Mental Health Of Adults Research Articles

Prevalence and associations of poor mental health in the third year of COVID-19: U.S. population-based analysis from 2020 to 2022

BackgroundPoorer mental health was found early in the COVID-19 pandemic, yet mental health in the third year of COVID-19 has not been assessed on a general adult population level in the United States. MethodsWe used a nationally representative cross-sectional survey (Health Information National Trends Survey, HINTS 5 2020 n = 3,865 and HINTS 6 2022 n = 6,252). The prevalence of poor mental health was examined using a Patient Health Questionnaire-4 scale in 2020 and 2022. We also investigated the factors associated with poor mental health in 2022 using a weighted multivariable logistic regression adjusting for sociodemographic and health status characteristics to obtain the odds ratio (OR). OutcomesThe prevalence of poor mental health in adults increased from 2020 to 2022 (31.5% vs 36.3 %, p = 0.0005). U.S. adults in 2022 were 1.28 times as likely to have poor mental health than early in the pandemic. Moreover, individuals with food insecurity, housing instability, and low income had greater odds of poor mental health (ORs=1.78–2.55). Adults who were females, non-Hispanic Whites, or age 18–64 years were more likely to have poor mental health (ORs=1.46–4.15). InterpretationMental health of U.S. adults worsened in the third year of COVID-19 compared to the beginning of the pandemic.

Prevalence of chronic pain or analgesic use in children and young people and its long-term impact on substance misuse, mental illness, and prescription opioid use: a retrospective longitudinal cohort study

Epidemiological studies suggest chronic and recurrent pain affects around a quarter of children, while 8% report intense and frequent pain. The long-term implications of chronic pain in childhood are uncertain. Using electronic health records (EHRs) we used both disease codes and medicines prescription records to investigate the scale of chronic pain and long-term analgesic use in children and young people (CYP), and if chronic pain and/or use of analgesic medicines at an early age is associated with substance misuse, use of prescription opioids, and poor mental health in adulthood. We conducted a cohort study using data from IQVIA Medical Research Data UK. We identified individuals aged 2-24 with exposure to either a diagnostic code indicating chronic pain (diagnosis-exposed), repeat prescription for medicines commonly used to treat pain (prescription-exposed), or both. Follow-up began at 25, and the unexposed population acted as comparators. We calculated hazard ratios (HR) for mental health and substance misuse outcomes, and rate ratios (RR) for opioid prescriptions in adulthood. Additionally, we investigated which diagnoses, if any, were over-represented in the prescription-exposed subgroup. The cohort constituted 853,625 individuals; 146,431 had one or more of the exposures of interest (diagnosis-exposed=115,101, prescription-exposed=20,298, both-exposed=11,032), leaving 707,194 as comparators. Median age at index exposure was 18.7 years (IQR 14.7-22.3). On average during follow-up, the pooled exposed group had, respectively, a 31% and 17% higher risk of adverse mental health and substance misuse outcomes (adjusted HR [95% CI] of 1.31 [1.29-1.32] and 1.17 [1.11-1.24]). Exposed individuals also received prescription opioids at double the rate of unexposed individuals on average during follow-up (adjusted RR 2.01 [95% CI 1.95-2.10]). Outcomes varied between exposure subgroups, with prescription- and both-exposure tending to have worse outcomes. Unlike these two subgroups, in the diagnosis-exposed subgroup we did not detect a greater risk of substance misuse. Chronic pain in CYP is associated with increased prescription opioid use and adverse mental health outcomes in adulthood, as is repeat prescription for analgesic medicines, but only the latter is also associated with substance misuse in adulthood. It is essential to avoid the harms of under-treating pain in CYP while giving due consideration to the risks posed by analgesic medicines. Early recognition of chronic pain in CYP and utilising non-pharmacological management options may help minimise overprescribing, and long-term reliance on dependence-forming-drugs. AL is an NIHR funded academic clinical fellow, and was supported by funding from UCLH Charities while carrying out this work. RS and DS are part of the Advanced Pain Discovery Platform and were supported by a UKRI and Versus Arthritis grant (MR/W002566/1) as part of the Consortium Against Pain Inequality. AW was supported by the Wellcome Trust (220558/Z/20/Z).

