Mental Health Burden Research Articles

Mental health burden among females living with HIV and AIDS in sub-Saharan Africa: A systematic review.

Mental health problems, particularly depression and anxiety, are common in women and young girls living with HIV/ AIDS particularly in low- and middle-income (LMICs) countries where women's vulnerability to psychiatric symptoms is heightened due to the prevalent intersectional stressors such as stigma and intimate partner violence. However, no synthesized evidence exists on the mental health burden of females living with HIV/AIDS (FLWHA) in Africa. This systematic review aimed to synthesize the current evidence on the mental health burden among FLWHA in sub-Saharan Africa. A systematic literature review of articles published from 2013-2023 was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). Five electronic databases; PubMed, MEDLINE with full text, Scopus, Academic Search Complete, and Health Source: Nursing Academic Edition were searched for articles published in English. Nineteen articles (15 quantitative, 3 qualitative, and 1 case study) from over 7 African countries met the inclusion criteria. The majority of the studies' quality was determined to be moderate. The prevalence of depression ranged from 5.9 to 61% and anxiety from 28.9 to 61%. Mental health burden was a logical outcome of HIV diagnosis. Predictors of mental health outcomes in the context of HIV/AIDS were identified as intimate partner violence (IPV), stigma, childhood traumas, sexual abuse, poverty, unemployment, and social isolation. Social support and resilience were identified as protective factors against mental illness in FLWHA. Mental illness had a deleterious effect on viral suppression rates among FLWHA, resulting in delayed initiation of antiretroviral therapy treatment and increased mortality but had no impact on immune reconstitution in the face of ART adherence. Given the high prevalence rates of depression and anxiety and their relationship with HIV progression, it is crucial that mental health care services are integrated into routine HIV care.

Creation of the Youth Integration Project Framework: A Narrative Synthesis of the Youth Mental Health Integrated Care Literature.

Integrated care has been posited as a potential solution to the global burden of youth mental health (YMH), but there is limited evidence on how best to design, staff, and evaluate different integrated care models. Our review aimed to consolidate the evidence on integrated models of mental healthcare for young people, to identify the core components of integration, and create a framework that can be used to analyse levels of YMH integration. We conducted a systematic review of literature across PubMed, SCOPUS, and PsycINFO databases and the grey literature We performed a narrative synthesis extracting core components of integrated YMH care. Inductive themes from the literature described core components of integrated care. These themes were mapped into a novel framework combining the World Health Organisation health system building blocks and six intensity levels of integrated care to consider how best to implement and sustain integrated care within the YMH system. The Youth Integration Project framework can form a basis for the development, implementation and evaluation of well-articulated models of youth integrated mental health pathways, assisting services identify what operational changes are needed to best implement and sustain integrated care.

Severity, impact on quality of life and mental health burden of pruritus in prurigo nodularis: a cross-sectional study of a diverse patient cohort.

We performed a cross-sectional study using validated survey instruments, finding severe pruritus, reduced quality of life (QoL) and a significant mental health burden in a diverse cohort of patients with prurigo nodularis (PN) from the USA. Itch severity and QoL scores were comparable to those found in European populations, aside from ItchyQoL scores (higher scores in this US cohort). Black patients reported higher itch intensity scores than White patients. More than 37% of patients met the cutoff for severe depression, but only 26% had a clinical diagnosis of depression. Dermatologists should be aware that PN extends beyond severe pruritus, consider screening for psychiatric comorbidities and address other concerns that affect QoL as needed.

COVID-19 Personal Protective Behaviors during Large Social Events: The Value of Behavioral Observations.

