Impaired Psychological Well-being Research Articles

Screen exposure, mental health and emotional well-being in the adolescent population: is it time for governments to take action?

During the last decade, a multitude of epidemiological studies with different designs have been published assessing the association between the use of digital media and psychological well-being, including the incidence...

“This is an illness. No one is supposed to be treated badly”: community-based stigma assessments in South Africa to inform tuberculosis stigma intervention design

BackgroundThough tuberculosis (TB)-related stigma is a recognized barrier to care, interventions are lacking, and gaps remain in understanding the drivers and experiences of TB-related stigma. We undertook community-based mixed methods stigma assessments to inform stigma intervention design.MethodsWe adapted the Stop TB Partnership stigma assessment tool and trained three peer research associates (PRAs; two TB survivors, one community health worker) to conduct surveys with people with TB (PWTB, n = 93) and caregivers of children with TB (n = 24) at peri-urban and rural clinic sites in Khayelitsha, Western Cape, and Hammanskraal, Gauteng Province, South Africa. We descriptively analyzed responses for each stigma experience (anticipated, internal, and enacted), calculated stigma scores, and undertook generalized linear regression analysis. We conducted 25 in-depth interviews with PWTB (n = 21) and caregivers of children with TB (n = 4). Using inductive thematic analysis, we performed open coding to identify emergent themes, and selective coding to identify relevant quotes. Themes were organized using the Constraints, Actions, Risks, and Desires (CARD) framework.ResultsSurveys revealed almost all PWTB (89/93, 96%) experienced some form of anticipated, internal, and/or enacted stigma, which affected engagement throughout the care cascade. Participants in the rural setting (compared to peri-urban) reported higher anticipated, internal, and enacted stigma (β-coefficient 0.72, 0.71, 0.74). Interview participants described how stigma experiences, including HIV intersectional stigma, act individually and together as key constraints to impede care, leading to decisions not to disclose a TB diagnosis, isolation, and exclusion. Stigma resilience arose through the understanding that TB can affect anyone and should not diminish self-worth. Risks of stigma, driven by fears related to disease severity and infectiousness, led to care disengagement and impaired psychological well-being. Participants desired counselling, identifying a specific role for TB survivors as peer counselors, and community education.ConclusionsStigma is highly prevalent and negatively impacts TB care and the well-being of PWTB, warranting its assessment as a primary outcome rather than an intermediary contributor to poor outcomes. Multi-component, multi-level stigma interventions are needed, including counseling for PWTB and education for health workers and communities. Such interventions must incorporate contextual differences based on gender or setting, and use survivor-guided messaging to foster stigma resilience.

Mentalizing as a Predictor of Well-Being and Emotion Regulation: Longitudinal Evidence from a Community Sample of Young Adults.

Background: In recent years, mentalizing - the capacity to understand one's own and others' intentional mental states in social contexts - has been considered to be a protective capacity that enables adaptive processing of stress-related emotional arousal, benefits general well-being and underpins adaptive emotion regulation. Objective: Several studies using cross-sectional research designs have demonstrated the potential health-promoting effect of mentalizing in non-clinical samples. However, longitudinal evidence is scarce. The present study aimed to investigate whether mentalizing predicts well-being and emotion regulation strategies in a non-clinical sample of mainly young adults using a prospective longitudinal design. Methods: In a prospective research design, 135 participants completed questionnaires assessing well-being, psychological symptom severity and mentalizing capacity at baseline (T1). Twelve months later (T2), emotion regulation strategies (suppression and cognitive reappraisal), well-being and psychological symptom severity were assessed by self-report. The data were analyzed using multivariate linear regression analysis. Results: Impairments in mentalizing were a significant negative predictor of well-being 12months later. Furthermore, impairments in mentalizing positively predicted suppression of emotional states at T2. No association was found between deficits in mentalizing and cognitive reappraisal of emotional states over the course of 1year. Conclusion: The findings indicate that mentalizing is longitudinally associated with mental health indicators in a non-clinical adult sample. Specifically, ineffective mentalizing was associated with impaired psychological well-being and a tendency to suppress intense emotional states over a period of 1year. Future research should replicate these findings using multiple measurement timepoints to etablish causality.

