Mental Health Research Articles

How should policymakers, funders, and research teams mobilize to build the evidence base on universal early years services?

Health visiting in England is a universal service that aims to promote the healthy development of children aged under five years and safeguard their welfare. We consulted stakeholders about their priorities for research into health visiting and also used these consultations and a literature review to generate a logic model. Parents wanted research to explore how health visiting teams can provide a caring, responsive, accessible service (the mechanisms of change). Policymakers, commissioners, and clinical service leads wanted descriptions and evaluations of currently implemented and 'gold standard' health visiting. The challenges to evaluating health visiting (data quality, defining the intervention, measuring appropriate outcomes, and estimating causal effects) mean that quasi-experimental studies that rely on administrative data will likely underestimate impact or even fail to detect impact where it exists. Prospective and experimental studies are needed to understand how health visiting influences infant-parent attachments, breastfeeding, childhood accidents, family nutrition, school readiness, and mental health and well-being.

Experiences of Communities Living in Shelters During the 2022 Eastern Kentucky Floods.

On July 28, 2022, floods in eastern Kentucky displaced over 600 individuals. With the goal of understanding mental health needs of affected families, we surveyed households living in flood evacuation shelters after the 2022 Kentucky floods. Families experiencing displacement from the 2022 Kentucky floods currently living in three different temporary shelter locations were surveyed via convenience sampling. A rapid community needs assessment involving in-person interviews using modified two stage cluster methodology (CASPER) was conducted between September 6-9, 2022. Teams conducted 61 household interviews. Since the flood, 27.7% reported that their household received services from behavioral health and 19.6% received grief counseling. Experiencing agitation (36.7%), difficulty concentrating (47.5%), nightmares (62.3%), or suicidal thoughts/self-harm (6.6%) were reported by households surveyed. Over one-fourth (27.0%) of individuals surveyed reported being depressed nearly every day. Over 20% reported anhedonia (inability to feel pleasure) nearly every day. Over 75% of individuals surveyed reported being anxious several days or more over the last two weeks. Over one-third of individuals (34.0%) reported being unable to stop worrying nearly every day. Of those individuals surveyed, 36.1% reported barriers to mental health services. Symptoms of depressed mood, anhedonia, anxiety, and nightmares were prevalent in displaced families six weeks after the 2022 Kentucky floods. Providing and encouraging access to mental health services are important priorities during disaster recovery.

Debate: Where to next for universal school-based mental health interventions? Universal versus targeted school-based mental health interventions: a health economic perspective.

Mental health problems in schools are a concern and various initiatives have been developed to address these. Interventions can be universal (covering a whole school) or targeted (addressing those with specific needs). Any new intervention should be evaluated, and this should include an assessment of cost-effectiveness. Evidence to date suggests that while gains from universal schemes may be modest, they can still be cost-effective given the extent of their reach. However, targeted interventions can address key health inequalities which should also be an objective of an economic evaluation. Studies that have examined the longer term impact of both universal and targeted approaches have demonstrated that both can represent good values for money, and it is likely that a blended or tiered approach is appropriate.

Bridging the conversational gap in epilepsy: Using large language models to reveal insights into patient behavior and concerns from online discussions.

This study was undertaken to explore the experiences and concerns of people living with epilepsy by analyzing discussions in an online epilepsy community, using large language models (LLMs) to identify themes, demographic patterns, and associations with emotional distress, substance use, and suicidal ideation. We analyzed 56 970 posts and responses to them from 21 906 users on the epilepsy forum (subreddit) of Reddit and 768 504 posts from the same users in other subreddits, between 2010 and 2023. LLMs, validated against human labeling, were used to identify 23 recurring themes, assess demographic differences, and examine cross-posting to depression- and suicide-related subreddits. Hazard ratios (HRs) were calculated to assess the association between specific themes and activity in mental health forums. Prominent topics included seizure descriptions, medication management, stigma, drug and alcohol use, and emotional well-being. The posts on topics less likely to be discussed in clinical settings had the highest engagement. Younger users focused on stigma and emotional issues, whereas older users discussed medical treatments. Posts about emotional distress (HR = 1.3), postictal state (HR = 1.4), surgical treatment (HR = .7), and work challenges (HR = 1.6) predicted activity in a subreddit associated with suicidal ideation, whereas emotional distress (HR = 1.5), surgical treatment (HR = .6), and stigma (HR = 1.3) predicted activity in the depression subreddit. Substance use discussions showed a temporal pattern of association with seizure descriptions, implying possible opportunities for intervention. LLM analysis of online epilepsy communities provides novel insights into patient concerns often overlooked in clinical settings. These findings may improve patient-provider communication, inform personalized interventions, and support the development of patient-reported outcome measures. Additionally, hazard models can help identify at-risk individuals, offering opportunities for early mental health interventions.

