Mental Status Research Articles

The impact of COVID-19 on Health Science undergraduate students’ academic experience and mental health: A pilot study

The COVID-19 pandemic has created significant disruptions in teaching and learning at universities, predisposing university students to develop mental health issues which may impact their academic experience. This study evaluated the academic experience and mental health status of students enrolled in Health Science courses at Swinburne University of Technology via a mixed-methods cross-sectional survey conducted on 36 students (18+ years). Out of these students, 10 attended in-depth interviews. Results obtained from both quantitative and qualitative data analyses found high levels of stress, anxiety and depression, with more than 50% experiencing levels above the clinical thresholds. About 39% of the participants reported feeling able to concentrate on their learning when materials were delivered via an online mode. Students’ engagement through online learning was significantly disrupted, 97.2% of the respondents found it difficult to perform group work and 75% reported not being able to engage with their peers. Higher levels of stress, anxiety and depression were significantly associated with a compromised learning experience. Spearman’s Rank Correlation showed a significant negative association between stress and students’ engagement with online learning (Spearman’s rho=-0.49, p=0.003). Supporting the learning experiences along with monitoring the mental health of all university students should be of high priority for university authorities.

Quality of life and mental health status in caregivers of pediatric patients with nephropathic cystinosis.

There are few studies assessing psychological burden and quality of life (QoL) in caregivers of pediatric patients with nephropathic cystinosis, a severe chronic disease. This observational, single-center study aimed to explore the levels of anxiety, depression, care burden, and QoL status in caregivers of patients with nephropathic cystinosis. The Hospital Anxiety and Depression Scale (HADS), the Zarit Caregiver Burden Scale, and the Short Form-36 (SF-36) were administered to caregivers of pediatric patients with nephropathic cystinosis. Nine caregivers of pediatric patients with nephropathic cystinosis participated in the study (6 boys and 3 girls; mean age, 12.6 ± 4.2 years). All participating caregivers were the patient's mothers. Of the 9 caregivers, 6 showed anxiety/depression and 4 severe care burden. Overall, SF-36 QoL domains with a worse perception by caregivers were 'general health' and 'health change over time'. Mothers without depression/anxiety and low care burden had better QoL perception (p = 0.02). All caregivers with high care burden showed anxiety/depression. In our study cohort, caregivers of pediatric patients with nephropathic cystinosis showed high levels of anxiety/depression, high care burden, and impaired QoL, highlighting the importance of detecting psycho-social issues to implement strategies that relieve family stress and improve coping strategies.

Hardiness personality and mental health of financially-struggling medical students in private universities in China: the intervening roles of coping styles and gender

BackgroundChinese adolescents are at higher risk of depression, especially the mental health problems of financially disadvantaged medical students, which are significantly higher than those in other age groups, which brings great challenges to the mental health workers in universities.Methods1,280 medical students with a family poverty background in China completed a questionnaire on hardiness personality, coping style and mental health. After descriptive statistics and Pearson correlation analysis between hardiness personality, coping style and mental health levels, we tested the mediation of coping style and the moderating effects of gender.ResultsHardiness personality significantly positively affected the financially-struggling medical student’s mental health level. Positive coping style had a significant positive impact on hardiness personality and mental health level, while negative coping style had a significant negative effect on mental health level. Positive coping and negative coping are the mediators between financially-struggling medical students’ hardy personalities and mental health levels. In medical students with a family poverty background, gender plays a regulatory role in coping style and mental health levels. In medical students with a family poverty background, gender plays a moderate role in coping style and mental health levels.ConclusionThis study adds some knowledge about the effects of hardiness personality on individual mental health. It makes new recommendations for improving the mental health status of vulnerable groups, while it can support future investigations by scholars and educators on how to improve the mental health of students under learning and financial-related stress.

Mental Health Status of Patients Recovered from COVID-19 in Macau: A Cross-Sectional Survey.

