a means of decreasing depression risk.

Investigating the Status of Mothers and Newborns' Access to Safe and Quality Care from the Perspective of Midwifery Personnel Working in Government Hospitals: A Cross-Sectional Study

Aim The present study was conducted to determine the status of mothers’ and newborns' access to safe and quality care from the perspective of midwifery personnel. Background Safe and quality care is recognized as a principle in providing healthcare to mothers and newborns. Methods This was a cross-sectional study conducted through random sampling on 270 midwifery personnel working in government hospitals of Mashhad University of Medical Sciences in 2023. The data were collected using a questionnaire created by a researcher and analyzed using descriptive and inferential statistical tests in SPSS-22 statistical software at a significance level of less than 0.05. Results The average age of the participants was 34.41 ± 7.93 years. The results showed the status of mothers' and newborns' access to safe and quality care to be in the average range of 38.30 ± 6.67. The midwifery personnel have demonstrated adherence to scientific and specialized protocols regarding the way for childbirth and how to care for mothers and newborns to be the most frequent (51.5%), while the provision of emotional and psychological support to women who have given birth with newborn problems to be the least frequent (8.5%). Conclusion Midwifery personnel believe that the safe and quality care provided to mothers and newborns is adequate. Midwifery personnel are committed to following evidence-based practices, but need additional training and resources to support women in need emotionally and psychologically. This is particularly concerning given the potential impact of maternal mental health on both the mother and the newborn.

COVID-19 and Mortality in the Spinal Cord Injury Population: Examining the Impact of Sex, Mental Health, and Injury Etiology.

The purpose of this study was to investigate the impact of the COVID-19 pandemic on mortality rates in a community-dwelling spinal cord injury (SCI) population in Ontario. Using health administrative databases, monthly mortality rates were evaluated pre-pandemic, during the pandemic, and post-pandemic from March 2014 to May 2024. Data were stratified by sex, injury etiology, and mental health status. Group differences were evaluated using t-tests. Autoregressive integrated moving average (ARIMA) models evaluated the pandemic's impact on mortality rates. A significant increase of 21.4% in mortality rates during the pandemic was found for the SCI cohort. With the exception of the traumatic group, all subgroups also experienced a significant increase in mortality rates (males: 13.9%, females: 31.9%, non-traumatic: 32.3%, mental health diagnoses: 19.6%, and mental health diagnoses: 29.4%). During the pandemic, females had a significantly higher mortality rate than males. The non-traumatic group had higher mortality rates than the traumatic group at all time periods. Individuals with mental health diagnoses had higher mortality rates than those without at the pre-pandemic and pandemic periods. The variation in mortality rates across groups highlights inequitable access to medical care in the SCI population, with further research and interventions needed.

Sexual Harassment, Sexual Violence, and Mental Health Outcomes: Causal Inference with Ambiguous Exposures.

Social exposures and their impact on mental health has proven hard to capture, partly owing to the complex and multifaceted nature of social reality. Sexual harassment and sexual violence (SHV) are no exceptions. SHV can be conceptualized as a continuum of negative sexual experiences whose severity vary depending on multiple determinants. Further, SHV can be conceptualized as either discrete events or as a generally hostile sexual environment represented by latent variables. With any of these conceptualizations, SHV constitutes a broad construct containing many kinds of negative experiences. This ambiguity poses challenges for determining the mental health consequences, as different forms of SHV may vary in terms of their mental health impact. We discuss different conceptualizations of SHV in relation to mental health outcomes through the lens of the potential outcomes framework, with a focus on the consistency condition. The multiple versions of treatment theory is presented to show how to provide formal interpretations of causal estimates under ambiguous exposures. Lastly, we provide suggestions on how the increase the clarity and interpretability of the effects of SHV on mental health, by increasing the precision of the causal questions and the use of more specific definitions of SHV.

