Mental Health Scale Research Articles

What matters most? Network analysis of mental health, recovery experiences, sleep, and fatigue among career firefighters.

Firefighters exhibit a higher prevalence of mental health issues than other occupations because they often directly or indirectly experience potentially traumatic events. Previous research has suggested that recovery experiences, sleep, and fatigue may be protective or risk factors for firefighters' mental health. This study conducted regularised partial correlation network analysis to investigate and visualise the complex relationships between these variables. We collected data through an online survey, and 3144 career firefighters from a large east-coast city in China, were included in the analyses. The results of the network analysis showed that: (1) only relaxation and mastery experiences directly correlated with one dimension of the mental health scale, namely, life/social functioning; (2) sleep quality had stronger correlations with mental health issues than sleep quantity; and (3) mental health issues were central nodes of the network. These results indicated that firefighters' mental health was close to other variables in the network and acted as a bridge linking other variables. Therefore, more attention should be paid to the mental health of firefighters to prevent comorbidities. The study's results also indicated that recovery experiences and sleep may be protective factors for firefighters' mental health.

Cultural and contextual adaptation of mental health measures in Kenya: An adolescent-centered transcultural adaptation of measures study.

There is paucity of culturally adapted tools for assessing depression and anxiety in children and adolescents in low-and middle-income countries. This hinders early detection, provision of appropriate and culturally acceptable interventions. In a partnership with the University of Nairobi, Nairobi County, Kenyatta National Hospital, and UNICEF, a rapid cultural adaptation of three adolescent mental health scales was done, i.e., Revised Children's Anxiety and Depression Scale, Patient Health Questionnaire-9 and additional scales in the UNICEF mental health module for adolescents. Using a qualitative approach, we explored adolescent participants' views on cultural acceptability, comprehensibility, relevance, and completeness of specific items in these tools through an adolescent-centered approach to understand their psychosocial needs, focusing on gender and age-differentiated nuances around expression of distress. Forty-two adolescents and 20 caregivers participated in the study carried out in two primary care centers where we conducted cognitive interviews and focused group discussions assessing mental health knowledge, literacy, access to services, community, and family-level stigma. We reflect on process and findings of adaptations of the tools, including systematic identification of words adolescents did not understand in English and Kiswahili translations of these scales. Some translated words could not be understood and were not used in routine conversations. Response options were changed to increase comprehensibility; some statements were qualified by adding extra words to avoid ambiguity. Participants suggested alternative words that replaced difficult ones and arrived at culturally adapted tools. Study noted difficult words, phrases, dynamics in understanding words translated from one language to another, and differences in comprehension in adolescents ages 10-19 years. There is a critical need to consider cultural adaptation of depression and anxiety tools for adolescents. Results informed a set of culturally adapted scales. The process was community-driven and adhered to the principles of cultural adaptation for assessment tools.

Mothers with borderline personality disorders' experiences of mother-infant dialectical behavior therapy.

Borderline personality disorder (BPD) is increasingly diagnosed in perinatal and infant settings, and research suggests that as well as an escalation of BPD symptoms in this period, these symptoms may also be detrimental to infant development. Providing tailored treatments during the postnatal period may help women and prevent an intergenerational cycle of emotional and interpersonal symptoms in infants. Mother-infant dialectical behavior therapy (MI-DBT) has produced promising, yet inconsistent, improvements on quantitative scales of maternal mental health and the mother-infant relationship. The qualitative evaluation may provide complementary information. This study aimed to explore the subjective experiences of women who had completed MI-DBT. Thematic analysis of semistructured interviews conducted on 13 women undertaking MI-DBT before, post, and 12 months after MI-DBT were analyzed for themes. Five major themes were identified. Overall, the women expressed that their emotional literacy and regulation improved after MI-DBT, subsequently addressing key risks and challenges such as uncertainty around their child's cues, and low self-esteem, and potentially improving the women's mentalization capability. This study consolidates previous research on maternal BPD, and provides qualitative evidence of the benefits of MI-DBT for mothers as both individuals and as parents with likely flow-on effects for infants. Lived experience input for future adaptations was a valuable gain.