Risk of Unfavorable Trajectories of Chronic Pain Severity—Results of a Longitudinal Study in School Children

Chronic pain is a common burden among children and adolescents associated with impairments in many aspects of life. Higher pain severity increases this burden. Subsequently, it is important to identify factors predicting the course of pain severity, classified by the chronic pain grading (CPG). In a 1-year longitudinal assessment of a general school-age population (N = 2,280), we aimed to identify biopsychosocial factors associated with CPG trajectories. We focused on children and adolescents who reported chronic pain at the start of the year (N = 689). Using longitudinal latent class analysis, we identified 3 classes of CPG trajectories over 1 year: 1) the “pain recovery group” exhibited initially moderate CPG scores that rapidly and consistently declined to a pain-free level, 2) the “continuously moderate pain severity group” displayed initially high CPG levels with a mild decline over time, and 3) the “continuously low pain severity group” had initially moderate CPG levels, which only slightly declined. In comparison to the pain recovery group, the continuously moderate pain severity group presented with heightened levels of anxiety (odds ratio [OR] = 1.12, 95% confidence interval [CI] [1.02, 1.24], P = .023), depression (OR = 1.10, 95% CI [1.01, 1.19], P = .029), and affective pain perception (OR = 1.10, 95% CI [1.02, 1.18], P = .010) and were more likely to be female (OR = 2.14, 95% CI [1.05, 4.35], P = .036). The continuously low pain severity group was predominantly female (OR = 1.65, 95% CI [1.10, 2.49], P = .016) compared to the pain recovery group. In conclusion, girls and individuals with impaired psychological well-being more often exhibit unfavorable trajectories of chronic pain severity. PerspectivePediatric chronic pain patients, particularly females and those exhibiting elevated anxiety or depression scores or heightened affective pain perception warrant special attention in health care. These individuals have a greater risk of an unfavorable trajectory of chronic pain severity and might need more urgent and specialized treatment.

Eat healthy, feel better: Are differences in employees' longitudinal healthy-eating trajectories reflected in better psychological well-being?

Eating healthily in terms of fruit and vegetable consumption has beneficial effects for employees and their organisations. Yet, we know little about how employees' eating behaviour develops over longer periods of time (trajectories) as well as about how subgroups of employees in these trajectories differ (trajectory classes). Gaining such insights is critical to understand how employees address healthy eating recommendations over time as well as to develop individualised interventions that also consider the development of healthy eating (i.e. improvement versus impairment beyond mean levels). We analysed panel data (Longitudinal Internet Studies for the Social Sciences) from 1054 employees by means of growth mixture modelling. Our analyses revealed three relevant classes of healthy-eating trajectories: a favourable trajectory class, an unfavourable trajectory class and a strongly improving trajectory class. Furthermore, unfavourable healthy-eating trajectories were especially critical with respect to impaired psychological well-being. Specifically, we found robust results for impaired positive and negative affects, but not for self-esteem, in the unfavourable trajectory class. We discuss limitations and implications of these findings, thereby encouraging research and practice to further consider such fine-grained approaches (i.e. focusing on subgroups within a larger population) when addressing healthy-eating promotion over time.

Sleep Hygiene, Mediating the Association Between Circadian Typology and Psychological Distress: An Association Elicited by Mediation Analysis Model Among Young Sudanese Adults, 2022-2023