A systematic review of climate emotions and mental health in adults

There is increasing evidence of negative mental health implications associated with climate change. However, more knowledge is required to inform effective responses. This study systematically reviewed literature regarding the relationship between climate emotions and mental health in adults. The goal was to synthesise existing research and identify future research priorities. The review followed PRISMA guidelines and involved searching seven electronic databases. The inclusion criteria specified peer-reviewed studies published in English after 2000, focusing on climate emotions and mental health in participants over 18 years old. Two authors independently reviewed the studies and assessed their quality. Out of 8,495 identified papers, 36 studies meet the criteria. Most studies included in the review were cross-sectional (n = 27) and used quantitative descriptive surveys (n = 27). A large majority of studies primarily involved participants from high-income countries (n = 32) and were published between January 2020 and January 2023 (n = 26). Results from the included papers suggest a relationship between climate emotions and negative mental health in most cases (30 out of 36). However, this finding must be interpreted cautiously since just over half of included studies were considered lower quality (19 of 36). Future research should aim to improve the conceptual clarity of climate emotions and explore potential causal and resilience factors. Additionally, investigations should consider vulnerable populations outside of high-income countries. Furthermore, increased collaboration between researchers and practitioners is necessary to improve conceptual coherence, and practice.

Project ECHO-AIDD: recommendations for care of adults with intellectual and developmental disabilities

PurposeThis study aims to describe patients presented in an interprofessional, virtual education program focused on the mental health of adults with intellectual and developmental disabilities (IDD), as well as present interprofessional recommendations for care.Design/methodology/approachIn this retrospective chart review, descriptive statistics were used to describe patients. Content analysis was used to analyze interprofessional recommendations. The authors used the H.E.L.P. (health, environment, lived experience and psychiatric disorder) framework to conceptualize and analyze the interprofessional recommendations.FindingsThemes related to the needs of adults with IDD are presented according to the H.E.L.P. framework. Taking a team-based approach to care, as well as ensuring care provider knowledge of health and social histories, may help better tailor care.Originality/valueThis project draws on knowledge presented in a national interprofessional and intersectoral educational initiative, the first in Canada to focus on this population.

Effects of dance therapy on cognitive and mental health in adults aged 55 years and older with mild cognitive impairment: a systematic review and meta-analysis

BackgroundIndividuals with mild cognitive impairment are at high risk of developing dementia. Dance therapy has promising applications in delaying cognitive decline. However, the effectiveness of dance therapy for older adults with mild cognitive impairment is unclear. The objective of this review was to evaluate the effectiveness of dance therapy on global cognitive function, specific cognitive subdomains, quality of life, and mental health in older adults with mild cognitive impairment to enrich health management strategies for dementia.MethodsElectronic databases and grey literature were searched from inception up to September 23, 2023. The language was limited to English and Chinese. Relevant studies were screened and assessed for risk of bias. A meta-analysis and subgroup analyses stratified by measurement instrument, dance type, intervention duration, and frequency were conducted using the STATA 16.0 software. This review was conducted in accordance with the PRISMA guidelines.ResultsTen studies involving 984 participants aged 55 years and over who met the eligibility criteria were included. Dance therapy significantly improved global cognitive function, memory, executive function, attention, language, and mental health (i.e., depression and neuropsychiatric symptoms). However, the effects of dance therapy on processing speed, visuospatial ability, and quality of life in older adults with mild cognitive impairment remain inconclusive. Moreover, dance interventions of longer duration (> 3 months) improved global cognition more than shorter interventions.ConclusionThis review reported that dance therapy was effective in improving global cognitive function, memory, executive function, attention, language, and mental health (i.e., depression and neuropsychiatric symptoms). Hence, it may be an effective non-pharmacological complementary treatment for older adults with mild cognitive impairment.

A cross-sectional analysis of the relationships between anxiety sensitivity and youth irritability: the mediated roles of insomnia and selective attention for threat

