Severe Depression Research Articles

Correlation between self-efficacy, parental parenting patterns, and severe depression in adolescents

BACKGROUND Adolescence is a critical period marked by significant psychological changes. This study explores how self-efficacy and parental parenting styles may influence the risk of severe depression among teens. The hypothesis is that higher self-efficacy and authoritative parenting patterns will be negatively correlated with severe depression in adolescents. AIM To investigate the correlation between self-efficacy, parenting patterns and major depression in adolescents, and to provide guidance for mental intervention. METHODS Using a cross-sectional survey design, the data were collected through a questionnaire survey. Patients with major depression and healthy adolescents in the hospital control group were selected as the study objects. The General Self-Efficacy Scale, the Parenting Style Evaluation Scale, and the Beck Depression Inventory were used as research instruments. Data input and statistical analysis were performed, including descriptive statistics, correlation analysis, through SPSS software. RESULTS The study found that depressed patients had significantly lower self-efficacy than healthy controls, and parenting style was significantly associated with depressive symptoms in terms of emotional warmth and understanding, punishment severity, and denial. Specifically, parental emotional warmth and understanding were significantly negatively associated with depressive symptoms, while parental punishment severity and denial were significantly positively associated with depressive symptoms. Self-efficacy showed a significant negative correlation with depressive symptoms, indicating that higher self-efficacy had lower depressive symptoms. CONCLUSION Adolescent major depressive disorder patient was significantly associated with their parenting style and self-efficacy. Higher self-efficacy is associated with decreased depressive symptoms, so improving adolescent self-efficacy and improving parenting style are important.

Addiction to smartphones in Arabs is associated with severe depressive symptoms and insomnia: a cross-sectional study.

Addiction to smartphones is a global issue. Mental health disturbance is an emerging factor implicated in smartphone addiction. Whether depressive symptoms and anxiety are implicated in smartphone addiction in developing countries such as Jordan is a nexus that warrants investigation. The present study investigated whether depressive symptoms and insomnia are correlated with smartphone addiction in a cohort of Jordanian participants. We adopted a cross-sectional design for a convenient sample, smartphone addiction, depressive symptoms, and insomnia were assessed using validated scales. Data analysis from 484 participants revealed that smartphone addiction was reported in 180 (37.1%) of the participants. Symptoms of severe depression and severe insomnia were reported in 174 (35.9%) and 198 (40.9%) of the participants respectively. The multivariable regression analysis showed that severe depressive symptoms and severe insomnia were significantly associated with addiction to smartphones (OR = 1.69, 95% CI = 1.11-2.55, p = 0.01) and (OR = 2.19, 95% CI = 1.46-3.29, p < 0.001) respectively. In conclusion, poor mental health outcomes are correlated with unhealthy lifestyle habits such as addiction to smartphones, the addressing these alarming mental health symptoms is required to optimize the well-being of the community.

Effect of bright-light therapy on depression and anxiety of a patient with Alzheimer’s disease combined with sleep disorder: A case report

BACKGROUND Alzheimer’s disease (AD) is a common type of dementia due to neuronal impairment. In addition, psychobehavioral symptoms including severe sleep disorders, depression and anxiety can occur in most patients with AD. CASE SUMMARY We report a case of a 68-year-old woman with a 2-year history of AD. She initially presented with memory loss, progressively more severe, leading to a depressive and anxious status. The clinical symptoms also included severe sleep disturbances. Considering the age and health state of the patient, a non-pharmacological treatment of bright light therapy was used to improve her sleep quality. The treatment was provided for 30 minutes twice a day, during 8:30 am to 9:00 am and 16:30 pm to 17:00 pm. After 4 weeks of therapy, the sleep quality notably improved, with a marked decrease in daytime sleep, increase in nighttime sleep, and disappearance of nocturnal activity. The depression and anxiety were also suppressed significantly. CONCLUSION This case report suggested that bright light therapy can have a positive effect on sleep quality in elderly patients with AD and can be used as an effective and safe non-pharmacological treatment.

