Patient Health Questionnaire Research Articles

Depression, health-related quality of life and life satisfaction in patients with heart failure

Background: The Patient Health Questionnaire 9 (PHQ9) has been recognized as an effective tool for identification of patients with heart failure (HF) at risk for lower health-related quality of life (HRQoL). We aimed to compare HRQoL levels, overall satisfaction with health and life, disease severity variables, sociodemographic variables and behavioural risk factors between patients with HF with different levels of depressive symptomatology. Methods: In a >55 years-old general population cross-sectional HF prevalence study, 1851 subjects were screened and those with NTproBNP ≥125 pg/mL (n=930) underwent detailed diagnostic visit to confirm or rule out HF as per 2016 European Society of Cardiology guidelines. HRQoL (the ShortForm 12 Health Survey, SF12; EQ5D3L), depressive symptoms (Patient Health Questionnaire, PHQ9) and satisfaction with life (Satisfaction With Life Scale, SWLS) were also assessed. Patient with HF (75±8 years, 54 % male, New York Heart Association (NYHA) functional class IIII, with mean left ventricular ejection fraction (LVEF) 56±13) were divided into three groups based on the severity of depressive symptomatology as per PHQ9 score (none: score 04, mild: score 59, and moderate-to-severe: score 1027). Multiple group comparisons and pairwise post hoc analyses were performed. Results: Results indicated significant between group differences in NYHA status (p<0.001), number of comorbidities (p=0.006), functional capacity (p=0.01), as well as HRQoL variables (p=0.05 to 0.001) and SWLS score (p<0.05), with nondepressed group generally showing better physical and subjective indicators of health and wellbeing compared with the mild and moderate-to-severe group. Conclusions: Results indicate that even patients with HF with clinically non-significant levels of depressive symptomatology show significantly impaired psychosocial status (diminished HRQoL, lower life satisfaction).

Magnesium depletion score and depression: a positive correlation among US adults.

The Magnesium depletion score (MDS) serves as a novel metric for quantifying magnesium deficiency in the human body, comprehensively assessing four indicators: diuretic use, proton pump inhibitor use, estimated glomerular filtration rate, and alcohol abuse. However, there have been no studies examining the potential association between MDS and depression. The study population for this cross-sectional study comprised adults from the National Health and Nutrition Examination Survey database from 2009 to 2018. Participants with a score of 10 or above on the Patient Health Questionnaire-9 were defined as having depression. We employed multivariable logistic regression models to investigate the association between MDS and depression. Furthermore, subgroup analyses were conducted to assess potential differences in this association among populations with diverse characteristics. A total of 13,197 participants were included in this study. After adjusting for all covariates, a significant positive correlation was observed between MDS and depression. Specifically, for every unit increase in MDS, the likelihood of developing depression increased by 13% (OR = 1.13, 95% CI: 1.04-1.22, p = 0.0025). This positive correlation was consistent across MDS groups, with a 19% increase in depression likelihood in the medium group (OR = 1.19, 95% CI: 1.01-1.41, p = 0.0404) and a 58% increase in the high group (OR = 1.58, 95% CI: 1.21-2.07, p = 0.0007), using the low subgroup as a reference. Subgroup analyses revealed significant differences in the relationship between MDS and depression across races, marital statuses, and hypertension status. Our study has uncovered a significant positive association between MDS and depression. Reducing MDS in individuals may play a positive role in both the prevention and treatment of depression.

Oxygen supplementation and cognitive function in long-COVID.

