Mental Health Domains Research Articles

Towards an ontology of mental health: Protocol for developing an ontology to structure and integrate evidence regarding anxiety, depression and psychosis

Background Research about anxiety, depression and psychosis and their treatments is often reported using inconsistent language, and different aspects of the overall research may be conducted in separate silos. This leads to challenges in evidence synthesis and slows down the development of more effective interventions to prevent and treat these conditions. To address these challenges, the Global Alliance for Living Evidence on aNxiety, depressiOn and pSychosis (GALENOS) Project is conducting a series of living systematic reviews about anxiety, depression and psychosis. An ontology (a classification and specification framework) for the domain of mental health is being created to organise and synthesise evidence within these reviews and present them in a structured online data repository. Aim This study aims to develop an ontology of mental health that includes entities with clear labels and definitions to describe and synthesise evidence about mental health, focusing on anxiety, depression and psychosis. Methods We will develop and apply the GALENOS Mental Health Ontology through eight steps: (1) defining the ontology’s scope; (2) identifying, labelling and defining the ontology’s entities for the GALENOS living systematic reviews; (3) structuring the ontology’s upper level (4) refining entities via iterative stakeholder consultations regarding the ontology’s clarity and scope; (5) formally specifying the relationships between entities in the Mental Health Ontology; (6) making the ontology machine-readable and available online; (7) integrating the ontology into the data repository; and (8) exploring the ontology-structured repository’s usability. Conclusion and discussion The Mental Health Ontology supports the formal representation of complex upper-level entities within mental health and their relationships. It will enable more explicit and precise communication and evidence synthesis about anxiety, depression and psychosis across the GALENOS Project’s living systematic reviews. By being computer readable, the ontology can also be harnessed within algorithms that support automated categorising, linking, retrieving and synthesising evidence.

Novel Multicomponent Digital Care Assistant and Support Program for People After Stroke or Transient Ischaemic Attack: A Pilot Feasibility Study

Evidence is increasing for digital health programs targeting the secondary prevention of stroke. We aimed to determine the feasibility of the novel Care Assistant and support Program for people after Stroke (CAPS) or transient ischaemic attack (TIA) by combining person-centred goal setting and risk-factor monitoring through a web-based clinician portal, SMS messages, a mobile application (app), and a wearable device. We conducted a 12-week mixed-methods, open-label feasibility study. Participants (6 months–3 years after stroke or TIA, access to the internet via a smartphone/tablet) were recruited via the Australian Stroke Clinical Registry. Participants set one or two secondary prevention goals with a researcher and provided access and training in technology use. Feasibility outcomes included recruitment, retention, usability, acceptability, and satisfaction. Secondary outcomes included goal attainment, health outcomes, and program costs. Following 600 invitations, 58 responded, 34/36 (94%) eligible participants commenced the program (one withdrawal; 97% retention), and 10 were interviewed. Participants (27% female, 33% TIA) generally rated the usability of the mobile application as ‘Good’ to ‘Excellent’ (System Usability Scale). Most (94%) agreed the program helped with engagement in health self-monitoring. Overall, 52 goals were set, predominantly regarding exercise (21/52), which were the most frequently achieved (9/21). At 12 weeks, participants reported significant improvements (p < 0.05) in self-efficacy (Cohen’s d = 0.40), cardiovascular health (d = 0.71), and the mental health domain of the PROMIS GH (d = 0.63). CAPS was acceptable, with good retention and engagement of participants. Evaluation of this program in a randomised controlled trial is warranted.

Effectiveness of telerehabilitation-based mckenzie method versus manual therapy in low-back pain management: a randomised controlled trial