Integrating sleep care in psychological practice: A survey of Brazilian clinical psychologists and a global bibliometric analysis.

Given psychologists' role and the use of psychotherapies for sleep issues, our study explored: (1) whether psychologists inquire about patients' sleep quality and their beliefs regarding the relationship between mental health and biological rhythms, and (2) global trends in psychological approaches through a bibliometric analysis. We analyzed responses from 1011 Brazilian clinical psychologists (October 2018-May 2019) and found that most routinely inquire about sleep quality and address sleep problems, while a small portion did not perceive a direct link between mental disorders and biological rhythms. Behavioral psychotherapy practitioners showed greater interest in sleep quality. The bibliometric analysis revealed that cognitive behavioral therapy had the strongest associations with sleep-related terms compared to other approaches. In conclusion, clinical psychology plays a key role in addressing human health. Given rising concerns about biological rhythms, further exploration across psychological approaches is essential, especially to enhance education in this field.

The Implementation of Integrated Youth Services in Canada: Planning and Costing of a Pan-Canadian Model: La mise en œuvre des services intégrés pour les jeunes au Canada : planification et établissement des coûts d'un modèle pancanadien.

The implementation of Integrated Youth Services (IYS) can help ensure that youth are adequately supported. The objective of this analysis was to provide a model for the planning and costing of IYS throughout Canada over a 15-year period. To estimate resource allocation for IYS, we determined the number of hubs and hub staffing requirements by service level and jurisdiction, backbone support and infrastructure requirements by jurisdiction. A needs-based analytic framework for planning was employed to estimate the number of hubs required. The optimal mix of hub staffing requirements was determined based on prior literature. The costs of running each hub were estimated using publicly available data and internal documents from existing IYS agencies. Finally, the cost of setting up IYS hubs, IYS virtual care and respective backbone support throughout Canada was estimated and projected over 15 years and the cost-savings of IYS were calculated. At maturity, it was estimated that 399 hubs-188 small, 43 medium, 168 large-across Canada would be required to address youth mental health and substance use needs. The cost of implementing IYS initiatives across Canada would vary between $4,349,126 (for less populous jurisdictions) and $248,950,524 (for more populous jurisdictions), for a total annual cost of $676,633,388 (excluding costs of infrastructure). It was estimated that the implementation of IYS hubs would lead to cost-savings of $2.1 billion annually and have the potential to be cost-effective. The implementation of IYS hubs can provide good value for money, in the form of high client satisfaction, earlier supports with improved youth outcomes and decreased health care costs. Future work should address gaps in data availability on mental health and substance use-related needs of youth with neurodevelopmental disorders, youth experiencing homelessness, youth in congregate living and foster care, and Indigenous youth.

Quality of life in long-term breast cancer survivors in Sub-Saharan Africa: the African Breast Cancer-Disparities in Outcomes study.

