Mental Health Research Articles

Evaluation of dry eye disease symptomatology and mental health status among patients with different COVID-19 statuses

AIM: To evaluate dry eye disease (DED) symptomatology and mental health status in different COVID-19 patients. METHODS: A cross-sectional observational design was used. Totally 123 eligible adults (46.34% of men, age range, 18-59y) with COVID-19 included in the study from August to November, 2022. Ocular Surface Disease Index (OSDI), Five-item Dry Eye Questionnaire (DEQ-5), Hospital Anxiety and Depression Scale (HADS), and Pittsburgh Sleep Quality Index (PSQI) were used in this study. RESULTS: OSDI scores were 6.82 (1.25, 15.91) in asymptomatic carriers, 7.35 (2.50, 18.38) in mild cases, and 16.67 (4.43, 28.04) in recurrent cases, with 30.00%, 35.56%, and 57.89%, respectively evaluated as having DED symptoms (χ2=7.049, P=0.029). DEQ-5 score varied from 2.00 (0, 6.00) in asymptomatic carriers, 3.00 (0, 8.00) in mild cases, and 8.00 (5.00, 10.00) in recurrent cases, with 27.50%, 33.33%, and 55.26%, respectively assessed as having DED symptoms (χ2=8.532, P=0.014). The prevalence of clinical anxiety (50.00%) and depression (47.37%) symptoms were also significantly higher in patients with recurrent infection (χ2=24.541, P<0.001; χ2=30.871, P<0.001). Recurrent infection was a risk factor for high OSDI scores [odds ratio, 2.562; 95% confidence interval (CI), 1.631-7.979; P=0.033] and DEQ-5 scores (odds ratio, 3.353; 95%CI, 1.038-8.834; P=0.043), whereas having a fixed occupation was a protective factor for OSDI scores (odds ratio, 0.088; 95%CI, 0.022-0.360; P=0.001) and DEQ-5 scores (odds ratio, 0.126; 95%CI, 0.039-0.405; P=0.001). CONCLUSION: Patients with recurrent COVID-19 have more severe symptoms of DED, anxiety, and depression.

The longitudinal mediating role of sleep in associations between COVID-19 stressors predicting mental and physical health outcomes among emerging adult college students.

The current study tested a longitudinal mediation model throughout the COVID-19 pandemic focused on whether students' housing instability stress and food/financial instability stress at the beginning of the pandemic in spring 2020 (T1) informed sleep dissatisfaction and duration in fall 2020 (T2) and, in turn, physical and mental health in spring 2021 (T3). Further, we tested whether relations varied based on students' ethnic-racial backgrounds. Participants included 879 Asian, Black, Latine, Multiracial, and White emerging adult college students (Mage=19.95, SD=0.33) from a large public university in the mid-Atlantic region of the United States who attended college during the COVID-19 pandemic and completed surveys about their experiences. Findings indicated a significant mediation process, such that T1 housing instability stress predicted greater T2 sleep dissatisfaction and, in turn, less physical health, greater depressive symptoms, and greater anxiety symptoms at T3. Additionally, T1 food/financial instability stress was significantly associated with less T2 sleep duration but was not, in turn, associated with any T3 outcomes. Findings did not vary by students' ethnicity/race. Results highlight that sleep dissatisfaction is an important factor that accounts for relations between COVID-19 stressors predicting mental and physical health outcomes throughout the pandemic.

Dose-Dependent Association Between Body Mass Index and Mental Health and Changes Over Time.