BackgroundIrritability is common in multiple psychiatric disorders and is hallmark of disruptive mood dysregulation disorder. Child irritability is associated with higher risk of suicide and adulthood mental health problems. However, the psychological mechanisms of irritability are understudied. This study examined the relationship between anxiety sensitivity and irritability among youth, and further explored three possible mediated factors: selective attention for threat, delayed reward discounting, and insomnia.MethodsParticipants were 1417 students (51.7% male; mean age 13.83 years, SD = 1.48) recruited from one high school in Hunan province, China. Self-report questionnaires were used to measure irritability (The Affective Reactivity Index and The Brief Irritability Test), anxiety sensitivity (The Childhood Anxiety Sensitivity Index), selective attention for threat (The Davos Assessment of Cognitive Biases Scale-attention for threat bias subscale), insomnia (The Youth Self-Rating Insomnia Scale), and delayed reward discounting (The 27-item Monetary Choice Questionnaire). Structural equation modal (SEM) was performed to examine mediated relations.ResultsAnxiety sensitivity was modestly related to irritability and insomnia (r from 0.25 to 0.54) and slightly correlated with selective attention for threat (r from 0.12 to 0.28). However, there is no significant relationship of delayed rewards discounting with anxiety sensitivity and irritability. The results of SEM showed that selective attention for threat (indirect effect estimate = 0.04) and insomnia (indirect effect estimate = 0.20) partially mediate the relationship between anxiety sensitivity and irritability, which explained 34% variation.ConclusionsAnxiety sensitivity is an important susceptibility factor for irritability. Selective attention for threat and insomnia are two mediated mechanisms to understand the relationship between anxiety sensitivity and irritability.

The Top 100 Most Cited Papers in 2022 on Global Health indexed in Web of Science

Abstract Background Even if it is a controversial topic, citation counts are frequently used as an indicator of how popular and valuable published articles are. In this study, we aim to identify and analyze the characteristics of the most cited articles in the global health area. Methods We searched the Web of Science (WoS) database with the keywords: (TS=global health) AND (PY = 2022) AND (SU=public health). We filtered highly cited articles and selected the top 100 for our analysis. Scopus was used for extracting the journals’ CiteScore 2022 metrics. We conducted frequency analysis and Spearman's correlation test wit using SPSS 27. Results Most of the articles were about COVID-19 (37%) and environmental health (36%). One of four studies about COVID-19 was investigating COVID-19's effect on the mental health of adults or children. Affiliations of the first authors were mostly from (USA 21%) or China (20%) and they were followed by India (10%). Most of the papers were reviews (38%). The other frequent study types were prevalence studies (12%), estimation studies (11%) and systematic reviews (9%). The median of the WoS core citations was 48.5 (min. 33, max 770) and overall it was 49 (min. 33, max. 792). The papers were mostly published in Lancet (7%), Science of the Total Environment (7%) and Environmental Research (6%). CiteScore median for the journals was 16.7 (min 3.8, max 131.8). There were no correlations between WoS core citations of the papers and CiteScore of the journals (Correlation Coefficient=0.075, p = 0.459) and overall citations (Correlation Coefficient=0.083, p = 0.409). Conclusions Most of the highly cited papers about global health in 2022 were published by the authors from USA and China, and the papers were mostly about COVID-19 and environmental health. The majority of the publications were reviews. This might refer to the lack of powerful original research on the topic. Key messages • Most of the highly cited papers about global health are reviews. • Our findings suggest there is no correlation between one paper’s citation number and the CiteScore of the journal that published it.

Violence and abuse exposure and health complications in older age

Abstract Background Due to the ageing population, the extent and impacts of violence in later life could become increasingly prominent. However, there is a lack of evidence on violence and its effects in older age, which impedes prevention measures. The present research draws on data collected from two nationally representative population health surveys - the Adult Psychiatric Morbidity Survey (APMS) 2014 and the English Longitudinal Study of Ageing (ELSA) to examine associations between violence and health outcomes in older adults in England. Methods APMS is a cross-sectional design and collected data on violence and abuse as well as mental health in adults aged 16+. Multivariable regression analyses were run to measure associations between violence and common mental disorder (CMD) in adults aged 60+ in comparison with the younger population group (16-59). ELSA is a panel data study, which has collected information on health, social, and economic lives of individuals aged 50 and over every two years since 2002. In wave 3, ELSA included questions on childhood abuse and life experiences of physical and sexual violence. Logistic multilevel regressions were used to examine associations between violence and subsequent limiting illness and depression. Results Violence conferred an independent risk for CMD (AOR 2.2, 95% CI:1.0-4.8) based on the APMS data. According to ELSA results, physical violence (AOR 2.50, 95%CI 1.69-3.68) and childhood abuse (AOR 2.47, 95%CI 1.51-4.04) were associated with the development of limiting illness, with sex differences between men and women observed. Conclusions Violence remains a problem that affects older people and presents risks to their health. Moreover, earlier life victimization could cause long-lasting health impacts that persist in later life. To mitigate the challenges associated with the ageing population, policies and interventions should focus on the prevention of violence and its long-lasting effects on health.