Smartphone addiction and depression among health sciences students during COVID-19 pandemic

BackgroundPrevious studies indicate an increasing prevalence of depression among university students worldwide. Besides, university students are more likely to excessively use smartphones, making them more susceptible to smartphone addiction. Pandemic conditions can also have negative effects on mental health. Thus, this study aims to investigate the frequency of depression among university students during COVID-19 pandemic.MethodsThe study population for this mixed-method research, which includes both qualitative and quantitative components, consists of students studying health sciences at a state university in Istanbul, Türkiye. No sample was selected for the quantitative data collection; instead, it was aimed to reach the entire population. Sociodemographic characteristics, the 10-item Smartphone Addiction Scale-Short Version (SAS-SV), and the 21-item Beck Depression Inventory (BDI) were used. In the qualitative part of our study, semi-structured online interviews were conducted with 12 students. Statistical significance level was set at p < 0.05.ResultsThe study, involving 819 students, found that 25.2% had moderate depression and 5.7% had severe depression. A statistically significant relationship was found between self-perceived smartphone addiction and the presence of moderate-severe depression (p < 0.001). Participants who spent more than 4 h a day on their smartphones, those who checked their smartphones more than 30 times a day, those who perceived themselves as smartphone addicts, and those who experienced smartphone-related sleep problems obtained statistically significantly higher scores from BDI compared to others (p < 0.05). According to our qualitative results, some participants thought that smartphone use could cause a depressive mood by isolating people, while others believed it could do so through the negative effects of social media. All participants reported that the quarantine period increased their smartphone usage.ConclusionOur results suggest a potential interaction between smartphone addiction and depression. This indicates the potential benefit of assessing and addressing both conditions simultaneously.

Treatment Advances in Perinatal Depression: Innovations and Promising Approaches

Background/Objectives: Psychotherapy and antidepressants are the standard treatment for depression during pregnancy or postpartum. However, several new treatments for depression represent major advances and paradigm changes. This commentary highlights some innovative treatment options that are on the horizon. Most of these modalities are promising, and most are non-invasive. Many of these modalities have been used in the general population, where evidence supports their use. The methods have only recently been used for pregnant and postpartum women. Other modalities are specifically for perinatal women but do not have an established track record. Methods: This commentary describes some promising approaches to treatment, while acknowledging that the literature is preliminary. The goal is to highlight some interesting approaches drawn from a recent comprehensive review of the entire literature on treatment for perinatal mental illness. Results: Integrative treatments include vitamin D, infant massage, mindfulness-based cognitive therapy, acupuncture, and repetitive transcranial magnetic stimulation (rTMS). Many studies in the general population have found that these methods are effective, and they also show promise for perinatal women without side effects associated with medications. Some of these treatments can also be adjuncts to what is considered standard care. Two new medications, brexanolone and esketamine, quickly and effectively treat severe depression and work on GABA and glutamate receptors rather than serotonin or norepinephrine. These medications become less effective after 30 days but can be combined with selective serotonin reuptake inhibitors (SSRIs). Conclusions: Pregnant and postpartum women seeking care for depression and other mental health conditions have many options beyond psychotherapy and SSRI/SNRI antidepressants. These modalities can also be added to their care.

Assessment of Suicidal Ideation and Its Association with Mental Health Disorders Among Medical Sciences Students: A Cross-Sectional Study

Background: Depression, anxiety, and stress are prevalent among medical sciences students globally and contribute to suicidal ideation. Many risk factors are associated with the mental health problems of medical sciences students. Objectives: This study aimed to estimate the prevalence of depression, anxiety, stress, and suicidal ideation, as well as their associated factors, among medical, dental, and pharmacy students in the aftermath of the COVID-19 pandemic. Methods: In this cross-sectional study, we included 292 students. We collected background information and data on socioeconomic status (SES). We used the Depression, Anxiety, and Stress Scales-21 (DASS-21) and the Beck Scale for suicidal ideation (BSSI) to assess depression, anxiety, stress, and suicidal ideation. The data were analyzed using a linear regression model. Results: The prevalence of medium to high-risk suicidal thoughts among all students was 56.8%, with 6.5% of students reporting high-risk suicidal thoughts. The prevalence of mild to extremely severe depression, anxiety, and stress was 66.8%, 59.5%, and 52.1%, respectively. Factors significantly associated with the severity of suicidal thoughts included being single (β = -2.11), having a positive history of psychiatric illness (β = 2.64), having a positive history of chronic medical conditions (β = 4.23), and higher scores of depression (β = 1.97) and anxiety (β = 0.49). Additionally, a higher academic semester and greater interest in courses were significantly associated with lower scores of depression, anxiety, and stress. Conclusions: The findings of this study revealed a higher rate of depression, anxiety, stress, and suicidal ideation among medical sciences students compared to the global prevalence. This underscores the urgent need for targeted interventions to improve students’ mental health. More specifically, recognizing the risk factors for suicidality and promoting access to counseling services and mental health awareness programs can help prevent suicidal thoughts.

