Lower Mental Well-being Research Articles

Heterogeneity and heterotypic continuity of emotional and behavioural profiles across development.

To identify emotional and behavioural symptoms profiles from early childhood to adolescence, their stability across development and associated factors. Our sample included 17,216 children assessed at ages 3, 5, 7, 11 and 14years from the UK Millennium Cohort Study. We used latent profile and latent transition analysis to study their emotional and behavioural profiles from early childhood to adolescence. We included sociodemographic, family and parenting variables to study the effect on latent profile membership and transitions. The number and specific profiles of emotional and behavioural symptoms changed with the developmental stage. We found a higher number of profiles for ages 3, 5, and 14, suggesting greater heterogeneity in the presentation of emotional and behavioural symptoms in early childhood and adolescence compared to late childhood. There was greater heterotypic continuity between ages 3 and 5, particularly in transitions from higher to lower severity profiles. Children exposed to socioeconomic disadvantages were more likely to belong or transition to any moderate or high emotional and behavioural symptoms profiles. Maternal psychological distress and harsh parenting were associated with internalizing and externalizing profiles, respectively. Higher levels of internalizing and externalizing symptoms across development were associated with lower mental wellbeing and higher rates of self-harm and substance use in adolescence. Emotional and behavioural symptoms develop early in life, with levels of heterogeneity and heterotypic stability that change throughout development. These results call for interventions to prevent and treat paediatric mental illness that consider the heterogeneity and stability of symptoms across development.

Adverse childhood experiences: a retrospective study to understand their associations with lifetime mental health diagnosis, self-harm or suicide attempt, and current low mental wellbeing in a male Welsh prison population

BackgroundPrisoners are at increased risk of poor mental health and self-harming behaviours, with suicide being the leading cause of death in custody. Adverse childhood experiences (ACEs) such as child maltreatment are strong predictors of poor mental health and wellbeing yet despite high levels of ACEs in offender populations, relatively few studies have explored the relationships between ACEs and prisoners’ mental health and wellbeing. We conducted an ACE survey with 468 male adult prisoners in a Welsh prison who were not currently considered to be at risk of self-harm and suicide and explored relationships between ACEs, lifetime mental illness diagnosis, self-harm (lifetime and lifetime in prison) or suicide attempt (lifetime and lifetime in prison), and current low mental wellbeing.ResultsMost participants (84.2%) had suffered at least one ACE and 45.5% had suffered ≥4 ACEs. Prevalence of lifetime mental illness diagnosis, self-harm (lifetime and lifetime in prison) or suicide attempt (lifetime and lifetime in prison), and current low mental wellbeing increased with exposure to ACEs. For example, 2.7% of those with no ACEs reported lifetime self-harm or suicide attempt in prison compared with 31.0% (self-harm in prison) and 18.3% (suicide attempt in prison) of those with ≥4 ACEs. Compared with participants with no ACEs, those with ≥4 ACEs were four times more likely to report lifetime mental illness diagnosis and suicide attempt, and over 10 times more likely to report lifetime self-harm than those with no ACEs. Independent of lifetime mental illness diagnosis, self-harm or suicide attempt, participants with ≥4 ACEs were almost three times more likely to have current low mental wellbeing than those with no ACEs.ConclusionsMale prisoners that have suffered multiple ACEs are substantially more likely to have lifetime mental illness diagnosis, self-harm or suicide attempt, and to have current low mental wellbeing whilst in prison. Findings suggest that trauma-informed approaches are needed in prisons to support prisoner mental health and wellbeing.

Improving the Wellbeing of Female Prisoners via Psychological Skills Training: A Feasibility Study.

Prisoners display significantly higher rates of mental disorders and lower mental wellbeing than the general population. The integration of positive psychological interventions in offender supervision has received recent advocacy. The aim of the current pre-post pilot study was to determine the short-term effects of group-based resilience training on mental health outcomes for female offenders and explore intervention acceptability. Offenders (n = 24) self-selected to partake in a multi-component psychological skill program based on positive psychology, cognitive-behavioural therapy, and mindfulness-based activities. The training was taught in nine sessions of 1.5 hr each. Baseline and follow-up measurements of mental wellbeing and psychological distress were collected and focus groups conducted to investigate participants' experiences, acceptability, and appropriateness of the training. Moderate to large effect sizes indicating significant improvements were observed for wellbeing, g = 0.75 and distress, g = 0.56. Training was well received by participants and staff and was delivered feasibly within the prison context. The results are encouraging, and a future well-powered study using a rigorous controlled design is warranted.

