Mild Distress Research Articles

The impact of heart failure caregiver burden and patient heart failure severity: analysis of the needs assessment tool: advanced heart failure (NAT: PD-HF)

Abstract Background Not only patients with heart failure (HF), but also their caregivers have reported experiencing distress, depression, anxiety, social isolation, and health problems related to caring for a patient. Needs assessment tools have been used in clinical practice to identify patients' problems and needs from an early stage, however, their relationship with caregiver burden and the severity of the HF patients they care for has not been well investigated. Purpose The purpose of this study is to examine the relationship between distress and HF severity in patients and their caregivers using the Needs Assessment Tool: Progressive Disease-Heart Failure (NAT: PD- HF). Methods We enrolled consecutive 106 chronic HF patients who were admitted to a university hospital and assessed needs by the NAT: PD-HF between February 2023 and July 2023. We also enrolled 95 of their caregivers. The NAT: PD-HF is administered by the health care provider in the form of an interview with the patient and their caregiver. The questionnaire consists of an assessment of the patient's well-being and an assessment of the caregiver's ability to care for the patient. The healthcare provider completes the tool by indicating the level of distress (none, mild, significant) for each section. The severity of the New York Heart Association (NYHA) functional classification is examined in each patient. Results The median age was 72 years (interquartile range 59-81), and 41% were in NYHA class III or IV. The most common relationship between patients and their primary caregivers was partners (53%), followed by children (26%), parents (8%), and siblings (5%). There were 100 patients (94%) with more than mild distress, 57 with NYHA I or II and 43 with NYHA III or IV (P = 0.037). There were also 84 (88%) caregivers with more than mild distress, 47 with NYHA I or II, and 37 with NYHA III or IV of the patients they cared for (P = 0.026). Twenty-four patients (22.6%) were in severe distress, of which 10 were NYHA I or II and 14 were NYHA III or IV (P = 0.044). Among caregivers, 18 (18.9%) were in severe distress, of whom 6 with NYHA I or II and 12 with NYHA III or IV for whom they are caring (P = 0.010). Conclusions Regardless of the severity of HF, caregivers were found to experience distress as similar rate as that in the HF patients they cared for. The proportion of patients and caregivers experiencing distress was found to increase with the severity of HF. It is important to introduce palliative care for HF from the early stage of the disease and to support not only the patient but also the caregivers by using screening tools to identify distress.

The Living Lab at Home: Feasibility and Acceptability of Multimodal In-Home Data Collection Among Youth Across the Developmental Spectrum.

Dynamic, real-time, in-home methods of data collection are increasingly common in child health research. However, these methods are rarely cocreated or used with families of youth with developmental disabilities. We aimed to determine the feasibility of codesigned methods for in-home data collection for youth across the developmental spectrum. Sixteen youth (14-18 years) with autism spectrum disorder, cerebral palsy, and/or chronic pain completed 14 days of data collection, wearing an accelerometer, answering Ecological Momentary Assessment (EMA) questionnaires, and collecting salivary cortisol samples. Participants completed a poststudy interview regarding their experiences. Data were analyzed for feasibility, quantity, and quality. At least 1 EMA response was provided on 73% of days, with 54% of the total number of administered prompts answered before the next prompt arrived. In total, 77% of participants wore the accelerometer ≥10 hours for at least 7 days. Adherence to 8-day saliva sampling after accounting for protocol violations and dry samples was 28%. No significant adverse events were reported aside from mild emotional distress (25%). Families reported generally high satisfaction, willingness to participate again, and acceptability, with moderate burden and interference. Qualitative interviews described: (1) the research question's value to the family as a motivator of engagement; (2) in-home data collection is not a passive or neutral experience; (3) personalized approaches and context are important to families; and (4) a clear need for continued iteration and engagement. In-home multimodal data collection is potentially feasible for families across the developmental spectrum but requires iteration based on family feedback to increase adherence.

