Moderate Psychological Distress Research Articles

Structural equation modeling for the effects of family dysfunctions and communication on perceived mental health status among under/graduate students in the U.S.

Many of the college students expressed experiencing moderate or severe psychological distress. In their emergence as adults, college students encounter significant periods of drastic change. Family functions play a crucial role in determining individuals' mental health status. The first objective of this study was to investigate whether family communication mediates the relationships between family dysfunctions and perceived mental health status among under/graduate students. The second objective was to investigate whether the mediation effects of family communication on the relationships between family dysfunctions and perceived mental health status differ by gender. The current study applied Minuchin's Structural Family Theory with under/graduate students (N = 348) in Ohio. Structural Equation Modeling was conducted to examine the effects of family dysfunctions and communication on perceived mental health status among under/graduate students. Disengaged family function significantly influenced family communication, which, in turn, significantly impacted perceived mental health (mediation effect). Enmeshed family function did not show a significant relationship with family communication, whereas family communication had a significant impact on perceived mental health (no mediation effect). The model comparison test indicated that there were differences between males and females: the structural weights of the current path models were consistent with the full models, and there was a significant difference in the effect of parents' marital status on perceived mental health, with males being significantly impacted in both models. Practitioners should recognize that improving positive communication skills within the family unit can be a realistic approach to supporting the perceived mental health of under/graduate students. Colleges/universities should offer regular education programs to promote an understanding of the relationship between family communication strategies and the mental health of under/graduate students.

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.

Acculturative stress and psychological distress during COVID-19, among racial-ethnic minority immigrants in the US

ABSTRACT Guided by Berry’s conceptualization of acculturative stress and Hovey’s acculturative stress framework, this cross-sectional study examines the relationship between migratory acculturative stress and psychological distress among racial-ethnic minority US immigrants (n = 202). The multiple linear regression indicated that respondents reported moderate psychological distress, acculturative stress, social support, and COVID impact. Pre-migration and post-migration acculturative stress factors predicted higher psychological distress; however, only the subscale of socioeconomic stressors remained statistically significant once the COVID impact scale was also modeled. Future research and practice efforts need to attend to the cumulative impact of acculturative stress and pandemic disruptions inhibiting the psychological well-being of racially minoritized immigrants.

Design of a Remote Multiparametric Tool to Assess Mental Well-Being and Distress in Young People (mHealth Methods in Mental Health Research Project): Protocol for an Observational Study.

Mental health conditions have become a substantial cause of disability worldwide, resulting in economic burden and strain on the public health system. Incorporating cognitive and physiological biomarkers using noninvasive sensors combined with self-reported questionnaires can provide a more accurate characterization of the individual's well-being. Biomarkers such as heart rate variability or those extracted from the electrodermal activity signal are commonly considered as indices of autonomic nervous system functioning, providing objective indicators of stress response. A model combining a set of these biomarkers can constitute a comprehensive tool to remotely assess mental well-being and distress. This study aims to design and validate a remote multiparametric tool, including physiological and cognitive variables, to objectively assess mental well-being and distress. This ongoing observational study pursues to enroll 60 young participants (aged 18-34 years) in 3 groups, including participants with high mental well-being, participants with mild to moderate psychological distress, and participants diagnosed with depression or anxiety disorder. The inclusion and exclusion criteria are being evaluated through a web-based questionnaire, and for those with a mental health condition, the criteria are identified by psychologists. The assessment consists of collecting mental health self-reported measures and physiological data during a baseline state, the Stroop Color and Word Test as a stress-inducing stage, and a final recovery period. Several variables related to heart rate variability, pulse arrival time, breathing, electrodermal activity, and peripheral temperature are collected using medical and wearable devices. A second assessment is carried out after 1 month. The assessment tool will be developed using self-reported questionnaires assessing well-being (short version of Warwick-Edinburgh Mental Well-being Scale), anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9) as the reference. We will perform correlation and principal component analysis to reduce the number of variables, followed by the calculation of multiple regression models. Test-retest reliability, known-group validity, and predictive validity will be assessed. Participant recruitment is being carried out on a university campus and in mental health services. Recruitment commenced in October 2022 and is expected to be completed by June 2024. As of July 2023, we have recruited 41 participants. Most participants correspond to the group with mild to moderate psychological distress (n=20, 49%), followed by the high mental well-being group (n=13, 32%) and those diagnosed with a mental health condition (n=8, 20%). Data preprocessing is currently ongoing, and publication of the first results is expected by September 2024. This study will establish an initial framework for a comprehensive mental health assessment tool, taking measurements from sophisticated devices, with the goal of progressing toward a remotely accessible and objectively measured approach that maintains an acceptable level of accuracy in clinical practice and epidemiological studies. OSF Registries N3GCH; https://doi.org/10.17605/OSF.IO/N3GCH. DERR1-10.2196/51298.