Within the context of reopening society in the summer of 2021, as the UK moved away from 'lockdowns', the Government of Wales piloted the return of organized 'mass gatherings' of people at a number of test events. The current study reports behavioral observations that were made at two of the test events to inform this process. The researchers were particularly interested in four key factors: how (1) context within a venue, (2) environmental design, (3) staffing and social norms, and (4) time across an event, affected the personal protective behaviors of social distancing and face-covering use. Data collection was undertaken by trained observers. Adherence to protective behaviors was generally high, but there is clear evidence that these behaviors were shaped in a systematic way by the environment, situational cues, and the passage of time during the events. Some instances of large-scale non-adherence to personal protective behaviors were documented. An analysis within a dual-process framework suggests ways to understand and respond to supporting target health behaviors in groups of people where intervention is deemed valuable, such as in complex or ambiguous contexts. This is one of the first studies to include a 'true' behavioral measure in understanding human responses to COVID-19. It demonstrates that behavioral observations can add precision and granularity to understanding human behavior in complex real-world contexts. Given the significant physical and mental health burden created acutely and chronically by COVID-19, this work has implications for how governments and organizations support target populations in other complex challenges facing us today, such as in sustainability, and healthy lifestyle behaviors. An individual's intentions are not always matched by their actions, and so the findings support a balanced liberal paternalistic approach where system-level changes support appropriate individual-level decisions to engender collective responsibility and action.

Difference in the physical and mental health of informal caregivers pre- and post-COVID-19 National Emergency Declaration in the United States.

BackgroundThe burden of informal caregiving represents a chronic stressor for the informal caregivers (ICs). The study investigates differences in the physical and mental health of ICs and that of non-informal caregivers before and during COVID-19. MethodsWe used data from the 2019/2020 Behavioral Risk Factor Surveillance System (BRFSS) to investigate differences in the rates of days of poor physical and mental health among ICs compared to non-informal caregivers before and after the COVID-19 National Emergency Declaration (NED). A propensity score model simulated a pseudo experimental design, comparing ICs (“treated”) with non-informal caregivers (“control”). A difference-in-difference regression model estimated the incidence rate ratios for days of poor physical and mental health as a function of IC status and time of care provision. ResultsA total of 44,583 respondents were identified with valid responses on informal caregiving status and key sociodemographic characteristics. Of those, 6.24% (n = 3073) were ICs, matched against 15,365 non-informal caregivers. In the matched sample (n = 18,848), the incidence rate for days of poor physical health among ICs was 17% (p = 0.003) higher compared to non-informal caregivers. The incidence rate for days of poor physical health was 23% (p < 0.001) lower in the post-NED compared to the pre-NED periods. The incidence rate for days of poor mental health was 44% (p < 0.001) higher among ICs compared to non-informal caregivers and 22% higher among respondents who took the survey post-NED compared to those who answered during the pre-NED period. No statistically significant differences were found between the two groups in their incidence rates for days of poor physical and mental health from the pre-to the post-NED period. ConclusionThese findings suggest a need to balance between the benefits conferred by public health restrictions versus the mental health burden that may result among certain groups, including ICs, who experience higher negative mental health outcomes.

The double burden of COVID-19 and cancer at the Uganda Cancer Institute

Background Cancer is increasingly diagnosed in Africa, with more than one million new diagnoses annually. In Uganda, the Uganda Cancer Institute (UCI) is the primary cancer care facility, with patients travelling long distances to this facility to receive care. During the COVID-19 pandemic, cancer care was disrupted on several levels, including prevention, screening, diagnosis, treatment, and follow-up. National lockdowns impeded patient access to UCI and halted cancer screening. Methods This study used qualitative interviews to obtain primary data from professionals working at UCI. Interviews were conducted from April 2022 to January 2023. KI (key informants) ’s were purposively selected, identified by colleagues at UCI and recruited through email and WhatsApp messaging. Verbal consent was obtained. Thirty to 60-minute open-ended interviews conducted virtually and in person were audio recorded and transcribed verbatim. Transcripts were coded via MAXQDA software and analyzed to identify themes. Results Thematic analysis revealed three major challenges to cancer care during COVID-19. First, UCI experienced logistical barriers such as travel restrictions, staff shortages, and insufficient protective gear. Second, staff adapted to the inflexible national lockdown policy for chronic health care with modifications to treatment regimens. Third, KI reported a significant mental health burden and reflected on how care should be improved. Conclusions As colleagues got infected, UCI staff organized their training, discussed treatment plans with colleagues, and continued to care for patients at personal risk. Resilience characterized UCI’s response to COVID-19. They adapted treatment protocols to their setting, many of which remain the standard of care today. At the same time, there is a need for capacity building tailored to the Ugandan context to provide cancer care effectively in case of another pandemic.