Heart Disease and Pectus Excavatum: An Underestimated Issue—Single Center Experience and Literature Review

Pectus excavatum (PE) can be associated with either congenital or acquired heart disease. This study highlights the importance of PE surgical repair in cases of severe chest depression on the heart in underlying cardiac diseases exacerbating cardiopulmonary impairment. From January 2023 to March 2024, four male patients underwent PE repair, having heart disease including pericarditis, mitral valve prolapse, ventricular fibrillation arrest and type 1 second-degree atrioventricular block. PE severity was determined by the Haller index (HI). Preoperative assessment included a pulmonary function test, chest computed tomography and cardiac evaluation. The Nuss procedure was performed in three patients, whereas, in one patient, it was performed in combination with a modified Ravitch procedure. The median HI was five. The median time of chest tube removal was 6.5 days. Postoperative complications were prolonged air leak, atrial fibrillation and atelectasis. The median length of hospital stay was 19.5 days, and no 30-day postoperative mortality was recorded. In all patients, surgical repair helped to resolve the underlying cardiological issues, and surgical follow-ups were deemed regular. PE is generally an isolated congenital chest wall abnormality, and, when associated with a heart disease, it can have severe life-threatening hemodynamic consequences due to mechanical compression on the heart for which surgical corrections should be considered.

Anxiety and Depression in Emerging Adults: Exploring Identity Centrality, Disability Self-Identification, and Self-Concept

ABSTRACT Both identity and mental health disorders are independently well studied areas of research, yet little research has examined the ways in which mental health is incorporated (or not) into a person’s identity and whether such disorders are considered by individuals to be disabilities. To address this gap, college students with clinical anxiety and/or depression disorders (N = 126) were asked to complete an online survey regarding demographic characteristics, disorder symptomatology, self-concept, and identity. Descriptive results revealed that most students viewed anxiety and depression as being both central to their identities and as disabilities. Regression analyses revealed that being older and having more severe depression symptoms were associated with depression identity centrality, while identifying as bisexual was correlated with anxiety identity centrality. Increased severity of both anxiety and depression were related to identifying the disorder as a disability, and older students also were more likely to identify anxiety as a disability. Greater disability self-identification among those with depression was associated with higher self-esteem, suggesting that identifying depression as a disability might be beneficial to college students.

Gender-Specific Insights into Depression in Patients with Ischemic Heart Disease: Findings from a Pilot Study Using a Self-Developed Questionnaire

Background/Objectives: Ischemic heart disease (IHD) significantly affects mental health, with gender-specific differences being observed in psychological responses. This pilot study aimed to explore these differences in the demographic, clinical, psychological, psychiatric, and social profile of patients diagnosed with IHD. Methods: A descriptive, cross-sectional design was used, recruiting 183 adult patients diagnosed with coronary artery disease and depression at the Psychiatry Department of Arad County Emergency Hospital, Romania, between May 2021 and May 2024. Data were collected using a self-developed tool, named the Depression Assessment in Ischemic Heart Disease Questionnaire (DA-IHDQ), alongside standardized assessments. Statistical analysis was performed using JASP statistical software (Version 0.19.1, University of Amsterdam, Amsterdam, Netherlands), employing binomial and multinomial tests for categorical data, and Cronbach’s alpha was used to assess internal consistency. Results: This study found significant demographic differences, with female patients exhibiting higher levels of emotional distress and severe depression compared with the male subjects. Women reported greater social isolation and a stronger desire to seek for psychological or psychiatric support. Furthermore, a positive correlation between depression severity and physical symptoms was observed in both genders. Conclusions: These findings highlight the importance of recognizing gender-specific responses to IHD, emphasizing the need for tailored interventions in mental healthcare and cardiac rehabilitation. Future research should further explore these differences to enhance the understanding of the psychosocial/psychiatric aspects of IHD and improve patient outcomes.