The Hidden Toll of Psychological Distress in Australian Adults and Its Impact on Health-Related Quality of Life Measured as Health State Utilities.

Psychological distress (PD) is a major health problem that affects all aspects of health-related quality of life including physical, mental and social health, leading to a substantial human and economic burden. Studies have revealed a concerning rise in the prevalence of PD and various mental health conditions among Australians, particularly in female individuals. There is a scarcity of studies that estimate health state utilities (HSUs), which reflect the overall health-related quality of life in individuals with PD. No such studies have been conducted in Australia thus far. We aimed to evaluate the age-specific, sex-specific and PD category-specific HSUs (disutilities) in Australian adults with PD to inform healthcare decision making in the management of PD. Data on age, sex, SF-36/SF6D responses, Kessler psychological distress (K10) scale scores and other characteristics of N = 15,139 participants (n = 8149 female individuals) aged >15 years were derived from the latest wave (21) of the nationally representative Household, Income and Labor Dynamics in Australia survey. Participants were grouped into the severity categories of no (K10 score: 10-19), mild (K10: 20-24), moderate (K10: 25-29) and severe PD (K10: 30-50). Both crude and adjusted HSUs were calculated from participants' SF-36 profiles, considering potential confounders such as smoking, marital status, remoteness, education and income levels. The calculations were based on the SF-6D algorithm and aligned with Australian population norms. Additionally, the HSUs were stratified by age, sex and PD categories. Disutilities of PD, representing the mean difference between HSUs of people with PD and those without, were also calculated for each group. The average age of individuals was 46.130 years (46% male), and 31% experienced PD in the last 4 weeks. Overall, individuals with PD had significantly lower mean HSUs than those likely to be no PD, 0.637 (95% confidence interval [CI] 0.636, 0.640) vs 0.776 (95% CI 0.775, 0.777) i.e. disutility: -0.139 [95% CI -0.139, -0.138]). Mean disutilities of -0.108 (95% CI -0.110, -0.104), -0.140 (95% CI -0.142, -0.138), and -0.188 (95% CI -0.190, -0.187) were observed for mild PD, moderate PD and severe PD, respectively. Disutilities of PD also differed by age and sex groups. For instance, female individuals had up to 0.049 points lower mean HSUs than male individuals across the three classifications of PD. There was a clear decline in health-related quality of life with increasing age, demonstrated by lower mean HSUs in older population age groups, that ranged from 0.818 (95% CI 0.817, 0.818) for the 15-24 years age group with no PD to 0.496 (95% CI 0.491, 0.500) for the 65+ years age group with severe PD). Across all ages and genders, respondents were more likely to report issues in certain dimensions, notably vitality, and these responses did not uniformly align with ageing. The burden of PD in Australia is substantial, with a significant impact on female individuals and older individuals. Implementing age-specific and sex-specific healthcare interventions to address PD among Australian adults may greatly alleviate this burden. The PD state-specific HSUs calculated in our study can serve as valuable inputs for future health economic evaluations of PD in Australia and similar populations.

Neighborhood eviction trajectories and odds of moderate and serious psychological distress during pregnancy among African American women.