Social Identity, Core Self-Evaluation, School Adaptation, and Mental Health Problems in Migrant Children in China: A Chain Mediation Model

(1) Background: The present study investigated the relationships between social identity, core self-evaluation, school adaptation, and mental health problems in migrant children, and the mechanism underlying these relationships; (2) Methods: The participants were migrant middle school students in China. Data analysis was conducted using SPSS version 26. A survey comprising the social identity scale, core self-evaluation scale, school adaptation scale, and mental health scale MMHI-60 was deployed; (3) Results: Findings indicated a significant and negative association between social identity and mental health problems, and such an association was sequentially mediated by core self-evaluation and school adaptation. Furthermore, core self-evaluation and school adaptation played a chain mediation role between social identity and migrant children's mental health problems; (4) Conclusions: It is crucial to improve social identity, core self-evaluation, and school adaptation to reduce mental health problems among this population. Therefore, the research results provide a new direction for promoting the development of mental health education for migrant workers and their children in China.

The effect of emotion regulation on happiness and resilience of university students: The chain mediating role of learning motivation and target positioning.

To investigate the effect andmechanism among emotion regulation, relationship,happiness, learning motivation, target positioning, and resilience of university students. A total of 904 university students in China were included in this cross-sectional survey from April to May this year. The self-administered questionnaires, including the adapted Mental Health Scale with a Healthy Personality Orientation for College Students, were used to construct structural equations to test the chain mediating effects of learning motivation and target positioning based on a multi-stage whole group sample of university students. Emotion regulation indirectly affected happiness through the mediating effect of interpersonal relationship (Med = -0.387, p = 0.001). Learning motivation and target positioning play the chain mediating role in the effect of emotion regulation on happiness (Med = -0.307, p = 0.001) and resilience (Med = -0.275, p = 0.001). Emotion regulation indirectly affected happiness and resilience through the chain mediating effect of learning motivation and target positioning.

Mediation effects of post-series depression on the relationship between life satisfaction and positive mental health of Vietnamese: A cross-sectional study in COVID-19 pandemic context.

Vietnam, a middle-income country, has been suffering four waves of the Coronavirus disease 2019 (COVID-19) pandemic and a massive lockdown to suppress the spread of this infectious disease. Consequently, COVID-19 has caused psychological ramifications and affected humankind's life satisfaction. Because of the lockdown period, numerous people had plentiful time. Hence, they found solace in excessive watching of television and movies, which could lead to post-series depression. The purpose of this study is to investigate the relationship between life satisfaction (LS), post-series depression (PSD), and positive mental health (PMH) and inquire about the mediation effect of satisfaction of life and PSD. A total of 2,572 participants who were voluntarily recruited from various media platforms completed self-report questionnaires, including the Satisfaction with life scale, Post-series depression scale, and Positive Mental Health Scale. This study was assessed using the PLS-SEM approach. The findings of this research discovered (i) a significantly positive effect of LS on PMH; (ii) a significantly negative effect of PSD on PMH; (iii) a significantly negative effect of LS on PSD, and (iv) a significant indirect effect of LS on PMH through PSD. The study provided additional evidence to the relationship between life satisfaction and PMH of individuals. Besides, the negative effects of PSD, which is a non-clinical term for feeling down that frequently appears after individuals finish their much-loved film and TV series, on individuals' PMH is proved, especially in the COVID-19 pandemic context in which Vietnamese people must remain in their current location.

Usefulness of Implementation Outcome Scales for Digital Mental Health (iOSDMH): Experiences from Six Randomized Controlled Trials.

Measuring implementation outcomes for digital mental health interventions is essential for examining the effective delivery of these interventions. The "Implementation Outcome Scale of Digital Mental Health" (iOSDMH) has been validated and used in several trials. This study aimed to compare the iOSDMH for participants in six randomized controlled trials (RCTs) involving web-based interventions and to discuss the implications of the iOSDMH for improving the interventions. Additionally, this study examined the associations between iOSDMH scores and program completion rate (adherence). Variations in total scores and subscales of the iOSDMH were compared in six RCTs of digital mental health interventions conducted in Japan. The web-based intervention programs were based on cognitive behavioral therapy (2 programs), behavioral activation (1 program), acceptance and commitment (1 program), a combination of mindfulness, behavioral activation, and physical activity (1 program), and government guidelines for suicide prevention (1 program). Participants were full-time employees (2 programs), perinatal women (2 programs), working mothers with children (1 program), and students (1 program). The total score and subscale scores were tested using analysis of variance for between-group differences. Total score and subscale scores of the iOSDMH among six trials showed a significant group difference, reflecting users' perceptions of how each program was implemented, including aspects such as acceptability, appropriateness, feasibility, overall satisfaction, and harm. Subscale scores showed positive associations with completion rate, especially in terms of acceptability and satisfaction (R-squared = 0.93 and 0.89, respectively). The iOSDMH may be a useful tool for evaluating participants' perceptions of features implemented in web-based interventions, which could contribute to improvements and further development of the intervention.