Epidemic of COVID-19 in China and associated Psychological Problems.

The world is experiencing pandemic of the COVID-19 now, a RNA virus that spread out from Wuhan, China. Two countries, China first and later Italy, have gone to full lock down due to rapid spread of this virus. Till to date, no epidemiological data on mental health problems due to outbreak of the COVID-19 and mass isolation were not available. To meet this need, the present study was undertaken to assess the mental health status of Chinese people. An online survey was conducted on a sample of 1074 Chinese people, majority of whom from Hubei province. Lack of adequate opportunities to conduct face to face interview, anxiety, depression, mental well-being and alcohol consumption behavior were assessed via self-reported measures. Results showed higher rate of anxiety, depression, hazardous and harmful alcohol use, and lower mental wellbeing than usual ratio. Results also revealed that young people aged 21-40 years are in more vulnerable position in terms of their mental health conditions and alcohol use. To address mental health crisis during this epidemic, it is high time to implement multi-faceted approach (i.e. forming multidisciplinary mental health team, providing psychiatric treatments and other mental health services, utilizing online counseling platforms, rehabilitation program, ensuring certain care for vulnerable groups, etc.).

Predictors of high and low mental well-being and common mental disorders: findings from a Danish population-based study.

BackgroundMental well-being is fundamental for a good life. Previous literature has examined the predictors of mental disorders and continuous measures of positive mental health. Very few studies have specifically focused on the predictors of different levels of mental well-being, but those that have suggest a different picture. This study aimed to compare socioeconomic and relational/recreational behaviour predictors of different levels of mental well-being as well as common mental disorders (CMDs).MethodsData from 3508 adults aged 16+ years old from the Danish Mental Health and Well-Being Survey 2016 were linked to Danish national register-based data. Mental well-being was assessed using the Warwick-Edinburgh Mental Well-being Scale, and information on CMDs was assessed using the Patient Health Questionnaire (PHQ-4). Regression analyses were conducted to estimate the predictors of low and high mental well-being compared to moderate mental well-being and also of CMDs.ResultsLower socioeconomic position (education, income and employment status) was associated with increased odds of low mental well-being and the presence of CMDs, but did not significantly predict high mental well-being. Relational/recreational behaviours (informal and formal social participation, social support and recreational activity) were associated with reduced odds of low mental well-being and CMDs, and also with increased odds of high mental well-being.ConclusionsSocioeconomic predictors of high mental well-being do not mirror those of low mental well-being and CMDs, whereas relational/recreational predictors of high mental well-being do mirror those of low mental well-being and CMDs. These findings have important implications for public mental health strategies.

Mental Well-being, and Coping Strategies during Stress for Preclinical Medical Students in Vietnam

Inappropriate coping strategies may be key factors that have contributed to a consistently high prevalence of stress and mental disorders that have been reported worldwide, particularly in resource-limited countries. Thus, one aim of this paper is to estimate the prevalence of these inconstructive strategies, and explore more positive coping strategies through observation of undergraduate medical students in Vietnam. The methodology that has been employed for this project has been a cross-sectional analysis that was conducted on 411 first year medical students at the University of Medicine and Pharmacy in the cities of Ho Chi Minh and Can Tho who have shown signs of stress indicative of low mental well-being—that being a WHO-5 score of 13 or under or an answer of 0 to 1 to any of the five items of a WHO-5 mental disagnstic test. Participants completed a self-report questionnaire including a depression anxiety stress scale and a coping strategies inventory scale. The results show a prevalence of depression, anxiety, and stress that were identified in 51.6%, 70.3% and 49.9% of students respectively. Problem solving was impacted mostly by the failure of coping strategies, and subsequent failures in cognitive restructuring. Students who had mental disorders were more likely to engage in negative coping strategies such as self-criticism, and were less likely to choose positive coping strategies such as expressions of emotion and problem solving. Medical students face a wide range of stressful situations, and the findings of these particular students suggest that there is a failure of coping strategies to overcome these stressful occurences. The findings indicate an urgent need to develop stress management programs and training workshops to build up early preventive mental health services at medical schools and to improve student support systems.