Patients can experience persistent cognitive complaints and deficits in long-COVID. Inflammation and capillary damage may contribute to symptoms by interfering with tissue oxygenation. This was an exploratory pilot crossover study designed to describe the effects of supplemental oxygen (portable oxygen concentrator, POC) on cognitive performance and peripheral and cerebral oxygen saturation at rest and exercise. Participants with long-COVID (n = 21) were randomized 1:1 to: 1) POC (3h/day) for 2 weeks followed by standard of care (Control) for 2 weeks or 2) Control for 2 weeks then POC (3h/day) for 2 weeks, with a 1-week washout. Cognitive assessment (global cognition [Montreal Cognitive Assessment, MoCA], episodic memory [Hopkins], working memory [Digit Span], executive function [Verbal fluency]) was performed at baseline and after each treatment period. Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 were completed. Peripheral and cerebral oxygen saturation were measured at rest and exercise (treadmill) at baseline and after each treatment period. Statistical analyses were descriptive without formal testing. MoCA scores were similar under POC (26.45±2.31) and Control (26.37±2.85); overall POC-Control difference was -0.090 (95% CI [-1.031, 0.850]). Because of a learning effect, post-hoc analyses were performed for Period 1, where the MoCA score difference was 1.705 [0.140, 3.271]. MoCA subscores suggested better performance with POC for Visuospatial/executive (0.618 [-0.106, 1.342]) and Attention (0.975 [0.207, 1.743]). POC trended to have better scores on Digit Span backward (difference: 0.822 [-0.067, 1.711]) and self-reported depressive symptoms (difference: -1.335 [-3.166, 0.495]). For specific PHQ-9 items, POC tended to have lower (better) scores for Q1 (Little interest/pleasure) and Q7 (Trouble concentrating). Cerebral oxygen saturations at end of exercise showed no difference between POC and Control. Peripheral saturations during exercise were similar under POC and Control (difference: 0.519% [-1.675, 2.714]). An advantage of POC over Control was observed for global cognition, attention, visuospatial/executive performance and depressive symptoms. Results need to be validated in a larger study.

Association of uremic toxins and systemic inflammation with depression and anxiety among hemodialysis patients in Montenegro.

The purpose of this study was to examine the association between uremic toxins, inflammation, depression and anxiety among hemodialysis patients in Montenegro. The cross-sectional study included 88 patients undergoing hemodialysis. Depression and anxiety symptoms were assessed by Patient Health Questionnaire (PHQ-9) and Beck Anxiety Inventory (BAI). The standard laboratory methods were used to measure uremic toxins and systemic inflammation (C-reactive protein, Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR)). Clinically significant depression (PHQ-9 ≥ 10) and anxiety (BAI ≥16) were found in 55.7% and 27.2%, respectively. Logistic regression analyses revealed that serum urea, beta 2-microglobulin (B2M), and systemic inflammation (CRP, NLR, PLR) were significantly and independently associated with depressive symptoms, whereas serum urea, creatinine, uric acid, B2M, and systemic inflammation (CRP nad NLR) were associated with anxiety symptoms. Depressive symptoms and anxiety are common among hemodialysis patients in Montenegro, and are associated with increased levels of systematic inflammation, serum urea, and beta 2-microglobulin.

Gout Flare Burden in the United States: A Multiyear Cross-Sectional Survey Study.

The objective of this study was to assess the burden of gout flares and examine associated patient characteristics and outcomes in a sample of US adults. Data were collected via an online survey of US adults ≥18 years using a random stratified sampling framework. Participants with gout completed questions about treatments, serum urate (SU) levels, severity, satisfaction with control, and gout flares. All participants completed the Veterans RAND 12-Item Health Survey, the Generalized Anxiety Disorder 7-Item Scale, and the Patient Health Questionnaire 9-Item Scale. Data were summarized using descriptive statistics. Multivariable-adjusted logistic regression analyses examined factors predictive of reporting gout flares to a physician. A total of 933 participants met the study criteria for having gout. Those with gout tended to be older (58.3 [SD 13.3] years vs 45.4 [SD 16.1] years; P < 0.001), male (76.3% vs 46.9%; P < 0.001), White (80.5% vs 76.8%; P = 0.01), and married or living with their partner (58.9% vs 52.8%; P < 0.001) compared with those without gout (n = 30,146). The total gout flare burden for those with gout was 6.6 gout flares per year. Nearly 72% of gout flares were either not reported to physicians or pretreated or prevented. Characteristics of those who were less likely to report gout flares included being younger, being less educated, having a lower Charlson Comorbidity Index score, not being diagnosed with gout by their doctor, and not taking a urate-lowering therapy. This study confirmed that gout flares are common in US adults with gout and found that gout flares are underreported. Reliance on clinical documentation of physician-reported gout flares is insufficient to assess the true patient burden of gout.