Health care access, psychosocial outcomes and mental health in adults living with epilepsy during the COVID-19 pandemic

PurposePeople living with epilepsy (PLWE) have a higher prevalence of mental health comorbidities and poorer psychosocial outcomes compared to the general population. The aim of this study was to examine psychosocial outcomes, mental health, healthcare accessibility, and seizure burden in PLWE during the COVID-19 pandemic. MethodsWe conducted a cross-sectional study of adults with epilepsy treated in an urban multicenter health system from 2021 to 2022. A standardized questionnaire assessed for COVID-19 history, comorbidities, access to antiseizure medications (ASMs) and neurological care, seizure burden, and psychosocial outcomes (e.g., employment, social and financial support). The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were administered to evaluate for depression and anxiety. Frequency and proportions for categorical variables and median and interquartile ranges for continuous variables were calculated. ResultsFifty-five PLWE participated (95 % response rate). Median age was 40 years (IQR 31.5–66.5), 61.8 % were women, 47.3 % had a bachelor's degree or higher and 29.1 % each had Medicaid and Medicare insurance. Race (from highest to lowest %) was: 32.7 % White, 20 % Black, 20 % Latinx, 14.5 % Asian, and 12.7 % selected “other” or “prefer not to say.” COVID-19 had been diagnosed in 21.8 % of participants. Symptoms of anxiety and depression were self-reported by 43.6 % and 34.5 % of patients, respectively, with many describing this symptom as new post-pandemic (37.5 % and 31.6 %, respectively). Using validated scales, 52.7 % had depression (PHQ-9 score ≥ 5) with 30.9 % having moderate/severe depression (PHQ-9 score ≥ 10), while 29.1 % had probable generalized anxiety disorder (GAD-7 score ≥ 8). Seizure burden increased in 21.8 % of participants, while 20 % reported fewer seizures and 29.1 % were seizure free since the COVID-19 pandemic. Economic impacts of the pandemic included job loss (25 % amongst those employed at onset of pandemic), new or worsened financial difficulties (40 %), and new or worsened social support issues (30.9 %). Of all participants, 18.2 % reported difficulties accessing ASMs and 25.5 % cancelled visits, but of those with cancelled visits, 78.6 % had their appointments rescheduled as a telehealth visit. ConclusionOur cohort of PLWE experienced some challenges during the COVID-19 pandemic including poorer mental health and financial and employment-related stressors. Encouragingly, healthcare access was relatively spared during the COVID-19 crisis, with some patients even reporting a reduction in seizure burden. However, PLWE require ongoing psychosocial support with particular attention to decompensation of mental health and social stressors that may be exacerbated by the COVID-19 pandemic.

Assessing the utility of in silico tools in early drug development: The case of a pharmaceutically relevant formulation of the prodrug psilocybin

(1) Background: Depressive disorders contribute to an excruciating global mental health burden. Recently, there has been a great shift in interest towards substances with psychedelic potential as treatment for patients with resistant forms of depression, one of these substances being psilocybin. The need to expedite processes within the drug development pipeline and make potential therapy available for patients with treatment-resistant forms of depression is great. Approaches to combine computational and traditional experimental drug development are more consequential due to their potential to shorten development times and aid in setting product specifications. To date, the full extent to which in silico methods for early drug development yield valid and robust data which can be directly used for translation into safe and effective pharmaceutical products, remains unknown, especially for prodrug containing formulations. (2) Methods: Herein we explore the robustness and applicability of in silico generated data for the aid of experimental drug development by directly comparing computationally generated data to experimentally and literature derived data. Furthermore, by utilizing different computational approaches, we investigate to which extent these computational models can by utilized to create a novel capsule containing psilocybin, having in mind that psilocybin is a prodrug and psilocin is the active. (3) Results: In silico models provided valid data including intrinsic dissolution and capsule dissolution behavior, but were not able to predict stability issues. Simulations of the expected in vivo performance showed deviations from previously published clinical studies. Significant improvements in predictive accuracy were made by implementing physicochemical surface pH models and entering in vitro and in vivo data. (4) Conclusions: Computational models provide a valuable resource to aid in the planning and implementation of experimental drug product development. Prodrug and active were simulated for their in vitro and in vivo behavior. Even though the results appear to be robust, these models exhibit potential for improvement in predictive accuracy, and thus, applicability of computationally generated data for drug development. Moreover, the models are yet unable to perform a completely accurate drug development process solely supported by in silico data. Lastly, we were able to report psilocybin as a BCS class III drug and psilocin as a BCS class I drug in terms of a provisional classification supported by our data.