Overweight and obesity affect 340 million adolescents worldwide and constitute a risk factor for poor mental health. Understanding the association between body mass index (BMI) and mental health in adolescents may help to address rising mental health issues; however, existing studies lack comprehensive evaluations spanning diverse countries and periods. To estimate the association between BMI and mental health and examine changes over time from 2002 to 2018. This was a repeated multicountry cross-sectional study conducted between 2002 and 2018 and utilizing data from the Health Behaviour in School-aged Children (HBSC) survey in Europe and North America. The study population consisted of more than 1 million adolescents aged 11 to 15 years, with all surveyed children included in the analysis. Data were analyzed from October 2022 to March 2023. Mental health difficulties were measured by an 8-item scale for psychological concerns, scoring from 0 to 32, where a higher score reflects greater psychosomatic issues. BMI was calculated using weight divided by height squared and adjusted for age and sex. Data were fitted by multilevel generalized additive model. Confounders included sex, living with parents, sibling presence, academic pressure, the experience of being bullied, family affluence, screen time, and physical activity. Our analysis of 1 036 869 adolescents surveyed from 2002 to 2018, with a mean (SD) age of 13.55 (1.64) years and comprising 527 585 girls (50.9%), revealed a consistent U-shaped association between BMI and mental health. After accounting for confounders, adolescents with low body mass and overweight or obesity had increased psychosomatic symptoms compared to those with healthy weight (unstandardized β, 0.14; 95% CI, 0.08 to 0.19; unstandardized β, 0.27; 95% CI, 0.24 to 0.30; and unstandardized β, 0.62; 95% CI, 0.56 to 0.67, respectively), while adolescents with underweight had fewer symptoms (unstandardized β, -0.18; 95% CI, -0.22 to -0.15). This association was observed across different years, sex, and grade, indicating a broad relevance to adolescent mental health. Compared to 2002, psychosomatic concerns increased significantly in 2006 (unstandardized β, 0.19; 95% CI, 0.11 to 0.26), 2010 (unstandardized β, 0.14; 95% CI, 0.07 to 0.22), 2014 (unstandardized β, 0.48; 95% CI, 0.40 to 0.56), and 2018 (unstandardized β, 0.82; 95% CI, 0.74 to 0.89). Girls reported significantly higher psychosomatic concerns than boys (unstandardized β, 2.27; 95% CI, 2.25 to 2.30). Compared to primary school, psychosomatic concerns rose significantly in middle school (unstandardized β, 1.15; 95% CI, 1.12 to 1.18) and in high school (unstandardized β, 2.12; 95% CI, 2.09 to 2.15). Our study revealed a U-shaped association between adolescent BMI and mental health, which was consistent across sex and grades and became stronger over time. These insights emphasize the need for targeted interventions addressing body image and mental health, and call for further research into underlying mechanisms.

Psychological distress, well-being, resilience, posttraumatic growth, and turnover intention of mental health nurses during COVID-19: A cross-sectional study.

Mental health nurses (MHNs) experience a range of stressors as part of their work, which can impact their well-being and turnover intention. There is no prior evidence, however, on MHNs' mental health, well-being, resilience, and turnover intention during the COVID-19 pandemic. The aims of this online survey-based cross-sectional study, conducted during the pandemic, were to explore the psychological distress, well-being, emotional intelligence, coping self-efficacy, resilience, posttraumatic growth, sense of workplace belonging, and turnover intention of n = 144 Australian mental health registered and enrolled nurses; and explore relationships between these variables, in particular, psychological distress, well-being, and turnover intention. There was a higher percentage of MHNs with high (27.78%) and very high psychological distress (9.72%) compared to population norms as measured by the K10. Emotional intelligence behaviours were significantly lower than the population mean (GENOS-EI Short). Coping self-efficacy was mid-range (CSES-Short). Resilience was moderate overall (Brief Resilience Scale), and posttraumatic growth was mid-range (Posttraumatic Growth Inventory; PTGI). Sense of workplace belonging was moderate, and turnover intention was low. Higher levels of psychological distress were associated with higher turnover intention, and lower workplace belonging, coping self-efficacy, well-being, resilience, and emotional intelligence behaviours. Despite the levels of psychological distress, nearly half the sample (n = 71) was 'flourishing' in terms of well-being (Mental Health Continuum Short-Form). To help prevent staff distress in the post-pandemic period, organisations need to proactively offer support and professional development to strengthen staff's psychological well-being, emotional intelligence, and resilience skills. These strategies and group clinical supervision may also support lower turnover.