Abstract Background Studies comparing the effectiveness of telerehabilitation and spinal manual therapy (SMT) for chronic non-specific low-back pain (NSLBP) are limited. This study aimed to compare the efficacy of the telerehabilitation-based McKenzie therapy (TBMT) and SMT among patients with NSLBP. Methods Forty-nine consenting patients randomised into either TBMT (n = 28) or SMT (n = 21) group completed the study. TBMT is a mobile phone-based telerehabilitation involving the ‘McKenzie extension protocol’. SMT is a grade II (10 oscillations) posterior-anterior central vertebral pressure on the offending spinous process. Both interventions were applied thrice weekly for eight weeks, and outcomes were assessed on Pain Intensity (PI), Activity Limitation (AL), Participation Restriction (PR), and Health-related Quality of Life (HRQoL) in the fourth and eighth weeks. Results Within-group comparison across baseline, 4th and 8th week indicate that SMT had a significant effect on PI (F = 132.804, p = 0.001), AL (F = 75.984, p = 0.001), PR (F = 99.428, p = 0.001) and for all the scales of SF-12 except for mental health domain (p > 0.05). Similarly, TBMT had a significant effect on PI (F = 243.631; p = 0.001), AL (F = 85.930; p = 0.001), PR (F = 48.425; p = 0.001), and for all the scales except also for mental health domain (p > 0.05). However, there were no significant differences (p > 0.05) in the treatment effects between SMT and TBMT, except for the ‘health perception’ (p = 0.045) scale at week four and the ‘mental health’ scale (p = 0.023) at week eight. Conclusion Telerehabilitation-based McKenzie method and SMT are effective in chronic NSLBP, with TBMT leading to significantly higher long-term health perception improvement. Trial Registration Pan African Clinical Trial Registry (PACTR202010667228786), Registered 27 October 2020-Retrospectively registered.

Blood pressure status, quality of life, and emotional states in adults with different disease awareness and treatment adherence

This study aimed to examine the association between blood pressure (BP) with health-related quality of life (HRQoL) and emotional states, considering the disease awareness and commitment to treatment among the Iranian adult population. This cross-sectional study uses the data of 7257 and 2449 individuals aged ≥ 20 who had completed data on HRQoL and emotional states, respectively. Linear and logistic regression were used to evaluate the mentioned association. The results showed that commitment to treatment had an inverse association with physical HRQoL in both sexes, except for bodily pain in men. Concerning mental HRQoL, in women, poor medication adherence was linked to a decline in mental HRQoL and social functioning, while good treatment adherence was associated with a reduction in the mental health domain. However, except for a decrease in vitality of hypertensive males with high treatment adherence, no significant association was found between their mental HRQoL and BP. In women, increased commitment to treatment was associated with anxiety, whereas poor commitment was related to depression and stress. The undiagnosed disease was not associated with any HRQoL and emotional state deficits. This study highlights the significance of psychiatric assessment, counseling, and support services while taking into account gender-specific differences among hypertensive patients. It also emphasizes the necessity for customized interventions for both men and women to improve their mental well-being and adherence to treatment.

6.O. Scientific session: The unmet needs of LGBTQ+ persons and communities: perspectives from across the globe

Abstract Lesbian, gay, bisexual, transgender and queer persons suffer from rising anti-LGBTQ+ stigma. Such stigma entails laws that punish being LGBTQ+ such as in Uganda, Russia, Ghana, Iran, etc. The stigmatizing contexts have numerous health-harming effects, including perpetrating mental health harms and creating environments that hamper access & quality of services. Rising global anti-LGBTQ+ stigma and the adverse health impacts require more data on the topic to adequately dispel LGBTQ+ mis- and dis-information. This workshop will give examples of studies that examine LGBTQ+ disparities and inequities in health across different social and cultural contexts, drawing from research in Czechia, Kenya, Rwanda, and Sweden. The workshop will first outline the relevant social and cultural contexts of LGBTQ+ persons in various countries, such as attitudes, beliefs, and values. The workshop will then discuss LGBTQ+ inequities and disparities that arise from health-harming attitudes, beliefs, and values. Afterward, the workshop will discuss public health-oriented solutions & policy directions, including using data for interpretation and advocacy labs and efforts, enhancing data collection, improving knowledge and attitudes, and other implications for public health practice and policy. The workshop will open a session that will situate LGBTQ+ public health for the audience. The first study will be by Andreas Malm from the Karolinska Institute, Sweden, examining LGBTQ+ differences in mental health and treatment disparities in Sweden. This will be followed by Luis Roxo from the Karolinska Institute and Universidade NOVA de Lisboa, Portugal, discussing stressors and symptoms that shape inequalities in mental health service use. Then, Michal Pitonák from the National Institute of Mental Health, Czechia, will present treatment and outcome gaps in the mental health of LGBTQ+ persons in Czechia. Lastly, Emmy Kageha Igonya from the African Population Health Research Center, Kenya, will showcase work from a mixed-methods study with LGBTQ+ people in Rwanda and Kenya, examining access to and use of healthcare services. After the individual presentations, which will each last 7-8 minutes, the audience will be invited to a moderated 20-25-minute open discussion on the papers & how the findings can help inform public health practice & policy to address the unmet needs of LGBTQ+ populations globally. The continuing rise in anti-LGBTQ+ sentiments across the globe is problematic from a public health standpoint, given the severe health-harming effects across numerous physical and mental health states and domains. Our workshop aims to facilitate a conversation on understanding the structural situations that shape LGBTQ+ health and identifying strategies to reduce gaps in services and needs that disproportionately burden LGBTQ+ persons. Key messages • LGBTQ+ people across the globe are experiencing rising stigma and discrimination. • Rising anti-LGBTQ+ backlash disproportionately harms LGBTQ+ physical and mental health and creates gaps in care.

