Preventive Mental Health Services Research Articles

The Use of Nursing Theory and Model in Mental Health and Psychiatric Nursing Doctoral Theses: Turkiye Sample

Aim: The aim of this study is to identify nursing models used in doctoral theses in psychiatric and mental health nursing. Material and Methods: In this descriptive-type retrospective document analysis study, theses in mental health and psychiatric nursing departments of health sciences institutes were reviewed at the National Thesis Center of the Council of Higher Education on from September to October 2023. The study was completed with 14 doctoral theses. Word and Excel programs were used to record and analyze data. Results: The Roy Adaptation Model and then the Neuman Systems Model were mostly used in doctoral theses. It was determined that four theses were randomized controlled, and six theses were done within the scope of community mental health nursing when the sample group was examined. Conclusions: The Roy Adaptation Model has positive effects on issues such as emotional expression, self-esteem, and treatment areas. As a sample group, there was a tendency towards preventive mental health services. Experimental designs with control groups were used in doctoral theses, and four theses were determined to be randomized controlled.

Impact of Perceived Academic Stress Upon Academic Performance of Physiotherapy Students - A Cross Sectional Study

Introduction: Stress is prevalent among Healthcare students worldwide. Studies have shown that these students are more likely to suffer from mental health issues and have lower levels of life satisfaction. This research aimed to examine physical therapy students' experiences with academic stress and how it relates to and affects their academic performances. Methods: The study was done among the physical therapy students of AIHMS New Delhi. Using Yamane's formula, the sample size of 260 participants was calculated. The study sample was 272, and participants were asked to fill out a Perceived Mean Stress Score (PMSS) questionnaire using convenient sampling. The data was analyzed by using SPSS version 25. The mean and standard deviation for each response were calculated as a part of descriptive statistics, whereas the Student t-test and ANOVA were applied for inferential statistics to assess the impact of academic stress on their performance. Results: 272 students participated in the study, of which 173 and 99 respondents were females and males, respectively. The respondents were tested for differences in Perceived Mean Stress Score for 13 dimensions. Mean stress scores were significantly higher in students with lower GPA scores and less in students with high GPA scores. Personal finances and Accommodation were found to impact stress ratings significantly (P=0.036*,0.018*). The stress scores were significantly higher in the final years compared to the initial years in Physiotherapy school(P<0.05*). Conclusions: High mean scores for stress and anxiety necessitate early identification, especially in the initial years of Physiotherapy school, and integration of preventive mental health services in routine clinical services for Physiotherapy students.

Health behavior profiles and association with mental health status among US active-duty service members.

This study investigated the clustering of health behaviors among US active duty servicemembers (ADSM) into risk profiles and explored the association between these profiles with ADSM sociodemographic characteristics and mental health status. This study utilized secondary data from the 2018 Health Related Behaviors Survey (HRBS), a Department of Defense (DoD) self-administered online survey. Health behaviors included physical activity, screen use, sleep habits, tobacco/substance use, alcohol drinking, preventive health care seeking and condom use at last sex/having multiple sexual partners. Past-year mental health status was measured using the Kessler Screening Scale for Psychological Distress (K6). Latent class analysis (LCA) on health behaviors was used to cluster ADSMs into risk profiles. Multivariable logistic model was used to examine whether ADSM characteristics and mental health status were associated with ADSMs' risk profiles. The LCA identified a four-class model that clustered ADSMs into the following sub-groups: (1) Risk Inclined (14.4%), (2) High Screen Users (51.1%), (3) Poor Sleepers (23.9%) and (4) Risk Averse (10.6). Over a tenth (16.4%) of ADSMs were categorized as having serious psychological distress. Being male, younger, less educated, in the Army, Marine Corps or Navy were associated with higher odds of being Risk Inclined (AOR ranging from 1.26 to 2.42). Compared to the reference group of Risk Adverse ADSMs, those categorized as Risk Inclined (AOR: 8.30; 95% CI: 5.16-13.36), High Screen Users (AOR: 2.44; 95% CI: 1.56-3.82) and Poor Sleepers (AOR: 5.26; 95% CI: 3.38-8.19) had significantly higher odds of having serious psychological distress. Study findings suggest opportunities to tailor behavioral and health promotion interventions for each of the distinct risk profiles. For example, ADSM described as Risk Inclined may benefit from preventive mental health services. Solutions for ADSM described as Poor Sleepers may include education on sleep hygiene; instituting duty schedules; and shifting military cultural norms to promote sleep hygiene as a pathway to optimal performance and thus military readiness. ADSM with low-risk behavior profiles such as those described as Risk Averse may prove beneficial in the roll-out of interventions as they act as peer-educators or mentors.