African American mothers are unjustly burdened both by residential evictions and psychological distress. We quantified associations between trajectories of neighborhood evictions over time, and odds of moderate and serious psychological distress (MPD and SPD, respectively) during pregnancy among African American women. We linked publicly available neighborhood eviction filing and judgement rate data to preconception and during pregnancy addresses from the Life-course Influences on Fetal Environments Study (2009-2011, n=808). Multinomial logistic regression estimated odds of MPD and SPD during pregnancy associated with eviction filing and judgement rate trajectories incorporating preconception and during pregnancy addresses (each categorized as low/medium/high, with two 9-category trajectory measures). Psychological distress was measured with the Kessler (K6) scale (scores between 5-12 = MPD, and ≥ 13 = SPD). MPD was reported in 60% and SPD in 8% of the sample. Higher neighborhood eviction filing and judgement rates, compared to low/low in the preconception and pregnancy periods was associated with between 2- and 4-fold higher odds of both MDP and SPD during pregnancy among African American women, in adjusted models. Future studies should identify mechanisms of these findings to inform timely community-based interventions and effective policy solutions to ensure the basic human right to housing for all.

Associations between psychological distress in adolescence and menstrual symptoms across life: Longitudinal evidence from the 1970 British Cohort Study

PurposeThis study aimed to investigate the association between psychological distress (PD) at age 16 and menstrual symptoms experienced across women's life. MethodsUp to 2584 females from the 1970 British Cohort Study, a study of individuals born within one week in 1970, were included. PD at age 16 was measured with the 12-item General Health Questionnaire. Three categories were derived: low PD (<11), moderate PD (11–15), and severe PD (>15). Five menstrual health symptoms were self-reported at each age (16, 30 and 42 years). Binomial logistic regressions examined associations between PD at age 16 and each individual symptom, adjusted for age of menarche, sleep and appetite problems, physical activity levels and socioeconomic position. ResultsThe most prevalent symptoms were “pain” (61 %), “painful period” (10 %) and “heavy period” (33 %) at ages 16, 30 and 42, respectively. At age 16, those with severe PD were more likely to experience depression (OR: 2.92; 95% CI: 2.31, 3.70)), irritability (1.67; 1.33, 2.11), menstrual pain (1.34; 1.01, 1.80), and headaches (1.29; 1.02, 1.63). A weak association was found between severe PD at age 16 and pre-menstrual tension at age 30 (1.72; 1.01, 2.83). At age 42, those with severe PD at age 16 were more likely to experience pre-menstrual tension (1.89; 1.46, 2.44), painful periods (1.64; 1.27, 2.11), and heavy periods (1.28; 1.00, 1.62). DiscussionMenstruating females with higher levels of PD in adolescence have an increased risk of menstrual symptoms across adolescence, early and mid-adulthood. Our findings suggest the need to consider early-life psychological interventions to improve women's menstrual experiences across their reproductive years.

Effect of sleep disordered breathing severity in children with Down syndrome on parental wellbeing and social support

IntroductionSleep disorders, particularly sleep disordered breathing (SDB), are common in children with Down syndrome (DS). We investigated the relationship between SDB severity and parental psychological wellbeing and their perception of social support. Methods44 children with DS (3–19 years) underwent overnight polysomnography and were categorised into three groups: primary snoring, Mild and Moderate/Severe obstructive sleep apnoea (OSA). Parents completed questionnaires about their child's behaviour (Child Behavior Checklist), sleep symptoms (Pediatric Sleep Survey Instrument) and SDB-related quality of life (OSA-18), together with the DUKE-UNC Functional Social Support (DUKE) and Psychological General Well-Being Index (PGWBI) questionnaires for themselves. 34 children completed a follow-up study after 2 years. ResultsThere were no significant differences between SDB severity groups for parental perceived social support or psychological wellbeing. Total scores on the DUKE were below average and PGWBI scores were indicative of moderate psychological distress in all three groups. Reduced perceived levels of social support were significantly correlated with externalising child behaviour and sleep disturbance. Diminished parental psychological wellbeing was also significantly correlated with increased sleep disturbances and reduced quality of life in children. At follow-up there were no significant changes in any questionnaire outcome, however parents of children with improved SDB severity had improved PGWBI vitality scores. ConclusionThe degree of parent-reported sleep disturbance in children with DS was linked to suboptimal perceived parental social support and poor psychological wellbeing. Our results emphasise the need for enhanced awareness of the detrimental effects of sleep problems in children with DS on parental wellbeing.

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.

Mental health impact of multiple sexually minoritized and gender expansive stressors among LGBTQ+ young adults: a latent classanalysis.