Background/Objectives: The COVID-19 pandemic has led to a global health crisis, impacting physical, and mental well-being, particularly among those who have recovered from the illness. This study aimed to assess the mental health status of patients recovered from COVID-19 in Macau, focusing on the impact of sequelae of COVID-19, and identifying demographic factors associated with poor mental health. Methods: A cross-sectional online survey was conducted involving 494 adults who had recovered from COVID-19, with 426 participants included in the final analysis. Mental health was evaluated using the 12-item General Health Questionnaire (GHQ-12), with scores ≥3 indicating poor mental health. Results: This study revealed a high prevalence of poor mental health, affecting 71.8% of the respondents. Binary logistic regression identified experiencing COVID-19 sequelae (OR = 5.727, 95% CI: 2.973-11.031), being in the age groups of 26-45 (OR = 4.227, 95% CI: 1.754-10.185), or 61, and above (OR = 18.072, 95% CI: 3.590-90.962), being male (OR = 0.501, 95% CI: 0.257-0.979), being married (OR = 5.714, 95% CI: 1.919-17.016), and dissatisfaction with family relationships (OR = 2.957, 95% CI: 1.228-7.119) as significant risk factors for poor mental health. Conclusions: This study underscores the critical need for targeted psychological support for patients recovered from COVID-19 in Macau, particularly for those with sequelae, and those in vulnerable demographic groups. The findings suggest that specific age groups and individuals with sequelae may face higher mental health risks, indicating the necessity for prioritized interventions.

A Scoping Review of Arthropod-Borne Flavivirus Infections in Solid Organ Transplant Recipients.

Arthropod-borne flaviviruses (ABFs), transmitted by mosquitoes or ticks, are increasing due to climate change and globalization. This scoping review examines the epidemiology, clinical characteristics, diagnostics, treatment, and outcomes of ABF infection in solid organ transplant recipients (SOTRs). A database search up to January 25, 2024, focused on ABFs such as West Nile virus (WNV), dengue virus (DENV), Japanese encephalitis virus (JEV), Powassan virus (POWV), yellow fever virus (YFV), and Zika virus (ZIKV), limited to SOTRs. We identified 173 WNV cases from 84 studies, with 28 donor-derived infections (DDIs). Common clinical features included fever (78.5%), altered mental status (65.1%), and weakness or paralysis (45.6%). Treatment involved reducing immunosuppression (IS) in 93 cases, with intravenous immunoglobulin (IVIG), interferon alfa-2b, and ribavirin used in 75 cases. Seven cases involved graft loss or rejection post-infection. WNV infection had a 23.7% mortality rate, with severe neurological complications in 43.9% For DENV infection, 386 cases from 47 studies were identified, including 14 DDI cases. Symptoms included fever (85%), myalgias (56.4%), and headache or retro-orbital pain (34.6%). Severe dengue occurred in 50 cases (13.0%). IVIG was administered in six cases. Reduction in IS was reported in 116 patients. DENV mortality rate was 4.9%. Additionally, 26 cases of less common ABFs such as JEV, POWV, YFV, and ZIKV were described. In summary, ABF infections among SOTRs are associated with higher morbidity and mortality compared to the general population, emphasizing the need for improved preventive strategies, timely diagnosis, and optimized management protocols.

The effects of the paramedics’ field work on their mental status in Jeddah

ABSTRACT Background: Paramedics are continuously exposed to stressful events, making them liable to mental disorders. This study assesses the health of paramedics in Jeddah, focusing on their mental, emotional, and physical well-being. Methods: This cross-sectional study included fieldwork paramedics in Jeddah through an online survey distributed on social media. With a response rate of 86.09%, 192 complete responses were analyzed. Outcomes included mental health, mood and somatic effect, self-esteem, and sleep. Results: Most participants were males (83.85%), married (50%), non-heavy smokers (51.04%), and non-alcohol drinkers (51.04%). A significant number reported health-related work or daily life difficulties, with 62.5%–67.18% attributing these to physical and emotional issues, respectively. Over half rated their mental health as poor or somewhat poor, impacting their relationships significantly. Additionally, 70.31% frequently felt anger, and many faced limitations in physical activities. About 14.58% had a prior mental illness diagnosis, with nearly a quarter on medication, and 61.98% had recently sought psychiatric help. Sleep deprivation affected 61.98%, with 38.53% reporting poor sleep quality. Conclusions: The findings highlight the negative impact on paramedics’ mental health, showing a substantial diagnosis rate of mental disorders, activity limitations, negative mood, and relationship issues. Despite significant sleep problems, a positive aspect is their proactive psychiatric help-seeking behavior.