Differences in Depression, Anxiety, and Stress in Relation to Changes in Living Conditions, Work Conditions, and Daily Life During the COVID-19 Pandemic in Jordan.

The COVID-19 pandemic was associated with numerous changes in daily life conditions that could affect the psychological response of individuals worldwide. The study aimed to describe and examine differences in depression, anxiety, and stress in relation to living conditions during the COVID-19 pandemic. A cross-sectional design was used. Purposive snowball sampling was employed to include 642 participants. Arabic versions of the Depression, Anxiety, and Stress Scales were used to collect data. Descriptive statistics, t-test, ANOVA, and Pearson's correlation were used to analyze the data. The total mean scores of depression, anxiety, and stress were 12.26 (SD = 10.53), 9.04 (SD = 9.34), and 13.49 (SD = 10.72), respectively. Of the study sample, 122 (19.5%), 139 (22.2%), and 99 (15.9%) had severe to extremely severe levels of depression, anxiety, and stress, respectively. Significant differences were found in depression, anxiety, and stress in relation to age, chronic diseases, and house size. The findings showed an increased prevalence of depression and anxiety during the COVID-19 pandemic. Mental health practitioners need to recognize the impact of pandemics on youth, females, low-income populations, and individuals with chronic diseases. Preventive mental health services among these populations, such as screening and counseling, would help reduce the health risks.

Influence of Perceived Academic related Stress on Academic Performance of Medical Students - A Cross Sectional Study

Background and Aims: Stress among medical students across the globe is a common phenomenon, they have been found to be at serious risk of mental stress and disorders with diminished life satisfaction. The present study was carried out with the objective to assess the academic stress in medical school along with it’s correlation and impact on academic performance. Methods: This study was carried out among the male and female students of College of Medicine and preparatory year, Majmaah University. The participants were selected by simple random sampling. The participants were asked to fill Perceived Mean Stress Score (PMSS) questionnaire and the data was analyzed by using SPSS version 25. The Mean and standard deviation for each response for PMSS was calculated. Appropriate statistical tests like ANOVA & multi variable logistic regression were applied to assess the impact of academic stress on their performance. Results: 242 students participated in the study out of which there were 153 males and 89 females. Male and female students were tested for difference in Perceived Mean Stress Score for all 13 domains It was noted that the Overall a higher average PMSS scores were noticed with advancing courses and also the students developed more anxiety and depression in higher grades which was reflected on their Grade Point Average (GPA) scores. Conclusions: High mean scores for stress and anxiety necessitate early identification especially in initial years of medical school and integration of preventive mental health services in routine clinical services for medical students.

SUICIDE PROBABILITY AND RELATED FACTORS AMONG UNIVERSITY STUDENTS İN SANLIURFA

This study aimed to determine suicide, suicidal ideation and related predisposing factors among university students. The sample of this cross-sectional study included 1,451 students studying at a university in Sanlırfa between October 1, 2022 and January 1, 2023. Data were collected online using a questionnaire prepared by the researchers and the Suicide Probability Scale (SPS). The mean SPS score of the students was 73.53 ± 17.41. Sub-dimension scores were 26.55 ± 7.10 for the hopelessness sub-dimension, 12.19 ± 3.75 for the suicidal ideation sub-dimension, 12.21 ± 3.75 for the hostility sub-dimension and 22.5 ± 5.50 for the negative self-evaluation sub-dimension. Furthermore, it was observed that the total SPS score was higher in those with a monthly income of 20 $ or less, smokers and substance users, those with a psychiatric history, those who had attempted suicide before, those with a history of attempted suicide in their family or environment, those who used psychiatric drugs and those who had been subjected to harassment or abuse before (p ˂ 0.05). Addressing the possibility of suicide among university students and conducting periodic screenings in terms of mental health will contribute to planning preventive mental health services for university students.

Mental health and use of Medicare Benefits Schedule follow-up mental health services by Indigenous people in Australia during the COVID-19 pandemic.