Associations Between Physical, Cognitive, and Mental Health Domains of Post-Intensive Care Syndrome and Quality of Life: A Longitudinal Multicenter Cohort Study.

To explore associations between the physical, cognitive, and mental post-intensive care syndrome (PICS) health domains with changes in health-related quality of life (HRQoL) following ICU admission. A longitudinal prospective multicenter cohort study. Patients (n = 4092) from seven Dutch ICUs. None. At ICU admission, 3 and 12 months post-ICU, patients completed validated questionnaires regarding physical health problems, cognitive health problems, mental health problems, and HRQoL. Composite scores were created for the physical health domain (physical problems and fatigue) and mental health domain (anxiety, depression, and post-traumatic stress disorder). Adjusted multivariable linear regression analyses were performed, including covariables (e.g., patient characteristics, disease severity, pre-ICU HRQoL, etc.) to explore associations between the physical, cognitive, and mental health domains of PICS and changes in HRQoL at 3 and 12 months post-ICU. At 3 months (n = 3368), physical health problems (β = -0.04 [95% CI, -0.06 to 0.02]; p < 0.001), cognitive health problems (β = -0.05 [95% CI, -0.09 to -0.02]; p < 0.001), and mental health problems (β = -0.08 [95% CI, -0.10 to -0.05]; p < 0.001) were negatively associated with changes in HRQoL. Also, at 12 months (n = 2950), physical health problems (β = -0.06 [95% CI, -0.08 to -0.03]; p < 0.001), cognitive health problems (β = -0.04 [95% CI, -0.08 to -0.01]; p < 0.015), and mental health problems (β = -0.06 [95% CI, -0.08 to -0.03]; p < 0.001) were negatively associated with changes in HRQoL. PICS symptoms in the physical, cognitive, and mental domains are all negatively associated with changes in HRQoL at 3 and 12 months post-ICU. At 3 months, PICS symptoms in the mental domain seem to have the largest negative associations. At 12 months, the associations of PICS in the mental and physical domains are the same. This implies that daily ICU care and follow-up care should focus on preventing and mitigating health problems across all three PICS domains to prevent a decrease in HRQoL.

Correlation between parental willingness to pay, health-related quality of life, and satisfaction with physiotherapy services in Nigeria: a cross-sectional study

Abstract Background Being a parent of a child with a disability requiring many clinic visits is burdensome. Therefore, understanding the willingness-to-pay (WTP) for physiotherapy for children with disability is important to facilitating access to care and for policy-making. This study aimed to investigate patterns and correlates of parental WTP for physiotherapy. Methods A total of 65 parents of children with disability receiving physiotherapy as outpatients were recruited from selected tertiary hospitals in Nigeria. A WTP questionnaire, SF-12 health survey, and Physiotherapy Satisfaction Questionnaire were used to assess the WTP, health-related quality of life (HRQoL), and satisfaction with physiotherapy respectively. Descriptive statistics of mean, standard deviation, frequency, and percentages were used to summarize the data. Chi-square and regression analysis were also used to test the association and determinants of WTP from each of the socio-demographic factors, satisfaction with physiotherapy, and health-related quality of life, respectively. Results A majority (49.2%) of the respondents were in the 21–35 years age category. There was 30.8% “no WTP” for physiotherapy among parents of children with disability. A significant association was observed between socio-economic status and WTP for all treatment modalities (p &lt; 0.05). The majority of the respondents had above-average levels of physical and mental health domain of SF-12. No significant association was observed between WTP and each satisfaction with physiotherapy and HRQoL (p &gt; 0.05). Conclusion There was a high rate of ‘no WTP’ for physiotherapy among parents of children with disability. Level of satisfaction with physiotherapy and health-related quality of life was not significantly associated with parental WTP for physiotherapy.