Identification of relevant mental health indicators for European community-based health enhancing physical activity initiatives: An adapted Delphi study

Health enhancing physical activity (HEPA) initiatives can improve mental health; however there is a lack of standardised measures to evaluate mental health impact. This study aimed to identify the relevant indicators of mental health and well-being in community-based HEPA initiatives in Europe as determined by specialists and practitioners in the field, and understand assessment methods commonly used.An adapted, two round, Delphi method was conducted with N = 20 specialists (practitioners and academics) in the field of mental health and physical activity from Denmark, the Netherlands, the UK, and Ireland. Specialists selected the most important indicators and agreed consensus on definitions and operationalisation, where consensus ≥50% signified important indicators.Specialists compiled 66 (n = 21 outcome, n = 45 determinant) indicators. Top rated indicators for the evaluation of HEPA initiatives were self-rated mental health (69.2%), physical activity (69.2%) life satisfaction (53.8%), stress (53.8%), loneliness (53.8%), social participation, network, connection and support (53.8%). Consensus on definition and application of the nine indicators varied (44.4%–100%), with no consensus on a standardised measurement tool reached, although specialists pointed to the need for culturally sensitive measurement tools.While this study highlights a lack of conformity for evaluating mental health and wellbeing outcomes, it suggests utility in an agreed definition and application of nine indicators for the evaluation of HEPA initiatives, with social determinants of particularly high importance across the relevant contexts. Further research is recommended to develop guidance on pragmatic measurement tools that can be utilised across other (European) countries and their implementation tested.

Machine learning for anxiety and depression profiling and risk assessment in the aftermath of an emergency

Background & objectivesMental health disorders pose an increasing public health challenge worsened by the COVID-19 pandemic. The pandemic highlighted gaps in preparedness, emphasizing the need for early identification of at-risk groups and targeted interventions. This study aims to develop a risk assessment tool for anxiety, depression, and self-perceived stress using machine learning (ML) and explainable AI to identify key risk factors and stratify the population into meaningful risk profiles. MethodsWe utilized a cohort of 9291 individuals from Northern Spain, with extensive post-COVID-19 mental health surveys. ML classification algorithms predicted depression, anxiety, and self-reported stress in three classes: healthy, mild, and severe outcomes. A novel combination of SHAP (SHapley Additive exPlanations) and UMAP (Uniform Manifold Approximation and Projection) was employed to interpret model predictions and facilitate the identification of high-risk phenotypic clusters. ResultsThe mean macro-averaged one-vs-one AUROC was 0.77 (± 0.01) for depression, 0.72 (± 0.01) for anxiety, and 0.73 (± 0.02) for self-perceived stress. Key risk factors included poor self-reported health, chronic mental health conditions, and poor social support. High-risk profiles, such as women with reduced sleep hours, were identified for self-perceived stress. Binary classification of healthy vs. at-risk classes yielded F1-Scores over 0.70. ConclusionsCombining SHAP with UMAP for risk profile stratification offers valuable insights for developing effective interventions and shaping public health policies. This data-driven approach to mental health preparedness, when validated in real-world scenarios, can significantly address the mental health impact of public health crises like COVID-19.

State-level anti-transgender laws increase past-year suicide attempts among transgender and non-binary young people in the USA.

From 2018 to 2022, 48 anti-transgender laws (that is, laws that restrict the rights of transgender and non-binary people) were enacted in the USA across 19 different state governments. In this study, we estimated the causal impact of state-level anti-transgender laws on suicide risk among transgender and non-binary (TGNB) young people aged 13-17 (n = 35,196) and aged 13-24 (n = 61,240) using a difference-in-differences research design. We found minimal evidence of an anticipatory effect in the time periods leading up to the enactment of the laws. However, starting in the first year after anti-transgender laws were enacted, there were statistically significant increases in rates of past-year suicide attempts among TGNB young people ages 13-17 in states that enacted anti-transgender laws, relative to states that did not, and for all TGNB young people beginning in the second year. Enacting state-level anti-transgender laws increased incidents of past-year suicide attempts among TGNB young people by 7-72%. Our findings highlight the need to consider the mental health impact of recent anti-transgender laws and to advance protective policies.

The Impact of Sleep and Mental Health on the Quality of Work Among Paramedics in the Kingdom of Saudi Arabia

The emergency services sector is one of the most arduous and crucial fields wherein an individual’s life lies in the hands of emergency responders such as paramedics and police. Paramedics are crucial figures in the emergency medical services system. They deliver immediate medical care to patients who suffer from critical and life-threatening conditions, serving as a gap-filler between the accident scene and health facilities. In the Kingdom of Saudi Arabia, the health authority has been constantly striving to build a credible, professional, and trustworthy EMS system while discovering challenges faced by the service in the rapidly changing health scenario of KSA. This study employed a mixed-methods approach, combining quantitative surveys and qualitative interviews to assess the relationship between sleep patterns, mental health, and work quality among paramedics in the Kingdom of Saudi Arabia. The results of this study reveal a significant correlation between sleep quality, mental health, and the overall performance of paramedics in the Kingdom of Saudi Arabia. In conclusion, the findings of this comprehensive study emphasize and highlight the critical and significant relationship that exists between sleep quality, mental health, and overall job performance among paramedics working in the Kingdom of Saudi Arabia. This highlights an urgent need for targeted and effective interventions designed specifically to enhance their well-being and support their mental health in the demanding field of emergency services.

