Mental Health Functioning Research Articles

Emotion dysregulation can help predict severity of other disorders

Emotion dysregulation is a useful trait which runs across disorders, researchers have found. A study of two large samples of toddlers (1,544 children ages 1.5 to 5 years old) and school‐aged children (7,259 6–18‐year‐olds) found that equal levels of total emotion dysregulation were found across different disorders. The presence of emotion dysregulation predicted lower quality of life and a longer treatment duration, in addition to clinical diagnosis. The diagnoses of the children were internalizing, externalizing, and neurodevelopmental. In particular, the children had attention‐deficit hyperactivity disorder, autism spectrum disorder, oppositional defiant disorder/conduct disorder, and anxiety and mood disorders. Emotion dysregulation was measured by the CBCL‐Emotion Dysregulation Index, quality of life by the Kidscreen‐27, and treatment duration by electronic health records. The researchers concluded that emotion dysregulation is a clinically useful trait which can predict severity of impairment and treatment duration. Importantly, it is composed of shared features across disorders. Children and adolescents can easily be overwhelmed by emotions, but in children with mental disorders this is even more pronounced. Most definitions of emotion dysregulation include symptoms of heightened reactivity and quickness to anger, anxiety, or depression. Being able to regulate emotions means better mental and physical health, social relationships, academic performance, and work functioning. Emotion dysregulation itself, regardless of disorder, should, perhaps, be treated. More youth have emotion dysregulation than any other mental disorder. The study was conducted in the Netherlands. [Bierens, M., Hartman, C. A., Klip, H., et al. (2023, July 20). Emotion dysregulation as cross‐disorder trait in child psychiatry predicting quality of life and required treatment duration. Front Psychiatry, 14, 1101226. http://doi.org/10.3389/fpsyt.2023.1101226.]

Extracurricular Activities, Child and Caregiver Mental Health, and Parental Aggravation-A National Cross-Sectional Study.

Expanding access to extracurricular activities (EA) may help address the growing mental health needs of children and caregivers. Evidence supports that EA may benefit child mental health, but few studies explore whether this association is influenced by child and EA factors. Further, the impact of EA on caregivers remains unknown. We conducted a secondary analysis of the 2019 National Survey of Children's Health (NSCH), a nationally representative sample of children and their caregivers. We used responses from caregivers of children aged 6 to 17. Weighted logistic regressions tested associations between EA and 1) child anxiety and/or depression diagnosis, 2) caregiver mental health, and 3) parental aggravation, controlling for child, family, and neighborhood-level covariates. Interaction terms tested whether associations were moderated by child age, sex, and presence of physical, developmental, or behavioral condition. Subanalyses explored whether results varied by EA number and type. Weighted sample included 21,259 children. There were disparities in which children were engaged in EA. EA participation was associated with lower odds of a 1) child being diagnosed with anxiety and/or depression; 2) caregiver reporting "fair/poor" mental health, and 3) caregiver reporting "usually/always" experiencing parental aggravation. Child age, sex, EA number and type, but not health condition, influenced the relationship between EA and child anxiety and/or depression diagnosis. Access to EA is associated with child mental health and family functioning. Further studies should assess causality and specific mechanisms of action.

Internet Addiction and Depression among Syrian College Students: A Cross-Sectional Study