Evaluation of akathisia in patients receiving selective serotonin reuptake inhibitors/serotonin and noradrenaline reuptake inhibitors.

Akathisia is an underestimated but disturbing extrapyramidal side effect of antidepressants, which could reduce treatment compliance in mood disorders. This study aimed to investigate the frequency and risk factors in patients treated with selective serotonin reuptake inhibitors/serotonin and noradrenaline reuptake inhibitors (SSRI/SNRI). In addition, we assessed the impact of akathisia on the quality of life (QoL). Patients were aged between 18 and 75 years, receiving an SSRI/SNRI for 4-8 weeks, and were diagnosed with anxiety, depression, or obsessive-compulsive disorder. The Barnes Akathisia Rating Scale was used to assess the severity of the akathisia. QoL was evaluated using the Short Form 36 (SF-36) questionnaire. Akathisia was observed in 25% (50/198) of patients. Smokers and younger patients were more frequent among patients with akathisia. Physical functioning, physical role, vitality, and mental health domains of the SF-36 were reduced in the presence of akathisia. In conclusion, our results suggest that akathisia is not a rare side effect of SSRI/SNRI in patients with mood disorders, especially in smokers and younger patients. In addition, akathisia may reduce treatment compliance owing to a reduction in QoL. Further investigations are needed to confirm the risk factors, frequency, and consequences of treatment compliance for SSRI/SNRI-induced akathisia in patients with mood disorders.

The relationship between co-occurring traumatic experiences and co-occurring mental health domains for veterans resident in Northern Ireland

IntroductionVeterans residing in Northern Ireland (NI) likely experience higher levels of co-occurring lifetime trauma exposure and associated co-occurring mental health symptoms, due to the Troubles. As NI veterans have been subject to little exploration it is difficult to know how to support them. This exploratory study explored the co-occurrence of mental health symptoms as a function of co-occurring traumatic experiences.MethodsTwo latent class analyses (LCA) were conducted on NI veteran data (n = 609). One LCA factored endorsements of 16-lifetime traumatic events, with a separate LCA exploring the co-occurrence of symptoms across six mental health domains. Mental health symptom classes were considered as a function of trauma classes, military-specific variables, gender and age.ResultsThree trauma classes were identified: High Multi Trauma (10.84%); High Combat/Conflict (47.62%); Moderate Combat Conflict (41.54%), and three mental health symptom classes: High Co-occurring Mental Health (19.38%); High Depression Moderate Anxiety/Alcohol (24.63%); Moderate Alcohol/Normative (55.99%). Significant predictors of High Co-occurring Mental Health class membership were UDR service, ‘Worst’ military trauma and High Multi Trauma class membership. Both combat classes had a negative relationship with the High Co-occurring Mental Health. Predictors of the High Depression Moderate Anxiety/Alcohol class were High Multi Trauma class membership and UDR service, with Age and Moderate Combat Class membership having a negative relationship.DiscussionNI veterans could be labelled as ‘traumatised’ due to high levels of combat/conflict exposure, yet the two combat classes seemed unrelated to membership of poorer mental health classes. UDR membership indicated that living in one’s theatre of war could have mental health implications. It was concerning that 45% experienced some co-occurring mental health symptoms with 19% experiencing the poorest symptoms. Hazardous alcohol use appeared unrelated to poor mental health. Further research is needed, utilising robust methods. No clinical inferences are to be made from this exploratory study.

Effect of Flaxseed on Pain Relief and Quality of Life in Patients With Mastalgia: A Single Arm Interventional Study.

Mastalgia, a common complaint among women, denotes breast discomfort that can manifest as cyclical or non-cyclical. Reassurance, mechanical support and various non-pharmacological treatments, like flaxseeds, have been seen to have a good effect in treating mastalgia. Thus, the aim of this study was to investigates the efficacy of flaxseed in alleviating pain associated with mastalgia and its impact on the overall health-related quality of life among female patients. Conducted at a tertiary care center in Northern India over 18 months, it employed a single-arm interventional design. The participants included females aged 18 years and older presenting with breast pain at the Department of General Surgery. The intervention involved daily consumption of 30 g of milled flaxseed for each participant, administered over a period of six months. Pain severity was assessed using the visual analogue scale (VAS) before supplementation and at follow-up intervals up to six months. Concurrently, the Short Form-12 (SF-12) items Health Survey measured health-related quality of life, encompassing both physical and mental health domains. Statistical analysis employed parametric (paired t-test) and non-parametric tests (chi-square, McNemar) where appropriate, with statistical significance set at p<0.05. Two hundred women with mastalgia were included with a significant reduction in mean VAS scores from 6.03±0.83 at baseline to 2.19±0.66 at six months post-intervention (p = 0.0001). This reduction in pain intensity demonstrated a positive correlation with duration of flaxseed supplementation, notably declining after the initial three months. The mean difference in physical and mental SF-12 score at first visit and at 6 months after intervention was significant (p = 0.0001). This study underscores the potential of flaxseed as a therapeutic option for managing mastalgia and enhancing health-related quality of life among affected individuals.