Đánh giá tỷ lệ và mức độ nhận thức của sinh viên y khoa về trầm cảm chủ yếu tại Trường Đại học Nam Cần Thơ

Background: Major depressive disorder (MDD) is a prevalent mental illness, with a lifetime prevalence of approximately 12%, significantly impacting public health. The prevalence of depression among students in demanding fields, such as medical students, has not been thoroughly assessed. Objectives: This study aims to evaluate the prevalence and awareness of MDD among medical students. Methods: First and fifth-year medical students at Nam Can Tho University were invited to participate in this study. Participants completed the PHQ-9 questionnaire via Google Forms. The study employed a cross-sectional descriptive design. Result: Between May and June 2024, 593 eligible students were recruited. The mean age of participants was 22.08 ± 2,3% years, with 44,5% being male. The findings revealed that 244 students (44.1%) self-reported depressive symptoms based on the PHQ-9 scale. Specifically, 48.7% of first-year and 29.8% of fifth-year reported having major depressive disorder. Additionally, major depressive disorder affects the quality of life for 83.8% of students. Furthermore, 525 students (88.5%) expressed a need for mental health support centers. ConclusionThe prevalence of self-reported depressive symptoms among students, primarily assessed using the PHQ-9 scale, was notably high. Students also acknowledged the substantial impact of mental health on their quality of life. However, there remains a limited understanding and attention from social resources regarding this issue.

Data-Driven Cutoff Selection for the Patient Health Questionnaire-9 Depression Screening Tool

Test accuracy studies often use small datasets to simultaneously select an optimal cutoff score that maximizes test accuracy and generate accuracy estimates. To evaluate the degree to which using data-driven methods to simultaneously select an optimal Patient Health Questionnaire-9 (PHQ-9) cutoff score and estimate accuracy yields (1) optimal cutoff scores that differ from the population-level optimal cutoff score and (2) biased accuracy estimates. This study used cross-sectional data from an existing individual participant data meta-analysis (IPDMA) database on PHQ-9 screening accuracy to represent a hypothetical population. Studies in the IPDMA database compared participant PHQ-9 scores with a major depression classification. From the IPDMA population, 1000 studies of 100, 200, 500, and 1000 participants each were resampled. For the full IPDMA population and each simulated study, an optimal cutoff score was selected by maximizing the Youden index. Accuracy estimates for optimal cutoff scores in simulated studies were compared with accuracy in the full population. The IPDMA database included 100 primary studies with 44 503 participants (4541 [10%] cases of major depression). The population-level optimal cutoff score was 8 or higher. Optimal cutoff scores in simulated studies ranged from 2 or higher to 21 or higher in samples of 100 participants and 5 or higher to 11 or higher in samples of 1000 participants. The percentage of simulated studies that identified the true optimal cutoff score of 8 or higher was 17% for samples of 100 participants and 33% for samples of 1000 participants. Compared with estimates for a cutoff score of 8 or higher in the population, sensitivity was overestimated by 6.4 (95% CI, 5.7-7.1) percentage points in samples of 100 participants, 4.9 (95% CI, 4.3-5.5) percentage points in samples of 200 participants, 2.2 (95% CI, 1.8-2.6) percentage points in samples of 500 participants, and 1.8 (95% CI, 1.5-2.1) percentage points in samples of 1000 participants. Specificity was within 1 percentage point across sample sizes. This study of cross-sectional data found that optimal cutoff scores and accuracy estimates differed substantially from population values when data-driven methods were used to simultaneously identify an optimal cutoff score and estimate accuracy. Users of diagnostic accuracy evidence should evaluate studies of accuracy with caution and ensure that cutoff score recommendations are based on adequately powered research or well-conducted meta-analyses.

Association between weight reduction achieved with tirzepatide and quality of life in adults with obesity: Results from the SURMOUNT-1 study.