Gendered Pathways of Internalizing Problems from Early Childhood to Adolescence and Associated Adolescent Outcomes

Despite trends indicating worsening internalizing problems, characterized by anxiety and depression, there is dearth of research examining gender differences in developmental trajectories of internalizing problems from early childhood to adolescence. Drawing on the UK Millennium Cohort Study (n = 17,206, 49% female), this study examines trajectories of parent-reported, clinically-meaningful (reflecting the top 10%) internalizing problems from ages 3 to 14 years and their early predictors and adolescent outcomes. Group-based modelling revealed three trajectories when examining boys and girls together, but there were significant gender differences. When examining boys and girls separately, four trajectories were identified including two relatively stable trajectories showing either high or low probabilities of internalizing problems. An increasing trajectory was also found for both boys and girls, showing an increasing probability of internalizing problems which continued to rise for girls, but levelled off for boys from age 11. A decreasing trajectory was revealed for boys, while a moderate but stable trajectory was identified for girls. Boys and girls in the increasing and high probability groups were more likely to report a number of problematic outcomes including high BMI, self-harm, low mental wellbeing, depressive symptoms, and low educational motivation than the low group. Girls on the increasing trajectory also reported more cigarette and cannabis use and early sexual activity at age 14 compared to girls on the low trajectory. Findings suggest that intervention strategies take a systemic view, targeting not only internal feelings, but also behaviours potentially associated with later negative outcomes.

Cognition and mental wellbeing after electrical accidents: a survey and a clinical study among Swedish male electricians

PurposeThe purpose was to examine long-term consequences of exposure to electrical current passing through the body. We investigated (1) whether electricians after having experienced an electrical accident report more cognitive problems and lower mental wellbeing and (2) have objectively verifiable reduced cognitive function; and (3) which circumstances at the time of the accident affect long-term subjective cognitive function and mental wellbeing?MethodsA survey of male electricians who had experienced electrical accidents (n = 510) and a clinical study in a subsample (n = 23) who reported residual health problems was carried out. Both groups were examined regarding subjective cognitive function (Euroquest-9) and mental wellbeing (Symptom Checklist-90 subscales). The clinical study included neuropsychological tests of memory, attention, spatial function, and premorbid intellectual capacity. A matched control group was retrieved from reference data.ResultsThe survey participants reported more cognitive problems and lower mental wellbeing than referents. Of the examined circumstances, having experienced mortal fear at the time of the accident and health complaints, especially mental symptoms, for > 1 week after the accident were the most significant risk factors for later subjective cognitive problems and lower mental wellbeing. The only statistically significant difference in neuropsychological tests was better performance in part of the memory tests by the clinical study group compared to the control group.ConclusionsThe participants reported more cognitive problems and lower mental wellbeing than referents, but no long-term objective cognitive dysfunction was detected. Emotional response at the time of the accident and health complaints in the aftermath of the accident may constitute important indications for medical and psychological follow-ups.

Who does what the cardiologist recommends? Psychosocial markers of unhealthy behavior in coronary disease patients.