The impact of care-recipient relationship type on mental health burden of caregivers for schizophrenia patients: evidence from Beijing, China.

To examine the impact of care-recipient relationship type on mental health burden of caregivers for schizophrenia patients in China, elucidating the underlying mechanisms. A cross-sectional study was conducted using face-to-face surveys administered to caregivers of patients with schizophrenia in selected communities in Beijing, China. 1,853 samples' data was used. Descriptive statistics, logistic regression models and Sheaf coefficient method were employed to analyze the data. The mental health burden experienced by caregivers of schizophrenia patients has reached a high level, with 66.9% reporting a moderate or severe impact from their caregiving responsibilities. Parents and spouses were the primary providers of care for schizophrenia patients in China. Parent caregivers experienced greater suffering in their caregiving role compared to spouse caregivers, whereas the difference between child caregivers and spouse caregivers was not significant. The factors influencing caregiver's mental health burden vary according to the type of relationship with the care-recipient. For parent caregivers, the mental health burden primarily stems from personal conditions of schizophrenia patients, while for spouse or child caregivers, it mainly arises from family economic conditions. This study reveals that caregivers having different types of care-recipient relationship with schizophrenia patients experience significantly different mental health burdens in Beijing, China, and major influencing factors are distinct according to different care-recipient relationship types.

Network analytical investigation of relationships between symptoms of common mental disorders among refugees and asylum seekers in Türkiye.

Forcibly displaced people, such as refugees and asylum-seekers (RAS), are at higher risk of mental disorders, mainly post-traumatic stress disorder (PTSD), depression and anxiety. Little is known about the complex relationships between these mental disorders among culturally and linguistically diverse RAS. To investigate this, the present study applied a novel network analytical approach to examine and compare the central and bridge symptoms within and between PTSD, depression and anxiety among Afghan and Syrian RAS in Türkiye. A large-scale online survey study with 785 Afghan and 798 Syrian RAS in Türkiye was conducted in 2021. Symptoms of PTSD (the short form of Post-Traumatic Stress Disorders Checklist [PCL-5]), depression and anxiety (Hopkins Symptoms Checklist-25) [HSCL-25]) were measured via self-administrated validated instruments. We conducted network analysis to identify symptoms that are most strongly connected with other symptoms (central symptoms) and those that connect the symptoms of different disorders (bridge symptoms) in R Studio using the qgraph package. Overall, Afghans and Syrians differed in terms of network structure, but not in network strength. Results showed that feeling blue, feeling restless and spells of terror or panic were the most central symptoms maintaining the overall symptom structure of common mental disorders among Afghan participants. For Syrian participants, worrying too much, feeling blue and feeling tense were identified as the central symptoms. For both samples, anger and irritability and feeling low in energy acted as a bridge connecting the symptoms of PTSD, depression and anxiety. The current findings provide insights into the interconnectedness within and between the symptoms of common mental disorders and highlight the key symptoms that can be potential targets for psychological interventions for RAS. Addressing these symptoms may aid in tailoring existing evidence-based interventions and enhance their effectiveness. This contributes to reducing the overall mental health burden and improving well-being in this population.

Factors associated with mental health burdens in physical therapists during the late stage of the COVID-19 pandemic

IntroductionIt has been a long time since the emergence of COVID-19 in China and its spread worldwide. Vaccines are a promising solution to overcome COVID-19 infection. Still, vaccine hesitancy is the only barrier to controlling the pandemic, as thinking about its side effects induces psychological exhaustion. There is still a lack of research targeting the mental health of Physical Therapists (PTs), especially during the late stage of the COVID-19 pandemic, so the study’s main aim was to identify the prevalence of anxiety, depression and insomnia and identify risk factors that influence anxiety and depression.MethodsA cross-sectional online survey via anonymous questionnaires and questions about socio-demographic information was launched on social media in the second half of February 2021.ResultsPrevalence of anxiety, depression, and insomnia was 42.7%, 50.10%, and 89.30%, respectively, among physical therapists. Common factors that induce anxiety and depression were having children and needing psychological support. Other risk factors for anxiety only were working in a quarantine hospital, being infected with COVID-19, self-isolation after return from the hospital, and hesitance about vaccine effectiveness. Treating COVID-19 patients and having a family member who had died from COVID-19 were risk factors for depression. Consulting a psychiatrist reduced this risk of depression.ConclusionsElevated mental health disturbances triggered the alarm for urgent psychological rehabilitation to prevent the failure of health care systems in this critical period. Additionally, fighting the anti-vaccine movement should be a priority along with enhancing telerehabilitation programs in hospitals.