Adaptation of The Modified BBC Subjective Well-being Scale (BBC-SWB) and The Positive Mental Health Scale (PMH-scale) on the Ukrainian sample

Introduction. Given the war of the Russian Federation against Ukraine, the promotion of mental health and subjective well-being of the population has become an important task of psychological services in Ukraine. This requires the use of adequate diagnostic methods and instruments, in particular, those that have proven themselves in foreign practice. For this purpose, they should be adapted and standardized on the Ukrainian sample. Aim: to adapt The Modified BBC Subjective Well-being Scale (BBC-SWB) and The Positive Mental Health Scale (PMH-scale) on the Ukrainian sample. Methods. The Modified BBC Subjective Well-being Scale (BBC-SWB) and the Positive Mental Health Scale (PMH-scale). In order to adapt and standardize these scales, a study was conducted on a sample of 502 respondents from the central regions of Ukraine. The sample included 69.7% of women and 30.3% of men aged 18 through 75 belonging to various social strata. Results. 1) The adaptation of The Modified BBC Subjective Well-being Scale (BBC-SWB) and The Positive Mental Health Scale (PMH-scale) made it possible to bring them into line with Ukrainian realities; 2) the Scales' standardization allows using them for the analysis of the general indicator and individual subscales of subjective well-being as well as for the analysis of mental health of representatives of different population groups in Ukraine; 3) The obtained data demonstrated the Scales' high reliability and validity. Conclusions. The adapted Scales can be used by psychological centers and services for diagnosing mental health and well-being of Ukrainian population.

Quality of life of long-term childhood acute lymphoblastic leukemia survivors: Comparison with healthy controls.

Improved treatment landscape has led to better outcomes for paediatric acute lymphoblastic leukemia (ALL) survivors. As the number of survivors increase, we need to elucidate the long-term quality of life (QoL) and domains of complaints in these patients. Furthermore, the main priorities of these patients need to be clarified. We assessed long-term QoL outcomes of survivors of childhood ALL compared to matched population controls. QoL data were collected from survivors recruited in France and Belgium between 2012 and 2017, including the Short Form Health Survey (SF-12) and the Quality of Life Systemic Inventory (QLSI). The Wilcoxon test was used to compare SF-12 scale scores between survivors and matched population controls. For the QLSI, comparisons were mainly descriptive. One hundred and eighty-six survivors (mean age: 27.6years; range: 18.1-52.8) at follow-up completed QoL measures, amongst whom 180 were matched to controls. Overall, survivors had higher QoL on all SF12 scale scores, indicating that they had better functioning compared to controls. Statistically significant differences on the SF12 were observed for Vitality, Social Functioning, Role Limitations due to Emotional Problems and Mental Health scales. QLSI outcomes suggested that survivors were happier than controls with Couple and Social Relations. Controls were unhappiest compared to survivors with Money, Love life, Self-esteem, Nutrition and Paid Work. Our findings suggest that survivors of childhood ALL have better QoL outcomes on some domains compared to the general population, specifically around social and emotional functioning, and that they tend to prioritize their relationships more. Interventions for improving QoL outcomes, might build on existing positive experiences with family, friends and partners.

Yoga for chronic non-specific low back pain.

Yoga for chronic non-specific low back pain.