Psychological Distress Among Ethnically Diverse Participants From Eastern and Southern Africa

Psychological distress is characterized by anxiety and depressive symptoms. Although prior research has investigated the occurrence and factors associated with psychological distress in low- and middle-income countries, including those in Africa, these studies' findings are not very generalizable and have focused on different kinds of population groups. To investigate the prevalence and characteristics (sociodemographic, psychosocial, and clinical) associated with psychological distress among African participants. This case-control study analyzed data of participants in the Neuropsychiatric Genetics in African Populations-Psychosis (NeuroGAP-Psychosis) study, which recruited from general outpatient clinics in Eastern (Uganda, Kenya, and Ethiopia) and Southern (South Africa) Africa. Individuals who participated in the control group of NeuroGAP-Psychosis from 2018 to 2023 were analyzed as part of this study. Data were analyzed from May 2023 to January 2024. The prevalence of psychological distress was determined using the Kessler Psychological Distress Scale (K10), which measures distress on a scale of 10 to 50, with higher scores indicating more distress. Participants from the NeuroGAP-Psychosis study were categorized into cases as mild (score of 20-24), moderate (score of 25-29), and severe (score of 30-50), and participants with scores less than 20 were considered controls. Factors that were associated with psychological distress were examined using binomial logistic regression. From the data on 21 308 participants, the mean (SD) age was 36.5 (11.8) years, and 12 096 participants (56.8%) were male. The majority of the participants were married or cohabiting (10 279 participants [48.2%]), most had attained secondary education as their highest form of learning (9133 participants [42.9%]), and most lived with their families (17 231 participants [80.9%]). The prevalence of mild, moderate, and severe psychological distress was 4.2% (869 participants), 1.5% (308 participants), and 0.8% (170 participants), respectively. There were 19 961 participants (93.7%) who served as controls. Binomial logistic regression analyses indicated that the independent associations of psychological distress were experience of traumatic events, substance use (alcohol, tobacco, or cannabis), the physical comorbidity of arthritis, chronic neck or back pain, and frequent or severe headaches. In this case-control study among ethnically diverse African participants, psychological distress was associated with traumatic stress, substance use, and physical symptoms. These findings were observed to be consistent with previous research that emphasizes the importance of traumatic events as a factor associated with risk for psychopathology and notes the frequent co-occurrence of conditions such as physical symptoms, depression, and anxiety.

Latent profile analysis of transdiagnostic emotional distress, suicidality, and resilience in first responders

BackgroundFirst responders (i.e., law enforcement officers, firefighters, and emergency medical technicians/paramedics), experience significantly higher occupational trauma exposure than U.S. adult workers outside these fields, leading to increased risks of comorbid mental health disorders. Repeated and intense trauma exposure may combine with personal factors to place them at higher risk for suicide. Conversely, first responders may show higher levels of psychological resilience in the face of occupational trauma experiences. Some research exists on resilience, though little is known about suicide resilience in first responder populations. MethodsWe used latent profile analysis (LPA) on a treatment-seeking sample of first responders (N = 340) with measures of posttraumatic stress disorder (PTSD), generalized anxiety, depression, suicidality, and resilience. ResultsWe determined the best fit was a five-class solution, including the following emotional distress categories: minimal (19 %), mild (33 %), moderate (8 %), moderately severe (27 %), and severe (13 %) emotional distress. In this study, all multivariate analyses of variance (MANOVAs) were statistically significant and had large effect sizes ranging from the lowest (resilience) to the largest (depression). LimitationsWe used self-report assessments and not a clinical interview. Also, we did not have data on measures of substance use, emotional dysregulation (e.g., attachment), or trauma exposure. ConclusionsThis study underscores the critical need for developing and implementing transdiagnostic interventions that not only address the spectrum of emotional distress and suicidality but also actively enhance resilience among treatment-seeking first responders.