The SURMOUNT-1 trial investigated effects of tirzepatide, a glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, on body weight in participants with obesity or overweight. This analysis evaluated changes in patient-reported outcomes (PROs) assessing physical function, psychosocial well-being, and overall health aspects of participants' health-related quality of life (HRQoL) in SURMOUNT-1. PRO instruments included the Impact of Weight on Quality of Life-Lite Clinical Trials version (IWQOL-Lite-CT), Short Form Survey-36 version 2 (SF-36v2) and EQ-5D-5L. Scores were analysed by treatment group and by categorical degree of weight reduction group: >0 to <5%, ≥5 to <10%, ≥10 to <20% and ≥20%. Relevant PROs were evaluated for participants with or without physical or psychosocial limitations at baseline, as measured by Patient Global Impression of Status for physical activity (PGIS) and Patient Health Questionnaire-2 (PHQ-2), respectively. All tirzepatide groups demonstrated significant improvements in PRO scores versus placebo. There was a consistent trend of incremental PRO improvement with greater degrees of weight reduction, starting from ≥5% weight reduction. Participants achieving ≥20% weight reduction demonstrated the greatest changes from baseline to week 72 (SF-36v2 Physical Component Summary, 4.60; SF-36v2 Mental Component Summary, 0.80; IWQOL-Lite CT Total score, 24.7). Those with baseline physical and psychosocial limitations experienced greater improvements than those without. Tirzepatide treatment was associated with improved HRQoL compared to placebo in people with overweight or obesity. Higher percentages of weight reduction were associated with greater improvements. Clinical trial registration number for SURMOUNT-1: NCT04184622.

The mediating role of coping in the relationship between perceived health and psychological wellbeing in recurrent urinary tract infection: the rUTI Illness Process Model

ABSTRACT Background: Recurrent urinary tract infection (rUTI) is associated with significant symptom and quality of life burden. Given the unique challenges in diagnostics and management, healthcare disillusionment and stigmatisation which distinguish rUTI from other urological conditions, specific identification of the key illness processes experienced by this patient population is required. This study aimed to identify the unique illness processes and perceptions that contribute to quality of life in rUTI, through perceived health status, psychological wellbeing, and coping. Methods: An international sample of adults living with rUTI (N = 389, 96.9% female) completed a cross-sectional survey comprising the following standardised questionnaires: the EuroQoL EQ-5D-5L, Patient Health Questionnaire 9 (PHQ-9), Generalised Anxiety Disorder 7 (GAD-7), Connor-Davidson Resilience Scale–10 (CD-RISC-10), Pain Catastrophising Scale (PCS). Sociodemographic characteristics were also assessed. Structural equation modelling was conducted to identify the underlying constructs which contributed to psychological wellbeing in rUTI, establishing the ‘rUTI Illness Process Model’. Results: The positive relationship between ‘perceived health status’ and ‘psychological wellbeing’ was partially mediated by ‘rUTI coping’, after controlling for the impact of household income and age (p < .001). The model demonstrated a large effect size (R 2 = .81) and good local and global fit. Overall, rUTI coping skills, boosted by resilience and weakened by pain catastrophising, contribute to a significant proportion of the positive relationship between perceived health status and psychological wellbeing in rUTI. A uniquely vulnerable patient phenotype emerges from this new research, with patients who are younger and/or of lower socioeconomic status at greater risk of poorer rUTI health outcomes and psychological wellbeing, potentially requiring further support. Conclusions: The rUTI Illness Process Model establishes the crucial need to clinically characterise the individualised illness perceptions and metacognitive strategies held by people living with rUTI, revealing that patient-centred interventions targeting illness perceptions and coping strategies require prioritisation to enhance patient outcomes and the patient experience of living with rUTI.