Cognitive reappraisal in mHealth interventions to foster mental health in adults: a systematic review and meta-analysis

BackgroundAn increasing number of mHealth interventions aim to contribute to mental healthcare of which interventions that foster cognitive reappraisal may be particularly effective.ObjectivesTo evaluate the efficacy of mHealth interventions enhancing cognitive reappraisal to improve mental health in adult populations.MethodsThe literature search (four databases) yielded 30 eligible randomized controlled trials (comprising 3,904 participants). We performed a multi-level meta-analysis to examine differences between intervention and comparator conditions at post-intervention assessment. Moderator analyses were conducted for potential moderator variables (e.g., type of comparators).ResultsMost interventions were CBT-based with other training components in addition to cognitive reappraisal. We found preliminary evidence for a small to medium effect favouring mHealth interventions to enhance cognitive reappraisal over comparators, M(SMD) = 0.34, p = .002. When analysing single symptoms, there was evidence for a small to medium effect of mHealth interventions on anxiety and depressive symptoms, but not for psychological distress and well-being. All analyses showed substantial heterogeneity. Moderator analyses revealed evidence for more favourable effects in studies with passive comparators. There was an overall high risk of bias in most of the studies.ConclusionsWe found preliminary evidence for a small to medium effect of mHealth interventions including a cognitive reappraisal component to improve mental health. However, most of the interventions were complex (i.e., reappraisal was provided alongside other components), which prevents us from examining reappraisal-specific effects beyond general mental health promotion in mHealth. Dismantling studies examining the effects of single intervention components are warranted to corroborate these promising results.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=142149, identifier [CRD42019142149].

Positive mental health in adults with bipolar disorder: exploring social support subtypes, negative social interactions and potential to flourish

BackgroundBipolar disorder (BD) (i.e., BD-I or BD-II) is a serious mental illness (SMI) that can cause significant life challenges, but its impact and management may be mediated by psychosocial factors. This study’s primary objectives were to investigate whether adults with BD differ from those without in terms of social support, negative social interactions (NSIs), and positive mental health (PMH). Secondly, examine whether gender differences exist in terms of these variables, as well as whether specific social support subscales and NSI predict PMH for those with BD.MethodsUsing data extracted from a national Canadian survey, 563 adults reporting a lifetime BD diagnosis were compared to a matched, non-BD sample using the Social Provisions Scale 10 Items (SPS-10), the NSI Scale, and the Mental Health Continuum – Short Form (MHC-SF) Scale. For the BD sample, males and females were compared based on study variables, and hierarchical regressions were subsequently performed to assess whether SPS-10 subscales and NSIs predicted PMH.ResultsRespondents with BD reported significantly lower SPS-10 and PMH scores, and significantly higher NSI scores. Within the BD sample, females reported significantly higher SPS-10 and NSIs scores, and ‘social integration’ and ‘reassurance of worth’ positively predicted PMH, while NSI uniquely predicted lower PMH levels for both males and females.ConclusionsThe results implicate specific psychosocial factors and gender in the degree to which adults with BD might flourish, particularly in terms negative relationships. The implications of social erosion and the bi-directionality of social support are also considered.

Relationship Between Physical Activity and Mental Health in Adults in Brazil

Purpose: The aim of the study was to investigate the relationship between physical activity and mental health in adults in Brazil.
 Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries.
 Findings: Research on the relationship between physical activity and mental health in adults consistently demonstrates a strong and positive association. Multiple studies have revealed that engaging in regular physical activity is linked to improved mental well-being. It has been found that individuals who participate in physical activity, such as aerobic exercises, walking, or sports, often experience reduced symptoms of anxiety, depression, and stress. Moreover, physical activity appears to enhance mood and self-esteem, contributing to better overall mental health. These findings underscore the significant role of exercise as a preventive and therapeutic measure for promoting mental well-being in adults.
 Unique Contribution to Theory, Practice and Policy: Self-Determination Theory (SDT), Social Cognitive Theory and Biopsychosocial Model may be used to anchor future studies on the relationship between physical activity and mental health in adults. Mental health practitioners should incorporate physical activity interventions into mental health treatment plans. policy level, governments and public health agencies should prioritize the development and implementation of evidence-based policies that promote physical activity as a means to improve mental health outcomes.