“I've been really happy since I got that letter!”: Longitudinal patient perspectives on lung cancer screening communication

ObjectiveExperts recommend structured shared decision making when discussing lung cancer screening (LCS) and reporting low-dose computed tomography (LDCT) results. We examined patients' reactions to pre- and post-LDCT results communication processes at three medical centers in the US with established LCS programs. MethodsMulticenter, qualitative, longitudinal study of patients considering and receiving LCS using data from semi-structured interviews guided by a patient-centered communication model using conventional content analysis. We conducted 61 interviews among 32 patients (sixteen of whom had a nodule on their LDCT) at one month and 12 months after an initial LCS decision making interaction. ResultsParticipants were mostly satisfied with LCS communication processes pre- and post-LDCT even though guideline concordant shared decision making was rare. Most participants reported no more than mild distress even if the LDCT detected a pulmonary nodule, felt relief after getting the results, and reported the perceived benefits of LCS outweighed their distress. Nearly all participants were satisfied with recommended follow-up plans. They reported that they trusted their clinicians and health care system to provide appropriate care and recommendations. They did not appear to regret their decision since almost all participants planned to get their next LDCT. However, they were at risk of non-adherence to follow-up recommendations since they often relied on the health care system to ensure they received timely follow-up. ConclusionsDespite receiving guideline discordant decision-making communication, patients seem very satisfied, rarely experience severe distress, and have low decisional regret after LCS decision making and receiving the results of their LDCT.

The Role of Social Determinants of Health in Self-Reported Psychological Distress among United States Adults Post-COVID-19 Pandemic.

Psychological distress, an emotional condition with symptoms of anxiety and depression, leads to impaired function, behavior, and personal traits. The current study examined the association between social determinants of health and the severity of psychological distress among adults in the United States after the COVID-19 pandemic. Using multinomial multivariable logistic regression, we analyzed data from 5106 (n = 5106) participants in the Health Information National Trends Survey (HINTS) 6. Compared to non-Hispanic Whites, African Americans (AOR = 0.62, CI = 0.42-0.93) had lower odds of reporting mild psychological distress rather than no stress. Other variables associated with a higher likelihood of reporting moderate to severe psychological distress, rather than no distress, are being in the 50-64 years age group (AOR = 2.77, CI = 1.45-5.28), divorced (AOR = 2.50, CI = 1.70-3.69), and widowed (AOR = 3.78, CI = 2.15-6.64). Respondents living in an urban area had lower odds of reporting moderate to severe psychological distress (AOR = 0.56, CI = 0.39-0.80) compared to those living in rural areas. Our findings identify several risk factors for psychological distress by sociodemographic characteristics such as age, race, marital status, and urban living, providing empirical evidence for interventions in behavioral health. These findings suggest there is an utmost need for a multi-sectoral approach to address the social determinants of health associated with psychological distress post-COVID-19 pandemic.

Palliative care needs and utilisation of specialist services for people diagnosed with motor neuron disease: a national population-based study

IntroductionThere is a growing emphasis on the importance of the availability of specialist palliative care for people with motor neuron disease (MND). However, the palliative care needs of this population...

Longitudinal Assessment of Communication With Patient-Reported Outcomes During Lung Cancer Screening

BackgroundMany organizations recommend clinicians use structured communication processes, referred to as “shared decision making,” to improve patient-reported outcomes for patients considering lung cancer screening (LCS). Research QuestionWhich components of high-quality patient-centered communication are associated with decision regret and distress? Study Design and MethodsWe conducted a prospective, longitudinal, repeated measures, cohort study among patients undergoing lung cancer screening in three different healthcare systems. We surveyed participants using validated measures of decision regret, decision satisfaction, distress, and patient-clinician communication domains up to a year after the low-dose computed tomography (LDCT) for LCS. For longitudinal analyses, we applied a series of generalized estimating equations to measure the association of the “patient as person” communication domain, screening knowledge, and decision concordance with decision regret and distress. ResultsWhen assessed 2-4 weeks after the LDCT, 202 (58.9%) and 8 (2.3%) of 343 total respondents reported mild and moderate/severe decision regret, respectively, while 29 (9.2%) participants of 315 total reported mild distress and 19 (6.0%) moderate or greater distress. The mean ± SD decision satisfaction scores (0 to 10 scale) were 9.82 ± 0.89, 9.08 ± 1.54, and 6.13 ± 3.40 among those with no, mild, and moderate/severe regret respectively. Distress scores remained low after the LDCT, even among those with nodules. Patient-centered communication domains were not associated with decision regret or distress. InterpretationPatients undergoing LCS rarely experience moderate or greater decision regret and distress. Although many participants reported mild decision regret, most were very satisfied over the year after their LDCT for LCS. Communication processes were not associated with regret and distress, suggesting that it may be challenging for communication interventions to reduce the harms of LCS.