BACKGROUND: Circadian rhythms are regulated by genetic and environmental components. The association of intrinsic and extrinsic factor modulates physiological and individual sleep schedules sleep hygiene and even different chronotype. Evidence suggests evening-type individuals have a higher risk of reporting psychological distress than morning-type individuals. However, less is known regarding the underlying processes that might mediate this association among Sudanese young adults. This study aimed at assessing the mediating role of sleep hygiene on the relationship between circadian typology and psychological distress among young Sudanese adults. METHODS: This is a cross sectional study. Conducted among medical students, graduates and medical interns of Al-Neelain University. Between April and August 2022. Morningness–Eveningness 19 items Questionnaire (MEQ) was used to assess chronotype preference. Kessler10-item Questionnaire was used to assess Psychological Distress, and sleep hygiene index (SHI) was used to screen Sleep hygiene behaviors. Hayes PROCESS macro (model 4) was used to perform the mediation analysis. RESULTS: Among 303 medical students who complete the study questionnaire. Mean of age for study participants was (22.71±2.49). Sleep hygiene index mean score was (29.35±5.46) indicating poor sleep hygiene behaviors. Most of the population were Neutral in their circadian typology preference (58.1%). (89.8%) of our population had psychological distress, Chronotype correlated with severe psychological distress and poor sleep hygiene behaviors (r=-0.141, P<0.05) (r=-0.292, P<0.001) respectively. Poor sleep hygiene behaviors also correlated with severe psychological distress (r=0.466, P<0.001). Individuals who were severely psychologically distressed mostly had higher sleep hygiene mean scores than normal individuals (29.35±5.46), (21.61±6.42) (p<0.001). Sleep hygiene index scores were lower for Morning circadian typologies [definite Morning 22.50± (7.00), moderate morning 24.89± (5.63)] compared to evening typologies [definite evening 32.25± (4.43), moderate evening 29.00± (6.09)]. Which indicated good sleep hygiene behaviors for Morning chronotype groups. Figure 1.0 illustrates the distribution of mean sleep hygiene index scores across circadian preference groups. Multiple regression analysis results showed that there was no significant direct effect of chronotype on psychological distress β=-.0096, SE= .0496, t=-.1937, P=.8466, CI [-.1073-.0881]. We also found a significant indirect effect of sleep chronotype on psychological Distress (β=-0.113, SE=0.0265, CI [-.1698 - -.0649]. According to bias-corrected percentile bootstrap method the total effect was negatively significant, (β=-0.123, SE=0.0534, t=-2.30, p<0.05, CI [-0.2280 - -0.0178], indicating a full complimentary mediation between evening chronotype and impaired psychological wellbeing through sleep hygiene behaviors. CONCLUSION: Sleep hygiene was found to mediate the correlation between eveningness and impaired psychological wellbeing, Improvement of Sleep hygiene behaviors is advised to enhance morning circadian typology as to prevent and reduce psychological distress. Interventions to enhance morning circadian typology should be prioritized to medical students, graduates and medical interns who are prone to eveningness to minimize the risk for psychological distress.

Caregiver’s psychological well-being and quality of relationship with cardiac amyloidosis patients

ABSTRACT Caregivers’ psychological well-being is linked to the quality of care provided for familiar with chronic illness. Despite caregivers of cardiac patients present an impaired psychological well-being, less investigated is the psychological well-being of caregivers of individuals with a rare disease such as the Transthyretin Cardiac Amyloidosis (ATTR-CA). Specifically, given that no study explored the well-being of the caregiver and the caregiver-patient relationship, this study aimed to analyze the prevalence of anxiety and depression in ATTR-CA caregivers and if these disorders were associated with patient’s and caregiver’s characteristics. Fifty-eight dyad caregiver-ATTR-CA patients completed the Hospital Anxiety and Depression Scale and the Network of Relationships Inventory. Moreover, ATTR-CA patients completed the Kansas City Cardiomyopathy Questionnaire, while caregivers completed the Multidimensional Scale of Social Support. Results showed that anxious caregivers (44%) reported higher conflict with patients. They had ATTR-CA relatives with a worse perception of cardiac symptoms and higher anxiety and depression. Depressed caregivers (39%) reported higher conflict with ATTR-CA relatives and lower perceived social support. Caregiver reported a high prevalence of anxiety and depression associated with worse personal relational well-being and to patient’s psycho-physical condition. The care of ATTR-CA patient should consider the caregiver well-being.

The psychological legacy of past obesity and early mortality: evidence from two longitudinal studies