Patients diagnosed with coronary heart disease should follow lifestyle recommendations that can reduce their cardiovascular risk (e.g., avoid smoking). However, some patients fail to follow these recommendations and engage in unhealthy behavior. With the aim to identify psychosocial factors that characterize patients at high risk of repeated cardiovascular events, we investigated the relationship between social support, mental health (coping, self-esteem, and perceived stress), and unhealthy behavior. We conducted a cross-sectional study of 419 patients recently diagnosed with coronary heart disease (myocardial infarction or angina) who participated in the National Health Survey in Spain (2018). Unhealthy behaviors were defined according to the European Guidelines on cardiovascular disease prevention. Only 1% of patients reported no unhealthy behaviors, with 11% reporting one, 40% two, 35% three, and 13% four or more unhealthy behaviors. In multiple regression controlling for demographic and traditional risk factors, mental health was the only significant psychosocial factor, doubling the odds of accumulated unhealthy behaviors, OR(high vs. low) = 2.03, 95% CI [1.14, 3.64]. Mental health was especially strongly related to unhealthy behavior among patients with obesity, OR(high vs. low) = 3.50, 95% CI [1.49, 8.45]. The relationship between mental health and unhealthy behaviors suggests that a large proportion of patients may not adhere to lifestyle recommendations not because they purposefully choose to do so, but because they lack coping skills to maintain the recommended healthy behaviors. Low mental well-being may be especially detrimental for behavior change of patients with obesity.

Socio-demographic predictors of well-being in United Kingdom adolescents, and the impact of well-being on a range of health-related outcomes

The deleterious impact of low mental well-being, and higher levels psychological symptoms (collectively well-being), on concurrent and prospective health outcomes has elsewhere been demonstrated. Further, variables such as conurbation and deprivation have been found to be related to mental and physical heath. This study used data from a longitudinal study to examine which demographic predicted well-being scores, and how scores on these constructs were related to six health-related outcomes. Participants were adolescents (N = 4,956; Male = 2376[48%]), from 72 High Schools in Northern Ireland. Three waves of data were gathered on mental well-being, psychological symptoms, subjective life expectancy (living to age 35 and age 75 years), self-rated health, frequency of physical exercise, and lifetime use of cigarettes and cannabis. Results showed that both well-being scores were significantly associated with gender cross-sectionally, but demographic variables did not predict changes in well-being longitudinally. Both well-being measures were significantly associated with health outcomes cross-sectionally, with mental well-being (over time) predicting life subjective life expectancy, self-rated health, and addictive behaviors, while psychological symptoms (over time) predicted the former two, but not addictive behaviors. Overall, the relationship between mental well-being, psychological symptoms, and the health outcomes assessed, was small in terms of effect size.

What does mental health have to do with well-being?

Positive mental health involves not the absence of mental disorder but rather the presence of certain mental goods. Institutions, practitioners, and theorists often identify positive mental health with well-being. There are strong reasons, however, to keep the concepts of well-being and positive mental health separate. Someone with high positive mental health can have low well-being, someone with high well-being can have low positive mental health, and well-being and positive mental health sometimes conflict. But, while positive mental health and well-being are not identical, there is an informative conceptual connection between them. Positive mental health usually contributes instrumentally to the living of a good human life, where a good human life includes (but is not limited to) well-being.

Emotional overeating questionnaire: a validation study in Italian adults with obesity, overweight or normal weight.

This study aimed at testing the validity and reliability of the Emotional Overeating Questionnaire (EOQ) in a sample of Italian adults with obesity, overweight or normal weight. Participants were 314 Italian adults (72.6% females, aged 18-76years) with obesity (27.4%), overweight (21.3%), or normal weight (51.3%), who completed the EOQ and measures of binge eating, mental well-being, and mindful eating. Retesting was performed 4weeks later in a randomly selected subsample of 60 participants. Factor structure of the EOQ was estimated by confirmatory factor analysis (CFA). Reliability was tested with McDonald's ω and ordinal α coefficients for internal consistency and Cohen's weighted Kappa coefficient (Kw) for test-retest reliability. Based on CFA, the five negative emotional items formed one factor (EOQ-5) with good reliability (ω = 0.89; ordinal α = 0.88; Kw= 0.71), while the item referring to happiness was dropped. EOQ-5 scores were associated with higher binge eating, lower mental well-being, and lower mindful eating. A cut-off point of two identified individuals at risk for binge eating disorders with 75% sensitivity and 67% specificity. Negative emotional overeating was more frequent in women with obesity than women with normal weight and men with obesity. EOQ-5 is a valid and reliable tool for measuring the frequency of emotional overeating at the Italian community-level. Level V, cross-sectional, descriptive study.