The Prevalence and Burden of Psychiatric Disorders in Primary Health Care Visits in Asir Region Saudi Arabia.

Psychiatric disorders encompass a wide range of conditions that affect an individual's mental health and well-being. These disorders can manifest in various ways. The recognition, diagnosis, treatment, and referral of psychological conditions heavily rely on general practitioners, who handle consultations that involve a psychological aspect in at least one third of cases. To assess the prevalence and burden of common psychiatric disorders at primary health care centers (PHCs) using the Kessler Psychological Distress Scale (K6) in the general population, aged 18-65, and examine their symptom patterns and comorbidity. A descriptive online cross-sectional survey was conducted over a one-month period, spanning from September to October 2023. The survey targeted the population living in the Asir region. To fulfill the objectives, the K6 scale was used. Data analysis was carried out using the Statistical Package for the Social Sciences (SPSS) version 25. P values were considered statistically significant when they were ≤0.05. The survey included a total of 1,595 participants. Of these, 21.3% of respondents were male, while 78.7% were female. The majority of respondents fall within the 18-25 age group, accounting for 50.5% of the total. A significant portion of the population experiences some form of psychological distress, with 4.6% reporting low psychological distress, 36.1% reporting mild psychological distress, and a substantial 59.2% reporting severe psychological distress. Age (p-value=0.024), gender (p-value=0.001), educational level (p-value=0.001), occupation (p-value=0.008), and monthly income (p-value=0.001) had significant associations with the psychological distress score of psychiatric disorders. The prevalence and burden of psychiatric disorders in primary health care visits in Saudi Arabia is a significant public health concern. Our findings showed that the majority of participants reported having severe to mild psychological distress.

Factors influencing psychological distress among breast cancer survivors using machine learning techniques

Breast cancer is the most commonly diagnosed cancer among women worldwide. Breast cancer patients experience significant distress relating to their diagnosis and treatment. Managing this distress is critical for improving the lifespan and quality of life of breast cancer survivors. This study aimed to assess the level of distress in breast cancer survivors and analyze the variables that significantly affect distress using machine learning techniques. A survey was conducted with 641 adult breast cancer patients using the National Comprehensive Cancer Network Distress Thermometer tool. Participants identified various factors that caused distress. Five machine learning models were used to predict the classification of patients into mild and severe distress groups. The survey results indicated that 57.7% of the participants experienced severe distress. The top-three best-performing models indicated that depression, dealing with a partner, housing, work/school, and fatigue are the primary indicators. Among the emotional problems, depression, fear, worry, loss of interest in regular activities, and nervousness were determined as significant predictive factors. Therefore, machine learning models can be effectively applied to determine various factors influencing distress in breast cancer patients who have completed primary treatment, thereby identifying breast cancer patients who are vulnerable to distress in clinical settings.

Psychological Distress and Its Associated Factors among Older Adults Living in a Rural Area of West Bengal