Individual mental health patterns and the role of lifestyle among ageing adults over 20 years - the Doetinchem Cohort Study

ObjectiveWe explored the prevalence of individual mental health patterns and the role of lifestyle factors over 20 years. Study designWe used data from the Doetinchem Cohort Study (1995–2019), a population-based study amongst adults (26–90 years) examined every five years in the Netherlands. Participants were classified in five pre-defined mental health patterns (persistent good, persistent poor, worsening, improving, varying) over 20 years (five rounds) using the MHI-5 questionnaire. BMI, sleep, smoking, alcohol consumption, and physical activity were dichotomised as healthy/unhealthy based on guidelines. The role of lifestyle at baseline (t1), 20 years later (t5), and longitudinally over 20 years (using pre-defined patterns) was explored using logistic regression. ResultsMost participants had good mental health at t1 (85 %) and t5 (88 %). Over 20 years, 67 % followed a persistent good mental health pattern, 30 % a changing pattern, and 3 % a persistent poor pattern. Persistent poor and changing patterns were associated with unhealthy sleep and smoking at t1, t5, and with the 20-year unhealthy patterns. Persistent poor mental health was associated with stable unhealthy and changing sleep (OR=5.58(2.48–12.54) and OR=2.07(1.14–3.74), respectively), and with stable unhealthy and changing smoking (OR=3.35(1.58–7.11) and OR=2.53(1.40–4.57), respectively). Changing mental health was associated with changing (OR=1.54(1.26–1.88) and OR=1.64(1.30–2.07), respectively) and stable unhealthy (OR=1.80(1.23–2.64) and OR=2.24(1.60–3.14), respectively) sleep and smoking, respectively. ConclusionsPersistent good and changing mental health patterns were more common than poor mental health in adults and were associated with smoking and sleep. Clarifying the underlying mechanisms and directionality between mental health and lifestyle could improve interventions.

Socioeconomic Factors, Movement Behavior Context, and Self-reported Physical and Mental Health in Adults Living in New York City

Objective: The purpose of this study was to examine the associations of socioeconomic factors, movement behavior context, and self-reported physical and mental health in adults living in New York City. Methods: Participants were adults from the Physical Activity and Transit Survey (N = 3811; 53.2% female). The dependent variables were items asking about the number of days the participant experienced poor physical and mental health. Independent variables were socioeconomic factors and items asking about the frequency of physical activity (PA) within certain contexts and rest/sleep behaviors. Weighted multivariable negative binomial regression models examined the associations. Results: More days of bicycling transit (IRR = 0.79, p = .001) and higher levels of household income (IRR range = 0.44-0.66, p < .025) were associated with lower rates of poor physical health. More days of poor rest/sleep (IRR = 1.05, p < .001) and labor PA (IRR = 1.10, p < .001) were associated with higher rates of poor mental health, and higher household income (IRR range = 0.58-0.65, p < .01) were associated with a lower rate of poor mental health. Conclusions: The strength and direction of associations with self-reported health varied according to PA context. Poor rest/sleep and low household income were strongly associated with both poor physical and mental health.

Future-oriented cognition: links to mental health problems and mental wellbeing in preschool-aged and primary-school-aged children.

Future-oriented cognition plays a manifold role for adults' mental health. The present study aimed to investigate the relationship between future-oriented cognition and mental health in N = 191 children aged between 3 and 7 years. Parents completed an online-questionnaire including children's future-oriented cognition (e.g., episodic foresight; Children Future Thinking Questionnaire; CFTQ), children's mental health problems (Strengths and Difficulties Questionnaire; SDQ), and wellbeing (Parent-rated Life Orientation Test of children; PLOT and Positive-Mental-Health Scale; PMH). More externalizing problems (especially hyperactivity) related to lower future-oriented cognition. For mental wellbeing, higher levels of optimism were associated with higher episodic foresight. Future-oriented cognition increased with age cross-sectionally. This increase was flatter at higher levels of wellbeing (indicated by lower pessimism). Results are discussed considering findings on the role of future-oriented cognition for mental health in adults and adolescents. Suggestions for future work are presented regarding the direction of the observed links and underlying mechanisms.