BackgroundWe test a novel ‘weight scarring’ hypothesis which suggests that past obesity is associated with impairments in current psychological well-being and this increases risk of negative physical health outcomes associated with obesity. Across two nationally representative studies, we tested whether past obesity is associated with current psychological outcomes and whether these psychological outcomes explain the association between past obesity and subsequent early mortality.MethodsData were from the National Health and Nutrition Examination Survey (NHANES) (n = 29,047) and the Health and Retirement Study (HRS) (n = 11,998). Past obesity was defined based on maximum lifetime weight in NHANES and the highest weight from past study waves in the HRS. Across both studies, current depressive symptoms were analysed. A set of 10 additional well-being measures were combined to produce an ‘index of impaired well-being’ in HRS. Subsequent all-cause mortality was examined using National Deaths Index records in NHANES and household interviews in HRS. Linear or logistic regression, Cox proportional hazard regression, and causal mediation models were used.ResultsWe found that past obesity was associated with greater current depressive symptoms after controlling for current weight status and in analyses limited to those who were no longer classified as having obesity in NHANES (β = 0.17; 95% CI: 0.13, 0.22) and HRS (β = 0.20; 95% CI: 0.08, 0.31). In HRS, past obesity was also associated with a range of current negative psychological outcomes, including an index of impaired psychological well-being (β = 0.16; 95% CI: 0.05, 0.27). Past obesity was associated with a higher risk of early mortality in both NHANES and HRS (HR = 1.31; 95% CI: 1.16, 1.48 and HR = 1.34; 95% CI: 1.20, 1.50, respectively). Depressive symptoms explained 6% (95% CI: 0.01, 0.10) and 5% (95% CI: 0.01, 0.09) of the association between past obesity and premature mortality in NHANES and HRS, respectively. Impaired psychological well-being partly mediated the association between past obesity and premature mortality by 10% (95% CI: 0.04, 0.16) in HRS.ConclusionsOur findings suggest that there may be a psychological legacy of past obesity that is associated with raised mortality risk. Ensuring people with obesity receive psychological support even after experiencing weight loss may be important.

Relationship between Smoking and Clinical, Inflammatory and Radiographic Parameters in Patients with Ankylosing Spondylitis

Abstract Background Axial spondyloarthritis (axSPA) are chronic often progressive inflammatory disorders of the axial skeleton including the sacroiliac joints. Patients suffer from pain, limited spinal mobility, functional disability and impaired psychological wellbeing. The prototype is Ankylosing spondylitis (AS) which is mainly associated with sacroiliac joint, spine, peripheral joints and entheses. Aim of the Work to investigate the relationship between smoking and each of clinical, inflammatory and radiographic parameters in patients with ankylosing spondylitis. Patients and Methods This a cross sectional study included 50 adult ankylosing spondylitis patients diagnosed according to the modified New York criteria, Attending to The outpatient clinic and the inpatients of Internal Medicine and Rheumatology Departments, Ain Shams University Hospitals and the outpatient clinic of Nasser Institute for Research and Treatment Hospital. Results Fifty patients were included in the study. In relation to smoking status, 27(54%) patients were never smoked, 20(40%) were current smokers and 3(6%) were past smokers. In the study they were divided into two groups, group I, the smokers included current smokers and group II, the non-smokers including past and never smokers. Comparisons of clinical, radiographic and acute phase reactants between smokers and non smokers AS patients showed a statistically significant decrease in chest expansion (p < 0.001**) and increase in the occiput to wall distance (p < 0.001**) in smokers than non-smokers. Regarding disease activity indices, it demonstrated that smokers had a significantly higher BASDAI (P < 0.001**), BASFI (P < 0.001**) and ASDAS (P < 0.001**) compared with non smokers which reflects more functional disability and disease progression in smokers AS patients. Additionally, most of smokers had grade IV sacroiliitis while most of non-smokers had grade III. Also, there was a highly significant difference between the two groups as regards mSASSS (p < 0.001**) which reflects more radiographic progression in smokers. Regarding acute phase reactants ESR (P = 0.029*) and CRP (P < 0.001**), they were significantly higher in smokers in comparison with non-smokers.The correlations between for current smokers (pack/year) and clinical, laboratory and radiographic variables showed that smoking index was positively coorelated with BASFI (r = 0.568, p = 0.007*), ASDAS (r = 0.396, P = 0.046*) and mSASSS (r = 0.584, p = 0.005*) and negatively coorelated with chest expansion(r=-0.593, p = 0.005*). Conclusions current smoking is associated with higher disease activity, inflammatory markers, functional disability and radiological progression and this may interfere with personal daily activities, physical mobility and quality of life. Taking into account that smoking is a potentially modifiable lifestyle factor, AS smokers should be strongly advised to consider smoking cessation.

"Like fighting a fire with a water pistol": A qualitative study of the work experiences of critical care nurses during the COVID-19 pandemic.