Abstract Introduction: Psychological distress among older adults in India is a concerning issue due to the aging population, the unique challenges they face, and limited access to mental health resources. Understanding and addressing this concern are crucial for promoting better mental health and overall quality of life. This study aims to estimate the prevalence of psychological distress among older adults in selected subcenters of Budge Budge II block, West Bengal; and to find out the factors associated with psychological distress among the study participants. Methods: A descriptive cross-sectional study was conducted among 180 persons aged ≥60 years from different subcenters of the Budge Budge II block selected by multistage random sampling from May 2023 to July 2023 by face-to-face interview using a predesigned, pretested, structured schedule comprising the Kessler Psychological Distress Scale. Multivariable binary logistic regression was done to identify the sociodemographic factors associated with psychological distress. Results: In this study among 180 elderly individuals, the mean age was 67 (±6.34) years, with 65.5% in the 60–69 age group. Nearly two-thirds (70.5%) had no psychological distress, while 18.9%, 5%, and 5.6% had mild, moderate, and severe distress, respectively. Participants who were belonging to the age group 70–79 years [aOR (95% confidence interval [CI]) = 3.31 (1.27–8.63)], widowed or separated (aOR [95% CI] = 3.53 [1.33–9.31]), functionally dependent (aOR [95% CI]) = (8.89 [1.49–53.23]), and economically dependent (aOR [95% CI] = 7.81 [3.21–19.03]) were statistically significant covariates of psychological distress. Conclusion: Nearly one-third of the elderly were suffering from psychological distress. Preventive measures for psychological disorders should be integrated into public health at the local level by providing specialist outpatient services to diagnose and treat common psychological disorders at the primary health center level.

Implementing a mutidisciplinary approach for older adults with cancer: Challenges and achievements in a geriatric oncology program in Sao Paulo, Brazil.

e13769 Background: Treating an older adult with cancer is complex and requires multidisciplinary effort. Multiple studies demonstrate the benefits of timely integration of Geriatric Oncology (GO) with routine oncologic care. Despite this growing body of evidence, there are very few cancer centers around the world that have a dedicated GO program, notably in low- and middle- income countries (LMIC). The objective of this abstract is to describe the first year of the GO program in a private oncology center in São Paulo, Brazil. Methods: As an effort of oncologists, geriatricians and nurses, the team built a consultative model with a nurse performing the G8 triage score to every cancer patient aged ≥ 70 years. For those with a G8 less than 14 points, a comprehensive geriatric assessment (CGA) was performed. The results of the CGA were than provided as a report to the treating physician and all the members of the multidisciplinary team, so that a geriatric assessment (GA) driven intervention could be planned. The patients were then followed for 3, 6, and 12 months to detect falls, emergency rooms visits, hospitalizations, and death. Results: From January 2023 to January 2024, 110 patients with a median age of 79 were evaluated, with 57% having a G8 less than 14. 70 patients we submitted to a CGA. The majority of the tumors were gastrointestinal (30%), lung (20%) and genito-urinary (17%). Regarding the GA domains: 70% of the patients had a possible or probable cognitive impairment by the 10-point cognitive screener; 53% mild psychological distress by PHQ-4 Screening Tool; 47% showed important reduction in hand grip strength scale calling the attention to sarcopenia; 48% were found to be at nutritional risk and 42% were classified as malnourished at the mini-nutritional assessment; polypharmacy was detected in 67% of the patients. Despite these findings, 78% of the patients we classified as ECOG 0 or 1. After GA driven interventions, at 3 and 6 months follow up, 88% of the patients remained with no falls, with a mild rate of hospitalizations (40%) and a low rate of treatment discontinuation (15%). By the end of 6 month follow up, 24% of the patients have died. Conclusions: Geriatric conditions such as functional impairment are common and frequently unrecognized or inadequately addressed in older adults with cancer. Identifying geriatric conditions by performing a GA can help the health team to manage these conditions and provide better oncology care.

Psychological distress during the COVID-19 pandemic normalization phase in China: A multigroup latent profile analysis among healthcare workers and the general population

The COVID-19 pandemic is no longer considered a “global public health emergency”; nonetheless, it has left a long-lasting effect on people's mental health. Existing studies examined the impact of COVID-19 on people's mental health; however, most of these investigations were carried out during the acute phase. This study addresses the gaps in knowledge regarding the psychological distress experienced by healthcare workers and the general population in China during the normalization period, as well as the shared and distinct associated factors. Data were collected in March 2022. Five hundred and three healthcare workers and 307 general individuals participated. Online questionnaires were administered. Collected data for mental health indices included depression, anxiety, insomnia, and resilience. Various statistical analyses were conducted, including independent sample t-tests, chi-square tests, one-way analyses of variance, multigroup latent profile analyses, and multinomial logistic regression analyses. Healthcare workers had lower prevalence rates of depression and anxiety and a higher level of resilience than the general population. Latent profile analyses suggested four profiles based on levels of psychological distress (i.e., low, mild, moderate, and high) derived from four indices (i.e., depression, anxiety, insomnia, and resilience). The person-centered approach revealed that the general population had more individuals in moderate and high distress classes and fewer in the mild distress class. Healthy lifestyles, past mental health issues, and epidemic burnout were common influencing factors for both groups. However, epidemic uncertainty was identified as the distinct contributing factor for the general population. Directions for future research and interventions are discussed.