Investigation of Psychometric Properties and Correlation with Psychological Distress after Hurricane Hazards in Puerto Rico.

Puerto Rico (PR) is highly vulnerable to hurricanes, which severely impact cancer survivors by causing healthcare disruptions and increasing stress. This study investigates the reliability and factor structure of the Hurricane Hazards Inventory (HHI) and its relationship with psychological distress among cancer survivors and non-cancer controls in PR. Using secondary data from a longitudinal study following Hurricane Maria (HM), the baseline assessment included sociodemographic data from participants, HHI, Patient Health Questionnaire (PHQ-8), and Generalized Anxiety Disorder (GAD-7). Statistical analyses involved descriptive statistics, Exploratory Factor Analysis (EFA), and Partial Least Squares Structural Equation Modeling (PLS-SEM). Among 260 participants, 78.7% were women, with a median age of 58.0 years. EFA reduced the HHI to 17 items grouped into three factors explaining 62.6% of the variance with excellent reliability (Cronbach's alpha 0.91). The three factors also showed good to excellent reliability (alpha 0.81 to 0.92). The median HHI score was 11.0 (range 4.0-26.5) out of 68. PLS-SEM revealed a direct effect of being a cancer survivor and tertiary hazards on depression and anxiety. The HHI is a valid and reliable tool for assessing mental health impact in cancer survivors after hurricanes. However, the study had limitations, including its small sample size and lack of control for all confounding variables. Future research with larger and more diverse samples is needed to further validate the HHI and examine its generalizability.

Do acute mountain sickness and psychiatric disorders show overlapping symptoms?

The Lake Louise Score (LLS) is a common tool for diagnosing acute mountain sickness (AMS) after a recent gain in altitude. Required symptoms (headache, dizziness, fatigue or gastrointestinal symptoms) are unspecific, subjective and not detectable by physiological parameters. (Talks et al., 2022; Boos et al., 2018) This study aimed to enhance present knowledge concerning the impact of mental health on LLS. In a cross-sectional questionnaire study, we assessed 3 groups: 100 inpatients (Ward for psychosomatic medicine – Innsbruck, PSY), 73 mentally healthy individuals (Innsbruck, Austria at an altitude of 570 m, CO) and 223 mountaineers in Nepal (Pheriche 4,371 m and Dingboche 4,410 m, NEPAL). Beside social demographics and LLS 2018 (cutoff for LLS-positivity: LLS ≥ 3 including at least 1 point for headache), we examined symptoms of anxiety (Zung Self-Rating Anxiety Scale [SAS], General Anxiety Disorder Questionnaire 7 [GAD-7]), affective states (International Positive and Negative Affect Schedule Short form [I-PANAS-SF]) and sleep (Insomnia Severity Index [ISI]). In this preliminary analysis, the average age was 39 ± 16 years in PSY, 34 ± 16 years in CO and 40 ± 14 years in NEPAL. Gender distribution showed greater portion of women in PSY and CO (PSY: 72% female 24% male 3% non-binary, CO: 64% female 36% male) contrary to NEPAL (36% female 64% male). At sea level, 67% scored LLS-positive in PSY and 12% in CO (Fishers exact test, p < 0.001). In NEPAL 25% met AMS-criteria by LLS. CO and NEPAL score significantly lower in LLS than PSY (ANOVA: diff = -3.70, p < 0.0001; diff = -3.68, p < 0.0001, respectively). PSY and CO showed significant weak to moderate correlations (Spearman-Rho, p < 0.001) of anxiety (SAS, GAD), affective states (I-PANAS-SF) and sleep impairment (ISI) with LLS-sum. NEPAL showed significant very-weak to weak correlations of insomnia, anxiety and negative affect with LLS-sum. Using logistic regression analysis (Figure 1), higher odds of LLS-positivity are significantly associated with insomnia and anxiety (ISI, SAS) in PSY, with anxiety in CO (SAS) and insomnia and negative affect in NEPAL. While of course a recent gain in altitude is a prerequisite for the diagnosis of AMS this study shows that patients with pre-existing mental illness at low altitude score more frequently false-positive on the LLS than a mentally healthy cohort. Symptoms of anxiety, negative affect and sleep disturbance can affect the AMS-defining questionnaire of LLS both at sea level and at high altitude. There is still uncertainty on a possible common pathophysiological pathway of psychiatric diseases and AMS since there is no Gold Standard in diagnosing AMS. Concerning (well-)established risk-factors for AMS like speed of ascent (Berger et al., 2023) and female sex (Hou et al., 2019), we see no evident data. The data presented here suggest that strength of expression of negative affect can cause positive LLS scoring. Acute mountain sickness and psychiatric disorders show overlapping symptoms at sea level. At high altitudes, negative affect seems to be a possible cause for the development of AMS. Further research focus should be placed on mountaineers in high altitude with psychiatric disorders and their mental state.