To understand the experience of critical care nurses during the COVID-19 pandemic, through the application of the Job-Demand-Resource model of occupational stress. Qualitative interview study. Twenty-eight critical care nurses (CCN) working in ICU in the UK NHS during the COVID-19 pandemic took part in semi-structured interviews between May 2021 and May 2022. Interviews were guided by the constructs of the Job-Demand Resource model. Data were analysed using framework analysis. The most difficult job demands were the pace and amount, complexity, physical and emotional effort of their work. Prolonged high demands led to CCN experiencing emotional and physical exhaustion, burnout, post-traumatic stress symptoms and impaired sleep. Support from colleagues and supervisors was a core job resource. Sustained demands and impaired physical and psychological well-being had negative organizational consequences with CCN expressing increased intention to leave their role. The combination of high demands and reduced resources had negative impacts on the psychological well-being of nurses which is translating into increased consideration of leaving their profession. The full impacts of the pandemic on the mental health of CCN are unlikely to resolve without appropriate interventions. Managers of healthcare systems should use these findings to inform: (i) the structure and organization of critical care workplaces so that they support staff to be well, and (ii) supportive interventions for staff who are carrying significant psychological distress as a result of working during and after the pandemic. These changes are required to improve staff recruitment and retention. We used the COREQ guidelines for reporting qualitative studies. Six CCN provided input to survey content and interview schedule. Two authors and members of the study team (T.S. and S.C.) worked in critical care during the pandemic.

Psychological Well-being during Pregnancy: The Contribution of Stress Factors and Maternal-Fetal Bonding

ABSTRACT Background Pregnancy and anticipation of the birth of the first child is considered a happy and exciting time. However, the stress involved in pregnancy has been found to put women at greater risk of impaired psychological well-being, or higher distress. Confusion in the theoretical literature between the terms ‘stress’ and ‘distress’ makes it difficult to understand the underlying mechanism that may enhance or reduce psychological well-being. We suggest that maintaining this theoretical distinction and examining stress from different sources, may allow us to gain new knowledge regarding the psychological well-being of pregnant women. Objective Drawing on the Calming Cycle Theory, to examine a moderated mediation model for the explanation of the dynamic between two stress factors (COVID−19-related anxiety and pregnancy stress) that may pose a risk to psychological well-being, as well as the protective role of maternal-fetal bonding. Methods The sample consisted of 1,378 pregnant women who were expecting their first child, recruited through social media and completed self-report questionnaires. Results The higher the COVID−19-related anxiety, the higher the pregnancy stress, which, in turn, was associated with lower psychological well-being. However, this effect was weaker among women who reported greater maternal-fetal bonding. Conclusion The study expands knowledge of the dynamic between stress factors and psychological well-being during pregnancy, and sheds light on the unexplored role of maternal-fetal bonding as a protective factor against stress.

Social Policies and Theories on Quality of Life under COVID-19: In Search of the Missing Links

COVID-19 has generated many negative impacts on the family, including impaired psychological well-being of family members (parents and children) and family processes (such as parenting and family functioning). Regarding social policies to support families under the pandemic, there are several missing links. First, COVID-19 related policies mainly focus on physical well-being with a relatively weaker emphasis on psychological well-being. Second, with social policies primarily aiming at stabilizing the “financial capital” of the public, human capital (particularly personal resilience) and social capital (particularly family resilience) are relatively neglected. Third, while “general” social policies may help “averaged” individuals and families, there is a need to take pre-existing family vulnerabilities (such as poverty and caregiving burdens) and inequalities into account when formulating “down to earth” social policies. Fourth, while social science knowledge and theories have important potential contributions to help develop relevant policies and services to promote quality of life under COVID-19, explicit utilization is not strong. With reference to these missing links, we proposed several research and practice directions for the promotion of quality of life under the pandemic.