Gender differences in the prevalence of anxiety and depression and care seeking for mental health problems in Nepal: Analysis of nationally representative survey data.

Assessing gender disparity in mental health is crucial for targeted interventions. This study aims to quantify gender disparities in mental health burdens, specifically anxiety and depression, and related care-seeking behaviors across various sociodemographic factors in Nepal, highlighting the importance of gender-specific mental health interventions. Data from the 2022 Nepal Demographic and Health Survey was utilized, employing the Generalized Anxiety Disorder 7 scale (GAD-7) and Patient Health Questionnaire (PHQ-9) scales for anxiety and depression symptoms, respectively. Multiple logistic regression models assessed gender associations with these conditions and care-seeking behaviors. Women had a higher point prevalence of anxiety (21.9% vs. 11.3%) and depression (5.4% vs. 1.7%) than men. Large variations were noted in gender disparities in the prevalence of anxiety and depression, influenced by age, geographical areas, level of education and household wealth. After adjustment for sociodemographic factors, women were more likely to experience anxiety (adjusted odds ratio (aOR)=2.18, 95% confidence interval [CI]: 1.96-2.43) and depression (aOR=3.21, 95% CI: 2.53-4.07). However, no difference was observed in the rates of seeking care for anxiety or depression (aOR=1.13, 95% CI: 0.91-1.40). Our findings show a higher point prevalence of mental health issues among women than men, influenced by sociodemographic factors, underscoring the need for gender-focused mental health interventions in Nepal and globally.

Suicide bombing and impending mental health disaster in Pakistan

Pakistan grapples with a significant mental health burden, with 10-16% of its population experiencing psychiatric disorders. Depression and anxiety affect 34% of the population, with regional variations. The scarcity of mental health facilities and professionals exacerbates the situation, leading many to seek help from traditional healers. Socioeconomic challenges, terrorism, and internal conflicts contribute to the mental health crisis. Recent suicide bombings, such as the one in Peshawar, highlight the emotional aftermath and challenges faced by survivors. The complex interplay of factors, including sociocultural influences, contributes to the emergence of a martyrdom subculture. Understanding terrorism requires examining the broader sociocultural and political context. The prevalence of mental illness and rising terrorism suggests a potential connection, although causality is complex. Coping with terrorism-induced trauma poses challenges for survivors, necessitating comprehensive mental health support. Recommendations include nationwide studies, school mental health programs, and initiatives to counter misinformation and radicalization through media. Establishing telepsychiatry services and collaboration between mental health experts and religious scholars is crucial for enhancing social cohesion and mental wellbeing in Pakistan.

Estimating the joint association of adverse childhood experiences and asthma with subsequent depressive symptoms: a marginal structural modelling approach

BackgroundThe relationship between adverse childhood experiences (ACEs) and depression risk has been well documented. However, it remains unclear whether stress-related chronic conditions associated with ACEs, such as asthma, increase the...

Stress factors in veterinary medicine-a cross-sectional study among veterinary students and practicing vets in Austria.