In Sub-Saharan Africa (SSA), breast cancer survivors' (BCS) quality of life (QoL) remains understudied. We compared QoL in BCS to cancer-free (CF) women across SSA settings with different levels of development, healthcare systems, ethnic compositions, and HIV prevalence. In 2022-2023, all 5 + year BCS from the African Breast Cancer-Disparities in Outcomes study and age-matched CF women from the community setting answered the WHOQOL-BREF questionnaire in Namibia, Nigeria, and Uganda. For each WHOQOL-BREF domain and general item, we estimated BCS-CF adjusted mean differences (AMD) in scores in absolute percentage points (p.p.). Overall, 862 women (BCS 357 vs. CF 505) (mean age ± SD, 57.5 ± 12.5 vs. 55.1 ± 11.2; tertiary education, 30% vs. 20%) were included. BCS reported higher/better overall QoL (AMD (95% CI) 10.65 p.p. (7.56, 13.74), i.e., ~ 40% of a change in QoL category), general health (5.84 (2.71, 8.98)), psychological (3.46 (1.43, 5.49)), social relationships (3.94 (1.25, 6.63)), and environment scores (4.27 (1.88, 6.67)) than CF women. There was no BCS-CF difference for physical health in all settings (1.52 (- 0.82, 3.87)), psychological health in Namibian Black women (0.58 (- 2.90, 4.06)), and social relationships in Nigeria (- 0.33 (- 5.81, 5.14)). BCS reported both lower energy and sexual life satisfaction than CF women. In SSA, long-term BCS have slightly better QoL than CF women except for physical health. Areas for which BCS scored lower or similar than CF women may indicate BCS' QoL issues. BCS-only studies using cancer-specific QoL questionnaires are needed to better characterize BCS' QoL in SSA.

Perceived Psychological and Physical Health as Predictors of Mortality and Quality of Life in Patients with Lymphedema: A Prospective Study Spanning Almost Two Decades.

How does living with a chronic disease of the lymphatic system affect quality of life and mortality? Lymphedema is a chronic disease mostly affecting women and research is sparse. To this date, longitudinal studies evaluating biopsychosocial predictors for mortality and quality of life in lymphedema are largely missing. This study aims to identify possible predictors and could open innovative ways for treatment options. Two hundred ninety-two patients with lymphedema partaking in a rehabilitation program in a lymphedema clinic were longitudinally assessed. The sample consisted of 86.2% women, aged between 18 and 83years (M = 53.42, SD = 12.54), with a mean BMI (kg/m2) of 31.64 (SD = 8.26). Beginning with baseline assessment in 2002-2006, follow-up was evaluated 15-19years later (N = 91). We assessed a variety of potential biopsychosocial predictors of mortality and quality of life (i.e., depression, anxiety, cancer). At follow-up, 19.5% of participants were deceased. Age, gender, and cancer significantly predicted mortality (R2 = .27) and quality of life (R2 = .29). Anxiety and depression significantly predicted both quality of life and mortality when entered simultaneously. However, further analyses indicated suppressor effects and when entered separately, effects solely for depression or anxiety did not reach significance level. Age, gender, and cancer were the main predictors of mortality and quality of life in patients with lymphedema. Psychological predictors of mortality and quality of life were mainly due to suppressor effects, thus calling for caution when analyzing the contribution of mental health indicators for clinical outcomes. This study was preregistered with the German Clinical Trials Register (Identifier DRKS00024450) and Open Science Framework ( https://doi.org/10.17605/OSF.IO/RHXQJ ).

Exploring the longitudinal associations among fear of negative evaluation, self-disgust, and self-injury in Chinese adolescents: Disentangling between- and within-person associations.

Nonsuicidal self-injury (NSSI) and suicidal ideation (SI) are widespread mental health concerns among adolescents. As fear of negative evaluation (FNE) and self-disgust are also common psychological phenomena among adolescents, existing research suggests that there may be reciprocal predictive relationships between FNE and NSSI/SI with self-disgust playing a mediating role. This study aimed to investigate the reciprocal relationships between FNE and NSSI, as well as FNE and SI, and the mediating role of self-disgust. Random intercept cross-lagged panel models (RI-CLPMs) were employed. A total of 515 Chinese secondary school students (50.7% boys; baseline Mage = 12.31 years, SD = 0.81) completed self-report questionnaires regarding FNE, self-disgust, NSSI, and SI. The assessment was conducted in four waves, 6 months apart. The results were as follows: (1) There were bidirectional relations between FNE and NSSI through self-disgust. (2) There was a unidirectional association from FNE to SI via self-disgust. These findings have expanded the theoretical understanding of adolescent NSSI and SI, and highlighted the importance of offering personalized psychological counseling and therapy services at the intrapersonal level for adolescents.