In the United States, lesbian, gay, bisexual, transgender, queer, intersex, asexual and other sexually minoritized and gender expansive (LGBTQ+) young adults are at increased risk for experiencing mental health inequities, including anxiety, depression and psychological distress-related challenges associated with their sexual and gender identities. LGBTQ+ young adults may have unique experiences of sexual and gender minority-related vulnerability because of LGBTQ+-related minority stress and stressors, such as heterosexism, family rejection, identity concealment and internalized homophobia. Identifying and understanding specific LGBTQ+-related minority stress experiences and their complex roles in contributing to mental health burden among LGBTQ+ young adults could inform public health efforts to eliminate mental health inequities experienced by LGBTQ+ young adults. Therefore, this study sought to form empirically based risk profiles (i.e., latent classes) of LGBTQ+ young adults based on their experiences with familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment, and then identify associations of derived classes with psychological distress. We recruited and enrolled participants using nonprobability, cross-sectional online survey data collected between May and August 2020 (N=482). We used a three-step latent class analysis (LCA) approach to identify unique classes of response patterns to LGBTQ+-related minority stressor subscale items (i.e., familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment), and multinomial logistic regression to characterize the associations between the derived classes and psychological distress. Five distinct latent classes emerged from the LCA: (1) low minority stress, (2) LGBTQ+ identity concealment, (3) family rejection, (4) moderate minority stress and (5) high minority stress. Participants who were classified in the high and moderate minority stress classes were more likely to suffer from moderate and severe psychological distress compared to those classified in the low minority stress class. Additionally, relative to those in the low minority stress class, participants who were classified in the LGBTQ+ identity concealment group were more likely to suffer from severe psychological distress. Familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment are four constructs that have been extensively examined as predictors for mental health outcomes among LGBTQ+ persons, and our study is among the first to reveal nuanced gradients of these stressors. Additionally, we found that more severe endorsement of minority stress was associated with greater psychological distress. Given our study results and the previously established negative mental health impacts of minority stressors among LGBTQ+ young adults, findings from our study can inform research, practice, and policy reform and development that could prevent and reduce mental health inequities among LGBTQ+ young adults.

Evaluating the Efficacy of a Multifaceted Health Behavior Training Program on Psychological Distress

This study aimed to assess the effectiveness of a comprehensive Health Behavior Training Program in reducing psychological distress among adults. The program, integrating cognitive behavioral therapy, mindfulness, stress management, and health education, sought to provide participants with effective tools to manage distress and improve overall well-being. A randomized controlled trial design was employed, involving 50 participants with mild to moderate psychological distress, randomly assigned to either the experimental group receiving the Health Behavior Training Program or a control group receiving no intervention. The intervention consisted of 8 weekly sessions, each lasting 90 minutes. Psychological distress was measured at baseline, post-intervention, and at a three-month follow-up using the Kessler Psychological Distress Scale (K10). The experimental group exhibited a significant reduction in psychological distress scores from pre-test (Mean = 33.81, SD = 4.19) to post-test (Mean = 27.44, SD = 4.42) and maintained these improvements at the three-month follow-up (Mean = 27.39, SD = 4.37). In contrast, the control group showed no significant changes in distress scores over time. Analysis of variance with repeated measurements indicated significant effects of time (F(2) = 6.33, p &lt; 0.01), group (F(1) = 7.10, p &lt; 0.01), and their interaction (F(2) = 6.40, p &lt; 0.01) on psychological distress scores, underscoring the effectiveness of the intervention. The Health Behavior Training Program significantly reduced psychological distress among participants compared to a control group, with sustained effects at a three-month follow-up. These findings support the implementation of multifaceted health behavior interventions as effective tools for managing psychological distress and enhancing mental health outcomes.