Although the issue of high mental health burden among veterinarians is well-documented in previous studies, little is known about the specific occupational stress factors associated with mental health issues. Therefore, the aims of this study were twofold: (1) to assess occupational stress factors within the veterinary profession, with a particular emphasis on comparing the expectations of veterinary students with the experiences of practicing veterinarians and (2) to link the experienced stress with mental health indicators in veterinarians. All registered veterinarians and veterinary-medicine students in Austria were invited to participate in a cross-sectional online survey. The data collection took place during the winter of 2022/2023 and included standardized questionnaires on mental well-being (WHO-5), depression (PHQ-9), anxiety (GAD-7), stress (PSS-4), and insomnia (ISI-2). Additionally, participants were asked about various estimated (students) or experienced (vets) occupational stress factors, which were to be rated on a 5-point Likert scale ranging from "not at all" to "very strongly". An open question invited respondents to identify in free text further experienced/anticipated sources of work-related stressors in veterinary practice. A total of 430 students and 440 veterinarians participated in the study. The results of a repeated measures analysis of variance (ANOVA) indicate that the burden of bureaucracy is perceived as less stressful by students than experienced by veterinarians, all other areas are perceived as more stressful by students than by veterinarians. In veterinarians, bureaucracy is experienced as the most burdensome, followed by animal suffering, and communication with animal owners. Further analysis of possible associations between the extent of perceived stressors and indicators of mental health shows that while bureaucracy is the most burdensome, it has the smallest correlation with mental health indicators. On the other hand, financial concerns, which are not ranked among the main stressors, have the strongest correlation with impaired mental health. The results suggest that financial security for veterinarians is crucial to safeguard their mental health. The training of veterinary medicine students and practicing veterinarians in the areas of administration, time management, handling animal suffering, and communication with animal owners might be beneficial in reducing their job-related stressors.

The Most Vulnerable Children Faced Unique Risks During COVID-19: How Agencies Communicated with Communities on Parenting in Low Resource and Humanitarian Settings

Evidence suggests that children in low resource and humanitarian settings experienced added mental health burdens and violence in the home during the SARS-CoV-2 (COVID-19) pandemic, which may have affected their health and development. For humanitarian response agencies, conducting child protection services during this pandemic had been constrained by safety concerns related to the risk of COVID-19 transmission, and logistical issues aligned with social and public health measures. This paper describes how agencies responded to the identified risks children face, integrating remote risk communication and community engagement approaches and safe in-person dialogues with parents and caregivers into child protection interventions to educate about the disease and prevention, encourage a positive parenting environment and mitigate negative effects on children. United Nations (UN) agencies and non-government organizations (NGOs) must reflect on these different approaches and share lessons learned and best practices internally and at an inter-agency level to support evidence-based responses for future epidemics and pandemics.

Mental health impact of multiple sexually minoritized and gender expansive stressors among LGBTQ+ young adults: a latent classanalysis.

In the United States, lesbian, gay, bisexual, transgender, queer, intersex, asexual and other sexually minoritized and gender expansive (LGBTQ+) young adults are at increased risk for experiencing mental health inequities, including anxiety, depression and psychological distress-related challenges associated with their sexual and gender identities. LGBTQ+ young adults may have unique experiences of sexual and gender minority-related vulnerability because of LGBTQ+-related minority stress and stressors, such as heterosexism, family rejection, identity concealment and internalized homophobia. Identifying and understanding specific LGBTQ+-related minority stress experiences and their complex roles in contributing to mental health burden among LGBTQ+ young adults could inform public health efforts to eliminate mental health inequities experienced by LGBTQ+ young adults. Therefore, this study sought to form empirically based risk profiles (i.e., latent classes) of LGBTQ+ young adults based on their experiences with familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment, and then identify associations of derived classes with psychological distress. We recruited and enrolled participants using nonprobability, cross-sectional online survey data collected between May and August 2020 (N=482). We used a three-step latent class analysis (LCA) approach to identify unique classes of response patterns to LGBTQ+-related minority stressor subscale items (i.e., familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment), and multinomial logistic regression to characterize the associations between the derived classes and psychological distress. Five distinct latent classes emerged from the LCA: (1) low minority stress, (2) LGBTQ+ identity concealment, (3) family rejection, (4) moderate minority stress and (5) high minority stress. Participants who were classified in the high and moderate minority stress classes were more likely to suffer from moderate and severe psychological distress compared to those classified in the low minority stress class. Additionally, relative to those in the low minority stress class, participants who were classified in the LGBTQ+ identity concealment group were more likely to suffer from severe psychological distress. Familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment are four constructs that have been extensively examined as predictors for mental health outcomes among LGBTQ+ persons, and our study is among the first to reveal nuanced gradients of these stressors. Additionally, we found that more severe endorsement of minority stress was associated with greater psychological distress. Given our study results and the previously established negative mental health impacts of minority stressors among LGBTQ+ young adults, findings from our study can inform research, practice, and policy reform and development that could prevent and reduce mental health inequities among LGBTQ+ young adults.