Mental health and attitudes toward suicide amongst individuals with gender dysphoria in Iran

IntroductionGender dysphoria (GD) is associated with profound mental health challenges, including heightened suicide risk. This study aimed to explore the mental health status and attitudes toward suicide among individuals with GD in Iran.MethodsA comprehensive assessment was conducted using three validated tools: the General Health Questionnaire (GHQ-28) to gauge emotional distress and psychological well-being, the Beck Depression Inventory (BDI-II) to evaluate the severity of depressive symptoms, and the Predicament Questionnaire (PQ) to measure attitudes toward suicide in the context of social crises.ResultsAmong the 78 participants, 43 (55.1%) were identified as experiencing significant mental health issues, while 21 (26.9%) were found to suffer from severe depression. The average PQ score was 57.92, which aligns with findings from similar populations in previous studies, highlighting a concerning trend in suicide-related attitudes. Further statistical analysis revealed significant correlations between psychological distress (GHQ-28 scores) and attitudes toward suicide (PQ scores), as well as between depressive symptoms (BDI-II scores) and suicide-related attitudes.ConclusionsThese findings indicate a pervasive prevalence of psychological disorders, particularly depression, within this group, and underscore the strong association between depressive states and suicidal ideation. The study underscores the urgent need for targeted mental health interventions and comprehensive healthcare policies tailored to the specific needs of individuals with GD in Iran. Given the substantial mental health burden observed, particularly the risk of suicide, this research highlights the critical importance of integrating mental health care into broader support systems for this population.

The role of psychotropics on the associations between extreme temperature and heat-related outcomes among people with mental health conditions: population-based study.

The association between heatwave and heat-related outcomes in people with mental health conditions with and without psychotropics was unclear. We identified people with severe mental illness (SMI) and depression, respectively, using Japanese claim data of Ibaraki prefecture during 1/1/2014-31/12/2021. We conducted self-controlled case series to estimate the incidence rate ratio (IRR) of heat-related illness, myocardial infarction and delirium, respectively, during 5-day pre-heatwave, heatwave, and 5-day post-heatwave periods v. all other periods (baseline) within an individual, stratified by periods prescribed psychotropics and periods not prescribed psychotropics, respectively. Among people with SMI, heatwave was associated with an increased rate of heat-related illness v. baseline, with no evidence of a difference in the IRRs between those prescribed v. not prescribed antipsychotics (IRR: 1.48 [95% CI 1.40-1.56]; 1.45 [95% CI 1.35-1.56] respectively, p interaction: 0.53). Among people with depression, heatwave was similarly associated with heat-related illness, with no evidence of a difference in the IRRs between those prescribed v. not prescribed antidepressants (IRR: 1.54 [95% CI 1.46-1.64]; 1.64 [95% CI 1.57-1.71] respectively, p interaction: 0.33). Smaller increased rates of heat-related illness were also observed in pre- and post-heatwave periods, v. baseline in both cohorts. There was weak evidence of an increased risk of MI and delirium associated with heatwave v. baseline. We showed an increased risk of heat-related illness, myocardial infarction and delirium associated with heatwave in people with mental health conditions regardless of whether being prescribed psychotropics. Risks of heat-related illness, myocardial infarction and delirium associated with heatwave might not be factors to influence decisions about the routine use of psychotropics.

Severe depression episode with an incredible improvement after electroconvulsive therapy

Aim: The primary aim of this article is to present a case study of a patient with severe depressive episode that was refractory to extensive pharmacological treatment, but exhibited remarkable improvement following electroconvulsive therapy (ECT). Materials and Methods: The patient’s medical records were obtained from II Department of Psychiatry and Psychiatric Rehabilitation, Medical University of Lublin. Cited literature was searched on the PubMed database using the following keywords: Major depressive disorder or MDD, Electroconvulsive therapy, and Benzodiazepine dependence. Results and conclusions: A 55-year-old woman with recurrent depressive disorder and benzodiazepine dependance, unresponsive to multiple medications, requested an ECT. She was then treated with a cycle of 12 Seizure Electroconvulsive Therapy (SECT) sessions. Initially bedridden with severe anxiety, suicidal thoughts, and no clinical improvement despite maximal pharmacotherapy, she exhibited significant improvement after three SECT sessions. Her anxiety decreased, suicidal ideation resolved, and symptoms of anergy and anhedonia diminished. At the end of the SECT cycle, the patient's mood stabilised, and her activity level and social engagement increased. At discharge, she showed no suicidal ideation, tendencies, or psychotic symptoms.This case demonstrates the effectiveness of ECT in treating severe, pharmacologically resistant depressive episodes. It highlights the importance of considering patient requests in conjunction with clinical assessments to achieve positive outcomes. Raising awareness about ECT's safety and efficacy among the public and mental health professionals is crucial for optimizing treatment strategies for severe depression. Proper qualification and timely administration of ECT can significantly enhance treatment outcomes beyond pharmacotherapy alone.