Background: Problematic internet use (PIU) or internet addiction has become increasingly prevalent, and concerns about its impact on mental health and social functioning have grown. This study aimed to investigate the prevalence of PIU among Syrian university students and its relationship with their demographics, internet user behavior, and mental health. Methods: A cross-sectional study was conducted among undergraduate medical students in Syrian government universities between 12 April and 29 May 2022. The survey included the Beck Depression Inventory and the Internet Addiction Scale. Results: Out of 2891 participants, 75.2% were female, with an average age of 21.87. The average Internet Addiction Test (IAT) score was 49.4, and the overall prevalence of PIU was 89%. Furthermore, 93.0% of participants displayed possible signs and symptoms of depression. PIU was significantly linked with physical abuse (p = 0.001) and mental stress (p = 0.0001). Internet addiction is (AOR:1.723, COR:2.289) fold more likely to occur in those with more than 8 h of sleep per night than in those who sleep for less than 6 h (p-value < 0.05). Unadjusted regression analysis showed that 13 predictors of the independent variables were statistically significant in predicting the presence of internet addiction, such as participants who suffered from a breakup (COR:2.039), domestic violence (COR:2.136), physical abuse (COR:2.190), or mental stress (COR:2.621) were more likely to be affected by internet addiction than those who did not (p-value < 0.05). Conclusions: The study found a high rate of internet addiction among Syrian medical students, with those experiencing mental health problems and depression symptoms more likely to be internet addicts. To prevent PIU, students should be encouraged to participate in extracurricular activities, such as sports, and awareness programs should be enhanced to highlight the negative effects of internet addiction.

Mental Health, Alcohol Use, and Associations with Pre-deployment Family Functioning in Active-duty Service Members

As service members prepare to deploy, poor mental health and increased alcohol use associated with the difficulties of the pre-deployment period may negatively impact service members’ family functioning. The etiology of poor family functioning may also differ for men and women serving in the military. The current study recruited U.S. military service members (N = 343, 28% women, 59% White) preparing to deploy to Iraq or Afghanistan to examine the effects of symptoms of depression, anxiety, stress, post-traumatic stress (PTS), and alcohol use (frequency and quantity) on family functioning. We also sought to identify whether those effects differed between genders. Across participants, PTS was the only factor significantly associated with worse family functioning (β = .01, SE = .00, t(251.99) = 2.03, p = .043), however the effect of depression was similar in magnitude and trending toward significance (β = .01, SE = .00, t(297.49) = 1.96, p = .051). Interactions between gender, mental health, and alcohol use were non-significant. Findings suggest that addressing service members’ PTS and depression symptoms pre-deployment could improve family functioning. Gender may not be a major factor for pre-deployment mental health and family functioning, although more research is warranted. Contrary to expectations, alcohol use was unrelated to family functioning. Future studies should consider using measures of drinking that capture alcohol-related problems in addition to consumption. As service members prepare to deploy, it is important to understand which factors are most impactful on family functioning as this may help target preventative interventions during the pre-deployment stage.

Glycated Haemoglobin (HbA1c) and Future Physical and Mental Functional Health in the European Prospective Investigation into Cancer (EPIC)-Norfolk Population-Based Study.

Little is understood about the relationship between glycated haemoglobin and future functional health in the general population. In this work, we aimed to assess if glycaemic control is associated with future physical and mental functional health at 18-month follow-up in a UK general population, in those with and without diabetes. This work was a cross-sectional study. Between 1995 and 1997, participants of the European Prospective Investigation into Cancer, Norfolk, attended a health check including blood testing for haemoglobin A1c (HbA1c) and completed a health and lifestyle questionnaire. Eighteen months later, self-reported physical and mental functional health were assessed using short form-36 (SF-36). Outcomes of interest included physical and mental component summary (PCS and MCS, respectively) scores of the SF-36. A total of 7343 participants (56% women, mean (SD) 58.1 ± 9.5 years) were eligible to be included, of whom 167 had prevalent diabetes. In our linear regression analysis, a higher HbA1c (mmol/mol) was found to be associated with a poorer PCS score (coefficient -0.15 (p < 0.0001)) at follow-up. After adjustment for comorbid conditions, including obesity, this association was no longer statistically significant. A higher HbA1c (mmol/mol) was associated with a better MCS score at follow-up; this finding was significant when adjusted for comorbid conditions (coefficient 0.029 (p < 0.05)). Our findings suggest that the association between a higher HbA1c and poorer physical functional health is explained by a higher BMI and comorbidity status in a general population. While higher HbA1c was found to be associated with higher mental functional health at follow-up, the magnitude of this association was small. Healthy responder bias and unmeasured confounding variables may have influenced this result; thus, it should be interpreted with caution.