The stigma towards seeking help among university students: a cross-sectional study in Jordan

BackgroundMental disorders affect one in two people globally, with COVID-19 exacerbating anxiety and depression. Stigma, a major hindrance to seeking mental health services, manifests as public, perceived, and self-stigma. Cultural misconceptions contribute to public stigma. Studies show high stigmatization among university students, impacting help-seeking behavior. Arab populations exhibit varied attitudes influenced by religious beliefs. The research aims to bridge gaps in understanding stigma among university students in Jordan, focusing on the impact of post post-COVID-19 era on mental health perceptions. The study hypothesizes differences in attitudes and stigma between medical and non-medical students, investigating these aspects in Jordan.MethodsA cross-sectional study assessed attitudes and stigma related to seeking help among 1,151 university students in Jordan from June 20th to July 20th, 2023. The sample included diverse participants from Jordanian universities. Data were collected through an online survey covering sociodemographic details, psychological background, and attitudes using the Attitudes Toward Seeking Professional Psychological Help Scale (ATSPPH). Ethical considerations included approval from the University of Jordan Institutional Review Board and informed consent from participants.ResultsThe survey included 1151 participants. The overall mean age was 20.34 years. Among the participants, 761 (66.1%) were medical students, while 390 (33.9%) were non-medical students. The overall mean ATSPPHS score was 16.30. Medical students exhibited a significantly more positive attitude (73.3%) compared to non-medical students (26.7%). Being a medical student was associated with higher odds of having a positive attitude while being male was found to be a negative predictor.ConclusionFindings revealed that being a medical student and having prior mental health education were linked to more favorable attitudes, whereas male students tended to hold more negative views. Incorporating mental health education into non-medical curricula could be beneficial in diminishing stigma and fostering positive attitudes toward seeking help.

Building an implementation strategy for community-based rehabilitation for mental health in Colombia.

Scientific evidence indicates that the community-based rehabilitation (CBR) model is recommended for recovery from mental disorders. However, this approach encounters barriers and often lacks implementation strategies. The aim of this study is to create a strategy for the implementation of CBR for mental health in Colombia through the identification of barriers and facilitators, together with the expected outcomes, from the perspective of mental health decision-makers in Colombia. This study adopts a qualitative descriptive approach, using focus group data collection methods and thematic analysis to code and analyze the data. A total of 208 individuals participated in the study, including mental health decision-makers and health care professionals. Intersectoral collaboration, contextualization, financial resources, and community commitment and autonomy were identified as barriers and facilitators. The element that was considered a priority for successful implementation was the contextualization of strategies. CBR needs to be strengthened through implementation science if these strategies are to be successfully developed and implemented in various contexts. http://links.lww.com/IJEBH/A210.

Psychiatric Mental Health Nurses' Perceptions and Experiences of Inpatient Mental Health Care Safety Culture in Saudi Arabia.

Although patient safety culture is gaining attention globally, more studies are needed to investigate its relevance to the nursing care of mental health (MH) patients. This study aimed to illustrate the perceptions and experiences of nurses who work in inpatient mental health care (IMHC) concerning the patient safety practices that are employed to avert safety hazards encountered during the provision of care in IMHC settings. Eighteen postgraduate students working as MH nurses in nonprofit hospitals comprised the study sample. The participants had a minimum of 2 years' nursing experience in IMHC settings. Each participant was interviewed individually using a guided interview technique. The inductive data underwent thematic analysis. Patient protection and a safety perspective were the overarching themes that emerged from the data. Three principal themes and 9 subthemes were illuminated: (a) patient care safety knowledge and background, (b) improving MH care, and (c) development of MH nursing care. The findings of this investigation may assist in providing guidance for the further research into and development of a patient safety culture appropriate for IMHC nursing practice, including increased structured educational experiences, judicious risk assessment, assignment of staff to include a mixture of skills and experience levels during assignments, use of standardized handoff procedures, engagement with multidisciplinary care providers, blame-free reflective information sharing and mentoring, and attention to the built environment with consideration of patient and staff safety needs.

Intentions to use mental health and suicide prevention resources among individuals with symptoms of the suicide crisis syndrome and/or suicidal ideation.

The suicide crisis syndrome (SCS) has demonstrated efficacy in predicting suicide attempts, showing potential utility in detecting at-risk individuals who may not be willing to disclose suicidal ideation (SI). The present international study examined differences in intentions to utilize mental health and suicide prevention resources among community-based adults with varying suicide risk (i.e., presence/absence of SCS and/or SI). A sample of 16,934 community-based adults from 13 countries completed measures about the SCS and SI. Mental health and suicide prevention resources were provided to all participants, who indicated their intentions to use these resources. Individuals with SCS (55.7%) were just as likely as those with SI alone (54.0%), and more likely than those with no suicide-related symptoms (45.7%), to report willingness to utilize mental health resources. Those with SI (both with and without SCS) were more likely to seek suicide prevention resources (52.6% and 50.5%, respectively) than those without SI (41.7% and 41.8%); however, when examining endorsements for personal use, those with SCS (21.6%) were more likely to use resources than individuals not at risk (15.1%). These findings provide insight into individuals' willingness to use resources across configurations of explicitly disclosed (SI) and indirect (SCS) suicide risk.