Gambling with Your Health: Associations Between Gambling Problem Severity and Health Risk Behaviours, Health and Wellbeing

The current study examined the association between gambling problem severity and health risk behaviours, health and wellbeing. A cross-sectional survey (including representative population and supplementary convenience samples) was conducted with 2303 adult residents of a British Island. Gambling problem severity was assessed using the Problem Gambling Severity Index. The EQ-5D-5L, WEMWBS and AUDIT-C were used to measure general health, mental wellbeing and alcohol use, respectively. Other measures included diet, physical exercise and tobacco use. Differences between gambling severity levels for each measure were analysed using logistic regression adjusting for age, sex and income. Compared to non-problem gamblers, moderate/high severity gamblers had higher odds of a poor diet, low physical exercise and poor general health. Tobacco use was associated with both low and moderate/high severity gambling. Low severity, but not moderate/high severity gambling, was significantly associated with binge and higher risk drinking behaviours. Health risk behaviours tended to cluster, with a graded relationship between gambling problem severity and odds of reporting at least two health risk behaviours. Compared to non-problem gamblers, low severity gamblers were approximately twice as likely and moderate/high severity gamblers were three times as likely, to have low mental wellbeing. Findings suggest associations between gambling problems and a range of health risk behaviours and health issues, and crucially that such issues are not limited to gamblers with the highest severity of problems. Addressing gambling across the whole continuum of risk should be a key public health priority.

RELATED FACTORS OF MENTAL HEALTH WELL-BEING IN THE PARTICIPANTS OF SENIOR CITIZENS' COLLEGE

The aim of this study was to clarify the mental health well-being and its related factors of participants in senior citizen’s college. The participants were 364 persons (age 69.4+/-6.1) aged sixty years or over living in Hyogo Prefecture, Japan. We conducted a cross- sectional study that included age, family structure, employed status, self-related health, presence of chronic disorders, Instrumental ADL (TMIG index of competence score), dietary variety score (1-10), cognitive social capital, structural social capital, the scales of grandchild-grandparent relationships, Japanese version of the abbreviated Lubben Social Network Scale (LSNS-6), the frequency of going outdoors, and Mental health well-being was assessed using the Japanese version of the World Health Organization Mental Health Well-being Index-five items, WHO-5. We carried out the surveys in October in 2018. The total score of WHO-5 was 19. 6+/-4.7 among all participants. From the results of multivariate logistic regression analysis, “social isolation” (OR=4.001, 95%CI=1.584-10.043) was independently associated with low mental health well-being (WHO-5). These results suggest that, to advance the well-being of the elderly, it is necessary to develop and implement the projects which promote social functions including close relationship with others, neighbors or family members.

Employment status and impact on mental wellbeing in the UK working age population: a cross-sectional analysis

BackgroundGlobal evidence suggests that exposure to non-permanent or precarious employment can have negative effects on mental wellbeing, but research from the UK is sparse. This study explored whether these findings were applicable to the UK working population. As the employment market is evolving with more precarious working opportunities, we also ascertained whether any type of employment contract arrangement was more beneficial to mental wellbeing than being unemployed. MethodsWe retrospectively analysed the Understanding Society Wave 7 dataset (anonymous pan-UK dataset from 2015). In this study, we only included respondents aged 18–64 years, in paid employment or unemployed (n=18 525, 8473 men, 10 052 women). We used the seven components of, and the overall, Short Warwick Edinburgh Mental Wellbeing Score. A score lower than 18·82 determined low mental wellbeing. Part-time contracts were defined as working 30 h or less per week. To examine the associations between the respective employment statuses (contract types, in or out of employment) and mental wellbeing, we did a χ2 analysis and calculated odds ratios (adjusted for age group and gender). FindingsThe prevalence of low mental wellbeing was highest in those unemployed (30·1%, n=438/1457), followed by those in non-permanent (14·3%, n=135/945) and permanent (12·1%, n=1943/16 123) employment arrangements. Compared with individuals employed on permanent contracts, those in non-permanent arrangements were more likely to report struggling to deal with problems (odds ratio 1·26, 95% CI 1·01–1·58, p=0·042), being unable to make up their mind (1·57, 1·20–2·06, p=0·001) or think clearly (1·35, 1·06–1·72, p=0·014), and report not feeling close to others (1·48, 1·21–1·81, p<0·0001). The association between contract types (permanent vs non-permanent) and low mental wellbeing was not significant (1·16, 0·96–1·40, p=0·13) as were the associations between contract types and future optimism, feeling useful, or feeling relaxed. Unemployed individuals were more likely to report low mental wellbeing than permanent (3·07, 2·72–3·47, p<0·0001), non-permanent (2·59, 2·09–3·21, p<0·0001), full-time (3·16, 2·79–3·58, p<0·0001), or part-time (2·60, 2·25–3·01, p<0·0001) workers. InterpretationPrecarious employment is associated with components of poorer mental wellbeing. However, the strongest associations for low mental wellbeing are observed in currently unemployed people. To understand and explore these complex relationships in greater detail, longitudinal research is required. FundingNone.