Shifting Mindsets: The Impact of a Patient Portal on Functioning and Recovery in a Mental Health Setting.

This study aims to understand whether higher use of a patient portal can have an impact on mental health functioning and recovery. A mixed methods approach was used for this study. In 2019-2021, patients with mental health diagnoses at outpatient clinics in an academic centre were invited to complete World Health Organization Disability Assessment Scale 12 (WHODAS-12) and Mental Health Recovery Measure surveys at baseline, 3 months, and 6 months after signing up for the portal. At the 3-month time point, patients were invited to a semistructured interview with a member of the team to contextualize the findings obtained from the surveys. Analytics data was also collected from the platform to understand usage patterns on the portal. Overall, 113 participants were included in the analysis. There was no significant change in mental health functioning and recovery scores over the 6-month period. However, suboptimal usage was observed as 46% of participants did not complete any tasks within the portal. Thirty-five participants had low use of the portal (1-9 interactions) and 18 participants had high usage (10+ interactions). There were also no differences in mental health functioning and recovery scores between low and high users of the portal. Qualitative interviews highlighted many opportunities where the portal can support overall functioning and mental health recovery. Collectively, this study suggests that higher use of a portal had no impact, either positive or negative, on mental health outcomes. While it may offer convenience and improved patient satisfaction, adequate support is needed to fully enable these opportunities for patient care. As the type of interaction with the portal was not specifically addressed, future work should focus on looking at ways to support patient engagement and portal usage throughout their care journey.

Characterising the Educational Experiences and Mental Health of Children with Pre-Existing Learning Difficulty or Specific Learning Disorder (SLD) during the COVID-19 Pandemic

This prospective study sought to characterise the educational experiences, mental health, and behavioural functioning of Australian children with a pre-existing learning difficulty or specific learning disorder (SLD) during the COVID-19 pandemic. The study also evaluated the potential role of parent psychological distress as a risk factor for poorer child functioning in this high-risk population. Using a prospective longitudinal design, the study involved 58 parents of children and adolescents with a pre-existing learning difficulty or specific learning disorder (M age = 11.9 years; range 7–17 years) who were initially referred to a state-wide diagnostic centre for specific learning disorders in Melbourne, Victoria, Australia. Child outcomes were assessed using the COVID-19 Wellbeing and Mental Health Survey (a modified version of the CoRonavIruS Health Impact Survey [CRISIS] tool), the Strengths and Difficulties Questionnaire (SDQ), and the Emotional Distress Scale from the Patient-Reported Outcomes Measurement Information System (PROMIS). Parents’ mental health was assessed using the CRISIS tool and the Kessler Psychological Distress Scale (K10). In keeping with initial predictions, a large proportion of parents expressed significant disruption to child educational experience and routines, including challenges related to child engagement in remote learning platforms during COVID-19. Compared to pre-pandemic mental health symptom ratings, children experienced significantly higher symptoms of worry, negative thoughts, loneliness, agitation, and aggression during the pandemic period (all p &lt; 0.05). As expected, higher levels of parent distress predicted greater child worry symptoms (p = 0.003) and more frequent child behavioural difficulties (p = 0.004). These results help elucidate the specific psychological and educational challenges faced by children with pre-existing learning difficulty or SLD during the COVID-19 pandemic. Family-centred intervention and/or supports may help to address the unique educational and psychological needs of young people with pre-existing learning differences and their families during future global pandemics.

Influence of Food Type on Human Psychological-Behavioral Responses and Crime Reduction.