The moderating role of protective factors in shift work disorder and health outcomes: A cross-sectional study

ABSTRACT This study investigated whether sleep-specific (e.g. chronotype) and traditional (e.g. resilience) protective factors were associated with reduced shift work disorder (SWD) risk and explored their role as moderators in the relationship between SWD risk and health. Shift workers (n = 126) participated in a cross-sectional study evaluating SWD risk (i.e. low vs. high; SWD-screening Questionnaire), mental health (Patient Health Questionnaire-9; Generalized Anxiety Disorder Questionnaire-7), physical health (Subjective Health Complaints Inventory), sleep (Pittsburgh Sleep Quality Index; Insomnia Severity Index; Epworth Sleepiness Scale), and protective factors (Resilience Scale; Social Provisions Scale; Survey of Perceived Organizational Support; Short Impulsive Behavior Scale; Circadian Type Inventory; reduced-Morningness-Eveningness Questionnaire). Logistic regressions revealed lower sleep languidity was associated with reduced odds (OR = 0.88 [0.79,0.96]) for having high SWD risk. Multiple regression analyses showed in shift workers with high social support or morningness, having high SWD risk was not associated with increased depression symptoms, or insomnia severity and poor sleep quality, respectively. Finally, in those with high or medium levels of perceived organizational support, high SWD risk was not associated with increased gastrointestinal and allergy complaints. Longitudinal research with larger samples is needed to confirm the moderating role of protective factors in the relationship between SWD risk and health.

Assessing Mental Health During an Extreme Weather Event in Southern Brazil.

This study aimed to evaluate mental health factors in individuals affected by the floods in Rio Grande do Sul from May 10 to June 6, 2024. A real-time survey was conducted with 1,552 participants. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Acute Stress Disorder (ASD) symptom checklist were used to assess mental health outcomes. Sociodemographic factors, trauma exposure, rescue participation, and psychological support were evaluated. Statistical analyses included t-tests, ANOVA, linear regression, and MANCOVA. High rates of depressive and anxious symptoms were found, with over half of the individuals with moderate to severe symptoms reporting no prior history of these conditions. Participants directly affected by the floods, and those with close ones affected, had higher PHQ-9, GAD-7, and ASD scores compared to the unaffected group. Moreover, younger age, female sex, lower family income, participation in rescues, and unmet psychological support needs were correlated with worse mental health outcomes. Individuals who participated in rescues had significantly higher rates of suicide ideation. Notably, psychological support had the largest effect size in mitigating mental health symptoms, regardless of trauma exposure status, when controlled for age, sex, and income according to MANCOVA. The findings highlight the critical role of psychological support in disaster response and the importance of community resilience. Real-time data collection during crises can inform targeted interventions, emphasizing the need for robust mental health services and community support networks. These efforts are essential to reduce long-term psychological morbidity and foster recovery in vulnerable populations.

Mediation effects of subjective social status and personality traits between childhood nurturing experiences and depressive symptoms in adult volunteers.

Various risk factors, such as childhood nurturing experiences and subjective social status, have been identified to be involved in the onset of depression. However, the mechanism of depression is not yet fully understood. In this study, we hypothesized that nurturing experienced in childhood affects subjective social status and current personality traits, which in turn influence depressive symptoms in adulthood, and verified this hypothesis through structural equation modeling. A questionnaire survey was conducted on 404 adults. Multiple regression analysis and structural equation modeling were conducted using demographic information and scores for the Patient Health Questionnaire-9, Parental Bonding Instrument, and NEO Five-Factor Inventory. Subjective social status was found to mediate the association between nurturing experiences and neuroticism (0.029 for Overprotection and -0.034 for Care). On the other hand, neuroticism was found to mediate the association between subjective social status and depressive symptoms (-0.097 in Care model and -0.103 in Overprotection model), as well as the association between nurturing experiences and depressive symptoms (0.144 for Overprotection and -0.134 for Care). Furthermore, it was also shown that complex paths, in which the association of nurturing experiences with depressive symptoms was mediated by two factors, namely, subjective social status and neuroticism, were statistically significant as indirect effects (0.016 for Overprotection and -0.018 for Care). In this study, we clarified that nurturing experienced in childhood affects neuroticism in adulthood, which is mediated by subjective social status, and furthermore, the effects of nurturing on neuroticism lead to varying levels of depressive symptoms in adulthood. The mediation effects demonstrated in the present study may contribute towards unraveling the causes of depression and developing effective treatments for depressive symptoms.