Mental health care has declined during the COVID-19 pandemic as has attendance for preventive mental health health services. This study aimed to investigate trends in all types of mental health service claims identified in an Indigenous-specific health assessment for Indigenous people before and during COVID-19. We conducted an analysis of Medicare Benefits Scheme (MBS) mental health service items (Items 81,325 and 81,355), to investigate the trends in all types of mental health service claims specifically intended for Indigenous people of Australia. Data were analysed using descriptive statistics, including the total annual numbers of Indigenous peoples' mental health service claims cross-tabulated by age groups and gender, between the calendar years 2017-2021. Multivariable Poisson regression modelling was used to determine associations that were statistically significant. Our results indicate an overall rise in MBS claims for mental health follow-up services during 2019-2020 followed by a decline in 2020-2021. In addition, there was an overall decline in claims for follow-up psychology services across the time period 2019-2021. We found a significant decline in MBS items specific to follow-up mental health services (MBS Items 81,325 and 81,355) for Indigenous people in Australia suggesting a decline in attendance for mental health service follow-up which in turn may indicate a deficit in mental health care during the COVID-19 pandemic, an issue that may lead to poorer mental health outcomes in the future. Further research is needed to understand whether these changes were due to the impact of the COVID-19 pandemic or other factors.

Demographic Gradients of Mental Health in University Students: A Study of Medical Interns in Iran

Background: The mental health status of medical students is not optimistic. Understanding the factors associated with their poor mental health can contribute to alleviating this condition. Objectives: This study aimed to examine the mental health status of medical interns and its associated demographic and personal traits. Methods: From 2020 to 2021, 358 interns were enrolled in the study. Goldberg's general health questionnaire (GHQ-28) was used to assess their mental health, with scores ≥ 24 indicating poor mental health. Factors associated with GHQ scores were determined using multivariable regression. Results: Among the study population (age: 25.43 ± 2.31, 49.4% males), GHQ mean score was 30.09 ± 14.44, and 61.7% of interns had GHQ ≥ 24. Female gender (adjusted-OR: 1.78, P: 0.015), low hope for career prospects (adjusted-OR: 4.09, P: 0.001), and low and medium personal life satisfaction (adjusted-OR: 10.94, P < 0.001; adjusted-OR: 2.55, P: 0.001, respectively) significantly increased the risk of having poor mental health. Conclusions: In Iran, more than half of medical interns are not enjoying desirable mental health. Female students are more prone to being mentally unhealthy. Furthermore, lower hope and personal life satisfaction levels negatively affect students' mental health. Related university officials should identify the causes and develop effective preventive and therapeutic mental health services for interns. Female students should be the priority group.

Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER) 2.0 QUERI: study protocol for a cluster-randomized hybrid type 3 effectiveness-implementation trial

BackgroundWomen Veterans are the fastest-growing segment of Veterans Health Administration (VA) users. The VA has invested heavily in delivering care for women Veterans that is effective, comprehensive, and gender-tailored. However, gender disparities persist in cardiovascular (CV) and diabetes risk factor control, and the rate of perinatal depression among women Veterans is higher than that among civilian women. Challenges such as distance, rurality, negative perception of VA, discrimination (e.g., toward sexual and/or gender minority individuals), and harassment on VA grounds can further impede women’s regular use of VA care. Enhancing Mental and Physical Health of Women through Engagement and Retention (EMPOWER) 2.0 builds on work to date by expanding access to evidence-based, telehealth preventive and mental health services for women Veterans with high-priority health conditions in rural and urban-isolation areas.MethodsEMPOWER 2.0 will evaluate two implementation strategies, Replicating Effective Practices (REP) and Evidence-Based Quality Improvement (EBQI), in supporting the implementation and sustainment of three evidence-based interventions (Virtual Diabetes Prevention Program; Telephone Lifestyle Coaching Program; and Reach Out, Stay Strong Essentials) focused on preventive and mental health care for women Veterans. We will conduct a mixed-methods implementation evaluation using a cluster-randomized hybrid type 3 effectiveness-implementation trial design to compare the effectiveness of REP and EBQI on improved access to and rates of engagement in telehealth preventive lifestyle and mental health services. Other outcomes of interest include (a) VA performance metrics for telehealth care delivery and related clinical outcomes; (b) progression along the Stages of Implementation Completion; (c) adaptation, sensemaking, and experiences of implementation among multilevel stakeholders; and (d) cost and return on investment. We will also generate implementation playbooks for program partners to support scale-up and spread of these and future evidence-based women’s health programs and policies.DiscussionEMPOWER 2.0 provides a model for mixed-methods hybrid type 3 effectiveness-implementation trial design incorporating evaluation of performance metrics, implementation progress, stakeholder experience, and cost and return on investment, with the ultimate goal of improving access to evidence-based preventive and mental telehealth services for women Veterans with high-priority health conditions.Trial registrationClinicalTrials.gov, NCT05050266. Registered on 20 September 2021.