The purpose of this narrative review is to emphasize the importance of food consumption and meal selection on mental health and brain function, including psychological and behavioral reactions such as mood, loving relationships, violence, and criminal activity. Additionally, by being aware of the link between food and mental health, the community can be encouraged to make informed food choices in order to avoid unfavorable outcomes like criminality. Food behaviors are shifting significantly over the world. There are also significant changes in mood, sadness, happiness, and violence, as well as the spread of the variety and severity of mental diseases that lead to violent acts. Food intake and meal selection have evolved over the last ten years as the variety and accessibility of food options have become easier and more diverse. These modifications might have both beneficial and bad consequences. This article examines the relationship between food intake and its impact on marital satisfaction. The goal of this review is to support or refute the claim that food influences mood, love, or criminal behavior, or vice versa. Various diets can have an impact on one's mental health and brain, influencing psychological reactions and behavioral responses such as mood, loving relationships, violence, and even criminal activity. Food insecurity has been demonstrated in various studies to have a negative impact on health and psychological well-being, leading to despair, loss of happiness, marital conflict, and violence. For example, herbal extracts and flavonoids have the potential to improve gut microbiota and treat mood disorders. Understanding how the gut-brain axis communicates might help guide interventions for mood and cognitive function. Since the root of most diseases and behaviors is significantly related to the type of food consumed, this research addresses this issue in order to reduce the cost of treatment and prevention of crime and delinquency at the community level by consciously choosing the food consumed by the society. In other words, prevention is always better than cure.

Health-related quality of life, remission and low lupus disease activity state in patients with systemic lupus erythematosus.

To measure the association between SLE remission and scores of patients-reported outcome (PRO) measures. We performed a prospective cohort study of SLE patients with a 2-year follow-up, using Lupus Patient-Reported Outcome (LupusPRO), Lupus Quality of Life (LupusQoL), Systemic Lupus Erythematosus Quality of Life (SLEQOL) and 36-item Short Form (SF-36) questionnaires. Remission was defined as remission off treatment (ROFT) and remission on treatment (RONT) according to the definitions of remission in SLE consensus. Mixed models accounting for repeated measures were used to compare groups as follow: ROFT and RONT vs no remission and lupus low disease activity state (LLDAS) vs no LLDAS. A total of 1478 medical visits and 2547 PRO questionnaires were collected during the follow-up from the 336 recruited patients. A between-group difference in PRO scores reaching at least 5 points on a 0-100 scale was obtained in the following domains: lupus symptoms (LLDAS: +5 points on the 0-100 scale, RONT: +9, ROFT: +5), lupus medication (LLDAS: +5, RONT: +8, ROFT: +9), pain vitality (LLDAS: +6, RONT: +9, ROFT: +6) of LupusPRO; role emotional (LLDAS: +5, RONT: +8), role physical (RONT: +7 and ROFT: +7), bodily pain (RONT: +6), mental health (RONT: +5) and social functioning (RONT: +6) of SF-36. In contrast, a between-group difference reaching at least 5 points was not achieved for any of the LupusQoL and SLEQOL domains. RONT, ROFT and LLDAS were associated with significant and clinically relevant higher QoL in most PRO domains of the LupusPRO (disease specific) and SF-36 (generic) questionnaires, but not with LupusQoL and SLEQOL disease-specific questionnaires.

Profiles of Risk, Allostatic Load, and Mental Health in Low-Income Children.

Most health disparities originate in childhood and extend across the lifespan. However, studies on health disparities have been predominately focused on adults. This study evaluated the biological and psychosocial consequences of exposure to chronic adversity among 491 low-income children 8 to 12 years old (52.1% male; M age = 9.73, SD = 1.0; 68.2% Black/African American; 21.2% Latinx; 267 maltreated and 224 nonmaltreated). Latent profile analyses revealed six distinct profiles of cumulative socioeconomic risk, allostatic load, and mental health functioning. Childhood maltreatment, emotion regulation, affect, and personality characteristics were differentially associated with these latent profiles. Consistent with resilience theory, findings indicate differential effects of chronic adversity on adaptation. These findings also offer evidence that signs of physiological dysregulation emerge at earlier ages in development and suggest there may be a window of opportunity in childhood for interventions to reduce the detrimental effects of chronic adversity on health outcomes in children.