Cognitive-Behavioral Therapy for Persistent Post-Concussive Symptoms in Youth: Adaptations, Treatment Recommendations, and Implementation in Medical Settings

While many youths recover from concussions within several weeks, a subset of patients experience persistent postconcussive symptoms (PPCS), lasting 4 weeks or longer. PPCS have a significant negative impact on children’s social and academic functioning, often leading to extended absences from school, disruption of normal activities, and increased mental health burden. Cognitive-behavioral therapy (CBT) has demonstrated promise as a treatment for PPCS but requires tailoring to specifically address concussion-related targets. This paper describes the clinical adaptation of CBT for pediatric patients with PPCS, including core intervention modifications and recommendations for the implementation and delivery of CBT in medical settings. A model of an integrated concussion clinic with pediatric neurology and psychology is discussed.

Greater Mental Health Burden is Associated With Poor Postoperative Pain Control and Increased Opioid Utilization Following Total Shoulder Arthroplasty.

Prolonged opioid use is associated with higher complications and worse patient-reported outcomes following total shoulder arthroplasty (TSA). Identified risk factors for prolonged postoperative use are related to several medical comorbidities, gender, diagnoses of anxiety or depressive disorders, and preoperative opioid use. In this study, we hypothesized that patient-reported mental health characteristics can help to identify patients at risk of worse postoperative pain control, worse sleep, and higher opioid utilization following TSA. Ninety-three consecutive patients were asked to fill out 2 mental health questionnaires prior to undergoing TSA. Following surgery, patients filled out a daily pain diary to track their daily pain, pain medication use, and quality and duration of their sleep for 30 days. Preoperative opioid use and postoperative refill were determined by the New York State Prescription Monitoring Program. Mixed-model linear regressions were conducted. Significance was defined as p < 0.05. Postoperative opioid refill was associated with female gender, preoperative opioid therapy, higher inpatient opioid use, worse anxiety, depression, somatization, and pain catastrophizing scores. The number of days using opioids postoperatively was associated with worse pain catastrophizing scale (PCS) and somatization scores (patient health questionnaire-15). Preoperative opioid therapy was associated with worse somatization scores, whereas no opioids used after surgery were associated with better somatization scores. Worse sleep quality and duration were associated with worse PCS scores. A greater mental health burden is associated with worse postoperative pain control and higher opioid utilization during the acute postoperative period. This is especially evident in the pain catastrophizing and somatization domains.

A01: A Pilot Study of Student Cadres Mental Health at a Sport University During COVID-19

Purpose: Over 90% of college students have experienced negative mental health symptoms due to the pandemic, according to a survey from BestColleges.com. More than half (54%) of college students believe COVID-19 circumstances have impacted their mental health. Although the pandemic's influence on mental health expanded, not all students have felt its effects to the same degree. Physical activity has been reported to have many physical and mental health benefits. Students at sport universities tend to participate in more sport and physical activity. During the pandemic, student cadres are expected to take more responsibilities such as coordinating COVID-19 tests and interacting with more students. The purpose of this study was to examine the mental health of student cadres at a sport university in southwest China. Methods: Literature research, field observation and a survey questionnaire were used in this study. Forty college student cadres were surveyed from a sport university in Sichuan province. The Self-rating Symptom Checklist-90 (SCL-90) scale was used to estimate the mental status of students. A total of 33 surveys were returned with 29 valid samples were analyzed. Among the samples there were 13 males and 16 females with an average age of 19.62. The results were compared with general college students’ mental health reported in the literature. Results: According to a recent systematic review by meta-analysis, the anxiety prevalence was 33% in Asia, 51% in Europe, and 56% in the USA. University students have a high prevalence of anxiety, indicating an increased mental health burden during this pandemic. Only 6.9% of student cadres in this study showed anxiety symptoms. According to the SLC-90 score, compared with the documented normal mental health rate (62.2%) in the literature, the survey found 79.31% of sport university student cadres are in a normal mental health status. Conclusion: COVID-19 pandemic has impacted college students’ mental health. However, the student cadres of the sport university had a higher rate of normal mental health than the average rate reported in the literature, even though they had more responsibility and risks of being exposed to positive cases. It indicates sport and physical activity may reduce the mental health impact caused by the pandemic.