Effect of the Psychiatric Co-Morbidities of Migraine in Medical University Students: A Cross-Sectional Study

BACKGROUND: Migraine is a common neurological disorder with significant psychiatric co-morbidities and impact on quality of life. Medical students routinely have triggers, notably stress and irregular sleep, which are typically associated with migraine. The present study aimed to assess the effect of the psychiatric co-morbidities of migraine on medical university students. METHODS: We conducted a descriptive cross-sectional study at Khartoum University on 356 students chosen by a multi-stage stratified sampling for the batch and gender, followed by a simple random sampling using self-administered questionnaires. Our survey consisted of the Patient Health Questionnaire 4-item (PHQ-4) to examine the effect of the psychiatric co-morbidities of migraine on medical students at Khartoum University. Migraine diagnosis was made according to ID Migraine. We analyzed the data using SPSS Software version 26. RESULTS: The participants included 63.8% females and 36.2% males. The age of the participants ranged from 17–26-year-old, with the majority between 20-23 years old. Additionally, 73.6% of the students were caffeine consumers, and 6.5% were smokers. In addition, 66% of medical students confirmed having two or more general headaches during the past three months. The prevalence of migraine was 27.25% in the whole study group. According to the PHQ-4 scoring system, (36%) had mild psychological distress (score: 3-5), (28.9%) reported severe distress (score: 9-12), while (24.7%) and (10.3%) reported moderate (score: 6-8) and none (score: 0-2) psychological distress, respectively. There was a significant association between the intensity of migraine without medications and the psychological status of the patient (P &lt;0.05). CONCLUSION: In conclusion, the effect of the psychiatric co-morbidities of migraine was variable among medical students at Khartoum University. Our study findings revealed a significant association between the intensity of migraine without medications and the psychological status of the patient. However, these results need to be affirmed by furthermore research with a large sample of medical students in different universities in Sudan.

Abstract B021: Trends in psychological distress among adult survivors of childhood, adolescent and young adult cancers: Analysis of 2008-2018 National Health Interview Survey data

Abstract Background: Cancer survivors diagnosed at childhood, adolescent and young adults age face psychological distress in the form of depression, anxiety, and panic attacks. In addition, psychological distress has been found to have an impact on the medical expenditures of cancer survivors. Previous studies have examined psychological distress in survivors of childhood, and young adult cancers (AYA) and found them to be high, whether this increasing or decreasing over the years is unknown. The aim of our study was to examine trends in psychological distress among survivors of childhood AYA cancers. Methods: We analyzed the 2008-2018 National Health Interview Survey (NHIS) data, a cross-sectional household interview survey of the US civilian, non-institutionalized population that uses a multistage area probability design. We identified individuals (n=6,175) who were diagnosed with cancer between 0 to 39 years of age. Psychological distress was assessed using the validated Kessler 6-item scale. Using a 30-day reference period, respondents’ rate how often they felt nervous, hopeless, restless or fidgety, so sad that nothing could cheer them up, that everything was an effort, and worthless. Response options include ‘never’, ‘a little of the time’, ‘some of the time’, ‘most of the time’, and ‘all of the time’. Responses were scored and added to produce a range of 0–24. We defined mild distress as a score of less &amp;lt;5, moderate distress as a score between 5-13 and severe distress as a score of &amp;gt;13. Joinpoint regression estimated yearly increases/decreases in psychological distress using annual percent changes. Results: Overall, the proportion of childhood and AYA cancer survivors with moderate distress decreased slightly between 2008 and 2014 but increased from 2014-2018 by 5% per year, though not statistically significant. However, the proportion of childhood and AYA cancer survivors with mild and severe distress remained relatively stable throughout the study period. The proportion of females and males with moderate distress increased by an average of 5% and 6% annually from 2014-2018 respectively, however, the increase was not statistically significant. The proportion of childhood and AYA cancer survivors who were married with moderate distress increased by 8% from 2014-2018 whereas survivors who were never married with severe distress decreased by 29% in the same time range. Conclusion: There is an increase in the number of survivors with moderate psychological distress while mild psychological distress has declined from 2014-15 onwards. Severe distress has remained relatively stable in all the years. Citation Format: Pranali G. Patel, Chaitali S Dagli, Nosayaba Osazuwa-Peters, Mrudula Nair, Dina K. Abouelella, Oluwole A. Babatunde, Shreya P. Ramkumar, Eric Adjei Boakye. Trends in psychological distress among adult survivors of childhood, adolescent and young adult cancers: Analysis of 2008-2018 National Health Interview Survey data [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B021.