Racial/Ethnic Differences in Adverse Childhood Experiences and Health-Related Outcomes: A Scoping Review.

Racial and ethnic differences have been observed across patterns of substance use and exposure to adverse childhood experiences (ACEs). The goal of this review was to summarize the current evidence on ACE and health outcomes across racial and ethnic groups in the United States. A scoping review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta- Analysis for Scoping Review (PRISMA-ScR) guideline was performed. Using predetermined search terms and parameters, an electronic database search of peer-reviewed literature between 1997 and 2022 was performed. Forty-five articles met the inclusion and exclusion criteria. Thirteen articles focused on health behavior and education outcomes, fifteen reported on physical health outcomes, and eighteen reported on mental health outcomes. Relatively to mental health outcomes, race/ethnicity appeared to play a less significant role in the relationship between ACE and behavioral outcomes or physical health outcomes. There was stronger evidence that race/ethnicity may moderate relationships between ACE exposure and mental health outcomes. Across health behavior, physical health, and mental health domains, the evidence suggests that the relationship between ACE exposure and health outcomes is not uniform across different racial and ethnic groups. These findings highlight the need for future research to uncover how cultural, societal, and developmental factors interact to shape health in the context following exposure to childhood adversity.

MORe PREcISE: Longitudinal patient reported outcome measures in stroke at 3 and 6 months.

Background and PurposePost-stroke morbidity is common, but little is known about the burden on patients’ lives from their own perspective. Understanding morbidity from the point of view of the patient may support targeted intervention in post-stroke recovery. This study used a stroke specific Patient Reported Outcome Measure (PROM) containing Mental health (MH) and Physical Health (PH) domains and 5 stroke specific questions. We aimed to consider trends over a 6-month period and further assess the association between the MH and PH measures and common clinical measures. MethodsA multicenter prospective cohort study was conducted at 19 hospital sites across England and Wales. Patients were enrolled from August 2018 to September 2019. Clinical measures and PROMs were assessed at three timepoints: acutely following the index stroke, at 3 and 6-months post-stroke. Clinical measures and PROMs were assessed in each of these points. ResultsPhysical health PROM domains show significant gradual improvement across the study period (χ2 42.6312, p<0.0001), whereas cognitive function domains (χ2 3.7849, p<0.875) did not echo this trend. All clinical measures (GAD-7, PHQ9, MoCA, MRS) were associated with poorer PROM MH outcomes, (aMD -4.4, CI -0.59, -0.29, p≤0.001, aMD -0.45, CI -0.59, -0.32, p=<0.001, aMD 0.75, CI 0.56, 0.95, aMD -1.91, CI -2.41, -1.47, p≤0.001). Clinical measures of disability, as per the MRS, are associated with poor PROM PH scores (aMD -0.57, 95% CI -0.94, -0.20, p=0.003). ConclusionsThis research indicates there is unmet cognitive burden in stroke survivors. PROMs may be able to measure unmet more discretely than common clinical tools that are used post-stroke. Further research and guidance on how to integrate PROMs into current clinical frameworks is essential.

Long-term outcomes of mechanochemical ablation using the Clarivein device for the treatment of great saphenous vein incompetence