Interpregnancy intervals and behavioural outcomes in children: A population-based longitudinal study

BackgroundWhile the physical health consequence of short interpregnancy intervals (IPIs) is well documented, its mental health impact is not well explored. This study aimed to examine the associations between IPIs and behavioural outcomes in children born following the interval at four developmental time points between ages 7 and 16. MethodsOur study sample comprised participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort, an ongoing population-based longitudinal birth cohort in Bristol, Avon, United Kingdom. Behavioural problems, including total behavioural difficulties, hyperactivity, emotional symptoms, conduct problems, peer-problems, and problems of pro-social behaviour, were assessed using the Strengths and Difficulties Questionnaire (SDQ). Over 2300 mothers and their singleton children were included in this study. Generalized Estimating Equations (GEE) were used to estimate odds ratios for the associations. ResultsChildren born to mothers with short IPI (<6 months) were 1.54 (95%CI: 1.12–2.11), 1.42 (95% CI: 1.12–1.81) and 1.37 (95%CI: 1.04–1.79) times more likely to have total behavioural difficulties, conduct problems and hyperactivity/inattention problems across the child's age, respectively, compared with children of mothers with IPIs of 18–23 months. We found no evidence of associations between short IPI (<6 months) and emotional symptoms, peer-relationship problems and pro-social behaviour problems. ConclusionShort IPI (<6 months) was associated with externalising (conduct and hyperactivity/inattention) but not internalising (emotional and peer-relationship problems) problems. Further studies are needed to confirm this association and elucidate the underlying mechanisms.

Healthy Warrior Effect With Deployment to United Nations Peacekeeping Operation: A Longitudinal Study Among Japan Ground Self-Defense Forces.

The "healthy warrior effect" (HWE), in which deployed military personnel are healthier than those not deployed, is known to be associated with deployment. However, the HWE associated with deployment to United Nations (UN) peacekeeping operations (PKO) has not been examined. This study examined the HWE associated with deployment to UN PKO by examining the impact of pre-deployment mental health on the likelihood of deployment and whether this difference persisted after deployment. This retrospective cohort study included 2,712 Japan Ground Self-Defense Forces personnel from four engineering units who consented to participate in annual mental health checks conducted between August and October 2015. The Kessler Psychological Distress Scale (K6) was used to assess general psychological distress before and after deployment. Logistic regression analysis adjusted for age, sex, and rank was conducted with deployment as the dependent variable and the pre-deployment K6 total score as the independent variable. Additionally, a mixed-effects model was performed with K6 total scores as the dependent variable, time and deployment as fixed effect factors, and the individual as the random effect factor. Of the participants, 254 were in the deployed group, and 2,458 were in the non-deployed group. The pre-deployment K6 total score was significantly lower (t = 5.2, P < .001) for the deployed group (0.67 ± 1.60) than for the non-deployed group (1.26 ± 2.41). Logistic regression analysis showed an odds ratio for the K6 total score before deployment as 0.87 (95% CI = 0.79-0.94). The mixed-effects model exhibited a significant negative main effect of being deployed (t = -5.1, P < .001) and a significant interaction effect between time and being deployed (t = -2.5, P = .012). Psychologically healthier personnel were more likely to be deployed for UN PKO and their better mental health status persisted after deployment, reflecting the HWE. However, personnel in good health may develop new mental health issues after their deployment, and more attention to health management will be essential before and after deployment.