Serendipity in psychotropic drugs: Unearthing the origins

This is a dive into the history of several groundbreaking psychiatric drugs and their discoveries. The article begins by exploring the curious origin of the word “serendipity” following Horace Walpole’s encounter with a fairytale. This captivating emergence of “serendipity” is followed by an account of lithium discovered in 1817. About a century and a half later, lithium would receive FDA approval, becoming a cornerstone in the treatment of mania.The narrative meanders to other drugs that have a similar thread of serendipity woven into their beginnings— chlordiazepoxide, meprobamate, chlorpromazine, finally halting at iproniazid, an anti-tubercular agent that unexpectedly revealed its mood-enhancing potential and paved the way for the development of monoamine oxidase inhibitors as antidepressants.The authors navigate through the intricacies of chance and discovery that have influenced the trajectory of psychiatric drug development, leading to unexpected breakthroughs that have forever left their mark on the undeniably vast landscape that is mental health.

Assessing Tobacco Treatment Engagement in Assertive Community Treatment Programs.

Despite high tobacco use prevalence among those with serious mental illnesses, few Assertive Community Treatment (ACT) programs provide tobacco treatment. Understanding the factors associated with the intentions to engage in tobacco treatment from both provider and consumer perspectives is important. The purpose was to examine ACT providers' intention to provide and consumer intention to engage in tobacco treatment. A cross-sectional survey of ACT program providers (N = 51) and consumers (N = 43) from four community mental health centers. Multiple linear regression analyses were used to examine factors associated with the intentions to provide or engage in tobacco treatment from among attitudinal, subjective norms, and perceived behavioral control variables. Providers reported positive attitudes, high degree of perceived behavior control, and high intentions for delivering tobacco treatment, but poor perceptions of subjective norms. These results were like consumers' intentions to engage in tobacco treatment. In regression analysis, only subjective norms and perceived behavior control were significant predictors for providers' intentions to provide tobacco treatment, but there were no significant predictors of consumers' intentions to engage in tobacco treatment. Both providers and consumers endorsed poor implementation of evidence-based tobacco treatment. Poor engagement in tobacco treatment within ACT programs indicates the need for policymakers to support tobacco treatment within the services. This finding calls for training of mental and behavioral health providers while supporting tobacco-free initiatives in ACT treatment service settings.

Transforming Adolescent Smiles: Correcting Skeletal Mandibular Retrusion and Bimaxillary Protrusion with Clear Aligners.

Maxillary protrusion combined with mandibular retraction is a highly prevalent but extremely complex maxillofacial deformity that can have a serious negative impact on patients' facial aesthetics and mental health. The traditional orthodontic treatment strategy often involves extracting 4 first premolars and conventional fixed techniques, combined with mini-implant screws, to retract the anterior teeth and improve facial protrusion. In recent years, an invisible orthodontic technique, without brackets, has become increasingly popular. However, while an invisible aligner has been used in some cases with reasonable results, there remain significant challenges in achieving a perfect outcome. This case report presents an adolescent patient with bimaxillary protrusion and mandibular retrognathia. Based on the characteristics of the invisible aligners and the growth characteristics of the adolescent's teeth and jawbone, we designed precise three-dimensional tooth movement and corresponding resistance/over-correction for each tooth, while utilizing the patient's jawbone growth potential to promote rapid development of the mandible, accurately and efficiently correcting bimaxillary protrusion and skeletal mandibular retrognathia. The patient's facial aesthetics, especially the lateral morphology, have been greatly improved, and various aesthetic indicators have also shown significant changes, and to the patient's great benefit, invasive mini-implant screws were not used during the treatment. This case highlights the advantages of using invisible aligners in adolescent maxillary protrusion combined with mandibular retraction patients. Furthermore, comprehensive and accurate design combined with good application of growth potential can also enable invisible orthodontic technology to achieve perfect treatment effects in tooth extractions, providing clinical guidance for orthodontists.