Cross-country comparison of depressive symptoms and social-emotional aspects in university students from Brazil and Germany during the COVID-19 pandemic: results from two cross-sectional surveys.

The COVID-19 pandemic negatively affected students' mental health, increasing pre-existing psychosocial vulnerabilities. University students worldwide have presented differences in their mental health status; however, cross-country studies comparing students' mental health during the pandemic are lacking. To investigate potential differences between university students from Brazil and those from Germany with respect to (a) depressive symptoms and alcohol and drug consumption, (b) social and emotional aspects (loneliness, self-efficacy, perceived stress, social support and resilience) and (c) attitudes towards vaccination. Two online cross-sectional studies were conducted with university students during the COVID-19 pandemic in Brazil (November 2021 to March 2022) and in Germany (April to May 2022). Depressive symptoms, alcohol consumption, loneliness, self-efficacy, perceived stress, social support, resilience, sociodemographic information and attitudes towards vaccination were assessed. Data were analysed using univariate and bivariate models. The total sample comprised N = 7911 university students, with n = 2437 from Brazil and n = 5474 from Germany. Brazilian students presented significantly more depressive symptoms and suicidal thoughts, higher levels of perceived stress, higher frequency of drug or substance consumption, and lower levels of perceived social support and resilience than German students, whereas German students presented higher levels of loneliness than Brazilian students. A more favourable opinion towards vaccinations in general was found among Brazilian students compared with German students. In both countries, low-threshold (online) counselling targeting university students is needed. The differences between the samples could indicate country and/or cultural differences which justify further research in this area.

The distress and benefits of the Bereaved Family Survey: A mortality follow-back survey

ContextThe Bereaved Family Survey is an important method for evaluating the quality of palliative care. ObjectivesTo examine the distress and benefits of bereaved families of patients with or without cancer, who participated in a Bereaved Family Survey, and identify factors associated with distress and benefits. MethodsWe conducted a nationwide cross-sectional, self-reported questionnaire mail survey among the bereaved families of patients who died of cancer, heart disease, cerebrovascular disease, pneumonia, or kidney failure. Participants answered questions on a four-point Likert scale measuring the distress and benefit associated with participating in the Bereaved Family Survey. We conducted a qualitative analysis of responses to open-ended questions about the distress and benefits of participating in the survey to comprehensively examine the distress and benefits of participating in the survey. ResultsQuestionnaires were distributed to 115,816 eligible bereaved family members between February 2019 and February 2020; 62,576 (54.0%) family members returned valid responses. Distress and benefits accounted for 51.4% and 49.3%, respectively. The results of the binomial logistic analysis for distress were significantly higher among cancer patients (p<0.001–0.003), 20–39-year-old patients (p<0.001), female bereaved family members (p<0.001), and bereaved family members with poor mental health statuses (p<0.001). Factors related to “benefit” were significantly higher among over-80-year-old bereaved family members (p<0.001), higher care evaluation scale (CES) scores (p<0.001), and higher good death inventory (GDI) scores (p<0.001). ConclusionBereaved family members experience both distress and benefits. There is need to devise ways to reduce distress and increase its benefits to continue assessing the quality of palliative care.

Recent cohorts aging into Medicare use more counseling and psychotherapy than past cohorts.