The Impact of the Triglyceride-Glucose Index on the Development of Depression in Patients with Coronary Atherosclerotic Heart Disease.

Depression is common among patients with coronary atherosclerotic heart disease and is a prevalent mental health issue, particularly among those with cardiovascular diseases. Depression is commonly associated with elevated blood glucose and lipid levels. The triglyceride-glucose index is a novel indicator reflecting insulin resistance, which has been proven in numerous studies to be associated with cardiovascular diseases. Study on the impact of the triglyceride-glucose index (TyG index) on the development of depression in patients with coronary atherosclerotic heart disease (CHD). Using the Patient Health Questionnaire-9 (PHQ-9), 197 CHD patients were classified into a non-depressed group (n = 44, PHQ-9 < 5) and a depressed group (n = 153, PHQ-9 ≥ 5). Fasting blood glucose (GLU), HDL, total cholesterol (TC), LDL, triglycerides (TG), and TyG index were compared between groups. Depression risk factors were identified via logistic regression, and the predictive value of TyG index was evaluated using ROC analysis. In depressed patients, TyG index, TG, TC, LDL, and GLU were significantly higher, while HDL was lower than in the non-depressed group (p < 0.05). Logistic regression identified TyG index, LDL, GLU, TG, TC, HDL, female sex, smoking, alcohol consumption, and older age as independent risk factors for depression in CHD patients (p < 0.05). ROC analysis showed the TyG index had an AUC of 0.76 (95% CI 0.687-0.829, p < 0.001) for predicting depression, with a cutoff of 1.613, sensitivity of 45.1%, and specificity of 97.7%. Endpoint events were more frequent in the depression group (χ² = 8.015, p = 0.005). The TyG index is an independent risk factor for depression in patients with CHD, indicating a significant predictive value. Depressed patients have a higher rate of readmission, and managing depression effectively contributes to better prognosis.

Association Between Postpartum Depression Symptoms and Social Determinants of Health in Outpatient Pediatric Clinic

IntroductionWe aimed to (1) identify the prevalence of postpartum depression (PPD) symptoms using the Patient Health Questionnaire-2 (PHQ-2) and the Edinburgh Postnatal Depression Scale (EPDS), and (2) analyze the relationship between PPD symptoms and social determinants of health (SDoH). MethodWe obtained data from 1327 infant/mother dyads at 1 and 6-month well-child checks. We used Chi-square and T-tests to compare social determinants between PPD screening groups and logistical regression to construct predictive models for PPD. ResultsThe prevalence of positive PPD screens was 5–7%, but only 1.85% screened positive at both periods. Although the EPDS and PHQ-2 were correlated (Pearson 0.66), the PHQ-2 missed 65% of those identified by the EPDS. Positive PPD screens were associated with greater SDoH concerns. DiscussionOur study highlights the importance of repeated PPD screening. The EPDS detected more mothers at risk than the PHQ-2. Multiple SDoH were associated with PPD symptoms.

Validation of the Chinese Maudsley three-item visual analogue scale to measure depressive symptoms in a youth population.

Existing self-rated depression measurement tools possess a range of psychometric drawbacks, spanning a range of validity and reliability constructs. The gold standard self-rated depression scales contain several variable items that are often non-specific, require respondents to have a certain level of language understanding and limited scoring options resulting in low sensitivity. The Maudsley three-item visual analogue scale (M3VAS) was developed to address these challenges. This study aimed to translate the M3VAS into Chinese and test its reliability and validity. First, both M3VAS scales (assessing current severity and change in severity) were translated according to a standardised protocol to finalise the Chinese version. Reliability and validity were then examined among 550 young people with moderate to severe depression (patient health questionnaire-9 (PHQ-9) score ≥15) in a cross-sectional opportunistic questionnaire survey. The content validity of each item (six items, across both scales) ranged from 0.83 to 1.00. Exploratory factor analysis denoted a total of two common factors, with a variance contribution rate of 64.34%. The total score correlated positively with the PHQ-9 total score (r = 0.241, P < 0.01). The Chinese version of the M3VAS had good reliability and validity values, and the confirmatory factor model fit well. The psychometric properties of the Chinese version of the M3VAS suggest that this scale can feasibly evaluate depression among young people in China.