A depressed patient in outpatient settings

Depression is a clinically significant and growing public health issue. As a major global disease burden, its prevalence has been steadily increasing over the years, affecting different demographic groups. Depressive disorder is characterized by a low mood, loss of strength, sadness, insomnia, and inability to feel pleasure. In outpatient settings, up to one-third of patients with depressive symptoms may have a comorbidity. Many different diseases have been associated with depressive symptoms. Cardiovascular, metabolic, inflammatory, oncological, and neurological disorders are associated with an increased risk of depression, potentially due to chronic inflammation, neurochemical dysregulation, and emotional and social issues. As different drugs can cause depressive symptoms, the patient's medical history should include an assessment of the use of such drugs. Primary care physicians play an important role in identifying and treating depression. It is recommended to perform depression screening in all adult female patients in primary care facilities. There are general recommendations for the initial treatment of mild to moderate depressive disorder in adults. In mild depression, initial preference should be given to psychotherapy and symptom monitoring, and if improvement is insufficient, pharmacotherapy is to be used. Psychotherapy, pharmacotherapy or a combination of both should be considered for patients with moderate depression. Psychiatric consultation is recommended for patients with severe depression and urgently for any patient with psychotic symptoms or suicidal thoughts and behaviour. Antidepressants are the basic therapy for depression. Selective serotonin reuptake inhibitors are considered the first-line drugs to treat depression.

What is the role of cognitive-behavioral career coaching in mitigating work anxiety and depression among public employees?

This editorial explores the study by Mkpoikanke Sunday Otu and Maximus Monaheng Sefotho on the use of cognitive-behavioral career coaching (CBCC) to reduce work anxiety and depression among public employees. Public sector workers often face significant psychological stressors, leading to mental health issues that impair well-being and job performance. The study employed a group-randomized trial design, involving 120 public employees diagnosed with severe anxiety and depression. Participants were divided into a treatment group, receiving CBCC, and a control group with no intervention. Results showed a significant reduction in anxiety and depression levels in the treatment group, sustained through follow-up assessments. The findings underscore the clinical relevance of CBCC as an effective intervention for improving mental health among public employees. Future research should explore the scalability of CBCC across different sectors and cultural contexts, as well as its integration with other mental health interventions. This editorial advocates for the broader implementation of CBCC practices in public service to enhance employee productivity and psychological well-being. By addressing cognitive distortions and fostering adaptive coping mechanisms, CBCC can help public employees navigate complex professional environments, ultimately contributing to a healthier and more efficient workforce.

Real-world effects of antidepressants for depressive disorder in primary care: population-based cohort study.

Antidepressants' effects are established in randomised controlled trials (RCTs), but not in the real world. To investigate real-world comparative effects of antidepressants for depression and compare them with RCTs. We performed a cohort study based on the QResearch database. We included people with a newly recorded diagnosis of depression, exposed to licensed antidepressants in the UK. We assessed all-cause dropouts (acceptability), dropouts for adverse events (tolerability), occurrence of at least one adverse event (safety), and response and remission on the Patient Health Questionnaire (PHQ)-9 (effectiveness) at 2 and 12 months. Logistic regressions were used to compute adjusted-odds ratio (aOR) with 99% CIs, assessing the associations between exposure to each antidepressant against fluoxetine (comparator) and outcomes of interest. We compared estimates from the real world with RCTs using ratio-of-odds ratio (ROR) with 95% CI. A total of 673 177 depressed people were studied: females 57.1%, mean age 42.8 (s.d. 17.7) years, mean baseline PHQ-9 17.1 (s.d. 5.0) (moderately severe depression). At 2 months, antidepressant acceptability was 61.4%, tolerability 94.4%, safety 54.5%, PHQ-9 decreased to 12.3 (s.d. 6.5). At 12 months, acceptability was 12.3%, tolerability 87.5%, safety 28.8%, PHQ-9 12.9 (s.d. 6.8). In the short and long term, tricyclics, mirtazapine and trazodone were worse than fluoxetine for most outcomes; citalopram had better acceptability than fluoxetine (aOR 0.95; 99% CI 0.92, 0.97), sertraline had lower tolerability (aOR 1.12; 99% CI 1.06, 1.18), and both citalopram and sertraline had lower safety (aOR 1.17 and 1.25, respectively). In the long term, citalopram had better acceptability (aOR 0.78; 99% CI 0.76, 0.81) and effectiveness (aOR 1.12 for both response and remission), but worse tolerability (aOR 1.09; 99% CI 1.06, 1.13) and safety (aOR 1.12; 99% CI 1.08, 1.16). Observational and randomised data were similar for citalopram and sertraline, while there was some difference for drugs less prescribed in the real world. Antidepressants showed low acceptability, moderate-to-high tolerability and safety, and small-to-moderate effectiveness in the real world. Real-world and RCT estimates showed similar findings only when the analyses were carried out using large datasets; otherwise, the results diverged.