Physical activity levels of pregnant women at the time of diagnosis with gestational diabetes attending a tertiary care hospital in Lucknow City, Uttar Pradesh

: Gestational Diabetes Mellitus (GDM) is one of the pregnancy complications characterized by carbohydrate intolerance that develops or is discovered during pregnancy. Physical inactivity and excessive gestational weight gain have been identified as independent risk factors for maternal obesity and pregnancy-related disorders, such as gestational diabetes. Awareness of the significance of physical activity for bodily and psychological health is vitally essential. The woman and her family members need to be swayed to change with time and let go of their myths and false cultural perceptions that exercise can harm the baby. : To determine the physical activity pattern of pregnant women at the time of diagnosis with GDM. : 188 pregnant women diagnosed with gestational diabetes mellitus was selected for the study. Pregnancy Physical Activity Questionnaire was used to calculate the duration; frequency, intensity, and type of physical activity during current gestational period. An average weekly energy expenditure in Metabolic Equivalent of Task (MET-h-week) was calculated. Demographic data including age, socioeconomic status, parity, literacy and working status were collected. Data was analysed on 188 pregnant women diagnosed with GDM. The physical activity of moderate intensity was less performed by the pregnant women. None of the pregnant women were involved in vigorous type of physical activity. Only light intensity activities were performed by the study participants. The study concluded light intensity activity was commonly carried by pregnant women thus a low level of physical activity was observed during the pregnancy.

Efficacy of yoga package on cognitive flexibility and attention in university girls: A single group pilot study

Executive functions and attention are key indicator of cognitive health. Cognitive flexibility, the ability to flexibly switch between tasks, is a core dimension of executive functions. Yoga helps to improve mental wellness, which consequently provides cognitive flexibility.This study aimed to determine the effect of yoga on cognitive flexibility and attention in university girls.Thirty healthy university girls (group mean ± SD; 18.27 ± 1.44) were enrolled as participants in the study. Trail Making Test (TMT) parts A and B were used to assess their cognitive flexibility whereas sustained attention was determined using Six Letter Cancellation Test (SLCT). The assessments were taken at baseline and after three months of yogic practices. Statistical analysis was performed by paired t-test to examine the effect of yoga on cognitive flexibility and attention in university girls.There was a significant decrease in time taken to complete TMT part A (t= 4.33; P<0.05) and a significant increase in total attempts (t= -2.75; P<0.05) and net attempts (t=-2.80; P<0.01) in six letter cancellation test after three months of yoga practice.The results suggest that yoga improves visual search ability and motor speed skills and hence cognitive flexibility and attention in university girls.

Comparative effect of physical health training and psychological training of the theory of reasoned action (TRA) model on the life quality of patients with diabetes in Tehran, Iran: utilization of message texting

Background and purposeProviding physical health and mental health training promotion is necessary for a sustainable change in attitude and lifestyle of diabetic patients. The present study was conducted with the aim of comparing the effect of physical health training and psychological training of the theory of reasoned action (TRA) model on the life quality of patients with type 2 diabetes.MethodsThis experimental study was conducted in 2022 with two intervention groups and one control group consisting of 129 patients with type 2 diabetes who were referred to Imam Khomeini Hospital in Tehran. Over the course of one month, each individual in intervention group 1 received 15 text messages focusing on physical health, while intervention group 2 received 15 psychological text messages related to the TRA. The control group did not receive any text messages during this period. The data collection tool used was the “Audit of Diabetes-Dependent Quality of Life (ADDQoL)” questionnaire, which was completed by the participants before and after the intervention. The data were analyzed using SPSS version 16 software at a statistical significance level of 0.05.ResultsIn the intervention-1 group, the average life quality score was 8.51 units (P < 0.001), while in the intervention-2 group, it was 19.25 units (P < 0.001) higher than the control group. The psychological training group had a 17.62 units (P < 0.05) lower average fasting blood sugar (FBS) and a 10.74 units (P < 0.001) higher average quality of life compared to the physical training group.ConclusionThe results of this study showed that the effectiveness of psychological training of the TRA model in improving life quality and reducing FBS in patients with diabetes is greater than physical health training. It is suggested that policy makers and health managers base future plans on physical health promotion training along with TRA model mental health training for the development of education in patients with diabetes. Specialists and healthcare workers can also act to improve personal health characteristics, especially those related to reducing FBS and increasing the quality of life of patients with diabetes, by using training through mobile phone text messages, particularly with psychological content TRA based.