Health-Related Quality of Life in Children and Adolescents with Overweight, Obesity, and Severe Obesity: A Cross-Sectional Study

Introduction: Children and adolescents with overweight and obesity have an impaired health-related quality of life (HRQoL). However, it is unclear which of these children are most affected in their physical, psychological, and social functioning. Therefore, this study aimed to evaluate HRQoL in treatment-seeking children and adolescents with overweight, obesity, and severe obesity. Methods: A cross-sectional study was performed at the Centre for Overweight Adolescent and Children’s Healthcare (COACH). Children and adolescents (8–17 years) with overweight, obesity, and severe obesity were included. The primary outcome was the self-reported HRQoL measured with the KIDSCREEN-27. Results: A total of 419 participants with overweight (N = 121), obesity (N = 182), and severe obesity (N = 116) were included. One-way ANOVA analysis showed that children and adolescents with severe obesity reported significantly lower physical well-being (41.25 ± 13.14) compared to those with overweight (47.91 ± 12.53; p < 0.001) and obesity (46.74 ± 11.93; p < 0.001). Furthermore, impaired psychological well-being was found in the group with severe obesity (45.14 ± 13.27) in comparison to the group with overweight (50.90 ± 9.48; p < 0.001) and obesity (49.71 ± 10.95; p = 0.002). Multivariable linear regression analysis, while correcting for age, sex, cardio metabolic health risk, and ethnicity, revealed similar results. Additionally, children and adolescents with severe obesity scored lower regarding autonomy and parent relation than those with overweight (B = 3.95; p = 0.009). In almost all groups and dimensions of the KIDSCREEN-27, caregivers scored lower compared to the children and adolescents themselves. Furthermore, a low child-caregiver agreement seemed to exist, especially in the children and adolescents with overweight. Conclusion: The HRQoL of treatment-seeking children and adolescents with overweight and obesity was most affected in children and adolescents with the most severe grade of obesity. Following these findings, lifestyle intervention programs targeting childhood obesity should be aware of this even more vulnerable group so that treatments can be tailored according to their needs.

Suicidal behaviors in the entertainment industry: a preliminary exploration of the interplay between work scheduling, social support, and wellbeing in Australia

ObjectiveWorkers of the Australian entertainment industry exhibit disproportionately high rates of impaired psychological wellbeing and suicidal behaviors, with such rates being exacerbated by the negative impact of working long and odd hours (Work Scheduling Impact; WSI). Nonetheless, stable and secure social support networks may buffer the risks associated with such systemic difficulties.MethodsThe responses of 1302 Australian entertainment industry workers (50.3% females, Mage 38.39 years) on the Multidimensional Scale of Perceived Social Support, the Short Form Health Survey, WSI, and suicidal behaviors questions were examined via moderation analyses.ResultsHigher social support and lower WSI appeared to reduce the suicidal ideation of those experiencing poorer mental health, while lower WSI further enhanced social support’s positive effect.ConclusionsFindings highlight the likely detrimental effect of WSI regarding the suicidal ideation reported by vulnerable Australian entertainment industry workers and stress the importance of the social support they experience.Public health implicationsInterventions attempting to increase social support could improve inherent conditions associated with the Australian entertainment industry. Similarly, the negative effect of working long and odd hours on workers’ mental health and suicidal behaviors indicates the need to regulate the industry appropriately.

Decreased Psychological Well-Being in Patients With Bipolar Disorder in Remission.

The goals of this study were to introduce psychological well-being as an important subject of inquiry in bipolar disorder, to compare well-being in a cohort of patients with bipolar disorder with that of a normative sample, and to assess whether common measures of well-being and mood measure empirically distinct phenomena. Participants were outpatients with bipolar I disorder in remission (N=37) from the Enhancing Emotion Regulation in Bipolar Disorder (EERBD) study and a matched community normative sample from the Midlife in the United States (MIDUS) survey (N=6297). The Psychological Well-Being Scale (PWBS) was used to measure psychological well-being. We calculated means and SD of scores on the PWBS and evaluated the differences between the scores of the bipolar I and community samples. We also tested the association between raw and change scores in depression [Hamilton Rating Scale for Depression (HAM-D)] and eudaimonic well-being (PWBS) using Spearman correlation coefficients. The MIDUS survey sample (N=6297) was 48% male, with a mean age of 47 years (SD=13y). The EERBD sample (N=37) was 27% male, with a mean age of 41 years (SD=11y). In the bipolar sample, the baseline mean score on the HAM-D was 12.7 (SD=6.0) and the mean score on the Young Mania Rating Scale was 6.1 (SD=6.2). The baseline mean sum score on the PWBS in the normative community MIDUS sample was 100 (SD=14), while that of the bipolar I EERBD sample was 79 (SD=15) at baseline, 84 (SD=13) posttreatment, and 84 (SD=12) at the 3-month follow-up assessment. The effect sizes of the differences at all timepoints were large (Hedges g=1.42 at baseline, 1.11 at the end of treatment, and 1.06 at the 3-mo follow-up). No association was found between the PWBS and depression scores. Outpatients with bipolar disorder in remission demonstrated substantially impaired psychological well-being, despite low levels of depressive symptoms, compared with a normative community sample.