Severe depression association with the addiction to fast food and smartphones in Jordanians: a cross-sectional study

BackgroundThe connection between psychiatry health, mental health, and lifestyle is under-studied in the Arab world. This study examined whether addictions to smartphones and fast food are associated with severe depressive symptoms in a cohort of Arab Jordanians.MethodThis research is cross-sectional. The Patient Health Questionnaire-9 was used to measure the severity of depression (PHQ-9), food addiction was assessed using the 9-item Modified Yale Food Addiction Scale (mYFAS), and smartphone addiction was assessed using the Arabic-validated Smartphone Addiction Scale. Using multivariable binary logistic regression, the relationship between food addiction, and depressive symptoms. Results: Data were analyzed from 426 participants, 264 participants (62.0%) reported being addicted to smartphones, and 156 (36.6%) reported severe depressive symptoms. The multivariable binary logistic regression revealed that severe depression was significantly associated with lower income (OR = 2.14, 95% Cl 1.34–3.41, P = 0.001), addiction to smartphones (OR = 2.15, 95% = 1.39–3.32, P = 0.001), and increased addiction to fast food (OR = 1.06, 95% = 1.04–1.08, P = < 0.001).ConclusionAddiction to smartphones, addiction to fast food, and low income were all associated with severe depression in Arab Jordanians, community awareness is highly required to adopt a healthy lifestyle.

Preventing Depression Among Older Adults With Severe Illness: The Mediating Role of Life Satisfaction and the Moderating Role of Gender.

The occurrence of severe illness, the risk for which increases as people age, often results in depression. The current study aimed to explore how and when severe illness leads to depression among older adults. Data collected from a sample of 756 older adults were analyzed using moderated mediation analysis to examine the underlying mechanism between severe illness and depression. Results, as verified by a robustness check, demonstrated that life satisfaction mediated the association between severe illness and depression among older men and women, and that gender moderated the direct relationship between severe illness and depression. The formation path of depression from severe illness among older adults varies according to gender. For men, severe illness did not directly trigger depression, but indirectly triggered depression through decreased life satisfaction; for women, severe illness not only triggered depression directly, but also indirectly triggered depression through decreased life satisfaction. Results yield theoretical and practical implications for gerontological nursing. [Journal of Gerontological Nursing, xx(xx), xx-xx.].

Effects of support systems on the mental health of nursing students during the COVID-19 pandemic

Mental Health has been declining over the last three years, coinciding with the COVID-19 pandemic. A person’s support system can either improve or worsen their mental health. Nursing students likely have been severely impacted by COVID-19 and their support system may impact their mental health. This study used the Depression, Anxiety, and Stress Scale (DASS-21) and the Social Support Scale to measure the effects of a positive and negative social support system on undergraduate nursing students at a university in the Western United States during the COVID-19 pandemic. Descriptive statistics and correlations were used to examine the relationships between stress, anxiety, and depression and support systems among undergraduate nursing students. Data were collected from students prior to the start of their program through two pre-course surveys, including the DASS-21 symptom measure and a 11-item Social Support Scale. Both surveys had established reliability and validity. Results showed that 17.8% of participants scored with severe or extremely severe anxiety, 6.6% with severe or extremely severe depression and 6.7% with severe or extremely severe stress. The average score for instrumental support was M = 4.22 (SD = 0.72), positive support was M = 4.29 (SD = 0.73) and negative support was M = 3.96 (SD = 0.87). The correlational analyses support a significant relationship between negative support and stress (r = .26). The results indicate that nursing students had a strong positive and instrumental support system in place. The results also show a low number of students reporting negative social support. However, the significant correlation between negative social support and stress indicates the harmful effects of a negative support system on a student’s mental health when it did occur. These results help us to further understand how the COVID-19 pandemic impacted the mental health of undergraduate nursing students.