A Study to Evaluate Psychological Distress and Self-Esteem Among Patients with Hemodialysis

Background: Chronic kidney disease (CKD) is a progressive disease that affects more than 800 million people worldwide, representing more than 10% of the global population. It is more common in older people, women, and racial minorities, as well as in people with diabetes mellitus and high blood pressure. CKD has become one of the top causes of mortality worldwide, and is one of the few non-communicable diseases that have seen an increase in related deaths over the last few decades. The high number of affected people and the serious negative consequences of chronic disease should lead to increased efforts to improve prevention and treatment efforts. Around the world, there are an estimated 1,800-1,600 extra deaths per 10000 patients who are on dialysis.  Aim: The aim of the study is to determine the psychological distress and self-esteem among dialysis patients.  Research Methodology: A quantitative cross-sectional investigate plan was utilized to conduct a research study among 30 dialysis patients. Convenient sampling techniques were utilized to collect data from standardized tool using questionnaire techniques.  Result: Study showed that 36.7% of the samples were doing well, 23.3% had mild psychological distress, 23.3% of the samples had moderate psychological distress and severe distress is seen in 16.7% of the samples. 73.3% of them had normal self-esteem, 20% of the study population had low self-esteem and 6.7% had above average self-esteem. Significant relationship is seen between social and family support with self-esteem (p=0.033).  Conclusion: About half of the samples were having psychological distress which is of mild and moderate, severe psychological distress were seen in 16.7% of the samples, ordinal self-esteem were seen in 73% of the samples, 27% of samples had mild and average self- esteem.

Clinical and Ultrasound Aspects of Neonatal Hypoxia Ischaemia at the Regional University Hospital of Ouahigouya

Neonatal hypoxia ischaemia (HI) is the third leading cause of neonatal death worldwide. Medical imaging plays an important role in its diagnosis and monitoring. We aim to analyze the clinical and ultrasound aspects of neonatal HI at the Ouahigouya Regional University Hospital (CHUR/OHG). This was an analytical cross-sectional study with retrospective data collection covering the period from 1 January 2017 to 30 April 2019. During the study period, neonatal HI for 20.12% of pediatric admissions, of which 33.7% underwent Transfontanellar ultrasound (7.31% of all ultrasounds). The sex ratio was 1.6. The majority (85.81%) of children were born at term. According to the Sarnat classification, mild distress predominated (66.89%), followed by moderate distress (27.03%) and severe distress (6.08%). Transfontanellar ultrasound was abnormal in 71 patients (47.97%). Typical brain lesions found were hemorrhage (27.70%), anoxic-ischaemic encephalopathy (18.24%), and periventricular leukomalacia (2.70%). The outcome was normal in 81.08% of patients, with a mortality rate of 6.08%. In view of the seriousness of neonatal brain damage, it is necessary to improve diagnostic methods (MRI) and treatment (hypothermia) to limit the sequelae.