Psychological Distress and Cannabis Vaping Among U.S. Adolescents

IntroductionCannabis vaping has become increasingly popular among adolescents in recent years. However, research examining mental health determinants of cannabis vaping is scant. This study investigated the relationship between psychological distress and cannabis vaping among a nationally representative sample of U.S. adolescents. MethodsData are from the cross-sectional 2022 National Youth Tobacco Survey, restricted to adolescents ages 11-18 (n=22,202). Psychological distress was categorized as normal, mild, moderate, and severe according to the Patient Health Questionnaire for Depression and Anxiety-4. Cannabis vaping was defined as any use in the past 30 days. To estimate the association between psychological distress and cannabis vaping, logistic regression was performed adjusted for age, sex, race/ethnicity, sexual orientation, school grades, family smoking/vaping, nicotine vaping, other tobacco use, and blunt use. Analyses were conducted in 2023. ResultsNearly 8% of adolescents vaped cannabis in the past 30 days, and 25.6% reported moderate or severe psychological distress. Mild, moderate, and severe psychological distress were associated with cannabis vaping in the unadjusted model. In the adjusted model, the odds of cannabis vaping were higher among adolescents who had severe psychological distress (OR: 1.46, 95% CI: 1.09-1.96), compared to adolescents with no distress. Older age, poor grades, family smoking/vaping, nicotine vaping, other tobacco use, and blunt use were also associated with cannabis vaping. ConclusionsSevere psychological distress was associated with past 30-day cannabis vaping among U.S. adolescents. Adolescents experiencing psychological distress need to be screened for cannabis vaping to help prevent and reduce use and promote mental health.

Bir Üniversite Hastanesinde Çalışan Hemşirelerin Mizah Yoluyla Başa Çıkma Yetenekleri ile Psikolojik Sıkıntı ve Tükenmişlik Düzeyleri Arasındaki İlişki

This research was conducted cross-sectionally with the aim of determining the relationship between nurses' coping abilities through humor and their levels of psychological distress and burnout. A total of 187 nurses working at a university hospital were administered a Personal Information Form, Questionnaire of Occupational Humorous Coping (QOHC), Psychological Distress Scale (PDS), and Burnout Scale Short Form (BS-SF). The study found that 23% of the nurses experienced moderate psychological distress, while 27.3% experienced severe psychological distress, and 9.6% suffered from severe burnout, indicating that 27.3% of them needed expert support. A significantly positive relationship was observed between PDS scores and BS-SF scores. Regression analysis revealed that nurses' PDS scores predicted 56.7% of the variance in BS-SF scores. Nurses were found to predominantly use instrumental-social coping as their coping strategy. Interestingly, no significant relationship was found between the coping through humor scale and the other measures in this study. In light of these findings, further research is recommended to explore the factors that hinder nurses from using effective coping methods and to investigate the causes of burnout and psychological distress among nurses. It is also suggested that healthcare institutions should plan to provide psychological support for nurses.

Psychological distress in subsequent pregnancy among women with a history of pregnancy loss: A latent profile analysis

BackgroundWomen who have undergone pregnancy loss can experience a range of psychological distress during subsequent pregnancies; however, the outcomes may vary based on individual circumstances. ObjectiveTo explore the potential patterns of psychological distress for pregnant women with a history of pregnancy loss, and to investigate the impact of factors related to pregnancy loss on these patterns. MethodsFrom October 2022 to August 2023, the participants were recruited from four medical centers in Guangdong Province, China. They completed a questionnaire survey comprising sociodemographic and obstetric characteristics, the Perceived Stress Scale-4 (PSS-4), the Impact of Event Scale-Revised (IES-R), the Pregnancy-related Anxiety Questionnaire-Revised 2 (PRAQ-R2), and the Patient Health Questionnaire-9 (PHQ-9). Latent profile analysis was used to determine optimal patterns of psychological distress. The logistic regression was conducted to assess the associations between the number of pregnancy loss, types of pregnancy loss, inter-pregnancy interval, and distinct psychological distress patterns. ResultsA total of 446 pregnant women with a history of pregnancy loss were included for formal analysis. Three distinct profiles were identified, namely the "mild psychological distress" (34.1 %), "moderate psychological distress" (57.8 %), and "severe psychological distress" (8.1 %). Recurrent pregnancy loss was associated with increased risks of both moderate (adjusted odds ratio [aOR] 2.45, 95 % confidence interval [CI]: 1.42–4.24; P = 0.001) and severe psychological distress (aOR 2.93, 95 %CI: 1.25–6.83; P = 0.013). Furthermore, compared to women who conceived after 6 months of pregnancy loss, those who conceived within 6 months of pregnancy loss were more likely to be categorized into the group of moderate psychological distress (aOR 2.00, 95 % CI: 1.21–3.30; P = 0.007). ConclusionsApproximately two-thirds of pregnant women with a history of pregnancy loss exhibit moderate to severe psychological distress. Such individuals could benefit from early screening and targeted psychological interventions, particularly those who have encountered recurrent pregnancy loss and those who conceive shortly after a pregnancy loss.