ObjectiveThe short-term anatomical success rates of mechanochemical ablation using the Clarivein device (Merit Medical) in the treatment of great saphenous vein (GSV) incompetence are high. However, the anatomical success rates seem to drop over time. The aim of this study was to determine the long-term outcomes of GSV treatment using the Clarivein and to assess whether specific anatomical features better correlate with clinical or quality of life (QoL)-related outcomes. MethodsThis is a single-center, prospective cohort study in follow-up of a multicenter, randomized controlled trial using Clarivein with liquid polidocanol for the treatment of GSV incompetence. The primary outcome was anatomical success (AS), defined as complete occlusion or a recanalized segment, irrespective of reflux, of <10 cm in length. In addition, reflux-free anatomical success (RF-AS) was determined, and defined as complete occlusion or a recanalized segment with <10 cm of reflux. Clinical success was assessed using the Venous Clinical Severity Score (VCSS), and QoL was assessed using the Dutch version of the Aberdeen Varicose Vein Questionnaire (DAVVQ) and the 36-Item Short Form Health Survey (SF-36). Subgroup analyses were performed based on whether AS or RF-AS was achieved or not. ResultsA total of 109 patients (115 limbs) were included. The mean follow-up time was 8.4 ± 0.9 years (range, 5.5-10.3 years). AS was seen in 60.5% of limbs, and RF-AS was seen in 72.8% of limbs. Compared with baseline, the overall mean VCSS improved from 5.3 ± 2.4 to 4.1 ± 2.4, and the overall median DAVVQ score from 13.5 (interquartile range [IQR], 8.7-20.0) to 10.5 (IQR, 5.3-16.2) (P < .001). Improvement in VCSS was only significant in patients with successful treatment: from 5.5 ± 2.7 to 3.7 ± 2.5 (P < .001) if AS was achieved and from 5.0 ± 1.7 to 4.5 ± 1.9 (P = .20) if AS was not achieved. The same results were found for DAVVQ scores: improvement from13.5 (IQR, 8.7-20.6) to 10.3 (IQR, 3.0-14.5) (P < .01) if AS was achieved and from 12.9 (IQR, 8.3-19.3) to 10.8 (IQR, 6.7-18.2) (P = .35) if AS was not achieved. Regarding the overall SF-36 scores, the domains of vitality, mental health, and general health worsened significantly. ConclusionsIn over 8 years of follow-up, the anatomical success rate after the treatment of GSV incompetence using the Clarivein device decreased to 60.5%. However, clinical scores and disease-specific QoL still improved significantly compared with baseline. We found no convincing evidence that the absence of reflux correlates better with clinical and QoL-related outcomes compared with recanalization irrespective of reflux.

Escala de Invalidación Emocional Percibida (PIES): Análisis psicométrico de la primera versión en español en adultos peruanos

Perceived emotion invalidation is a construct that is currently relevant due to its implications on mental health domains. The aim of this study was to linguistically adapt and to analyze the psychometric properties of the first Spanish-version of the Perceived Invalidation of Emotion Scale (PIES). This test was translated and reviewed by 10 experts to guarantee evidence of content validity. Confirmatory factor analysis verified the original two-dimensional proposal of the model. The study involved 411 adults (77.6% women, 22.4% men) with a mean age of 25.52 years (SD=6.64). Evidence of convergent and concurrent validity were found by associating scores with theoretically related constructs. In addition, the scores for both dimensions showed adequate levels of internal consistency. It is concluded that PIES complies with current psychometric standards and can be used in Peruvian samples similar to the one in this study.

Brazilian version of the “Primary Sjögren’s Syndrome - Quality of Life questionnaire (PSS-QoL)”: translation, cross-cultural adaptation and validation

BackgroundThe Primary Sjögren’s Syndrome Quality of Life questionnaire (PSS-QoL) is the first specific instrument to assess health-related quality of life (HRQoL) in Sjögren’s disease (SjD). The aim is to translate and cross-culturally adapt the PSS-QoL into Brazilian Portuguese and to evaluate its psychometric properties.MethodsThe original English version was translated into Brazilian Portuguese by two native Brazilians who were proficient in the English language. The retranslation was conducted by two native Americans proficient in Brazilian Portuguese. A committee undertook an analysis of the translated and retranslated versions, resulting in the generation of the first Brazilian version, which was submitted to the cross-cultural adaptation phase. In this phase, 50 participants with SjD responded to the instrument in Stages I and II, resulting in the generation of the second and final Brazilian version. To assess the psychometric properties, demographic and clinical data were collected from 75 patients. The HRQoL questionnaires (final Brazilian version of the PSS-QoL, Short Form-36 Health Survey (SF-36) and EuroQoL-5 dimension (EQ-5D)) were completed. Construct validity was analyzed using the Pearson or Spearman correlation coefficient. Reliability was analyzed using Cronbach’s alpha and the intraclass correlation coefficient (ICC).ResultsEight questions and one response item were revised due to an incomprehension rate of greater than 15% among the participants in the cross-cultural adaptation phase. The final Brazilian version of the PSS-QoL was validated, revealing a high correlation between the total score and functional capacity (r= −0.713, p < 0.001), and vitality (r= −0.770, p < 0. 001) and mental health (r= −0.742, p < 0.001) domains of the SF-36 and a moderate correlation with the other domains of the SF-36 and a moderate correlation with the EQ-5D-tto (r= −0.573, p < 0.001), and EQ-5D-VAS (r= −0.559, p < 0.001). The intraobserver (ICC = 0.939; Cronbach’s alpha = 0.964) and interobserver (ICC = 0.965; Cronbach’s alpha = 0.964) reliability of the total score showed very high consistency.ConclusionThe Brazilian version of the PSS-QoL has been demonstrated to be a valid and reproducible instrument for the assessment of HRQoL in patients with SjD.