Changes Over Time in Outcomes of School-Age Children and Parents Receiving Integrated Mental Health Care in Federally Qualified Health Centers.

The purpose of this study is to understand change in parent-reported outcomes of mental health symptoms, health-related quality of life (QoL), and school-related functioning among children receiving mental health care at 3 federally qualified health centers engaging in a comprehensive pediatric mental health integration model. Trained personnel enrolled English- or Spanish-speaking families of 6- to 12-year-old children who had recently started receiving integrated mental health care and surveyed their parent/caregiver at 3 time points: entry into the cohort, 6-month follow-up, and 12-month follow-up (unique N = 51). Primary outcomes included validated measures of child symptoms, child health-related QoL, and child school-related functioning. Secondary outcomes focused on parental functioning and included validated measures of parental stress and depressive and internalizing symptoms. A multilevel mixed-effects generalized linear model was used to estimate the change in parent-reported outcomes over time, with inverse probability weights used to address attrition. Additional analyses were conducted to determine the degree to which changes in symptoms over time were associated with improvements in school-related functioning. Over 12 months, children's mental health symptoms, health-related QoL, and school-related functional outcomes significantly improved. No changes in parental functioning were observed. In addition, improvements in mental health symptoms and health-related QoL were associated with improvements in school-related functional outcomes over time. Findings demonstrate that outcomes of children who received integrated mental health care improved over time, both in regard to mental health and school functioning.

Psychological Flexibility Training to Enhance Resilience in Military Personnel

The U.S. Department of Defense continues to have a significant interest in the development and evaluation of evidence-based programs for enhancing resilience in military personnel. However, few studies have documented evidence-based interventions to maintain or boost performance and enhance resilience among service members. A robust body of literature describes the positive association between psychological flexibility and resilience as well as outcomes including performance, mental health, and social functioning in both healthy and clinical populations. Acceptance and Commitment Therapy (ACT) is an evidence-based intervention that directly targets the enhancement of psychological flexibility. In the current paper, we first describe the association between psychological flexibility and resilience. Then we briefly note the limitations of existing military resilience training programs and outline the relevant evidence in support of an ACT-based resilience training program. Finally, we describe the six psychological flexibility processes that comprise ACT interventions along with the relevance of each process for resilience enhancement in military personnel. We conclude with information about an in-progress study of a novel ACT-based training program targeting resilience enhancement and readiness optimization in active duty service members.

An Executive Functioning Composite Does Not Moderate the Relationship Between Combat Exposure and Posttraumatic Stress Disorder Symptom Clusters.

Posttraumatic stress disorder (PTSD) is prevalent among U.S. combat Veterans, and associated with poor health and wellbeing. As combat experiences are likely to significantly modify self-, other-, and society-oriented cognitions and heighten risk for PTSD, examination of related cognitive processes may yield new treatment strategies. The cognitive model of PTSD suggests that persistent threat perceptions contribute to symptom worsening. Thus, cognitive processes of shifting perspectives or generating novel interpretations may be particularly relevant to lessen PTSD symptoms. This cross-sectional study examined executive functioning as a moderator to the relationship between combat exposure and PTSD symptom clusters among post-9/11 Veterans. Data from 168 Veterans were drawn from a larger study examining post-deployment mental health and cognitive function. An executive functioning composite derived from Wisconsin Card Sorting Test Perseveration Errors, WAIS-III Similarities, Trail Making Test B, and Stroop Color-Word Inhibition scores was computed. Path analysis was used to test the moderation model. After accounting for age, sex, and estimated premorbid functioning, results indicated that combat exposure was associated with all symptom clusters on the PTSD Checklist-Military. Executive functioning was not significantly associated with the PTSD symptom clusters and did not moderate the relationship between combat exposure and any of the PTSD symptom clusters. Combat exposure is an important dimension of risk related to PTSD in Veterans that warrants regular screening. Moderation by executive functioning was not observed despite theoretical support. Future work could test methodological and sampling reasons for this finding to determine if theoretical adjustment is necessary.