EVALUATION OF EMOTIONAL DISTRESS IN A COHORT OF NEWLY DIAGNOSED CANCER PATIENTS: A STUDY OF 67 INDIVIDUAS

Purpose: To evaluate distress in newly diagnosed cancer patients. Subjects and Methods: Cross-sectional prospective study of 67 newly diagnosed patients at the Department of Pain management and Palliative Care, 108 Military Central Hospital, from August to October 2023. The patient's level of distress was assessed by the Distress Thermometer - DT and the Problem List (PL) of NCCN February 2022, Vietnamese version. Results: The average distress score among newly diagnosed cancer patients was 4.42 ± 2.237, with 3% reporting no distress, 44.8% experiencing mild distress, and 52.2% reporting moderate to severe distress (≥ 4 points). Common sources of distress among the participants included physical discomfort (94.0%), with 73.1% reporting sleep problems and 71.6% experiencing fatigue. Emotional challenges were prevalent as well (91.0%), with 49.3% reporting feelings of sadness and 47.8% experiencing anxiety. Additionally, concerns regarding self-care (53.7%) and financial worries (43.3%) were notable contributors to distress, accounting for 76.1% of the participants' concerns overall. The rate of moderate and severe distress in newly diagnosed cancer patients were statistically significantly related to age (more prevalent in patients under 60), gender (higher in females) education level (more in those with secondary school education or less), income (higher in those with below-average incomes), health insurance benefits (higher in patients with less comprehensive coverage).

P1079 Mindfulness-based cognitive therapy to reduce psychological distress in patients with Inflammatory Bowel Disease: first results of a multicentre randomised controlled trial (MindIBD)

Abstract Background Many patients with Inflammatory Bowel Diseases (IBD) suffer from psychological distress and fatigue. Moreover they report a reduced quality of life. The availability of psychosocial treatment options is limited. As mindfulness-based cognitive therapy (MBCT) has been shown to reduce psychological distress and fatigue, and improve quality of life in other populations, MBCT might also be effective in patients with IBD. Methods The MindIBD study was a prospective, multicentre, randomised controlled trial, conducted in one academic and three general hospitals in the Netherlands. Patients of 16 years and older with a confirmed IBD diagnosis were eligible if the IBD was in remission (based on faecal calprotectin <250 mg/kg and no changes in IBD medication for at least three months) and they experienced at least mild psychological distress (based on Hospital Anxiety and Depression Scale (HADS) total score ≥ 11). Participants were allocated in the intervention group (MBCT plus treatment as usual) or control group (treatment as usual alone). Assessments were conducted at baseline, post-intervention (3 months) and at 6, 9 and 12 months after baseline. Primary outcome was the effect on psychological distress post-intervention. Secondary outcomes included fatigue, perceived disease control, disease activity, disease-specific quality of life and positive mental health. This trial was registered at ClinicalTrials.gov: NCT04646785. Results A total of 142 IBD patients were randomly assigned to the intervention group (n=70) or the control group (n=72). The study population had a median age of 50 years (IQR 39-59 years), consisted of 91 women (64%) and 68 participants (48%) were diagnosed with Crohn’s disease. Post-intervention, participants in the intervention group showed a mean decrease on the HADS total of 4.7 ± 6.3 points compared to a mean decrease of 1.2 ± 5.2 points in the control group. This difference in improvement of psychological distress was statistically significant (p<0.001), and this benefit was maintained during follow-up (p=0.005). MBCT did also result in a significant improvement on fatigue (p=0.022) and positive mental health (p=0.022) post-intervention. These improvements remained in favour of the intervention group during follow-up, although not significantly different. No differences were found on perceived disease control, disease activity and disease-specific quality of life. Conclusion MBCT reduces psychological distress and improves fatigue and positive mental health. Therefore MBCT can be considered as a valuable addition to the limited psychosocial interventions for patients with IBD to improve psychological distress, fatigue and positive mental health.

Resilience and Social Support Improve Mental Health and Quality of Life in Patients with Post-COVID-19 Syndrome.