How Does Health Literacy Modify Indicators of Health Behaviour and of Health? A Longitudinal Study with Trainees in North Germany.

Background: Health literacy (HL) is a resource that can help individuals to achieve more control over their health and over factors that influence health. In the present follow-up study, we have investigated the extent to which HL in trainees changes over time and whether or to what extent HL influences health behaviour and health. Methods: In 2017, we performed a baseline survey (T0) of trainees from six different branches, who were contacted through vocational colleges in four northern federal states in Germany. The survey was repeated at the midpoint of their training in 2019 (T1). Demographic data were surveyed, together with information on HL (HLS-EU-Q16), health behaviour and on health status (psychological well-being, subjective health status). Multivariate regression analyses were performed in SPSS 26. Results: Three hundred and ninety-one (391) data sets were evaluated, with a follow-up rate of 27%; 79% of the trainees were female. The mean age was 21.2 years. Over all subjects, the mean HL increased over time ( (SD): 11.9 (2.9) to 12.2 (2.9), p = 0.070). This increase was only statistically significant for the health service trainees ( (SD): 12.1 (2.8) to 12.5 (2.9), p = 0.019). Relative to persons with adequate HL, the odds ratio over time for impaired psychological well-being was increased by 230% in persons with inadequate HL (OR: 3.3, 95% CI: 1.70–6.32, p < 0.001). For persons with problematical HL, the corresponding increase in odds ratio was 110% (OR: 2.1, 95% CI: 1.30–3.38, p = 0.002). Relative to persons with adequate HL, trainees with inadequate HL exhibited a significant increase in odds ratio of 2.8 over time for poor or less good subjective health status (OR: 2.8, 95% CI: 1.23–6.33, p = 0.014). Conclusions: We observed a positive longitudinal association between HL and health. A significant increase in HL was observed in trainees in the health service. Thus the study shows that the concept of HL may provide a potential preventive approach for trainees.

The Role of Psychological Well-Being in Weight Loss: New Insights from a Comprehensive Lifestyle Intervention

Background/ObjectiveAlthough the literature suggested that impaired psychological well-being (PWB) is associated with obesity, evidence on the role of PWB in weight outcomes is limited and inconclusive. This research aimed to investigate the joint role of PWB in achieving clinically significant weight loss (CWL; loss of 5% of the initial weight) through a comprehensive lifestyle intervention for obesity using a broad-based evaluation. MethodThis study is a prospective cohort of 96 patients with obesity attending a comprehensive lifestyle intervention for weight loss. Data on weight, lifestyle, PWB, and distress, were collected before and after the intervention. Results30.5% of the participants achieved CWL at the end of treatment. A more pronounced increase in autonomy (odds ratio = 0.80 [95% CI: 0.68, 0.93], p ≤ .01) and somatization (odds ratio = 0.83 [95% CI: 0.70, 0.98], p ≤ .05) from pre- to post-treatment were independently associated with a lower probability of CWL. ConclusionsUnbalanced dimensions of PWB, in particular exceedingly high autonomy, may contribute to a poor weight loss outcome. This study paves the way for the addition of psychotherapeutic strategies geared to euthymia in comprehensive lifestyle intervention.

Gastrointestinal Symptoms in Women With Endometriosis and Microscopic Colitis in Comparison to Irritable Bowel Syndrome: A Cross-Sectional Study.