Mental health workers’ perspectives on the implementation of a peer support intervention in five countries: qualitative findings from the UPSIDES study

ObjectiveThe introduction of peer support in mental health teams creates opportunities and challenges for both peer and non-peer staff. However, the majority of research on mental health workers’ (MHWs) experiences...

Necessity of assessment and how it affects students' psyche and desire to learn: innovative digital technologies for assessment of art and music teaching in China

ABSTRACT This paper studies the use of innovative digital technologies to assess art and music creative works in China. The authors of the paper conducted an experimental study of the influence of various types of assessment, such as formative and summative, on the academic motivation and mental health of artists and musicians. The study involved second-year students from Xihua University (N = 548). The researchers used the Academic Motivation Scale (AMS) and the Depression, Anxiety and Stress Scale (DASS) as psychometric tools of the standardized methods. Summarizing the results obtained, they can conclude that summative assessment stimulates external motivation, while formative assessment contributes to the development of internal motivation of students. These results allow teachers to offer different types of assessment to strengthen a certain type of students’ motivation. The researchers also found that summative assessment could result in a higher level of amotivation. However, they did not confirm the assumption about the negative impact of summative assessment on the mental state of students.

"All Children in Focus": Effects of a Universal Parenting Program at a 6-Month Follow-Up in a Randomized Controlled Trial in Sweden.

Parenting programs have been shown to empower parents and prevent mental health problems in children. However, few programs are designed to promote wellbeing, which led to the development of the Swedish-promotive universal program, "All Children in Focus" (ACF). This study aimed to understand the effects of parents' participation in the ACF program on parents' emotion regulation and parenting practices over a 6-month follow-up and if intervention-produced changes predict child wellbeing (CW). Parental self-efficacy (PSE) was also included to assess the relation with parental outcomes and CW. This is an evaluation of a multicenter randomized waitlisted control trial conducted in Stockholm County, Sweden, with parents of children aged 3 to 12 years (n = 621) in 2012. Parents were randomized 1:1 to enter the program or to a waitlist. Questionnaires were completed by parents at baseline, post-intervention, and 6 months post-baseline. We used generalized mixed modeling to test effects on parental outcomes over time and regression analyses to study the predictive role of parental outcomes on CW. From baseline to the post- and to the 6-month follow-ups, parents in the intervention group reported greater levels of emotion regulation skills, cognitive reappraisal, and positive parenting than did parents in the control group. A decrease in negative and harsh parenting was evident in both groups, although it was greater in the intervention group. An increase in PSE was associated with high negative parenting at baseline in the intervention group. Child gender moderated positive parenting, suggesting that parents of girls in the intervention group had more favorable development of positive strategies. The findings indicate that a change in PSE predicts a change in CW at 6 months. The ACF program can be used to strengthen and develop parenting. This study advances our knowledge about the potential advantages of using a health-promoting approach to strengthen the wellbeing of families in the general population. Clinical trial registration: ISRCTN70202532 Current Controlled Trials.

Long-Term Course of Remission and Recovery in Psychotic Disorders.

Understanding prognosis is critical to anticipating public health needs and providing care to individuals with psychotic disorders. However, the long-term course of remission and recovery remains unclear. In this study, the most common trajectories of illness course are described for a cohort of individuals followed for 25 years since first admission for psychosis. Participants are from the Suffolk County Mental Health Project, an epidemiological study of first-admission psychosis. Data for the present study was collected from six follow-ups, with 311 individuals assessed at the 25-year follow-up. Common patterns of remission and recovery were assessed in the baseline cohort of 591 individuals and the subsample from the 25-year follow up. In the baseline cohort and the 25-year subsample, the most common trajectory for individuals with schizophrenia spectrum disorders was no remission and no recovery. Among individuals with other psychotic disorders, in both the baseline and 25-year cohorts, the modal pattern was one of intermittent remission and recovery. Individuals with other psychotic disorders were more likely to experience stable remission (15.1%) and stable recovery (21.1%), outcomes that were rare among individuals with schizophrenia spectrum disorders (0% and 0.6%, respectively). The modal longitudinal pattern for individuals with other psychoses is one of multiple transitions into and out of symptomatic and functional recovery. Engagement in a long-term health care plan may help individuals detect and respond to these changes. Sustained remission and recovery are rare among people with schizophrenia spectrum disorders. Efforts should be directed toward developing more effective treatments for this population.