Media Studies of Regulatory Value of Healthy Lifestyle in English Media: A Corpus-Based Approach

This study presents the findings of a corpus analysis regarding the media studies of the concept of a healthy lifestyle as a paramount regulatory value in contemporary society. The empirical foundation of the research is based on the British segment of the News on Web (NOW) corpus. Semantic categorization and quantification of collocations reveal that in the media narratives of British outlets, the value of a healthy lifestyle is increasingly framed within psychological and mental dimensions, reflecting shifting societal perceptions of its content. An interpretative analysis of contexts capturing behavioral types indicates that excesses in healthy lifestyle practices are met with disapproval. Concerns and anxieties are linked to mental health domains and psychologically healthy relationships. A critical stance is observed towards the most manipulable area of healthy eating. It has been established that media narratives politicize healthy lifestyle practices, associating the challenges of their implementation with economic issues as well as the phenomenon of psychological fatigue. Thematic modeling of discursive practices demonstrates the predominance of mental health topics in quality press, alongside rational discursive strategies grounded in scientific research findings. In popular media, emphasis is placed on appearance as a result of a healthy lifestyle, with extensive use of emotional appeal strategies referencing well-known personalities as role models.

The psychosocial outcomes of young carers in Australia: a scoping review

ABSTRACT Young carers in Australia are people aged under 25 who undertake a substantial familial caring role. A range of associated disadvantages with this practice have been identified, however, no systematic literature review currently exists to consolidate the Australian research. Articles were included if they used a broadly quantitative methodology, were in English, and published since 2002 using original, contemporary Australian data and specifically discussed the caring role. The following databases were searched: Psychology and Behavioral Sciences Collection, APA PsychInfo, APA PsycArticles, MEDLINE Complete, Academic Search Complete, CINAHL with Full Text, Child Development & Adolescent Studies, APA PsycTherapy. Fourteen articles were included, and synthesised using a narrative style, capturing detailed information on approximately 8000 young carers, and briefer census-style data on 128,000 young carers. Quality ratings and risk of bias analyses were included. It was found that young carers exhibit a range of disadvantages across academic, social, and mental health domains, particularly when the care recipient is a parent, and even more so if the care needs are related to mental health or substance use. Additional research is required to further explore the relationships between the young caring role and outcomes.

The Moderating Role of Psychological Needs on the Relationship between Eudaimonia and Mental Health

Cultivating an eudaimonic lifestyle benefits mental health. However, it is not known under which circumstances the benefits of eudaimonia are the most pronounced. This cross-sectional study aimed to examine psychological needs (autonomy, competence, and relatedness) as the moderators of the effects eudaimonia has on mental health (general mental health, positive and negative mental health). In total, 328 young adults took part in this study, of which 36.6% were males, whose ages ranged between 18 and 30, with a median of 19 years (SD = 1.32). Questionnaires were used to measure eudaimonia (The Eudaimonia Scale from The Hedonic and Eudaimonic Motives for Activities), psychological needs (The Basic Psychological Needs Scale), and mental health (The Mental Health Inventory). To analyze the data, hierarchical regression analyses and analyses of variance have been performed. The results revealed that of all psychological needs, only the need for relatedness moderated the relationship between eudaimonia and general mental health and eudaimonia and negative mental health. Individuals with high eudaimonia and a highly satisfied need for relatedness had good general mental health and fewer mental health disturbances. The findings suggest that if one practices meaningful behaviors, the positive change in the mental health domain is greatest when those actions benefit not only this individual but others as well.

Debate and Dilemmas Regarding Generative AI in Mental Health Care: Scoping Review.