Perceived stress and its effect on cardio-respiratory system in first year medical students.

Objectives: To determine the correlation of perceived stress with blood pressure and pulmonary function tests in normal, healthy first-year medical students. Study Design: Cross Sectional study. Setting: Department of Physiology, Al-Tibri Medical College, Isra University Karachi Campus. Period: August 2021 to February 2022. Material & Methods: From all the students enrolled in the first year MBBS during academic year 2021-22, data from 72 students were evaluated who met the inclusion criteria. The sphygmomanometer was used to measure the blood pressure parameters, and the Biopac ® data acquisition system was used to measure the pulmonary function test variables. A ten-item classic stress assessment questionnaire was used to evaluate the perceived stress scale, and the observed values were then correlated with the variables of blood pressure and pulmonary function tests. Results: The majority of the study cohort (69.44%) is in a moderate level of stress with female predominance (p= 0.001), while diastolic blood pressure (p=0.008), mean arterial blood pressure (p=0.006), vital capacity (p=0.000), forced vital capacity (p=0.006), forced expiratory volume in the first second (p=0.003) all negatively correlated with perceived stress scale in the participants. Conclusion: The findings of the present study point toward possible delirious effects of stress on cardio-pulmonary health. The timely detection and address budding stress issues in the early years of medical schools by establishing counseling and preventive mental health services centers will prevent future morbidity and produce healthy doctors.

PREVALENCE OF STRESS AND ITS ASSOCIATION WITH RESILIENCE AMONG MEDICAL STUDENTS IN A TERTIARY CARE CENTER, AURANGABAD, MAHARASHTRA, INDIA

Background: Medical science is perceived as a stressful educational career, and medical students experience monstrous stress during their undergraduate studies and internships because of its depth and competitiveness. Prolonged stress can cause health problems, hamper academic achievements, and affect patient care. Objectives: The present study aimed to assess the prevalence of stress and its association with resilience, as well as the coping strategies adopted by medical students. Material & Methods: This was a cross-sectional study conducted among medical undergraduate students studying at a tertiary care hospital situated in Aurangabad, Maharashtra, between June and July 2022. Using Cochrans formula and the previous studys prevalence of 51.1%, 425 medical students from first year to internship were included. A self-administered questionnaire consisting of Sociodemographic characteristics, items from the Kessler 10 inventory, and the BRIEF resilient coping scale were used. Results: The overall response rate was 79.11%, with 380 out of 425 students returning the questionnaire. The study found that 57.6% of medical students were suffering from high levels of stress, and the highest prevalence was among the 1st year students, followed by the internship students, and then the final year students. Stress was classified as mild (13.9%), moderate (8.9%), severe (34.7%), or likely to be well (42.4%) on the Kessler 10-item inventory scale. Academic factors are a greater perceived cause of stress. The religion, present address, medium of education and BRCS coping score had significant impact on presence of stress.(p=0.027, p=0.03, p=0.001,p=0.001 ) Conclusion: The study recommended that consideration be given to program decision-makers and health decision-makers to focus on significant actions to reduce the academic stress perceived by medical students. Preventive mental health services could be made an integral part of routine clinical services for medical students, especially in the initial academic years, to prevent such occurrences.