A prospective analysis of physical activity and mental health in children: the GECKO Drenthe cohort

BackgroundMental health problems in young people have become a global health burden. The positive effects of physical activity on mental health in adults are well known but still not clear in children. The aim of this study was to investigate to what extent physical activity in early childhood would affect mental health in middle childhood.MethodsFrom the Dutch GECKO Drenthe birth cohort, 850 children (51.5% boys) were enrolled in this analysis. Physical activity and sedentary time were measured at age 5–6 using ActiGraph GT3X. Mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ) at age 5–6 and age 10–11. Multiple linear regression models were used to estimate the associations between physical activity, sedentary time and SDQ subscales, stratified by gender, adjusting for age, BMI, maternal education level, family size, accelerometer wear time and season, and additionally adjusting for SDQ scores at age 5–6 to take tracking of mental health over time into account.ResultsGreater physical activity volume at age 5–6 was associated with lower peer problems scores at age 10–11 in boys and girls. An increase in MVPA was associated with lower peer problems scores in boys (b = -0.445, -0.713 to -0.176) and girls (b = -0.354, -0.601 to -0.107), however, increased sedentary time was linked to higher peer problems scores in boys (b = 1.18, 0.455 to 1.906) and girls (b = 0.870, 0.191 to 1.550). For hyperactivity, higher levels of physical activity volume and MVPA were associated with higher hyperactivity scores in boys. Increased sedentary time was related to lower hyperactivity scores in boys. Further adjustment for SDQ scores at age 5–6 attenuated associations between physical activity and hyperactivity in boys but hardly changed the relationships with peer problems. No significant associations between physical activity and other SDQ subscales or total difficulties scores were observed, neither in boys nor in girls.ConclusionsChildren who are more physically active at age 5–6 have fewer peer problems at age 10–11, and for boys, greater activity levels at age 5–6 could be an indicator of hyperactivity at age 10–11.

Evaluation of the Effects of Adherence to the Mediterranean Diet in Adults on the Mental Well-Being During the COVID-19 Pandemic: A Pilot Study

Aim: A healthy diet supports the body's energy and physiological needs with adequate nutrients. The Mediterranean diet (MD) exemplifies balanced nutrition and can have protective effects on health. This research aims to evaluate the impact of adhering to the MD on the mental health of adults during the COVID-19 pandemic.
 Material and Methods: Data were collected through an online questionnaire including socio-demographic characteristics, the Mediterranean Diet Adequacy Scale (MEDAS), and the Warwick Edinburgh Mental Well-Being Scale (SWEMWBS). The questionnaire was shared via social media or email using a link. The study included 129 individuals (52 men, 77 women) who responded approximately one week after the questionnaire was shared.
 Results: The mean age of individuals was 26.5±7.37. Most men (59.61%) had a normal weight, while most women (50.65%) were overweight or obese. The majority of individuals (58.14%) showed low adherence to the MD, with a mean MEDAS score of 7.0±1.92. The proportion of underweight or normal-weight individuals who consumed red meat (in men) and nuts (in women) was significantly higher compared to overweight or obese individuals. However, there was no statistically significant relationship between the MEDAS scores and mental well-being scores of individuals.
 Conclusion: Adequate and balanced nutrition is crucial for physical and psychological health, particularly during the pandemic. This study revealed low adherence to the MD among individuals. Further research with a larger sample size is needed to investigate the relationship between the MD and mental health during the pandemic period.

Adverse childhood experiences (ACEs) and mental health by gender identity in the United States, 2019–2021

ObjectiveTo estimate the prevalence of adverse childhood experiences (ACEs) and their association with mental health outcomes in adulthood by gender identity. MethodsData come from 2019 to 2021 US Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System, among 17 states collecting gender identity and ACEs. We estimated the prevalence of ACEs and used Poisson family regression to estimate the association between ACEs and mental health stratified by gender identity. Mental health was assessed as current frequent mental distress and lifetime depression diagnosis. ResultsThe sample included n = 141,615 adults, 556 of whom identified as gender minority (including transgender or gender non-binary). Gender minority respondents were 18% more likely [95% CI 8% to 29%, p < 0.01] to be exposed to 3 or more ACEs relative to cisgender respondents. Among respondents exposed to 3 or more ACEs, gender minority adults were 25% [95% CI 10% to 43%, p < 0.01] more likely to report current frequent mental distress and 26% [95% CI 14% to 40%, p < 0.01] more likely to report a lifetime depression diagnosis than their cisgender peers. ConclusionUsing population-level data, we identified higher prevalence of ACEs among gender minority adults than cisgender adults, and greater associations of ACEs and adverse mental health in adulthood. The prevalence of current and lifetime adverse mental health outcomes increased with higher levels of ACE exposure among cisgender and gender minority respondents. Action by stakeholders at the community, health system, and legislative levels are needed to improve gender minority population health.