Gender differences in self-reported health - the significance of inequality in domestic work

Abstract Background Gender difference in health is an important public health issue. Although biological factors contribute, social processes and living conditions create, maintain and exacerbate health differences between women and men. The aim of this study was to examine if lack of equality in domestic work contributes to the explanation of gender differences in self-reported mental well-being, common symptoms and persistent illness. Methods Population based questionnaire data on co-habiting women and men in Sweden, aged 19-64 years (n = 2666), was used. Division of planning and performing domestic work, satisfaction with division of domestic work and equality in partner relationship, were analysed in relation to health outcomes using binary logistic regression analysis with adjustments for age, income, country of birth, occupational class, weekly hours in paid work and number of children. Results Women, compared to men, showed higher odds (OR) for having low mental well-being, OR 1.35 (1.07-1.70), &amp;gt; 7 common symptoms, OR 1.98 (CI 1.59-2.46) and ≥ 1 persistent illness, OR 1.25 (CI 1.06-1.47). When equal partner relationship and planning and performing domestic work were included in the regression, the ORs for mental well-being and persistent illness slightly weakened and decreased to non-significance when satisfaction with division of domestic work were analysed, OR 1.14 (0.99-1.44) and OR 1.18 (0.99-1.39) respectively. Corresponding ORs for common symptoms were almost unchanged throughout the analysis. Conclusions Satisfaction with division of domestic work contributed to explanation of gender differences in persistent illness and notably to differences in mental well-being. Key messages Inequality in domestic work could contribute to explanation of gender difference in health. Satisfaction in division of domestic work is of specific relevance in gender difference in mental health.

The Culture Of Health In Early Care And Education: Workers' Wages, Health, And Job Characteristics.

Little is known about the health of the 2.2 million early care and education (ECE) workers responsible for the care, well-being, and success of the approximately ten million children younger than age six enrolled in ECE, or the extent to which ECE environments and employers play a role in workers’ health. The purpose of this analysis was to describe the health of an ECE worker sample by wage and by job and center characteristics and to begin to explore the relationships between these factors and workers’ health. Our data indicate that ECE workers earn low wages and experience poor mental well-being and high rates of food insecurity. Lower-wage workers worked at centers with more children enrolled in subsidy programs and were more likely to work at centers that did not offer health insurance, paid sick leave, or parental or family leave. Policies and programs that raised workers’ wages or mandated the provision of meals to both children and workers could better support teacher health and the quality of ECE for children. Our results suggest that the culture of health in ECE settings and equity-related outcomes could be improved by helping centers provide support and flexibility to teachers (for example, offsetting workers’ benefit costs or reducing teacher-to-child ratios to reduce stress) who are managing their own health in the context of demanding work.