Assessments of Depression Anxiety and Stress among Volunteers Health Workers in Lagos, Nigeria

This study aimed at investigating the prevalence and factors associated with depression, anxiety, and stress symptoms among volunteers who volunteered to carry out free health services in Lagos, Nigeria. It was a cross-sectional survey. The secondary objective was to determine whether there were differences between individuals who were experiencing depression, anxiety, or stress and those who were not. One hundred and sixty-three consecutive health workers were invited to take part in the study. Sociodemographic and clinical data were gathered using a semi-structured proforma. Assessments were further done using the Depression, Anxiety, and Stress Scale. According to the DASS-21 scale, 30.3% had various levels of depression, and various levels of anxiety were detected in 47.5% of participants. Similarly, various levels of stress were detected in 29.5% of the participants. There were significant associations between the sub-domains of depression anxiety and stress. High levels of depression, anxiety and stress were detected among the participants. The higher degree was evident, particularly among the single, female participants. The results will serve as supporting evidence for the timely intervention of further planning of preventative mental health services by the supervising ministry for volunteer health workers within the public and private health sectors. This implicates the need for mental health training. Hospital management and medical policymakers should continue to provide various types of therapies to increase the emotional resilience and coping skills of healthcare workers.

Prevalence of and institutional factors associated with depression among undergraduate students at Gulu University

Background: Many institutional factors predispose University students to mental health issues, including depression. However, with no central database for depression in Uganda, literature on depression and associated institutional factors among undergraduate students is scarce. This study examined the prevalence of and institutional factors associated with depression among undergraduate students at Gulu University. Methods: This was a cross-sectional survey among 452 undergraduate students at Gulu University in the academic year 2018/2019 in February and March 2019. A stratified simple random sampling was used to identify the participants. A self-administered questionnaire was used to collect data. Descriptive statistics, including mean and frequency, were used. We conducted a bivariate analysis to determine the association between variables employing Pearson’s chi-square test or Fischer’s exact test. We conducted a multivariate analysis with factors that had significant P-values of less than 0.05. Results: The average age of the respondents was 22.4 (SD - 2.4), more than half (53.1%) were male and 38.50% were in the second year. The results show that 31.19% reported depression. After controlling for age and sex, the results showed that there was a statistically significant correlation between depression and faculty (aOR - 1.15), year of study (aOR - 0.77), happiness with the course (aOR - 0-0.49), satisfaction with academic performance (aOR - 0.45), and satisfaction with academic quality (aOR - 0.61). The results indicated that the predictors of depression among undergraduate students were faculty, year of study, satisfaction with academic performance, and satisfaction with academic quality. Conclusion: A substantial proportion of Gulu University undergraduate students reported high levels of depression. The results, therefore, showed that depression in undergraduate students is an identifiable disorder that needs diagnosis, prevention, and treatment. Faculty, year of study, satisfaction with academic performance, satisfaction with academic quality were predictors of depression. Thus there is an urgent need for counseling, psychoeducation, and preventive mental health services as an essential part of the university setup.

Burnout among German oncologists: a cross-sectional study in cooperation with the Arbeitsgemeinschaft Internistische Onkologie Quality of Life Working Group

PurposeOncologists are at an increased risk of developing burnout, leading to negative consequences in patient care and in professional satisfaction and quality of life. This study was designed to investigate exhaustion and disengagement among German oncologists and assess the prevalence of burnout among oncologists within different professional settings. Furthermore, we wanted to examine possible relations between sociodemographic factors, the oncological setting, professional experience and different aspects of burnout.MethodsIn a cross-sectional study design, an Internet-based survey was conducted with 121 oncologists between April and July 2020 using the Oldenburg Burnout Inventory, which contains items on exhaustion, disengagement, and burnout. Furthermore, sociodemographic data of the participants were assessed. The participants were members of the Working Group Medical Oncology (Arbeitsgemeinschaft Internistische Onkologie) within the German Cancer Society.ResultsThe survey showed a burnout prevalence of 43.8%, which correlated with age and professional experience; that is, the prevalence is particularly high among younger oncologists. Exhaustion is closely related to employment status; that is, it was significantly higher among employed oncologists. There were remarkably low levels of disengagement among oncologists, highlighting the own demand to fulfil job requirements despite imminent or actual overburdening in daily work.ConclusionMore support is necessary to mitigate the professional stressors in the healthcare system. To ensure quality medical care, employees should be offered preventive mental health services early in their careers.