Despite recent policy interest in improving access to mental health care in Medicare, little is known about how demand for care will change among the Medicare population as newer cohorts age into the program. We documented the growing rate of counseling and psychotherapy use in the decade prior to turning age 65years among subsequent cohorts aging into Medicare. We characterized how this growth varied across demographic groups, income levels, and mental and physical health status. We present trends using data from the 2002-2017 Medical Expenditure Panel Survey HouseholdComponent. We categorized individuals into 5-year Medicare entry cohorts based on the year they turned age 65 years. Our outcome was an indicator for having a visit for counseling or psychotherapy in a given year. Employing a probit regression, we characterized visit rates across 5-year cohorts, presenting both unadjusted and covariate-adjusted results. We ran stratified regressions by subpopulations. Our sample included 54,666 individuals aged 55to 64 years, weighted to be nationally representative. The cohort aging into Medicare between 2021 and 2025 was 88% (95% CI, 57%-119%) more likely to have a counseling or psychotherapy visit between the ages of 55 and 64years compared with the cohort that gained eligibility for Medicare between 2006 and 2010 at the same age. Growth in utilization was pervasive across many subpopulations. Our findings suggest that more recent cohorts aging into Medicare seek significantly more counseling and psychotherapy than prior cohorts. This increased utilization is pervasive across subpopulations, suggesting that plans must prepare to accommodate the needs of new Medicare entrants.

Long-term course and factors influencing work ability and return to work in post-COVID patients 12 months after inpatient rehabilitation

BackgroundRehabilitation plays a crucial role in restoring work ability and facilitating the reintegration of post-COVID patients into the workforce. The impact of rehabilitation on work ability and return to work (RTW) of post-COVID patients remains poorly understood. This study was conducted to assess the work ability and RTW of post-COVID patients before rehabilitation and 12 months after rehabilitation and to identify physical and neuropsychological health factors influencing RTW 12 months after rehabilitation.MethodsThis longitudinal observational study included 114 post-COVID patients with work-related SARS-CoV-2 infection who underwent inpatient post-COVID rehabilitation with indicative focus on pulmonology and/or psychotraumatology (interval between date of SARS-CoV-2 infection and start of rehabilitation: M = 412.90 days). Employment status, work ability, and the subjective prognosis of employment (SPE) scale were assessed before rehabilitation (T1) and 12 months after rehabilitation (T4). The predictors analysed at T4 were functional exercise capacity, physical activity, subjective physical and mental health status, fatigue, depression, and cognitive function. Longitudinal analyses were performed via the Wilcoxon signed-rank test. Logistic and linear regression analyses identified predictors of work ability and return to work (RTW), whereas mediation analyses examined the relationships between these predictors and work ability.ResultsAt T4, the median of WAI total score indicated poor work ability, which significantly worsened over time (p < 0.001; r = 0.484). The SPE scale significantly increased from T1 to T4 (p = 0.022, r = -0.216). A total of 48.6% of patients had returned to work 12 months after rehabilitation. Fatigue was identified as the main predictor of reduced work ability and RTW, with each unit increase in fatigue severity decreasing the odds of RTW by 3.1%. In addition, physical capacity and subjective health status were significant predictors of perceived work ability.ConclusionsThe findings highlight the significant challenges that post-COVID patients face in regaining work ability and achieving successful RTW 12 months after rehabilitation. Fatigue appears to be an important predictor of work ability and RTW. To optimize recovery and enhance both biopsychosocial health and work ability, it is crucial to develop and implement personalised interventions that address fatigue, improve physical capacity, and support mental health.Trial registrationThis study is registered in the German Clinical Trials Register under DRKS00022928.

Neuropsychiatric complications in chronic kidney disease: Role of gender, clinical, and sociodemographic factors