Understanding self-healing: Recovery insights from Indonesian suicide loss survivors and support providers.

This study examines the vital but underexplored role of self-healing in postvention efforts for suicide loss survivors (SLS) in Indonesia. We investigate the perspectives of Indonesian SLS and grief support providers (GSP) on self-healing's role in managing grief. Through in-depth interviews with 31 participants (16 SLS and 15 GSP), reflexive thematic analysis reveals both shared and divergent views. Our study developed three main themes: (1) Redefining self-healing, (2) Disconnectedness following loss, and (3) Reestablishing connection. The first theme shows both groups viewing self-healing as an intentional and dynamic process of confronting pain, and the latter themes highlight its role in restoring connections disrupted by suicide loss-spanning self, social, and spiritual dimensions. The findings offer practical implications for mental health professionals, policymakers, and support networks, promoting a more compassionate approach to post-suicide grief in Indonesia.

Co-Occurring Mental Health and Substance Use Research Among Aboriginal and Torres Strait Islander People: A Systematic Review.

Objective: This systematic review describes studies focussed on co-occurring mental health and substance use (MH/SU) conditions among Aboriginal and Torres Strait Islander people, including the: characteristics; co-occurring conditions examined; cultural methodological quality; traditional scientific methodological quality of studies; and study outcomes. Methods: A systematic review examined the literature on co-occurring MH/SU conditions among Aboriginal and Torres Strait Islander people. Four databases were searched, with data from relevant studies extracted for narrative synthesis. Results: Twelve articles (11 studies) were included. Nine studies used cross-sectional designs; one was a qualitative study and one a mixed methods study with a nested randomized controlled trial. Cultural methodological quality was low across the studies, with a maximum of 7 out of 14 criteria met. Thirty-three combinations of co-occurring conditions were examined. Conclusion: Most research to date has been cross-sectional with limited research exploring the effectiveness of treatments for co-occurring MH/SU conditions. Further Indigenous-led research is needed to find culturally safe, responsive and effective solutions in reducing the burden associated with MH/SU conditions and improving wellbeing.

Oral Hygiene Status and Psychological Factors Among Sheltered Adolescents in Recife.

To investigate the association between oral hygiene status and psychological factors among foster adolescents in Recife. This cross-sectional study was carried out in Recife in 10 shelters for adolescents aged 10-17 years. After obtaining ethics approval, the adolescents were clinically examined. Their oral hygiene was recorded using the simplified oral hygiene index (OHI), and they were asked about their oral hygiene and visits to the dentist. They were also asked about anxiety, depression and stress (DASS-21). The results were statistically analysed using the chi-squared and Fisher's exact test or odds ratios, as appropriate. Eighty-one adolescents, of whom 56 were males and 25 were females, participated in the study. They had been admitted to shelters 2-6 months before because they had been neglected and/or abandoned and/or were homeless. Only 8.6% had visited a dentist in the previous 12 months. Seventy-eight (94%) had access to toothbrushes and toothpaste and performed daily oral hygiene. Seventy-one (88%) reported anxiety, 69 (85%) depression and 74 (91%) stress. There was no association between these three factors and OHI. Several factors, including the region of origin (p = 0.434) and time living in the shelter (p = 0.0303), were associated with stress. Attention should be given to adolescents living in shelters to ensure their good oral hygiene and regular visits to the dentist, especially those who have suffered abuse/violence/exploitation. They must also be given mental health assistance.