Mental disorders have ranked among the top 10 prevalent causes of burden on a global scale. Generative artificial intelligence (GAI) has emerged as a promising and innovative technological advancement that has significant potential in the field of mental health care. Nevertheless, there is a scarcity of research dedicated to examining and understanding the application landscape of GAI within this domain. This review aims to inform the current state of GAI knowledge and identify its key uses in the mental health domain by consolidating relevant literature. Records were searched within 8 reputable sources including Web of Science, PubMed, IEEE Xplore, medRxiv, bioRxiv, Google Scholar, CNKI and Wanfang databases between 2013 and 2023. Our focus was on original, empirical research with either English or Chinese publications that use GAI technologies to benefit mental health. For an exhaustive search, we also checked the studies cited by relevant literature. Two reviewers were responsible for the data selection process, and all the extracted data were synthesized and summarized for brief and in-depth analyses depending on the GAI approaches used (traditional retrieval and rule-based techniques vs advanced GAI techniques). In this review of 144 articles, 44 (30.6%) met the inclusion criteria for detailed analysis. Six key uses of advanced GAI emerged: mental disorder detection, counseling support, therapeutic application, clinical training, clinical decision-making support, and goal-driven optimization. Advanced GAI systems have been mainly focused on therapeutic applications (n=19, 43%) and counseling support (n=13, 30%), with clinical training being the least common. Most studies (n=28, 64%) focused broadly on mental health, while specific conditions such as anxiety (n=1, 2%), bipolar disorder (n=2, 5%), eating disorders (n=1, 2%), posttraumatic stress disorder (n=2, 5%), and schizophrenia (n=1, 2%) received limited attention. Despite prevalent use, the efficacy of ChatGPT in the detection of mental disorders remains insufficient. In addition, 100 articles on traditional GAI approaches were found, indicating diverse areas where advanced GAI could enhance mental health care. This study provides a comprehensive overview of the use of GAI in mental health care, which serves as a valuable guide for future research, practical applications, and policy development in this domain. While GAI demonstrates promise in augmenting mental health care services, its inherent limitations emphasize its role as a supplementary tool rather than a replacement for trained mental health providers. A conscientious and ethical integration of GAI techniques is necessary, ensuring a balanced approach that maximizes benefits while mitigating potential challenges in mental health care practices.

Psychometric analysis and the implications for the use of the scoliosis research society questionnaire (SRS-22r English) for individuals with adolescent idiopathic scoliosis

Despite widespread usage of the SRS-22r questionnaire (Scoliosis Research Society Questionnaire-22r), the English version has only sparingly been subjected to analysis using modern psychometric techniques for patients with adolescent idiopathic scoliosis (AIS). The study purpose was to improve interpretation and clinical utility of the SRS-22r for adolescents with AIS by generating additional robust evidence, using modern statistical techniques. Questions about (1) Structure and (2) Item and Scale Functioning are addressed and interpreted for clinicians and researchers. This retrospective case review analyzed SRS-22r data collected from 1823 patients (mean age 14.9±2.2years) with a primary diagnosis of AIS who clinically completed an SRS-22r questionnaire.Individual SRS-22r questions and domain scores were retrieved through data queries. Patient information collected through chart review included diagnosis, age at assessment, sex, race and radiographic parameters. From 6044 SRS-22r assessments, 1 assessment per patient was randomly selected. Exploratory structural equation modeling (ESEM) and item response theory (IRT) techniques were used for data modeling, item calibration, and reliability assessment. ESEM demonstrated acceptable fit to the data: χ2 (130)=343.73, p<.001; RMSEA=0.035; CFI=0.98; TLI=0.96; SRMR=0.02. Several items failed to adequately load onto their assigned factor. Item fit was adequate for all items except SRSq10 (Self-Image), SRSq16 (Mental Health), and SRSq20 (Mental Health). IRT models found item discriminations are within normal levels for items in psychological measures, except items SRSq1 (pain), SRSq2 (pain), and SRSq16 (mental health). Estimated reliability of the Function domain (ρ=0.69) was low, however, Pain, Self-Image and Mental Health domains exhibited high (ρ>0.80) reliability. Modern psychometric assessment of the SRS-22r, in adolescent patients with AIS, are presented and interpreted to assist clinicians and researchers in understanding its strengths and limitations. Overall, the SRS-22r demonstrated good psychometric properties in all domains except function. Cautious interpretation of the total score is suggested, as it does not reflect a single HRQoL construct.