ABSTRACT Introduction: Patients with chronic kidney disease (CKD) frequently experience neuropsychiatric conditions, such as depression, anxiety, and cognitive impairment, which not only significantly diminish their quality of life, but also contribute to longer hospitalizations, poor treatment adherence, and increased mortality. This hospital-based cross-sectional study aimed to investigate neuropsychiatric complications in CKD patients, focusing on gender differences, and clinical and other sociodemographic factors. Materials and Methods: Diagnosis of CKD was based on the Kidney Disease: Improving Global Outcomes (KDIGO) criteria, and patients aged 18 years or above were included. Delirium was assessed using the Confusion Assessment Method (CAM) Scale. Those without delirium underwent evaluation using the Hindi Mental Status Examination (HMSE), Brief Psychiatric Rating Scale (BPRS), and Hospital Anxiety and Depression Scale (HADS) to identify cognitive and psychiatric symptoms. Results: Among the 104 participants, 50% were male, with a predominant age group over 45 years (61.5%). A majority portion of the cohort was married (72.1%), employed (57.7%), and identified as Christian (56.7%). The majority of CKD cases were diagnosed as stage 5 (87.5%) and on dialysis treatment. Delirium was present in 19.2% of participants. In those without delirium, anxiety affected 46.3%, depression impacted 50.0%, and cognitive dysfunction was present in 11.1%. A gender-based analysis revealed no significant differences in age or illness duration; however, males exhibited a higher level of education (P &lt; 0.02). While females tended to display more severe psychiatric symptoms (P &lt; 0.06), males had more cognitive dysfunction (P &lt; 0.08); however, these differences did not reach statistical significance. Socioeconomic status (SES) comparisons demonstrated that lower SES correlated with a reduced number of years of education (P &lt; 0.00). Conclusion: Anxiety and depression were prevalent in nearly half of CKD patients, without gender or socioeconomic disparities. This underscores the imperative need for holistic, multidisciplinary interventions to effectively manage these conditions and enhance overall quality of life.

Psychedelic mushroom-containing chocolate exposures: Case series

IntroductionThe recreational use of psilocybin or psilocin-containing products, a chemical found naturally in certain mushroom species, is on the rise across the United States. Several cases of serious clinical effects related to mushroom-containing products have recently been reported to the Food and Drug Administration (FDA). The emergence of these new products and their health consequences are not yet well understood. This case series aims to characterize exposures to mushroom-containing chocolate products, including patient characteristics, clinical effects, treatment(s), and clinical outcome severity, reported to a poison center network. Material and methodsThis was a retrospective case series conducted in patients exposed to mushroom-containing chocolate products across three poison centers between January 2023 to August 2024. Patients were identified via a database search of ToxSentry®. Patients were included if they were exposed to a mushroom-containing chocolate product. Patients were excluded if they ingested an unrelated product or if there was insufficient information documented within ToxSentry®. The primary endpoint was to describe clinical outcome severity after exposure to mushroom-containing chocolate products. ResultsA query of ToxSentry® identified 164 cases; 36 cases met study criteria. The median age of patients in this case series was 17 years old. For most patients (23, 64 %), the reason for the exposure was intentional, with 20 reporting intentional abuse or misuse of the product. Common clinical effects reported included mental status changes (26, 76 %), paranoia/hallucinations (10, 28 %), dysrhythmias (7, 19 %) and gastrointestinal discomfort (6, 17 %). There was one report of seizure. Most clinical effects lasted between 3 and 24 h after ingestion (29, 81 %). Intravenous fluids (18, 50 %) and benzodiazepines (7, 19 %) were the most common treatments given. No fatalities were reported. DiscussionWhile most patients in this series experienced minor clinical effects, some developed serious effects after ingestion of a mushroom-containing chocolate product. Findings from this study further characterize the limited patient demographics, clinical effects, and outcomes published thus far. Further characterization in a larger cohort of patients could expand on our initial findings and is needed to better identify factors that may influence clinical outcomes.

Ethical Issues in the Forensic Psychiatric Examination of Competency for Execution

Ethical Issues in the Forensic Psychiatric Examination of Competency for Execution

Effects of Social Determinants of Health and Social Support on Surgical Outcomes Among Patients Undergoing Hysterectomy.