Unusual urinary discoloration: A case report of blue urine in a patient with advanced Prostate cancer

Here, we present a case of blue urine in an 89 -year-old male with advanced prostate cancer and difficult to control hypertension as well as comorbid type II diabetes mellitus (T2DM), hyperlipidemia and chronic urinary retention. The patient was newly diagnosed with COVID-19 and returned to our hospital after 30 days of first admission, this time in respiratory failure. Administration of Urogesic-Blue (methenamine, sodium phosphate, methylene blue and hyoscyamine) can cause this discolorization due to its content in part of methelyene blue as evidenced by the presence after analysis. These cases emphasize the importance of being aware that this is a potential harmless side effect to avoid unnecessary diagnostic procedures. Prostate Cancer, especially when it comes with bone metastasis, increases complexity and difficulty in managing the patient. Comorbidity in the patient and attendant polypharmacy made treatment planning difficult, given that one had to be very cautious about drug-drug interactions so as not only manage mental health effectively but also treat actively existing medical conditions. The situation escalated following the recent COVID-19 infection, which required hospitalization for final comprehensive monitoring and supportive care. High levels of proBNP suggest that the heart was under some stress, probably further increased by the presence of a virus making this case complex and certainly multidisciplinary. This case informs the need for a complete medication history and patient counseling in cases of strange clinical presentations. Recognition of Urogesic-Blue as the agent in bluish urine permits health care providers to reassure patients and avoid unnecessary diagnostic work-ups. This report gives an insight into avoidable handling of intricate past medical history and multi-morbidity and adds knowledge on the bedside approach regarding blue urine. Keywords:Blue Urine, Prostate Cancer, Methylene Blue, Urogesic-Blue, COVID-19 Complications

Clinical Characteristics of Early Leavers From a Private Dual-Diagnosis Program.

Objective: Early leaving in substance use disorder treatment may be the single largest variable undermining treatment success. Existing work on early leaving tends to explore either client factors, which include age, race, gender, and diagnoses, or treatment factors, which include the type of treatment activities offered, treatment experiences of clients and staff, treatment amenities, and environmental factors in the residential treatment program. However, existing work on both client factors and treatment factors provides mixed results on what contributes to early leaving. Further, there has been very little research in the private residential treatment setting. This study aims to explore the factors influencing early leaving in a private residential treatment setting. Methods: The study analyzed admission and treatment records from 247 consecutive clients at a private treatment facility in Southern California to identify factors related to shorter retention. The program employs a biopsychosocial approach and evidence-based practices to assist clients in recovery from substance use disorders and mental health conditions. We utilize a battery of client measures, including the Outcome Questionnaire 45.2, Trauma History Questionnaire, as well as demographic and psychiatric variables in our analyses. Results: Findings challenge previous research by showing that age and gender do not predict shorter retention, contrary to findings in the extant literature on public treatment centers. Instead, clients with higher symptoms of distress stay longer, as indicated by scores on the Outcome Questionnaire 45.2. Additionally, we find the majority of the cohort stayed in residential treatment for more than 30 days, with the average length of stay being 47.92 days, indicating that treatment completion of clients with severe symptomatology for an extended time in treatment (30 days or more) is achievable. Conclusions: The study underscores the importance of considering client symptomologies and severities in understanding and improving retention in substance use disorder treatment programs. This study highlights the potential impact of treatment services offered in private settings on client retention.

Development of individualized risk assessment models for predicting post-traumatic epilepsy 1 and 2 years after moderate-to-severe traumatic brain injury: A traumatic brain injury model system study.