빗속의 사람 그림 검사(PITR) 반응에 대한 대학생의 우울, 불안, 부정정서에 관한 연구

Objectives This study aims to identify the responses shown in the picture test and negative psychological aspects such as depression, anxiety, and negative emotions by using both the subjective responses shown in the People-in-the-Rain Picture Test(PITR), a projective test, and a multiple-choice self-report test. Methods The target was college students attending K University in Region P. 146 copies were distributed and 125 copies were collected. Of these, the data from 108 people, excluding 17 who responded insincerely, was analyzed. The collected data were subjected to frequency analysis, reliability analysis, descriptive statistics, and correlation analysis using the SPSS statics 26.0 program. An independent sample t-test was conducted to confirm gender differences in variables, and a simple regression analysis was conducted to determine the effect of the PITR re-sponse on depression, anxiety, and negative emotions. An independent samples t-test was conducted to confirm the differences in responses to the PITR according to the upper and lower levels of the average emotional score. Results First, as a result of checking the correlation between variables, the ‘stress’ response did not have a stat-istically significant relationship with depression, anxiety, and negative emotions in the PITR response, and the ‘coping resources’ response did not have a statistically significant relationship with depression, it was found to be negatively correlated with anxiety and negative emotions, and the ‘coping ability’ response was also found to be negatively correlated with depression, anxiety, and negative emotions. Second, differences in variables according to gender were confirmed in the ‘coping resources’ response and the ‘coping ability’ response among the PITR responses. Third, PITR response was found to affect depression, anxiety, and negative emotions. Fourth, as a re-sult of checking whether there was a difference in the response to the PITR depending on the average score of depression, anxiety, and negative emotions, it was found that there was no difference in the response to the PITR according to depression, the differences in responses to the PITR according to anxiety and negative emotions were verified to have statistically significant differences in both ‘coping ability’ responses. Conclusions Through the results of this study, it was confirmed that negative psychological aspects such as de-pression, anxiety, and negative emotions can vary depending on how one copes with the stress rather than the stress itself, and that the response to the PITR differs depending on gender in terms of coping with stress. It was confirmed that there was a difference. In addition, we were able to understand that depression, anxiety, and neg-ative emotions are different psychological characteristics, and it was confirmed that coping abilities vary accordingly. The significance of this study is that it provided evidence for early detection, appropriate treatment, and prevention education for college students with mental health difficulties.

Patient-initiated follow-up for high-risk cutaneous squamous cell carcinoma. How we do it and two years of outcome data.

Why do we follow-up patients with high-risk cutaneous squamous-cell carcinomas (cSCC)? Current guidance suggests we offer post-treatment follow-up appointments at regular intervals for 24 months. Is this to improve prognosis, provide psychological support or find the next cancer? Recent data confirms recurrence and metastasis to be rarer events. We question whether these follow-up practices are truly 'needed' by introducing an option of patient-initiated follow-up (PIFU). We enrolled 476 cSCC patients (January 2020 - January 2023) who fulfilled the definition of high-risk cSCC based on guidelines in use at the time. 59 patients were excluded. 53% (n=250) did not re-contact us during the 2-year period, with no clinical record of complications or recurrences. 35% (n=167) utilised the PIFU pathway, of which 119 patients only required 1 face-to-face appointment. 7 patients (1.5%) developed metastatic disease, 11 patients developed recurrence, and 68 patients developed cSCC at another site. All lesions were identified by the patient via PIFU. We saved 1250 follow-up appointments from those that did not contact us (n=250); financially equating to £181,462.50. Our data implies that PIFU can be considered safe alternative practice for patients with cSCC. Patients independently identified the need for review without scheduled follow-up, making these appointments available to other patient cohorts. Although follow-up appointments may provide mental health support, they can be inconvenient and not the ideal use of our health resources. Our findings support a call for revision of existing skin cancer health policies, to cope with and subsequently improve our practices, to better patient care.