Birding Benefits: A Review of Mental Health, Cognitive, Social, and Conservation Impacts

Birding Benefits: A Review of Mental Health, Cognitive, Social, and Conservation Impacts

Falls as a mental health risk among Korean-American residents in subsidized senior housing: mediating effect of fall-related self-efficacy

Objectives The study examined the mediating role of fall-related self-efficacy in the association between falls and mental health among older Korean Americans living in subsidized senior housing in the greater Los Angeles area. We focused on serious fall incidents (i.e. multiple falls or any fall with a fracture) and used symptoms of depression and anxiety as indicators of mental health. Method Survey data from 315 participants (M age = 79.4 years) were used to examine the direct effects of serious fall incidents on mental health symptoms, as well as indirect effects through fall-related self-efficacy. Results The mediating effect of fall-related self-efficacy was found to be significant in both models for depressive symptoms (B [SE] = 0.15 [0.07], bias-corrected 95% CI = [0.03, 0.31]) and anxiety symptoms (B [SE] = 0.11 [0.05], bias-corrected 95% CI = [0.02, 0.23]). Conclusion The mental health impact of serious fall incidents was shaped by older individuals’ perceived concerns about falls and confidence in performance. The findings highlight the importance of addressing fall-related psychological responses in preventing falls and promoting mental health among senior housing residents.

Impact of occupational stress on healthcare workers’ family members before and during COVID-19: A systematic review

We aimed to explore the experiences, needs, and mental health impact of family members of healthcare workers (HCWs) before and during the COVID-19 pandemic. Eleven quantitative and nine qualitative studies were included in this review. Based on the narrative synthesis, we identified five outcomes: ‘Mental health outcomes’, ‘Family relationships, ‘Coping skills and resilience’, ‘Quality of life and social life’, and ‘Practical outcomes’. Our findings indicated that there was a high risk to the mental health and well-being of families of healthcare workers both before and during the pandemic. However, with the COVID-19 pandemic, some experiences and mental health issues of families were worsened. There was also a negative association between working long hours/shift work and family relationships/communication, family social life, and joint activities, and family members taking on more domestic responsibilities. Families tended to use both positive and negative coping strategies to deal with their loved one’s job stress. Organisations and support services working with people in health care work should consider widening support to families where possible. With this understanding, HCWs and their families could be supported more effectively in clinical and organisational settings. Trial registration: Systematic Review Registration Number: CRD42022310729. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022310729.

Am I willing to take a mental health day off? Integrating perspectives from self-determination theory and the theory of planned behavior

Purpose The mental health issues faced by young people can significantly hinder a nation’s development. The purpose of this study is to integrate the Self-Determination Theory and the Theory of Planned Behavior to examine the factors influencing the utilization of mental health days among young individuals. Design/methodology/approach An online survey was conducted to collect data from young people. Findings The results indicated that more positive attitudes, favorable subjective norms and a stronger sense of perceived behavioral control regarding mental health days are all associated with a higher intention to use them. Young individuals who have used counseling resources are more likely to endorse the use of mental health days. Satisfaction of the three basic psychological needs of autonomy, competence and relatedness has a diminishing effect on both motivation and intention to request mental health days. However, there is a positive relationship between motivation and intention to apply for mental health days. When competence needs are less well satisfied, the motivation and, in turn, the intention to request mental health days are enhanced. Research limitations/implications Shifting the leave framework from a disease-centered approach to a psychological leave model focused on mood adjustment can maximize the positive impact of mental health leave. Originality/value This study contributes to the theoretical understanding of the relationships between needs and motivation within the framework of self-determination theory. Furthermore, it integrates components from the theory of planned behavior to examine the influence of social pressures and self-efficacy on the intention to use mental health days. Mental health days can be seen as a cry for help from young adults. The utilization of mental health days serves as an effective means of managing one's mental state.

The impacts of cancer treatment on lifestyle habits and mental health in Vietnamese women: an exploratory qualitative study.