Research on the Transitional Care Model-based Health Management Protocol for Patients after Sleeve Gastrectomy

Background: Postoperative care after sleeve gastrectomy is critical to a successful outcome because of the increasing popularity of the procedure in the treatment of obesity and related conditions. Objectives: The purpose of this study was to evaluate the effectiveness of a health intervention plan for sleeve gastrectomy patients based on the Transitional Care Model (TCM). Methods: This study was conducted from January 2021 to January 2022 at Mudanjiang Hospital. The study included a total of 72 patients who underwent sleeve gastric volume reduction. Patients were randomly divided into an intervention group (36 cases) and a control group (36 cases). The intervention group received care based on a health intervention plan, while the control group received routine care. Various assessments were performed on the first day of hospitalization and three months after surgery, such as questionnaires on general information, physical activity, eating behavior, quality of life, and adherence to implementation. Results: After the intervention, the intervention group showed significant improvements in total duration of physical activity, moderate-intensity activity, restrained eating, emotional eating, physical pain, mental health, and social functioning (p&lt;0.05). However, there were no significant differences between groups in activity intensity, walking, external diet, physical functioning, physical role, general health, or vitality (p&gt;0.05). Adherence to the health management protocol was significantly higher in the intervention group (p&lt;0.05). Conclusion: The health intervention plan based on the transitional care model improves physical activity, eating behaviors, quality of life, and compliance in sleeve gastrectomy patients.

Improving older adults' autobiographical memory through video-conferencing intervention during COVID-19.

Autobiographical memory (AM) is valuable not only as an indicator of mental health and cognitive function, but also as a target of therapeutic intervention for older adults. In the context of the COVID-19 pandemic, the demand for online psychosocial interventions and assessment services has sharply increased. Thus, the present study examined the effectiveness of videoconferencing AM (vAM) intervention using the Ecological Momentary Assessment (EMA) method in addition to the traditional paper-and-pencil assessment among samples of community dwelling older adults. Twenty-seven older adults (aged 66-86years) participated in a vAM intervention composed of 4 weekly 90-min sessions. The primary outcome was AM specificity, with secondary outcomes as depressive symptom and cognitive function, measured before and after the intervention. In addition, daily emotions were measured through EMA over 4weeks of intervention. The EMA data were analyzed using a multilevel analysis. The results showed low dropout rates (7%) and high EMA response rates (85%). Autobiographical memory specificity increased (Cohen's d=0.678), and the level of depression declined significantly (Cohen's d=0.375) after the program. Additionally, measures assessing cognitive function, such as Seoul Verbal Learning Test and DSC (Digit Symbol Coding), showed significant improvements. The EMA results indicated a decrease in the intensity and proportion of negative emotions experienced during the program. This study is the first to utilize videoconferencing and EMA to deliver an AM intervention targeting older adults. The intervention was effective in improving mental health and cognitive function, including AM in older adults. Additionally, EMA was found to be a feasible tool for use in older adults.

Relationship focused mother-infant groups: Preliminary evaluation of improvements in maternal mental health, parenting confidence, and parental reflective functioning.