Prevalence of Depression and Anxiety among Students Preparing for National Eligibility Cum Entrance Test- Undergraduate Exam in Chennai, Tamil Nadu, India

Introduction: Indian students are subjected to enormous stress to compete and perform since competitive exams have been made mandatory to enter professional courses. Inability to handle performance pressure, meet parental expectations, and achieve aspirations may lead to psychological distress and subsequent depression. Aim: To estimate the prevalence of depression and anxiety and identify the associated factors among National Eligibility cum Entrance Test (NEET) aspirants in the Chennai, India. Materials and Methods: The present community-based, cross-sectional analytical study was conducted at various NEET coaching centres in Chennai, Tamil Nadu, India, among 250 NEET aspirants between July 2021 and August 2021. A pretested, semi-structured, self-administered online questionnaire with 45 questions, consisting of the Beck Depression Inventory-II and Beck Anxiety Inventory, in the English language was used. Categorical data were presented as frequency and proportions. Pearson’s, Chi-square test was used to evaluate differences between groups for categorised variables. Results: Out of the total 250 students, 147 (58.8%) were males and mean age of the participants was 19.38±1.146 years. Overall, 112 (45%) participants had attempted NEET-Undergraduate (UG) exam once and 94 (38%) participants had two attempts. The overall prevalence of depressive symptoms was n=148 (59.2%) and anxiety symptoms were seen in all 250 (100%) participants. Symptoms of severe depression were high among those with three previous attempts(44) and those awaiting their first NEET attempt. The number of previous attempts had a statistically significant (p-value<0.001) association with the severity of anxiety symptoms. Conclusion: This high morbidity of depressive and anxiety symptoms highlights the need for access to preventive and curative mental health services for students preparing for highly competitive exams like NEET.

Understanding risk in younger Veterans: Risk and protective factors associated with suicide attempt, homelessness, and arrest in a nationally representative Veteran sample

ABSTRACT Accumulating research suggests unique patterns of suicide risk, homelessness, and criminal-justice involvement in younger (age < 40) relative to older (aged 40+) cohorts of Veterans. However, potential explanations for these differences remain unclear. To address this gap, we analyzed data from a nationally representative sample of more than 4,000 US military Veterans to compare risk and protective correlations of prior suicidal behavior, homelessness, and justice-involvement in younger versus older Veterans. Results revealed that younger Veterans were significantly more likely than older Veterans to have a history of suicide attempt(s) (13.9% vs. 2.7%) and homelessness (22.5% vs. 8.7%). They also scored higher on measures of risk factors and lower on measures of protective factors. However, some factors – specifically, resilience, grit, impulsiveness, perceptions of the effect of the military on one’s life and social support – were less strongly associated with a history of adverse events in younger versus older Veterans. Findings highlight the need for preventative homelessness and mental health services for younger Veterans that are tailored to the unique characteristics and needs of this age cohort.

7.P. Workshop: Mental health during the Covid19 pandemic &amp; corresponding national health promotion measures

BackgroundTo an initially non-expected degree, the wellbeing of the population in European countries has been affected by the containment measures during the course of the COVID-19 pandemic. The longer the pandemic holds the more visible become also the economic effects, which in turn will affect the populations mental health and wellbeing on the longer term and have the potential to dramatically increase health inequalities. Whether the psychosocial burden of containment measures will be followed by a significant increase of mental illness is hotly debated and yet to be determined. National institutions have the task to promote health during such crises. Therefore, mental health and wellbeing was monitored in most European countries, and in many countries, approaches to support the population and its subgroups under the burden were developed, acknowledging the monitoring data and dynamics within the pandemic and containment activities. In this workshop the data on population wellbeing during the pandemic from Germany, Italy and France will be presented and the different approaches to promote mental health explained and discussed. The input from the three countries will be the basis for a discussion with the audience: What similarities can be identified from the measures and programs presented? What lessons can be learned for their further development? What synergies could arise in the future?ObjectiveThe goal is to present, compare and critically review the mental wellbeing of populations and subgroups in the three countries since the beginning of 2020, to assess its association with the pandemic waves and the according containment measures and discuss the resulting health promotion activities (with a focus on national-level interventions and approaches). Selected interventions to promote mental health and wellbeing will be presented that were developed based on the monitoring data available in the countries. The interventions will be discussed in terms of their relevance to reach subgroups and improve wellbeing in the dynamic situation of the COVID-19 pandemic.Key messages The longer-term effects of the pandemic and its containments measures on mental health and wellbeing of populations is yet to be defined.The psychosocial burden is higher in certain subgroups and demands specific interventions that improve access to preventive (partly preexisting) mental health services.