Gastrointestinal (GI) symptoms similar to irritable bowel syndrome (IBS) are often present in women with endometriosis and microscopic colitis (MC). The objective of this study was to estimate GI symptoms in IBS, endometriosis, and MC, to compare the clinical expression of the diseases. Women with IBS, endometriosis, and MC were identified by diagnosis codes at a tertiary center. The patients had to complete the visual analog scale for IBS to estimate specific GI symptoms. Women fulfilling Rome III criteria for IBS were diagnosed as IBS (n = 109) and divided into subgroups depending on predominating symptoms. Women diagnosed with endometriosis (n = 158) and MC (n = 88) were evaluated whether they also fulfilled the Rome III criteria for IBS. Women with IBS experienced aggravated abdominal pain, diarrhea, bloating and flatulence, nausea and vomiting, the urgency to defecate, the sensation of incomplete evacuation and intestinal symptom's influence on daily life, and impaired psychological wellbeing, compared to women with endometriosis. When patients with endometriosis also fulfilled the criteria for IBS, all symptoms in the 2 cohorts, except intestinal symptom's influence on daily life, were equal. Women with IBS or diarrhea-predominated IBS experienced aggravated abdominal pain, bloating and flatulence, intestinal symptom's influence on daily life, and impaired psychological well-being compared to MC, but at equal levels as MC with IBS-like symptoms. Women with IBS generally experience aggravated GI symptoms and impaired psychological well-being compared to endometriosis and MC. Patients with endometriosis or MC, in combination with IBS, express similar symptoms as patients with sole IBS.

Psychological Aspects of Media Communication during the COVID-19 Pandemic: Insights from Healthcare and Pharmacy Specialists in Lithuania.

In the setting of disasters, people seek information as they hope that knowledge will provide security. This makes the media a critical source of crisis exposure. The aim of the study described in this article was to analyze COVID-19 pandemic-related psychological aspects of media use by healthcare and pharmacy workers in Lithuania and to reveal the subjective effects of media consumption on their psychological well-being. 967 healthcare workers and pharmacists in Lithuania completed an electronic survey, which consisted of questions about the changes in well-being experienced since the beginning of the lockdown and media use in the search for information on COVID-19. It was found that communication might have ambiguous effects on psychological well-being. Excessive, unreliable, misleading, contradictory information and “catastrophizing” were subjectively related to impaired psychological well-being. Objective and reliable, relevant, clear, timely, hopeful and supportive information had a subjective positive effect. Seeking COVID-19-related information many times a day was associated with increased fear of becoming infected with COVID-19, feeling unable to control the risk of contracting COVID-19, fear of infecting relatives with COVID-19 and feeling that other people would avoid interaction with healthcare workers and pharmacists because of their job. General browsing was not consistently associated with COVID-19-related fears.

Impaired psychological well-being of healthcare workers in a German department of anesthesiology is independent of immediate SARS-CoV-2 exposure - a longitudinal observational study.

Background: The study aimed to assess the mental well-being of healthcare professionals at a German department of anesthesiology and critical care with a specialized ICU for treatment of COVID-19 patients during the first two peaks of the 2020 pandemic, and identifying risk and protective factors.Methods: A single-center longitudinal, online-based survey was conducted in healthcare workers from a department of anesthesiology and critical care in Bavaria, the most affected federal state in Germany at the time of assessment. Validated scores for depression, anxiety, somatic disorders, burnout, resilience, and self-management were used and complemented by questions about perceived COVID-19-related stressors. In parallel, patient characteristics in the ICU were collected.Results: 24 and 23 critically ill COVID-19 patients were treated during both observation periods in April/May and November/December 2020, respectively. 87.5% and 78.2% of patients had moderate to severe acute respiratory distress syndrome. From March 6, 2020 onwards, the hospital had switched to a command and control-based hospital incident command system (HICS) and increased work forces. Point prevalence of depression-like symptoms (13.6% and 12.8%) and burnout (21.6% and 17.4%) in the department’s healthcare professionals was high. Exposure to SARS-CoV-2 did not increase psychological burden. Consequences of the lockdown were rated as highly distressing by a majority of all ICU personnel. High self-reported trait resilience was protective against signs of depression, generalized anxiety, and burnout.Conclusions: During the pandemic, healthcare professionals have been suffering from increased psychological distress compared to reference data for both the general population and ICU personnel. General effects of the lockdown appear more relevant than actual COVID-19 patient contact. High trait resilience has a protective effect, yet vulnerable individuals may require specific support. Prevention against potential after effects of the lockdown, and in particular measures allowing to avoid another lockdown, appear warranted.