We report on two preliminary evaluations of a group intervention, targeting vulnerable infants and their mothers within the first 6-months postpartum. The Mother-Baby Nurture® program aims to strengthen the developing infant-mother attachment relationship by increasing maternal mentalizing. These studies were undertaken with pre-post evaluations with the mothers of infants under 10-months of age. The mother-infant dyads participated in ten 2-h group sessions. Study one (N=69 dyads) included self-reported maternal depression, anxiety, and parenting confidence. In study two (N=27 dyads), parenting stress and reflective functioning were measured by self-report, and reflective functioning coded on the 5 min speech sample (completed by N=22). Results from study one confirmed a decrease in depression (p<.001, d=.79) and anxiety (p<.001, d=.72) symptoms, and an increase in mothers' scores for parenting confidence (p<.001, d=-.98). Results from Study Two demonstrated a significant decrease in parenting stress (p<.001, d=.94) and significant improvement in measures of self-report reflective functioning (p=.007, .024; d=.56, .61). These findings are preliminary yet promising indications that this program could be effective in alleviating parenting stress, depression, and anxiety, and improving mother's reflective functioning and parenting confidence. Further research is needed, with a control group and long-term follow-up assessments.

Patient-Reported Outcomes After Ferric Carboxymaltose Treatment for Iron Deficiency Anemia: A Prospective Observational Study.

Iron deficiency anemia (IDA) is a common cause of fatigue and impaired quality of life. The present study aimed to evaluate the impact of intravenous iron supplementation with ferric carboxymaltose (FCM) on fatigue, physical function, and general health among patients with IDA attending routine clinical care. This was a prospective, single arm, observational study of adult patients prescribed with intravenous FCM for the treatment of IDA during routine clinical care. We used Patient-Reported Outcomes Measurement Information System (PROMIS) instruments to evaluate fatigue (PROMIS Short Form v1.0 13a [FACIT-Fatigue]), general health status (PROMIS Scale v1.2), and physical function (PROMIS Short Form v2.0 4a) before and at 3 and 6 months after FCM treatment. A total of 152 patients were enrolled. Mean age was 47.4 ± 16.0 years and 82.2% were female. Mean serum hemoglobin was 10.2 ± 1.4 g/dL at baseline. All patients were treated with at least one FCM dose at baseline, with 77.6% receiving a two-dose treatment course. The mean baseline FACIT-Fatigue score was 61.0 ± 9.0, improving significantly to 50.2 ± 9.5 at 3 months after FCM treatment. A minimum 5-point improvement, pre-defined as clinically meaningful, was seen in the FACIT-Fatigue, PROMIS Global Physical Health, Global Mental Health and PROMIS Physical Function scores for 72.7%, 52.8%, 41.7% and 39.8% of patients at 3 months (p < 0.0001 for each change from baseline), with statistically significant improvement continuing at 6 months. Mean serum hemoglobin was significantly increased at both 3 and 6 months (12.8 g/dL [N = 44] and 12.4 g/dL [N = 54], respectively). IDA patients attending routine clinical practice reported substantial levels of fatigue and impairments in physical function and global health prior to intravenous iron treatment. Patients experienced significant improvements in fatigue symptoms, physical function, and global health at 3 months after treatment with FCM, which were sustained at 6 months.

A mixed methods analysis of U.S. military veterans’ suicidal ideation experiences during the COVID-19 pandemic: Prevalence, correlates, and perceived impact

This mixed methods study sought to increase understanding of veterans’ experiences of suicidal ideation (SI) during the COVID-19 pandemic, including prevalence, correlates, and perceived impact. A national survey of veterans (n=567) was conducted from 12/2020 to 2/2021. Quantitative analyses (weighted to the veteran population) examined SI prevalence and correlates. Qualitative thematic analysis of veterans’ free text responses was used to examine veterans’ lived experiences regarding the perceived impact of the pandemic. Among veterans, 9.6% (95% CI: 6.8, 12.5) experienced past-year SI, and 5.0% (95% CI: 2.8, 7.3) experienced past-month SI, estimates of prevalence during the early phase of the pandemic. Additionally, 3.1% (95% CI: 1.4, 4.7) reported experiencing increased SI frequency, and 2.2% (95% CI: 0.7, 3.6) reported experiencing increased SI intensity, during the pandemic. SI (past-year, past-month, and increased frequency during the pandemic) was more prevalent among veterans who were younger, Black, had minor(s) at home, screened positive for posttraumatic stress disorder, screened positive for depression, obtained lifetime mental health treatment, and accessed past-year outpatient mental health care. In qualitative analyses, Veterans with increased SI frequency described multi-faceted negative impacts of the pandemic, including in regard to their mental health, employment, and family. Negative perceptions of the personal impact of the pandemic were strongly associated with SI (past-year, past-month, and increased frequency). Supporting veterans who have been negatively impacted by the pandemic, including with respect to mental health and family functioning, may be particularly important to addressing SI in the aftermath of the COVID-19 pandemic and for prevention in future pandemics.