Resilience and Religious Coping in Libyan Survivors of Hurricane Daniele.

The aim of the study was to investigate the mediating roles of resilience, posttraumatic growth (PTG) and religiosity between the impact of hurricane trauma and psychological distress. Using a cross-sectional design, the study involved 101 Libyan participants with an average age of 30.43 years (SD = 9.59), of whom 72% were women. Participants completed validated tests, including the Impact of Event Scale (IES), Brief Resilience Scale, Muslim Religiosity Scale and Patient Health Questionnaire (PHQ). The results indicated that posttraumatic stress symptoms (PTSS) were not associated with PTG (r = 0.04, p > 0.05) or religiosity (r = 0.02, p > 0.05) but were negatively associated with resilience (r = -0.39, p < 0.001) and positively associated with psychological distress including anxiety (r = 0.72, p < 0.001) and depression (r = 0.69, p < 0.001). Structural equation modelling (SEM) revealed that only resilience positively mediated the association between PTSS and anxiety (indirect effect = 0.04, p = 0.031), while PTSS positively predicted psychological distress (β = 0.037, p < 0.001). Network analysis identified parent loss is strongly connected with intrusion (r = 0.121), as most central node, while partner loss was associated with hyperarousal (r = 0.063), irritability (r = 0.036) and both share the same connection with numbing, while interestingly partner and friends loss share connection with resilience (r = 0.177). The study concludes that urgent clinical interventions, such as trauma-focused cognitive behavioural therapy, are required for the affected individuals, with a focus on enhancing resilience as a protective factor against PTSS.

The psychological impact of disaster on first responders in the aftermath of Bahanaga train tragedy: A mixed methods approach

Background: First responders are at high risk for adverse mental health outcomes following trauma exposure during disaster response. This mixed methods study aimed to quantify psychological impacts and explore personal experiences among first responders after the Bahanaga train accident that killed 294 passengers in the month of June 2023. Methods: For qualitative data, in-depth interviews (IDIs) were conducted, and quantitative data was collected using the PTSD checklist for DSM-5 (PCL-5), generalized anxiety disorder scale (GAD-7), and patient health questionnaire (PHQ-9) for symptoms of post-traumatic stress disorder (PTSD), depression, and anxiety. The study was conducted over one month during July 2023. Results: Among 225 responders, alarming rates of symptoms of probable PTSD (10.2%), anxiety (11.6%), and depression (24.9%) were noted. Those with no prior exposure to disasters and those with no formal training in disaster response scored higher in measures for PTSD. IDIs were conducted with 22 first responders, including various stakeholders. Qualitative analysis identified themes of preoccupation with witnessing trauma, feeling overwhelmed, scary and terrible emotions, avoidance, guilt, hypervigilance, intrusive memories, emotional numbing, unmet needs for mental health support, worsening physical health, re-emergence of past traumas, compounding impact of graphic images in the media, certain positive impact, including increased empathy, resilience and finding purpose, and the beneficial role of peer support. Conclusion: Significant psychological impacts are noted with elevated rates of probable PTSD, anxiety, and depressive symptoms among first responders one month after the Bahanaga train tragedy. These results underscore the vulnerability of first responders to mental health challenges following disaster response in India.