To describe composite 30-day postoperative complication rates among patients undergoing hysterectomy during the coronavirus disease 2019 (COVID-19) pandemic and to determine baseline and postoperative mental health symptoms, levels of social support, and socioeconomic status and their association with hysterectomy outcomes. This multicenter prospective cohort study at eight centers across the United States enrolled patients who underwent minimally invasive hysterectomy for benign indications during the COVID-19 pandemic. Patients completed preoperative and postoperative surveys assessing mental health (PHQ-9 [Patient Health Questionnaire]), social support (MOS-SS [Medical Outcomes Study Social Support Survey]), and socioeconomic status (Hollingshead Index [Hollingshead Four Factor Index of Socioeconomic Status]). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates and 30-day composite complication rates were measured and categorized by Clavien-Dindo Grade. Bivariate associations of survey data on complications were assessed. Logistic regression analyses were used to identify independent predictors of 30-day complications and complication severity. Postoperative complications within 30 days occurred in 67 of 273 (24.5%) patients. Most (88.1%) complications were mild, but eight (11.9%) experienced severe complications. Only three patients (1.1%) tested positive for SARS-CoV-2 infection. There were no differences in complication rates when comparing race and ethnicity, age, or socioeconomic status. Survey responses that indicated more depression and worse support from preoperative to postoperative were seen in patients with severe complications (P=.008 and P=.09, respectively). Multivariate analysis demonstrated that an increase in support scores was protective against severe complications (P=.02). Worsening depression scores were associated with more severe complications (P=.03). This study showed a high rate of complications (24.5%) among patients who underwent hysterectomy during the COVID-19 pandemic. Lower social support and worse mental health status are associated with worse postoperative outcomes after hysterectomy.

Epstein–Barr Virus encephalitis associated hemophagocytic lymphohistiocytosis in childhood-onset systemic lupus erythematosus: a case-based review

BackgroundHemophagocytic lymphohistiocytosis (HLH) is characterized by immune dysregulation that results in an uncontrolled hyperinflammatory state. HLH is classified into two main categories: primary (familial) HLH and secondary (acquired) HLH. Secondary HLH can result from various underlying, including infection-associated hemophagocytic syndrome (IAHS) and macrophage activation syndrome (MAS) associated with rheumatologic disorders, among others. Epstein–Barr virus (EBV) often causes IAHS, but central nervous system (CNS) involvement is rare among systemic lupus erythematosus (SLE) patients. We report a case of EBV encephalitis associated with HLH in a patient with childhood-onset SLE.Case presentationA 12-year-old girl had received a diagnosis of SLE 2 months before presentation. After a period of inactive disease on treatment, fever and seizures, with altered mental status and hallucinations, developed over several weeks. A complete blood cell count (CBC) revealed pancytopenia, accompanied by elevated levels of inflammatory markers: 86 mm/hr erythrocyte sedimentation rate, 8.9 mg/dl c-reactive protein, and 3,966 ng/mL of ferritin. The differential diagnosis included active neuropsychiatric SLE, CNS infection and neurological manifestations in secondary HLH, which could have represented either IAHS or MAS. Meropenem and acyclovir were initially administered for clinical acute encephalitis, followed by pulse methylprednisolone; however, the fever persisted, and another CBC revealed progressive cytopenia. A bone marrow study showed hypocellularity and active hemophagocytic activity, and intravenous immunoglobulin was additionally given due to the diagnosis of HLH. Cerebrospinal fluid (CSF) analysis showed 60/mm3 white blood cells (N 55%, L 45%), 141 mg/dL glucose (0.7 blood-CSF glucose ratio), < 4 mg/dL protein; results of Gram stain and bacterial culture were negative. The viral encephalitis panel from the CSF confirmed EBV infection. Bone marrow immunohistochemistry examination revealed increasing levels of CD8 + T-cell and equivocal positive results for EBV-encoded RNA in situ hybridization; therefore, HLH potentially associated with EBV was diagnosed. After treatment with IVIg, cyclosporin A, and prednisolone, the patient’s symptoms gradually improved and she was eventually able to return to school.ConclusionsOur case highlights the importance of a thorough differential diagnosis, including EBV encephalitis associated with HLH, in patients with childhood SLE, particularly in cases of clinical deterioration occurs after initial treatment.

Clinical Characteristics and Risk Factors for Severe Japanese Spotted Fever: A Retrospective Multicenter Study in Nagasaki Prefecture, Western Japan.