Mental health and cognitive function among medical students after the COVID-19 pandemic in China.

Chinese people experienced a nationwide coronavirus disease 2019 (COVID-19) pandemic after the adjustment of epidemic response policies from December 2022 to January 2023. This study aims to explore the prevalence of mental and cognitive symptoms and their associated factors among medical students after the COVID-19 pandemic. A cross-sectional study was conducted between February 27th and March 8th, 2023. The symptoms of anxiety, depression, insomnia, post-traumatic stress disorder (PTSD), and cognitive function among medical students were examined using the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), the Athens Insomnia Scale (AIS), the Impact of Event Scale-6 (IES-6), and the Perceived Deficits Questionnaire-Depression-5 (PDQ-D-5). Data on demographic information was also collected. Statistical analyses were conducted to describe the prevalence and explore the associated factors of mental and cognitive symptoms. Among 947 participants, the proportion of students experiencing anxiety, depression, insomnia, and PTSD symptoms was 37.8, 39.3, 28.3, and 29.5%, respectively. The self-reported COVID-19 infection rate was 72.2%. Higher grades, childhood, and current rural residence were identified as potential risk factors for mental and cognitive symptoms. Gender, age, average monthly household income, and COVID-19 diagnosis were not associated with mental and cognitive symptoms among medical students. Our findings revealed a high prevalence of mental and cognitive symptoms among Chinese medical students after the COVID-19 pandemic. Special attention should be paid to the mental health of higher-grade students and those residing in rural areas.

"My brain freezes and I am blocked again": The subjective experience of post-migration living difficulties influenced by complex posttraumatic stress disorder of Afghan asylum seekers and refugees in Austria.

Potentially traumatic experiences and post-migration living difficulties (PMLDs) undoubtedly leave marks on mental health and psychosocial functioning. While PMLDs are recognised as a risk factor for posttraumatic stress disorder and complex posttraumatic stress disorder (described together here as C/PTSD), recent investigations have found that C/PTSD symptoms might also influence the experience of PMLDs. The subjective experience of and coping with PMLDs in the context of C/PTSD symptoms has not yet been explored. Semi-structured, interpreter-assisted interviews exploring the subjective experience of post-migration living difficulties were conducted with treatment-seeking Afghan refugees and asylum seekers (N = 24) and transcribed verbatim. Participants were screened using the International Trauma Questionnaire (ITQ) and allocated to a C/PTSD group or non-C/PTSD group. We analysed the qualitative interviews using content analysis and then compared the results of the two groups. Over half of the participants (58.3%) met the criteria for C/PTSD. While the two groups addressed numerous similar themes, the C/PTSD group more frequently mentioned themes associated with C/PTSD symptoms (e.g., intrusions, avoidance, sleep disturbances, affective dysregulation) that influenced their responses to PMLDs. The non-C/PTSD group more often experienced positive emotions such as gratitude and optimism, and showed more active, solution-oriented behaviour as well as positive self-verbalisation. To achieve a deeper understanding of PMLDs, post-traumatic psychopathology should be taken into account, as C/PTSD symptoms influence the experience of and coping with PMLDs. The specifics of individual experiences need to be considered in order to promote adaptive coping with PMLDs and to set individual trauma-focused and transdiagnostic treatment targets. In addition, psychological interventions should incorporate psychoeducation to improve the understanding of the impact of C/PTSD on the current experience of PMLDs.