Recalibrating the Scales: Enhancing Ethnographic Uses of Standardized Mental Health Instruments

This article reflects on the narrative data that can emerge through the use of standardized mental health scales, drawing from two studies related to emotional distress among immigrant populations in Texas. In both studies, standardized scales complemented in-depth interviews. The initial goal in using scales was to collect quantifiable data, yet through the research process, the scales also served to elicit complementary narratives that enhanced interview data, forcing the researchers to reconsider the potential uses of scales. In thinking about the ethnographic potential of standardized scales, the goal of this article is twofold. First, based on our findings, it presents methodological considerations for how to use scales in a way that can facilitate the emergence of in-depth responses that complement other ethnographic methods. Second, although the scope of data collected and analyzed utilizing scales is most often limited to quantitative data, this research demonstrates a need to more fully consider other forms of data that may emerge from using scales. Thus, this article reflects on three inter-related areas where scales provided ethnographic data, using examples from two studies. Overall, this research shows that scales have more ethnographic potential than what has typically been recognized.

A study on the changes in life habits, mental health, and sleep quality of college students due to COVID-19.

In early 2020, the coronavirus 2019 (COVID-19) pandemic necessitated changes in social behavior to prevent its spread, including holding online classes, implementing social distancing, and allowing employees to telecommute. However, these changes have had a negative impact on people's sleep patterns and mental health, particularly for college students. This study investigated the relationship between mental health and sleep quality according to the changes in lifestyle of college students in the periods before and after COVID-19. The study subjects were 164 college students from Korea who had both face-to-face and non-face-to-face college experiences before and after COVID-19. The experiment was conducted using a Google survey, and the participants were recruited from the college community. The general features and lifestyle habits for the individuals were assessed using the AUDIT-K, Delphi method, KGHQ (General Mental Health Scale), and PSQI-K (Pittsburg Sleep Quality Index). The KGHQ and PSQI scores increased with the spread of COVID-19, which means that the mental health and sleep quality of college students deteriorated. 11 categories of variables were further investigated to evaluate changes in lifestyle, and the results indicate significant changes in the number of private meetings per week, monthly drinking, outdoor activity time, electronic device usage time, weekly food delivery, weekly late-night snacks, daily snacks, and daily coffee intake and no significant changes in exercise, smoking, and fast food intake. COVID-19 caused many changes in the lifestyle of college students, which adversely affected mental health and sleep.

Difficulties Experienced by Psychiatric Nursing in Mental Health Hospitals and Clinics and Their Relationship to Performance Improvement

Nurses in the kingdom of Saudi Arabia work in a significantly challenging work environment. This research explored difficulties experienced by psychiatric nursing in mental health hospitals and clinics and their relationship to performance improvement. The study followed the correlation, the descriptive design, the study sample was randomly selected (201) participants from the psychiatric hospitals in Saudi Arabia – Hafar Al –Batan. The researcher used two questionnaires to answer the study questions and achieve their objectives. The first one is the Nurses Work Functioning Questionnaire (NWFQ) it consists of fifty items self-reported survey it contains seven subscale to measure the obstacle arises in work due to common mental illness. The other questionnaire is to measure difficulties and problems it consists of nine items and the scoring system is a five-scale point. Data were analyzed using SPSS 26 version. Results showed that 56% were males while 44% were females. The large percentage according to age was 47.8% to the range age group from 20-29. Then the age group from 30–39 with total number 42 and percentage 20.2%. regarding study sample years of experience, the high percentage was from 5 years- 7 years with 57%. Also , showed that nurses faced a lot of difficulties such as depression, stress and anxiety during their work shift. These symptoms can adversely affect work performance and care quality. But in the current research in general, the results indicate that there is no statistically significant relationship between the overall degree of the mental health scale and the professional performance scale.

Adolescent mothers and their children affected by HIV-An exploration of maternal mental health, and child cognitive development.