Although traumatic brain injury (TBI) and posttraumatic epilepsy (PTE) are common, there are no prospective models quantifying individual epilepsy risk after moderate-to-severe TBI (msTBI). We generated parsimonious prediction models to quantify individual epilepsy risk between acute inpatient rehabilitation for individuals 2 years after msTBI. We used data from 6089 prospectively enrolled participants (≥16 years) in the TBI Model Systems National Database. Of these, 4126 individuals had complete seizure data collected over a 2-year period post-injury. We performed a case-complete analysis to generate multiple prediction models using least absolute shrinkage and selection operator logistic regression. Baseline predictors were used to assess 2-year seizure risk (Model 1). Then a 2-year seizure risk was assessed excluding the acute care variables (Model 2). In addition, we generated prognostic models predicting new/recurrent seizures during Year 2 post-msTBI (Model 3) and predicting new seizures only during Year 2 (Model 4). We assessed model sensitivity when keeping specificity ≥.60, area under the receiver-operating characteristic curve (AUROC), and AUROC model performance through 5-fold cross-validation (CV). Model 1 (73.8% men, 44.1 ± 19.7 years, 76.1% moderate TBI) had a model sensitivity = 76.00% and average AUROC = .73 ± .02 in 5-fold CV. Model 2 had a model sensitivity = 72.16% and average AUROC = .70 ± .02 in 5-fold CV. Model 3 had a sensitivity = 86.63% and average AUROC = .84 ± .03 in 5-fold CV. Model 4 had a sensitivity = 73.68% and average AUROC = .67 ± .03 in 5-fold CV. Cranial surgeries, acute care seizures, intracranial fragments, and traumatic hemorrhages were consistent predictors across all models. Demographic and mental health variables contributed to some models. Simulated, clinical examples model individual PTE predictions. Using information available, acute-care, and year-1 post-injury data, parsimonious quantitative epilepsy prediction models following msTBI may facilitate timely evidence-based PTE prognostication within a 2-year period. We developed interactive web-based tools for testing prediction model external validity among independent cohorts. Individualized PTE risk may inform clinical trial development/design and clinical decision support tools for this population.

Exploitation and Trafficking of Women and Girls for Forced Marriage in India

ABSTRACT Trafficking of women and girls for forced marriage in India is a growing phenomenon. Acute poverty, dowry practices, and precarious family socioeconomic conditions after the COVID-19 pandemic in India have resulted in evidence that young girls are being sold and lured through false promises of employment and good quality of life for the purpose of exploitation. Studying the experiences of 34 Indian trafficking victims, this paper explores and analyses the dynamics of human trafficking for the purpose of marriage and to describe their experiences and health conditions (physical and mental) during the trafficking. Findings revealed that victims were forced to marry before reaching the legal marriage age (18 years), and were subjected to multiple forms of violence, including verbal abuse, threats, physical and sexual violence, which co-occurred in diverse contexts at work and resulted in a wide range of physical health consequences, from head injuries to broken bones and mental health problems. The study concluded on the need for strong implementation of law enforcement in the region to stop the trafficking for forced marriage, including a highly needed intensive awareness program to eradicate patriarchal attitudes and practices on the commoditisation of women, dowry practices, and curb the trafficking network.

Argumentation strategies in lobbying: the discursive struggle over proposals to regulate Big Tech

PurposeThis study investigates, through a case study where organisations held opposing lobbying objectives, the argumentation strategies employed by organisations in their lobbying. Big Tech companies lobbied against proposed online harm regulations in the UK, with their objectives clashing with public interest groups with a health focus, who advocated for broader regulations. The research explores the functional relationship between these argumentation strategies and the lobbying objectives of the organisations involved. Additionally, it examines the extent to which organisations with similar lobbying objectives converge in the argumentation strategies they deploy.Design/methodology/approachA qualitative content analysis of N = 13 submissions in response to the UK Online Safety Bill from seven public interest groups and six Big Tech companies was conducted. It captured both the public affairs objectives and argumentation strategies submitted in response to the regulatory proposal.FindingsOur findings suggest Big Tech use argumentation strategies that emphasise cost implications, threats to freedom of speech and claim proposed regulations are impractical, while at the same time seeking to align their objectives with public interest norms. Public interest groups continuously stress the costs and risks for mental health if regulations are not widened in scope or rigorously enforced.Originality/valueSituating lobbying within communication management, the study contributes to theorising language strategies. It reveals the argumentation strategies with which both powerful corporations and public interest groups attempt to influence public policy. Both theoretically and practically, it will contribute to developing analytical frameworks for understanding the influence intent in lobbying argumentation.

Lifetime stressor exposure is related to suicidality in autistic adults: A multinational study.