Japanese spotted fever (JSF) is a tick-borne rickettsial disease prevalent in western Japan, with an increasing incidence and geographical distribution. This retrospective study aimed to describe the clinical features of JSF and identify factors associated with its severe form. We included adult patients with laboratory confirmed JSF in Nagasaki prefecture from 2010 to 2021. Severe JSF was defined by the presence of altered mental status, low blood pressure, or low oxygen saturation. In total, 65 JSF cases were diagnosed. Common symptoms were fever (87%), rash (48%), and fatigue (48%) with eschars detected in 50 (79.4%) of patients. Thirty-eight (60.3%) patients were initially diagnosed with non-JSF conditions. Twenty-one (33.3%) cases were categorized as severe JSF, including one death. Pre-hospital factors associated with severe JSF included age ≥75 (adjusted odds ratio [aOR] 37.53, 95% confidence interval [CI] 3.03-465.38), male sex (aOR 26.5, 95% CI 4.23-166.00), and a treatment delay ≥4 days from onset (aOR 5.96, 95% CI 1.13-31.60). This study highlights diagnostic challenges of JSF due to its non-organ-specific clinical presentation. Delayed initial treatment, advanced age, and male sex significantly increase the risk of severity. It is crucial to further raise awareness of JSF among clinicians and residents in endemic areas.

Effectiveness of exercise intervention in improving physical and mental status of patients with alcohol use disorders: A systematic review and meta-analysis.

This meta-analysis and systematic review examined the effects of an exercise intervention on alcohol dependence and physical and mental states in patients with alcohol use disorder (AUD). PubMed, Web of Science, Cochrane Library, EBSCO, and Embase. Randomized controlled trials published in English from the inception of the database until June 30, 2024, were included. All forms of exercise intervention (aerobic, resistance, yoga, mixed exercise, etc.) were included in the study, using an exercise intervention for patients with AUD and a non-exercise control group. Studies that excluded acute exercise or did not describe a specific intervention program; duplicate publications; review articles, conference articles, etc.; and studies that did not report appropriate outcome metrics. This protocol was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol standard. The risk of bias was assessed via the Cochrane risk-of-bias tool as described by the Cochrane Handbook for Systematic Reviews and Interventions. Alcohol dependence (number of drinks per day, number of drinks per week, AUDIT), physical and mental status [maximal oxygen uptake (VO2 max), resting heart rate, anxiety state, depression state, stress level]. Seventeen RCTs with a total of 1,905 patients with alcohol use disorders were included as subjects, and the results revealed that the exercise intervention had a significant effect on alcohol dependence, the number of drinks per day and the AUDIT score, the exercise intervention also had a significant effect on physical and mental status, VO2max, the resting heart rate, the anxiety state, the depression state, and the stress level. High heterogeneity in the number of drinks per day, anxiety, depression and stress outcomes (I2 > 50%), but Egger's test showed no publication bias for all outcome indicators (p > 0.05). Exercise intervention can effectively reduce alcohol dependence and significantly improve the physical and mental states of AUD patients, and exercise intervention as an adjunct to the treatment of AUD patients is significantly effective.

Cannabis use and sleep problems among young adults by mental health status: A prospective cohort study.