Physical and mental health problems among post-COVID-19 patients are common, even a year after infection. As there is no prior study available, we investigated the impacts of resilience and social support on anxiety, depression, and quality of life among patients with post-COVID-19 syndrome. We conducted a cross-sectional study with a convenience sample. The measures included the demographic and clinical characteristics of patients, the Brief Resilience Scale, the Multidimensional Scale of Perceived Social Support, the Patient Health Questionnaire-4 (PHQ-4), and the EuroQol-5D-3L. The mean age of patients was 44.8 years. The total PHQ-4 score suggested that 32.8% of patients with post-COVID-19 syndrome experienced severe psychological distress, 32.8% experienced moderate distress, 23% experienced mild distress, and 11.5% had no distress. Moreover, 60.7% of patients had anxiety scores of ≥3 and 69.7% had depression scores of ≥3, indicating possible major anxiety or depression disorder. The mean EQ-5D-3L index value was 0.36, and the mean EQ-5D-3L VAS was 54.1. Multivariable analysis identified that resilience and social support reduced anxiety and depression among patients. Also, we found a significant positive relationship between resilience and social support, and quality of life. Our findings suggest that resilience and social support can be protective by reducing anxiety and depression and improving quality of life among patients with post-COVID-19 syndrome. Policymakers should develop and implement healthcare management programs to provide psychological support to these patients.

Psychological distress of medical students in western Saudi Arabia: A mixed-methods study

Background: Psychological distress such as anxiety and depression can negatively affect medical students’ academic performance and future careers. Aim: This study examined the prevalence and impact of psychological distress on medical students’ academic achievement, their associated learner characteristics, and how students handle stress in western Saudi Arabia. Setting and Design: This cross-sectional study incorporated a mixed-methods design, including quantitative and qualitative components for Phase 2 medical students. Methods: A self-administered questionnaire was used for quantitative components to examine the prevalence of psychological distress among medical students. In addition, a qualitative study component was conducted with students with severe psychological distress using structured interviews with a predetermined list of responses to which to select and assess factors that lead to severe psychological distress and how students handle stress. This study began on January 15, 2018, at the medical college Taif University and lasted 3 months. Statistical Analysis Used: The quantitative and qualitative data were coded, verified, and analyzed by a statistician using the Statistical Package for the Social Sciences software (SPSS version 22.0). Chi-squared tests were used to examine differences between proportions. Results: This study (n = 289) revealed that more than 69% of medical students experienced some form of psychological distress, 52% suffered from mild and moderate psychological distress, and 17% with severe psychological distress. There were no statistically significant differences between genders and years of study regarding psychological distress. Overall, there was no statistically significant association between grade point average and psychological distress scores. Conclusions: This study revealed a high prevalence of psychological distress among medical students. This study recommends establishing a psychological counseling unit at medical schools in western Saudi Arabia to detect psychological distress in medical students and timely referrals of those who need medical advice.

Neurocognitive Features of Mild Cognitive Impairment and Distress Symptoms in Older Adults Without Major Depression.

Two distinct symptom dimensions were identified in older adults who did not have major depressive disorder (MDD): a) a dimension associated with mild cognitive dysfunction, and b) a dimension related to distress symptoms of old age (DSOA). It is uncertain whether previous findings regarding the features of amnestic mild cognitive impairment (aMCI) remain valid when patients with MDD are excluded. To examine the neurocognitive features of aMCI (n = 61) versus controls (n=59) and the objective cognitive characteristics of DSOA in participants without MDD. Neurocognition was evaluated utilizing the Cambridge Neurological Test Automated Battery (CANTAB) and memory tests. This research demonstrated that CANTAB tests may differentiate between aMCI and controls. The One Touch Stockings of Cambridge, probability solved on first choice (OTS_PSFC), Rapid Visual Information Processing, A prime (RVP_ A´), and the Motor Screening Task, mean latency, were identified as the significant discriminatory CANTAB tests. 37.6% of the variance in the severity of aMCI was predicted by OTS_PSFC, RVP_ A´, word list recognition scores, and education years. Psychosocial stressors (adverse childhood experiences, negative life events), subjective feelings of cognitive impairment, and RVP, the probability of false alarm, account for 40.0% of the DSOA score. When MDD is ruled out, aMCI is linked to deficits in attention, executive functions, and memory. Psychosocial stressors did not have a statistically significant impact on aMCI or its severity. Enhanced false alarm response bias coupled with heightened psychological stress (including subjective perceptions of cognitive decline) may contribute to an increase in DSOA among older adults.