Network structure of functional somatic symptoms

ObjectiveThe overlap among functional somatic syndromes (FSS) is substantial, which is why various empirical attempts at an improved understanding of related symptoms have been undertaken. Network analyses are particularly valuable from a clinical point of view, since they focus on the extent to which symptoms expression is co-dependent. The aim of this study was to provide the first estimation of the network structure of symptoms in 17 FSS. MethodsN = 3054 young adults participated in an online survey. The Questionnaire on Functional Somatic Syndromes (FSSQ) was used to diagnose FSS and to assess related symptoms. The Patient Health Questionnaire (PHQ-9) was used to assess (comorbid) depression. Various R packages were used for network analysis, which yielded correlations between symptoms (edges), symptom groups (communities), and measures of centrality for individual symptoms (e.g., node strength). ResultsThe final network had a relatively small number of edges, with small (46.5 %) or small- to medium-sized (47.1 %) correlations. Ten communities were identified: cognitive problems/fatigue/depression, sensory problems, facial pain, head/neck/upper back pain, dizziness/nausea, throat pain/problems with swallowing, chest pain, widespread pain, abdominal pain/problems with digestion, and genital pain. The highest node strength in the network was found for the symptoms “tired”, “down, depressed, or hopeless”, and “tired after minimal exertion”. ConclusionsThe network analyses pointed to ten distinct groups of moderately associated symptoms in individuals with FSS. Fatigue and depression emerged as important symptoms connecting groups. Future studies should test whether (transdiagnostic) interventions specifically targeting these symptoms are particularly potent in alleviating FSS.

Anxiety, Depression, and Fear of COVID-19 and Its Association With Psychosocial Factors Among the Employees of a Malaysian Public University During Movement Control Order.

This cross-sectional study among the employees of the National Defense University of Malaysia (NDUM) assessed the levels of depression, anxiety, and fear related to COVID-19 and its association with psychosocial factors. It was conducted during the strict lockdown period imposed by the Malaysian government due to the COVID-19 pandemic. A stratified sampling method was used, and 277 employees were randomly selected to participate in the study. Generalized anxiety disorder (GAD-7) was used to measure anxiety symptoms. Patient health questionnaire (PHQ-9) was utilized to assess depression. The fear of COVID-19 (FOC) was calculated using the Fear of COVID-19 Scale (FCV), while the psychosocial factors affecting psychological impact were measured using a self-generated questionnaire. The study obtained a response rate of 46.2% (n=128). Most respondents were female, married, permanent employees, and from the non-academic group. Depressive and anxiety symptoms were reported by 47% (n=55) and 32.5% (n=38) of the respondents, respectively. Statistically, a higher level of fear related to COVID-19 was found among non-academic employees (p=0.015) and those with permanent employment status (p=0.030). Anxiety was significantly correlated with depression (r=0.70, p≤0.001), while no correlations were found between these factors and fear related to COVID-19. Taking over school lessons was the most troubling factor that affected the respondents' level of distress, followed by working from home and worrying about their family member's health. This study identified significant psychological effects of the pandemic on university employees, with anxiety and depression being notably correlated. While the generalizability of the findings is limited due to a low response rate, several key psychosocial distress factors were identified. These findings emphasize the necessity of addressing psychosocial factors to mitigate the mental health impact of pandemics. Further research with a higher response rate is required to confirm these findings and to design targeted interventions to support affected employees.

Association between Sleep Quality and Personality Based on the Big Five Factor Model in a Non-clinical Sample

Introduction. Sleep is essential for maintaining health, well-being, and functionality. The personality traits of the Five Factor Model (FFM) have proven promising as determinants of sleep quality. Objective. To explore the relationship between personality traits and sleep quality in a Brazilian sample by testing a predictive model based on multiple linear regression. Method. The study involved 447 adult participants (with an average age of 37.7 years), who completed an online survey including the following instruments: a sociodemographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI-BR), the Patient Health Questionnaire (PHQ-4), and the Big Five Inventory (BFI). Participants were selected through social media advertisements calling for volunteers for a study on sleep quality. Results. The regression model revealed that age, educational attainment, family income, BMI, neuroticism, and psychopathological symptoms were predictors of sleep quality. The gender, conscientiousness, extraversion, and agreeableness variables were not predictors of sleep quality in the multivariate analysis. Discussion and conclusion. The study emphasizes the role of neuroticism in predicting sleep quality over other personality traits. Additionally, the results suggest that the risk of or protection against the development of anxiety and depressive symptoms is a key mechanism linking personality traits to sleep. These findings can therefore contribute to identifying individuals at risk for sleep disturbances and developing health intervention strategies.