This qualitative study explores the experiences of women after cancer treatment in terms of habit changes and mental health impact. The study involved 10 women who had undergone cancer treatment, recruited from three major hospitals in Hanoi, Vietnam. Data were collected through semi-structured interviews, which were transcribed and analyzed using thematic analysis. The findings of the study shed light on the various factors influencing lifestyle behavior and mental health changes among women after cancer treatment. Ten participants, aged 39 to 64 years, shared experiences including dietary changes, sleep disruptions, and reliance on non-scientific sources for health decisions. Initially shocked by their diagnosis, many transitioned to acceptance, adopting a "giving-in" attitude. Cultural beliefs, word-of-mouth sharing, and social support networks played significant roles in shaping post-treatment lifestyle changes, coping mechanisms, information-seeking behaviors, and mental health. The study highlights the need for accessible and scientifically verified information for women after cancer treatment to make informed decisions about their health. It emphasizes the importance of addressing traditional beliefs and promoting evidence-based practices. Moreover, the study underscores the importance of social support and relationships in coping with the challenges of post-cancer experiences.

Perceived Pressures and Mental Health of Breastfeeding Mothers: A Qualitative Descriptive Study.

When a mother is supported to breastfeed, the benefits for her mental health are significant. However, if pressured or unsupported, the opposite is true. This research examines mothers' breastfeeding experiences, exploring how perceived pressure can impact perinatal mental health. A sample of 501 respondents to a research questionnaire was explored using Reflexive Thematic Analysis. Three main themes identified were perceived pressure to breastfeed, perceived pressure not to breastfeed and mental health impact. The main findings were that mothers received conflicting advice from healthcare professionals, and pressures to feed in a certain way came from their support networks, as well as from their internal beliefs. Perceived pressures negatively impacted maternal mental health, while positive breastfeeding experiences benefitted mental health outcomes.

IMPACT OF MENTAL HEALTH &amp; WELL-BEING ON ACADEMIC PERFORMANCE OF UNIVERSITY STUDENTS

The study was conducted to investigate the impact of mental health and well-being on academic performance of university students. Quantitative research design was adopted for the study. The sample of study comprised 300 university students from both private and public sector universities. A random sampling technique was used to select the study sample. Data was collected by a self-constructed questionnaire designed on a 5-point Likert scale. Experts validated the tool's content. Data analysis was done through SPSS, version 22, including independent frequency distribution, sample t-test, ANOVA, and regression analysis. The results of study offer significant information that showed that mental health and well-being significantly impacted the academic performance of university students. Thus, based on conclusion of study, it was recommended that a great focus on judgment and improvement of missing areas of the students' mental health should be considered by universities, their faculties, and their parents. Moreover, this study may open new interdisciplinary horizons for the future researchers by merging education and psychology to consider the different issues in a tailor-made format.

The impact of mental health on major complications following total shoulder arthroplasty

BackgroundThe volume of total shoulder arthroplasty (TSA) procedures has seen a remarkable surge over the past decade in the United States. Recent research has shown an association between depression and poorer postoperative outcomes following shoulder, hip, and knee arthroplasties. The purpose of this study was to examine the relationship between patients with a diagnosis of depression and/or anxiety and the risk of major postoperative complications after TSA. MethodsThe TriNetX Research Network database was queried on May 30, 2023. Patient cohorts and outcomes were defined using International Classification for Disease, 10th Edition diagnosis codes and Current Procedural Terminology codes. After propensity score matching, the two cohorts were analyzed for differences in major outcomes within two years following the initial procedure. ResultsOf the 45,838 patients who underwent TSA identified in TriNetX, 15,074 patients were included in the depression/anxiety cohort and 30,764 were included in the no depression/anxiety cohort. Propensity score matching was performed to match 13,392 patients from each cohort. Compared to patients with no depression nor anxiety, patients with either depression and/or anxiety were identified to have a higher risk for dislocation (odds ratio [OR] 1.502, 95% confidence interval [CI] 1.285-1.756; P < .001), periprosthetic joint infection (OR 1.309, 95% CI 1.123-1.525; P = .001), periprosthetic fracture (OR 1.661, 95% CI 1.341-2.056; P < .001), and revision TSA (OR 1.316, 95% CI 1.150-1.506; P < .001) within 2 years after the initial procedure. ConclusionOverall, this study showed that patients who have depression and/or anxiety have a higher risk for dislocation, periprosthetic joint infection, revision TSA, and periprosthetic fracture within two years after TSA.