Risk of Self-harm in Children and Adults With Autism Spectrum Disorder

Multiple studies have reported that people with autism spectrum disorder (ASD) are at a higher risk for self-injurious behavior and suicide. However, the magnitude of this association varies between studies. To appraise the available epidemiologic studies on the risk of self-injurious behavior and suicidality among children and adults with ASD. PubMed, Embase, CINAHL, PsycINFO, and Web of Science were systematically searched for epidemiologic studies on the association between ASD and self-injurious behavior and suicidality. Databases were searched from year of inception to April through June 2020. No language, age, or date restrictions were applied. This systematic review and meta-analysis included studies with an observational design and compared self-injurious behavior (defined as nonaccidental behavior resulting in self-inflicted physical injury but without intent of suicide or sexual arousal) and/or suicidality (defined as suicidal ideation, suicide attempt, or suicide) in children (aged <20 years) or adults (aged ≥20 years) with ASD. Information on study design, study population, ASD and self-harm definitions, and outcomes were extracted by independent investigators. Study quality was assessed using the Newcastle-Ottawa Scale. Overall summary odds ratios (ORs) and 95% CIs were estimated using DerSimonian-Laird random-effects models. The ORs for the associations of ASD with self-injurious behavior and suicidality were calculated. Analyses were stratified by study setting and age groups as planned a priori. The search identified 31 eligible studies, which were of moderate to high quality. Of these studies, 16 (52%) were conducted in children, 13 (42%) in adults, and 2 (6%) in both children and adults. Seventeen studies assessed the association between ASD and self-injurious behavior and reported ORs that ranged from 1.21 to 18.76, resulting in a pooled OR of 3.18 (95% CI, 2.45-4.12). Sixteen studies assessed the association between ASD and suicidality and reported ORs that ranged from 0.86 to 11.10, resulting in a pooled OR of 3.32 (95% CI, 2.60-4.24). In stratified analyses, results were consistent between clinical and nonclinical settings and between children and adults. This study found that ASD was associated with a substantial increase in odds of self-injurious behavior and suicidality in children and adults. Further research is needed to examine the role of primary care screenings, increased access to preventive mental health services, and lethal means counseling in reducing self-harm in this population.

Housing Instability and Depression among US Mothers Following a Nonmarital Birth.

Mothers who had a nonmarital birth experience multiple risk factors for depression, including housing instability. Yet, important questions remain about the extent of long-term housing instability and its association with future depression among at-risk mothers. Using the Fragile Families and Child Wellbeing Study data, we examine cumulative housing instability over a 15-year period following nonmarital birth and its association with maternal depression. Based on a sample of 2279 mothers who had a nonmarital birth in 20 major US cities between 1998–2000, we examined their 15-year residential moves and housing arrangements. Then, we tested the associations between the cumulative residential moves and major depressive episodes (MDE) in Year 15 using logistic regression analysis. One in every four mothers had six or more residential moves in 15 years following a nonmarital birth. For each additional move, mothers reported up to 27.9% higher odds of having a past-year MDE in Year 15, translating into the prevalence increases from 6.0% (zero move) to 20.6% (10 moves). Our findings suggest that greater attention should be paid to housing needs among mothers following a nonmarital birth, including temporary housing assistance and more fundamental programs to reduce housing instability as preventive mental health services.

Koronavirüse (COVID-19) yakalanma kaygısının uyku ertelemeye etkisi

Purpose: The novel Coronavirus (Covid-19) affects societies economically, socially, psychologically, and behaviorally. Sleep is one of the behavioral factors that affect the immune system. In this context, this study aims to examine the effect of the anxiety to catch the Covid-19 on bedtime procrastination.&#x0D; Materials and Methods: The research is cross-sectional and quantitative research. The data were collected by questionnaire technique. In the study, “Athlete’s Anxiety to Catch the Novel Coronavirus (Covid-19) Scale (AACNCS)” and “Bedtime Procrastination Scale” were used. The scales were distributed through online platforms, and a total of 768 individuals were included in the study &#x0D; Results: The results of the research revealed that the anxiety to catch the Covid-19 affected bedtime procrastination positively. The study has concluded that women’s anxiety and bedtime procrastination level is higher. The mean score of bedtime procrastination was higher for those who do not have to work outside. The findings exhibit that those with chronic diseases in their family are more anxious to catch the Covid-19. &#x0D; Conclusion: It is possible to state that health communication efforts should be carried out to reduce the anxiety level of the society. Besides, activities should be carried out to protect the mental health of society through preventive mental health services.