Some children born to adolescent mothers may have developmental challenges, while others do not. Research focusing on which children of adolescent mothers are at the highest risk for cognitive delay is still required. Both maternal HIV status and maternal mental health may affect child development. An examination of maternal mental health, especially in the presence of maternal HIV infection may be timely. This study explores the relationship between the mental health of adolescent mothers (comparing those living with and not living with HIV) and the cognitive development performance scores of their children. Additional possible risk and protective factors for poor child development are explored to identify those children born to adolescent mothers who may be at the greatest risk of poor cognitive development. Cross-sectional data utilised within the analyses was drawn from a large cohort of adolescent mothers and their children residing in South Africa. Detailed study questionnaires were completed by adolescent mothers relating to their self and their child and, standardised cognitive assessments were completed by trained researchers for all children using in the Mullen Scales of Early Learning. Chi-square, t-tests (Kruskal Wallis tests, where appropriate), and ANOVA were used to explore sample characteristics and child cognitive development scores by maternal mental health status (operationalised as likely common mental disorder) and combined maternal mental health and HIV status. Multivariable linear regression models were used to explore the relationship between possible risk factors (including poor maternal mental health and HIV) and, child cognitive development scores. The study included 954 adolescent mothers; 24.1% (230/954) were living with HIV, 12.6% (120/954) were classified as experiencing likely common mental disorder. After adjusting for covariates, maternal HIV was found to be associated with reduced child gross motor scores (B = -2.90 [95%CI: -5.35, -0.44], p = 0.02), however, no other associations were identified between maternal likely common mental disorder, or maternal HIV status (including interaction terms), and child cognitive development scores. Sensitivity analyses exploring individual maternal mental health scales identified higher posttraumatic stress symptomology scores as being associated with lower child cognitive development scores. Sensitivity analyses exploring potential risk and protective factors for child cognitive development also identified increased maternal educational attainment as being protective of child development scores, and increased child age as a risk factor for lower development scores. This study addresses a critical evidence gap relating to the understanding of possible risk factors for the cognitive development of children born to adolescent mothers affected by HIV. This group of mothers experience a complex combination of risk factors, including HIV, likely common mental disorder, and structural challenges such as educational interruption. Targeting interventions to support the cognitive development of children of adolescent mothers most at risk may be of benefit. Clearly a basket of interventions needs to be considered, such as the integration of mental health provision within existing services, identifying multiple syndemics of risk, and addressing educational and structural challenges, all of which may boost positive outcomes for both the mother and the child.

Psychological distress, depression, anxiety, and life satisfaction following COVID-19 infection: evidence from 11 UK longitudinal population studies

BackgroundEvidence on associations between COVID-19 illness and mental health is mixed. We aimed to examine whether COVID-19 is associated with deterioration in mental health while considering pre-pandemic mental health, time since infection, subgroup differences, and confirmation of infection via self-reported test and serology data.MethodsWe obtained data from 11 UK longitudinal studies with repeated measures of mental health (psychological distress, depression, anxiety, and life satisfaction; mental health scales were standardised within each study across time) and COVID-19 status between April, 2020, and April, 2021. We included participants with information available on at least one mental health outcome measure and self-reported COVID-19 status (suspected or test-confirmed) during the pandemic, and a subset with serology-confirmed COVID-19. Furthermore, only participants who had available data on a minimum set of covariates, including age, sex, and pre-pandemic mental health were included. We investigated associations between having ever had COVID-19 and mental health outcomes using generalised estimating equations. We examined whether associations varied by age, sex, ethnicity, education, and pre-pandemic mental health, whether the strength of the association varied according to time since infection, and whether associations differed between self-reported versus confirmed (by test or serology) infection.FindingsBetween 21 Dec, 2021, and July 11, 2022, we analysed data from 54 442 participants (ranging from a minimum age of 16 years in one study to a maximum category of 90 years and older in another; including 33 200 [61·0%] women and 21 242 [39·0%] men) from 11 longitudinal UK studies. Of 40 819 participants with available ethnicity data, 36 802 (90·2%) were White. Pooled estimates of standardised differences in outcomes suggested associations between COVID-19 and subsequent psychological distress (0·10 [95% CI 0·06 to 0·13], I2=42·8%), depression (0·08 [0·05 to 0·10], I2=20·8%), anxiety (0·08 [0·05 to 0·10], I2=0·0%), and lower life satisfaction (–0·06 [–0·08 to –0·04], I2=29·2%). We found no evidence of interactions between COVID-19 and sex, education, ethnicity, or pre-pandemic mental health. Associations did not vary substantially between time since infection of less than 4 weeks, 4–12 weeks, and more than 12 weeks, and were present in all age groups, with some evidence of stronger effects in those aged 50 years and older. Participants who self-reported COVID-19 but had negative serology had worse mental health outcomes for all measures than those without COVID-19 based on serology and self-report. Participants who had positive serology but did not self-report COVID-19 did not show association with mental health outcomes.InterpretationSelf-reporting COVID-19 was longitudinally associated with deterioration in mental health and life satisfaction. Our findings emphasise the need for greater post-infection mental health service provision, given the substantial prevalence of COVID-19 in the UK and worldwide.FundingUK Medical Research Council and UK National Institute for Health and Care Research.