When we encounter life events that we experience as stressful ("stressors"), it sets off a biological stress response that can impact mental health and contribute to suicidal thoughts and behaviors (STB). Although we know about specific stressors that are associated with STB in the general population, little is known about the kinds of stressors that increase the risk of STB in autistic people and whether these associations differ by gender. To examine this issue, we cataloged the life stressors that autistic men and women experienced over the entire life course and investigated how these stressors were related to STB. Data were derived from a multinational sample of 226 autistic adults from the United Kingdom and Australia who completed the Stress and Adversity Inventory for Adults. We found that autistic men and women differed in terms of both the lifetime stressors they experienced as well as their perceived severity. Whereas men experienced more legal/crime-related stressors, women experienced more stressors related to relationships with other people and more long-lasting stressors associated with humiliation. Autistic women often perceived life stressors as more severe than men, which is important given that it is the perceived severity of stressors that most strongly affects our health. We also found that different stressors may predict STB in autistic men versus women. Whereas loss of loved ones was most strongly associated with STB for men, for women, physically dangerous stressors were most relevant. In addition, women with fewer lifetime stressors involving entrapment had higher lifetime STB. These results suggest that lifetime stressor exposure may be important to assess to understand suicide risk in autistic people. Additional research is needed to confirm these associations and to examine possible mechanisms linking stress and STB.

Mental health and attitudes toward suicide amongst individuals with gender dysphoria in Iran

IntroductionGender dysphoria (GD) is associated with profound mental health challenges, including heightened suicide risk. This study aimed to explore the mental health status and attitudes toward suicide among individuals with GD in Iran.MethodsA comprehensive assessment was conducted using three validated tools: the General Health Questionnaire (GHQ-28) to gauge emotional distress and psychological well-being, the Beck Depression Inventory (BDI-II) to evaluate the severity of depressive symptoms, and the Predicament Questionnaire (PQ) to measure attitudes toward suicide in the context of social crises.ResultsAmong the 78 participants, 43 (55.1%) were identified as experiencing significant mental health issues, while 21 (26.9%) were found to suffer from severe depression. The average PQ score was 57.92, which aligns with findings from similar populations in previous studies, highlighting a concerning trend in suicide-related attitudes. Further statistical analysis revealed significant correlations between psychological distress (GHQ-28 scores) and attitudes toward suicide (PQ scores), as well as between depressive symptoms (BDI-II scores) and suicide-related attitudes.ConclusionsThese findings indicate a pervasive prevalence of psychological disorders, particularly depression, within this group, and underscore the strong association between depressive states and suicidal ideation. The study underscores the urgent need for targeted mental health interventions and comprehensive healthcare policies tailored to the specific needs of individuals with GD in Iran. Given the substantial mental health burden observed, particularly the risk of suicide, this research highlights the critical importance of integrating mental health care into broader support systems for this population.

Analysis of the Impact of Multidimensional Stressors on Adolescent Mental Health

Adolescence represents a pivotal developmental phase, marked by substantial physiological, psychological, and social changes that may result in various stressors that can profoundly affect mental health. As such, a comprehensive understanding of major stressors experienced by adolescents and their impact on mental health is essential for the formulation of effective intervention strategies and policies. The paper explores the main sources of stress for adolescents, which includes social interactions, familial expectations, academic pressures, and socioeconomic difficulties, and analyzes how these stressors contribute to mental health issues such as anxiety, depression, and decreased quality of life. Furthermore, it synthesizes relevant literature, and integrates quantitative data from longitudinal surveys and qualitative data from interviews with adolescents aged 12 to 18, including participants from diverse socioeconomic backgrounds. The results indicate that academic stress is the most prevalent, followed by stress from interpersonal relationships and family, with socioeconomic factors also having a notable impact. However, despite the variation in individual responses to stress, its impact on mental health is particularly pronounced during adolescence, which is a key period for emotional and psychological development. The paper concludes with recommendations for targeted interventions and emphasizes the need for policies to help adolescents manage stress and thereby improve mental health outcomes.