Mental Health and Coronavirus Anxiety in Active and Inactive Elderly People During COVID-19 Pandemic

Background: The coronavirus pandemic and the controlling measures have had disparate impacts on older adults' physical, mental, and social health. Objectives: This study examined the psychological status, vitality, happiness, loneliness, and anxiety among active and inactive older men during the COVID-19 pandemic. Methods: In this causal-comparative study, 400 men aged 60 - 75 were selected by convenience sampling. Subjects were assessed for cognitive status, vitality, happiness, loneliness, and coronavirus anxiety. Data were analyzed statistically using covariance and Pearson correlation coefficient tests. Results: There was a significant difference between active and inactive older adults regarding cognitive status, happiness, and vitality, such that the active older adults scored higher (P &lt; 0.05). Also, there was a significant difference between the two groups regarding coronavirus anxiety and loneliness, such that the inactive group scored higher in these two variables (P &lt; 0.05). The correlation analysis indicated a significant correlation between cognitive status and coronavirus anxiety in both active and inactive groups (P &lt; 0.05). Conclusions: An active lifestyle and physical activity in older adults are important factors in improving cognitive status and vitality and reducing anxiety, especially during the coronavirus outbreak. Therefore, engaging older adults in physical activities will elevate their mental health and cognitive status.

Internet access and older adults' health: Evidence from China

In the context of China's rapid population aging and internet expansion, this study examines the impact of information and communication technologies on the of older adults’ health. Using the China Health and Retirement Longitudinal Study 2011–2018, we find that internet access improves older adults' self-reported health, mental health, and activities of daily living (ADL). Further investigations provide evidence for several underlying mechanisms, including improving social participation, promoting healthy behaviors, and encouraging intergenerational interactions. Heterogeneity analyses show that disadvantaged groups, such as those with any ADL difficulty and without social participation or a spouse, benefit more from internet access.

Development and testing the feasibility of a sports-based mental health promotion intervention in Nepal: a protocol for a pilot cluster-randomised controlled trial

BackgroundMental wellbeing encompasses life satisfaction, social connectedness, agency and resilience. In adolescence, mental wellbeing reduces sexual health risk behaviours, substance use and violence; improves educational outcomes; and protects mental health in adulthood. Mental health promotion seeks to improve mental wellbeing and can include activities to engage participants in sport. However, few high-quality trials of mental health promotion interventions have been conducted with adolescents, especially in low- and middle-income countries. We sought to address this gap by testing SMART (Sports-based Mental heAlth pRomotion for adolescenTs) in a pilot cluster-randomised controlled trial (cRCT) in Bardiya, Nepal.MethodsThe objectives of the trial are to assess the acceptability and feasibility of SMART, test trial procedures, explore outcome distributions in intervention and control clusters and calculate the total annual cost of the intervention and unit cost per adolescent. The trial design is a parallel-group, two-arm superiority pilot cRCT with a 1:1 allocation ratio and two cross-sectional census surveys with adolescents aged 12–19, one pre-intervention (baseline) and one post-intervention (endline). The study area is four communities of approximately 1000 population (166 adolescents per community). Each community represents one cluster. SMART comprises twice weekly football, martial arts and dance coaching, open to all adolescents in the community, led by local sports coaches who have received psychosocial training. Sports melas (festivals) and theatre performances will raise community awareness about SMART, mental health and the benefits of sport. Adolescents in control clusters will participate in sport as usual. In baseline and endline surveys, we will measure mental wellbeing, self-esteem, self-efficacy, emotion regulation, social support, depression, anxiety and functional impairment. Using observation checklists, unstructured observation and attendance registers from coaching sessions, and minutes of meetings between coaches and supervisors, we will assess intervention fidelity, exposure and reach. In focus group discussions and interviews with coaches, teachers, caregivers and adolescents, we will explore intervention acceptability and mechanisms of change. Intervention costs will be captured from monthly project accounts, timesheets and discussions with staff members.DiscussionFindings will identify elements of the intervention and trial procedures requiring revision prior to a full cRCT to evaluate the effectiveness of SMART.Trial registrationISRCTN, ISRCTN15973986, registered on 6 September 2022; ClinicalTrials.gov, NCT05394311, registered 27 May 2022.