Research on the association between the status of physical fitness and psychological distress among Chinese children and adolescents aged 13-18 years

Objective: To describe the status of physical fitness of children and adolescents aged 13-18 years in China in 2019 and analyze its association with psychological distress. Methods: Data were drawn from the 2019 Chinese National Survey on Students' Constitution and Health, and 90 633 Han children and adolescents aged 13-18 years were included. Physical fitness was evaluated by "National Students Constitutional Health Standards" (2014 revised edition). Psychological distress was classified according to the scores of the Kessler Psychological Distress Scale: ≤19, 20-24, 25-29, and ≥30 scores indicated no, mild, moderate, and severe psychological distress, respectively, with moderate and severe psychological distress collectively referred to as high psychological distress. The χ2 test was used to compare the distribution differences between boys and girls, the Cochran-Armitage test was used to analyze the trend, and the multinomial logistic regression in the mixed effect model was established to analyze the association between physical fitness and psychological distress. Results: In 2019, the unqualified rate of physical fitness among children and adolescents aged 13-18 years in China was 17.2%, and the prevalence of excellent and good physical fitness was 18.2%, which was lower among boys (15.9%) than girls (20.5%) with a statistically significant difference (P<0.05). The excellent and good physical fitness rate showed a significantly decreasing trend with age (trend test P<0.05). The rate of high psychological distress among children and adolescents aged 13-18 years in China in 2019 was 39.3%, with boys (37.0%) having a lower prevalence than girls (41.6%), supported by a statistically significant difference (P<0.05), and a decreasing trend with the degree of physical fitness was observed both in boys and girls (trend test P<0.05). The multinomial logistic regression model showed that the prevalence of moderate (OR=0.83, 95%CI: 0.79-0.88, P<0.001) and severe (OR=0.81, 95%CI: 0.77-0.86, P<0.001) psychological distress were both lower in children and adolescents with excellent and good physical fitness. Conclusion: The status of physical fitness and psychological distress of Chinese children and adolescents aged 13-18 in 2019 was not optimistic, with physical fitness showing a significantly negative association with psychological distress.

Prevalence of psychological distress among Chinese children and adolescents aged 9-18 years

Objective: To describe the prevalence of psychological distress and to analyze its influencing factors among Chinese children and adolescents aged 9-18 years in 2019. Methods: Data was from the 2019 Chinese National Survey on Students' Constitution and Health, and 148 892 children and adolescents were included. Psychological distress was measured using the Kessler Psychological Distress Scale (K10): scores ≤19 were defined as no psychological distress, scores between 20-24 were defined as mild psychological distress, scores between 25-29 were defined as moderate psychological distress, and scores ≥30 were defined as severe psychological distress (moderate to severe psychological distress were defined as high psychological distress). The ANOVA, t test, and χ2 test were used to compare the differences in K10 scores and high psychological distress rates among children and adolescents with different characteristics. The ANOVA and trend χ2 test were used to analyze the trends. Modified-Poisson regression models were used to determine influencing factors of high psychological distress. Results: The K10 scores for Chinese children and adolescents aged 9-18 years in 2019 was 21.5±9.2, and their rate of high psychological distress was 31.6%. The rates of high psychological distress among children and adolescents aged 9-12, 13-15, and 16-18 years were 22.3%, 35.9%, and 38.8%. K10 scores and rates of high psychological distress showed an increasing trend as age increased (trends test all P<0.001). K10 scores and rates of high psychological distress were higher among children and adolescents who were older, female, rural, in areas with medium to low GDP per capita level, and with lower parental education (all P<0.001). Multifactorial modified-Poisson regression analysis showed that children and adolescents aged 13-15 years, 16-18 years, female, rural, and in areas with low to moderate GDP per capita level were at higher risk of high psychological distress (all P<0.05), with aOR (95%CI) of 1.55 (1.52-1.58), 1.66 (1.63-1.69), 1.07 (1.05-1.09), 1.02 (1.01-1.04), 1.10 (1.07-1.12). Children and adolescents in areas with medium to high GDP per capita level, whose father had a secondary or high school degree, whose father had a college degree or above, whose mother had a secondary or high school degree, and whose mother had a college degree or above were at lower risk of high psychological distress (all P<0.05), with aOR (95%CI) of 0.96 (0.94-0.98), 0.92 (0.90-0.93), 0.84 (0.82-0.86), 0.95 (0.93-0.97), 0.86 (0.83-0.88). Conclusions: The prevalence of psychological distress was high among Chinese children and adolescents aged 9-18 years in 2019, which is a vital problem. Mental health interventions need to be implemented among children and adolescents that were older, girls, rural, live in areas with lower economic levels, and whose parents have a lower education level.