Young adult cannabis use is common; while cannabis is often marketed as a product that can improve sleep, evidence supporting these claims is limited, and effects may differ for individuals with underlying mental health issues. This study measured the association between cannabis use and sleep problems among young adults and determined whether associations differ by mental health status. Using two waves of a young adult cohort study (baseline: March-September 2020; follow-up: January-June 2021), we measured the association of cannabis use frequency with subsequent sleep problems overall and stratified by baseline sleep quality and mental health status in separate moderation analyses. This study was conducted in Southern California, USA, and included 1926 participants aged 20-23 years (mean age = 21; 61% female, 46% Hispanic). Exposure was baseline cannabis use frequency (never use, prior use, 1-5 days/month, 6-19 days/month, ≥ 20 days/month). The outcome was sleep problems at follow-up (range = 4-24, higher score indicating worse sleep). Models were adjusted for socio-demographic factors, baseline sleep problems, mental health symptoms (depression and/or anxiety versus neither) and past 30-day nicotine or alcohol use. In moderation analyses, models were additionally stratified by mental health symptoms and baseline sleep quality (excellent versus imperfect sleep). Among the young adult sample, 11% used cannabis ≥ 20 days/month at baseline. For participants without baseline anxiety or depression symptoms, using cannabis ≥ 20 days/month (versus never use) was associated with greater sleep problems at follow-up [mean difference (MD) = 1.66, 95% confidence interval (CI) = 0.59-2.74]. Among participants with anxiety and/or depression and pre-existing sleep problems at baseline, using cannabis ≥ 20 days/month (versus never use) was associated with fewer sleep problems at follow-up (MD = -1.42, 95% CI = -2.81 to -0.02). The effects of cannabis use on sleep appear to differ by underlying mental health symptoms. Frequent cannabis use may improve sleep for young adults with depression and/or anxiety who have pre-existing sleep problems, but worsen sleep for young adults without depression and/or anxiety.

Impact of Mental Health on Academic Performance: A Study on the Risk of Failure in Higher Education

Building healthy spaces and adequate mental health in the university context is of vital importance for optimal, quality and warm academic development, both for students and teachers. The purpose of the research is to determine the state of mental health of students as a risk factor for academic failure in higher education. For the methodological procedure, the “GHQ-28 Mental Health Assessment Scale and Questionnaire” was applied and a socio-educational form was used to measure academic performance. The level of mental health of students was estimated by applying the principal component factor analysis (PCA). To determine the variance of the factor analysis, Bartlett's sphericity test was used, then the factorization process was carried out by the PCA method with a varimax rotation. They were selected for the sample by the simple random method, resulting in a total of 212 cases. The results obtained revealed that the “mental health status” variable has a significant effect on academic risk, with an estimated coefficient of -0.0878 and an associated p-value of 0.014. This indicates that as the mental health status of students decreases, an increase in the probability of repeating the academic semester is observed.

Quality of life of patients with neurofibromatosis 1-Physical disability does not necessarily result in poor mental health.

Neurofibromatosis 1 (NF1) is a chronic neurocutaneous disease known to profoundly affect quality of life (QoL). We have performed an analysis of disease severity, mental and physical QoL and compare the different subclasses among patients with neurofibromatosis 1 (NF1). We conducted a prospective analysis of 89 NF1 patients between January 2016 and March 2018. Data sourced from local records including demographic information, employment status, education level, and marital status. All patients completed 36-Item Short Form Health Survey (SF-36) and additionally the numerical pain rating scale (NPS). Patients were stratified based on severity of NF1, visibility and disease severity. Among 89 patients, severity was classified as grade 4 was identified in 42 (47.2%), moderate in 17 (19.1%), mild in 23 (25.8%) and minimal in 7 (7.9%) cases. According to visibility scale, severe grade 3 was found in 28 (31.5%), moderate grade 2 in 26 (29.2%) and mild grade in 35 (39.3%) cases. SF-36 data, except for pain, showed significantly lower values, if compared to the standard German population (P < 0.001, physical component summary P = 0.045). Sex, marital status and education level did not significantly influence results. Employment was significantly associated with better mental and physical status (P = 0.028 and P = 0.01 respectively) and age >40 was linked to lower physical (P = 0.027) but not mental component scores (P = 0.362). The numerical pain rating scale indicated pain levels of 7-10 in 9 cases (10,1%), 5-6 in 10 patients (11.2%), 1-4 in 26 patients (29.2%) and no pain in 44 cases (49.4%). Physical component scores significantly differed across different NPS grades (P < 0.001) but not in mental component scores (P = 0.06). Finally, no significant differences were found in mental component scores across severity or visibility grades. Severity and visibility grades of patients with NF1 may not necessarily result in poor mental health. Symptomatic treatment should be considered even for severely disabled patients as they may have comparable QoL to less severely affected patients with NF1. Employment was linked to better quality of life outcomes in our findings.