“I AM MENTALLY HEALTHY, SO I CAN CHOOSE WELL.” QUARTER-LIFE CRISIS AND POSITIVE MENTAL HEALTH IN STUDENTS

The transition from adolescence to adulthood is marked by psychosocial and other psychological changes. Quarter-life crisis is a symptom that appears during the transition period. We examined how quarter-life crisis impacts mental health using a convenience sampling technique. A total of 459 students, 18 to 25 years old, filled out questionnaires distributed online. The data measurement tool used quarter-life crisis and positive mental health scales adjusted into Indonesian form. The results show a significant negative correlation (R = -0.437; p < .001) between quarter-life crisis and positive mental health in students. The regression analysis shows an impact of quarter-life crisis on positive mental health of 19%, which is relatively small. The implications of our research results are discussed.

Predictors of persistent depressive and anxiety symptoms among older adults during the COVID-19 pandemic in Canada.

The COVID-19 pandemic has increased the risk of psychological distress for older adults during a period of reduced access to mental health support. We identified predictors of persistent depressive and anxiety symptoms among older adults throughout the initial 9 months of the pandemic. This was a longitudinal study using web-based surveys sent to a convenience sample of Canadians aged ≥55 years. A baseline survey was sent in May 2020, with eight surveys sent monthly between June 2020 and January 2021. Data were separated into three study periods, corresponding to coronavirus case rates. Respondents who met predetermined thresholds for elevated depressive or anxiety symptoms using standardized mental health scales during all three periods were defined as having persistent symptoms. Multivariable Poisson regression was used to compare the risk of persistent symptoms across respondent characteristics selected a priori. There were 835 respondents who answered questions about depressive symptoms and 865 who answered questions about anxiety symptoms across all three study periods. Among those with complete follow-up data, 19.2% (n= 159/827) reported persistent depressive symptoms and 16.4% (n= 140/856) reported persistent anxiety symptoms. Respondents with persistent depressive symptoms were more likely to be women (adjusted relative risk [aRR] 1.71; 95% CI 1.19-2.46), and report multimorbidity (aRR 1.45; 95% CI 1.07-1.97), pre-existing depression (aRR 2.00; 95% CI 1.45-2.77) and pre-existing anxiety (aRR 1.50; 95% CI 1.10-2.06). The same respondent characteristics were correlates of persistently elevated anxiety symptoms. Older women, older adults with pre-existing depression and anxiety, and those with multimorbidity were more likely to report persistent mental health symptoms during the first 9 months of the COVID-19 pandemic. These individuals were known to have elevated risk prior to the pandemic, and expanded interventions targeted to these groups are necessary to adequately address their mental health needs.

COVID-19 Lockdown Stress and the Mental Health of College Students: A Cross-Sectional Survey in China

To prevent the spread of the COVID-19 pandemic, countries around the world adopted varying degrees of lockdown. The lockdowns restricted the freedom of college students, which led to stress and mental health issues. This study constructed a mediating model to explore the relationship between COVID-19 lockdown stress and Chinese college students’ mental health; the mediating role of fear of missing out (FoMO) was also investigated. A 7-item COVID-19 student stress questionnaire (CSSQ), a 6-item mental health scale, and a 10-item FoMO scale were distributed among 695 college students who experienced lockdown in China. The results showed that COVID-19 lockdown stress was significantly and negatively correlated with mental health, significantly and positively correlated with FoMO, and FoMO was significantly and negatively correlated with mental health. COVID-19 lockdown stress significantly and negatively influenced Chinese college students’ mental health directly and indirectly via the complementary partial mediating effect of FoMO. The results intensify our comprehension of the influence of COVID-19 lockdown stress and mental health problems in Chinese college students and also provide practical suggestions for college educators to address such scenarios.