Effects of Mental Illness Amongst Adults in the United States Living With Diabetes Mellitus on Hospital Admissions.

To examine the influence of comorbid mental illness on hospitalization among adults reporting diabetes mellitus. This cross-sectional observational study used National Health Interview Survey (NHIS) data from 2000-2018 to examine hospitalization. Mental illness was defined as no to low psychological distress (NLPD), moderate psychological distress (MPD), and serious psychological distress (SPD) as per the Kessler-6 scale. Socio-demographic factors and health status were added as covariates in binary logistic regression. This study involved 48,807 survey participants and reflected an estimated population of 17,524,418 adults with diabetes in the United States, of whom 19.9% were hospitalized in the year prior to the survey. Among those who were hospitalized, 71.5% exhibited None to Low Psychological Distress (NLPD), 17.7% reported Moderate Psychological Distress (MPD), and 10.8% reported Serious Psychological Distress (SPD). Conversely, among non-hospitalized individuals, the percentages were as follows: 83.2% had NLPD, 11.4% had MPD, and 5.3% had SPD. The odds ratio (OR) for hospitalization was found to be OR=1.31 (95% CI: 1.20, 1.43, p<0.0001) for MPD and OR=1.42 (95% CI: 1.28, 1.58, p<0.0001) for SPD, in comparison to those with no or low psychological distress. Among adults with diabetes mellitus, those with mental illness were more likely to be hospitalized than those without mental illness. Programs and policies to improve care among adults with both mental illness and diabetes may help to reduce hospitalizations.

The association of current exclusive e-cigarette use and dual use of e-cigarettes and cigarettes with psychological distress among U.S. adults

This observational study examines the association of current e-cigarette use and dual use of e-cigarettes and cigarettes (dual use) with psychological distress among U.S. adults. We differentiate dual use based on the smoking frequency and compare the relationship between dual use and psychological distress to that of exclusive cigarette smoking with the same smoking frequency.Using data from the 2015–2018 National Health Interview Surveys, we analyzed adults aged 18+ (N = 55,780) who currently use e-cigarettes or/and cigarettes and have no history of using other tobacco products, and adults who never used any tobacco. Multinomial logistic regression models estimate the association of current e-cigarette use and dual use with psychological distress severity (no/mild, moderate, and severe).In the sample, 15.3% and 2.9% of adults experienced moderate and severe psychological distress. Compared to never tobacco users, current exclusive e-cigarette users and dual users who smoke daily had higher odds of moderate and severe psychological distress. Dual users who smoke nondaily had higher odds of moderate, but not severe psychological distress than never tobacco users. Compared to exclusive daily smokers, dual users with daily smoking had higher odds of moderate and severe psychological distress. Compared to exclusive nondaily smokers, dual users with nondaily smoking had higher odds of moderate but not severe psychological distress.Our findings suggest that exclusive e-cigarette use is associated with psychological distress severity. Dual use is associated with higher odds of psychological distress severity compared to never tobacco users and exclusive cigarette smoking, and this association differs by smoking frequency.