Alcohol's harms to others in Wales, United Kingdom: Nature, magnitude and associations with mental well-being

AimTo explore the nature and magnitude of alcohol's harms to others (AHTOs), and associations with mental well-being. MethodsCross-sectional survey implemented amongst 891 randomly selected Welsh residents (aged 18+ years), via computer assisted telephone interviews. Questions established past 12-month experience of nine direct harms resulting from another person's alcohol consumption (e.g. violence) and five linked outcomes (e.g. concern for a child). The source (e.g. partner/stranger) and frequency of the AHTO were collected, and respondents' socio-demographics, drinking behaviours and mental well-being status. ResultsDuring the past 12 months, 43.5% of respondents had experienced at least one direct harm (45.5% at least one direct harm/linked outcome). In demographically adjusted analyses, the odds of experiencing any direct harm decreased sequentially as age group increased (Adjusted Odds Ratio [AORs]: 1.9 [age 65–74 years] - 4.2 [age 18–34 years]), and was higher amongst binge drinkers (AOR, 1.5, p < 0.05). Associations between age group and suffering the direct harms anxiety, disrupted sleep, feeling threatened, property damage and emotional neglect were found. Experience of feeling threatened was lower amongst females (AOR 0.6, p < 0.05). In demographically adjusted analyses, low mental well-being was higher amongst those who had suffered alcohol-related financial issues (AOR 2.2, p < 0.001), emotional neglect (AOR 2.3, p < 0.01) and property damage (AOR 2.2, p < 0.05). ConclusionAHTOs place a large, although unequal burden on adults in Wales. Individuals' drinking patterns are associated with experience of AHTOs. Critically, experience of some harms is associated with low mental well-being.

Patient reported barriers are associated with low physical and mental well-being in patients with co-morbid diabetes and chronic kidney disease

BackgroundLittle is known about how patient reported barriers to health care impact the quality of life (HRQoL) of patients with comorbid disease. We investigated patient reported barriers to health care and low physical and mental well-being among people with diabetes and chronic kidney disease (CKD).MethodsAdults with diabetes and CKD (estimated Glomerular Filtration Rate < 60 ml/min/1.73m2) were recruited and completed a questionnaire on barriers to health care, the 12-Item HRQoL Short Form Survey and clinical assessment. Low physical and mental health status were defined as mean scores < 50. Logistic regression models were used.ResultsThree hundred eight participants (mean age 66.9 ± 11 years) were studied. Patient reported ‘impact of the disease on family and friends’ (OR 2.07; 95% CI 1.14 to 3.78), ‘feeling unwell’ (OR 4.23; 95% CI 1.45 to 12.3) and ‘having other life stressors that make self-care a low priority’ (OR 2.59; 95% CI 1.20 to 5.61), were all associated with higher odds of low physical health status. Patient reported ‘feeling unwell’ (OR 2.92; 95% CI 1.07 to 8.01), ‘low mood’ (OR 2.82; 95% CI 1.64 to 4.87) and ‘unavailability of home help’ (OR 1.91; 95% CI 1.57 to 2.33) were all associated with higher odds of low mental health status. The greater the number of patient reported barriers the higher the odds of low mental health but not physical health status.ConclusionsPatient reported barriers to health care were associated with lower physical and mental well-being. Interventions addressing these barriers may improve HRQoL among people with comorbid diabetes and CKD.

The Association between Mental Wellbeing, Levels of Harmful Drinking, and Drinking Motivations: A Cross-Sectional Study of the UK Adult Population.

Mental well-being and excessive alcohol consumption each represent a significant public health concern, and evidence suggests an association between them. Furthermore, drinking motivations associated with harmful drinking have been studied, but not systematically in the UK population. A representative sample of 6174 UK adults aged 18–75 were surveyed online. Low risk drinkers were found to have higher mental well-being than hazardous, harmful, and, probable, dependence drinkers. Using a hierarchical multiple regression analysis, it was found that just over 5% of the variance in well-being scores was accounted for by the level of harmful drinking and drinking motivation; the most significant contribution was drinking to cope. Among people drinking to cope, those drinking in more harmful ways were statistically significantly more likely to have low well-being compared to less harmful drinkers. In the UK adult population there is a clear association between poor mental well-being and harmful drinking. Furthermore, coping was a significant motivation to drink for many with low mental well-being. While mental well-being was found to be directly linked with levels of harmful drinking, the motivation for drinking was a stronger predictor of mental well-being.