Prevalence and Associated Factors of Depression, Anxiety, and Stress in University Students in Paraguay during the COVID-19 Pandemic.

We aimed to determine the prevalence of depression, anxiety, and stress in university students in Paraguay during the COVID-19 pandemic. A cross-sectional study was conducted among 293 students from four universities in Paraguay in 2021. The DASS-21 mental health scale was used to measure the outcomes (depression, anxiety, and stress) and evaluate their association with socio-educational variables. A total of 77.1% of the participants were women and 136 (46.4%) were between 21 and 25 years old. The prevalence of depression, anxiety, and stress was 74.7%, 87.4%, and 57%, respectively. We found that being a woman and studying at a public university was positively associated with depression, anxiety, and stress. Receiving COVID-19 training increases the prevalence of mental health problems. In conclusion, high levels of anxiety, depression, and stress were found in university students during the COVID-19 pandemic. Being a woman, studying at a public university, and receiving training on COVID-19 were factors associated with a higher prevalence of presenting all the mental health problems evaluated. Furthermore, students aged 31 and over had a higher prevalence of depression and stress.

Comparative Study of Patients Treated with the Original Lapidus Procedure That Evolved with and without Fusion Between the First and Second Metatarsals

Category: Midfoot/Forefoot; Bunion Introduction/Purpose: The Original Lapidus procedure (OLP) consists of realigning the varus of the first metatarsal (M1) present in the hallux valgus (HV) deformities, by fusing the first tarsometatarsal joint (TMJ) and the M1 to the second metatarsal (M2). Compared to its modified version, some studies support that the OLP is more stable with less motion around the TMJ, which may prevent complications such as recurrence. However, fusion between M1 to M2 may not occur and its clinical and radiographic impact is still unknown. The aim of this study was to compare clinical, functional and radiographic outcomes in patients who underwent the OLP that evolved with and without fusion between the M1 and M2. Our null hypothesis was that they would have the same results. Methods: A retrospective and comparative study of twenty-nine patients (thirty-eight feet) with a mean follow-up of 18.03 (range, 6-51) months who underwent the OLP. They were divided in two different groups based on the presence of fusion and non-fusion between the M1 and M2 (Figure1). Twenty-three patients were included in the first group and fifteen in the second. Their average age was 48.74 (range,18-73) years. Twenty-five patients were female and four, male. Their mean body mass index (BMI) was 25.6 (range, 19.13-31.64). Clinical and functional data were assessed with the VAS for pain, AOFAS, LEFS and SF-12. SF- 12 comprises physical and mental health scales (PCS-12 and MCS-12). Radiographic parameters assessed were bony and soft tissue forefoot widths (BSFW), intermetatarsal-angle(IMA) and HV-angle(HVA). Intraclass Correlation Coefficients (ICC) were calculated for all radiographic measurements. Clinical, functional and radiographic measurements were compared between the two groups pre- and postoperatively using Student t Test. Results: The two groups were demographically similar in terms of mean age, BMI and follow-up time (p=.28, p=.84 and p=.06, respectively). Separately, patients from both groups presented significant improvements in all questionnaires (p<.001), except on MCS-12 (fusion p=.08 and non-fusion p=.27). Concerning radiographic parameters, they improved significantly in all measures (p<.001). When comparing the two groups, patients with fusion had higher scores only on the AOFAS questionnaire compared to those without (Table1). They improved from 37.61 preoperatively to 87.26 postoperatively and those without fusion improved from 44.47 to 82.80 (p<.05). Regarding radiographic parameters, there were no differences between both groups. They showed the same improvements on bony and soft tissue width, IMA and HVA (p=.09, p=16, p=.52 and p=.63, respectively), meaning that even when there is no fusion between M1 and M2, satisfactory radiographic corrections can be achieved (Table2). Pre- and postoperative ICC was good to excellent for most measurements (Table3). Conclusion: The present study showed that there was no difference in the amount of correction of HV deformities between patients who evolved with and without fusion between M1 and M2 after the OLP. However, patients with fusion may have better postoperative function when considering AOFAS scores. Further prospective and comparative studies with larger populations are required to assess the role of non-union between M1 and M2 in the outcomes of the OLP.