Postpartum depression in Gujarat, India: Associations with social support, breastfeeding attitudes, and self-efficacy

ABSTRACT Background: Postpartum depression (PPD) is a significant public health concern with detrimental effects on maternal and child well-being. Social support, breastfeeding attitudes, and self-efficacy have been identified as potential protective or risk factors for PPD. This study aimed to investigate the associations between PPD, social support, breastfeeding attitudes, and self-efficacy among postpartum women in Gujarat, India. Methods: A cross-sectional study was conducted among 403 postpartum women in Gujarat, India. Data on sociodemographic characteristics, obstetric factors, PPD (assessed using the Edinburgh Postnatal Depression Scale), social support, breastfeeding attitudes, and self-efficacy were collected through structured interviews. Bivariate and multivariate logistic regression analyses were performed to examine the associations between PPD and the independent variables. Results: The prevalence of PPD in the study population was 50.1% (n = 202), with 28.8% (n = 116) experiencing mild depression, 16.6% (n = 67) moderate depression, and 4.7% (n = 19) severe depression. Lower educational level (n = 120, 29.8%; AOR: 1.72, 95% CI: 1.04–2.85), lower socioeconomic status (n = 242, 60%; AOR: 1.84, 95% CI: 1.12–3.02), non-exclusive breastfeeding (n = 167, 41.4%; AOR: 1.68, 95% CI: 1.11–2.54), low social support (n = 101, 25.1%; AOR: 2.51, 95% CI: 1.57–4.02), and a history of depression (n = 93, 23.1%; AOR: 2.94, 95% CI: 1.82–4.75) were significantly associated with higher odds of PPD in the multivariate analysis. In addition, negative breastfeeding attitudes and low self-efficacy levels were associated with increased odds of PPD. Conclusions: The findings highlight the significant associations between PPD and various sociodemographic, obstetric, and psychosocial factors among postpartum women in Gujarat, India. Interventions targeting social support, breastfeeding attitudes, and self-efficacy, as well as targeted support for women with identified risk factors, may help mitigate the burden of PPD and promote maternal well-being.

A community-based peer-facilitated psychological and social support model to improve retention in care among Cameroonian adolescents perinatally infected with human immunodeficiency virus: A randomized controlled trial

BackgroundPsychological and social support for adolescents living with HIV remains undocumented and unaddressed in Central Africa. This study aimed at assessing effectiveness of a peer-facilitated community-based support model in improving retention in care among adolescents living with HIV and attending care in Chantal Biya Foundation, Yaounde, Cameroon. Materials and methodsWe conducted an analysis of adolescents aged 10–19 years old, perinatally infected with HIV, on follow-up in the Day Care Unit of a reference hospital in Yaounde, Cameroon, and enrolled in the IAS-CIPHER-2021/1214-ATE-SMAVI, a individually randomized controlled trial. While the control arm only received routine care in the health facility, the intervention arm, in addition, was assigned to an HIV association for sustained support model, including support groups, leisure workshops and home visits. Structured questionnaires, including validated French versions of mental health scales, were quarterly administered to the study participants in both study arms by trained healthcare providers. The main outcome was maintaining retention in care beyond the first 15-month period of the study start. Kaplan-Meier and Cox regression models were fitted to assess association between intervention and outcome. Hazard Ratio (HR) across categories of exposure variables were compared using Wald's test. p-value <0.05 was considered significant. ResultsIn total, 305 adolescents were recruited in the study at a median age of 15.2 years old, including 162 (53.1 %) females and 153 individuals in the intervention arm. Mental health troubles were prevalent: severe depression (26.9 %), high or very high anxiety (28.9 %), and low self-esteem (84.9 %). Noteworthy, all of the baseline characteristics were balanced irrelevant to the study arm. Probability of maintaining good retention in care beyond the first 15-month period of study start remained higher in the intervention arm (82.0 % [95 %CI: 73.7 %-88.4 %]) versus the control arm (71.0 % [95 %CI: 63.2 %-78.1 %]), [cHR (95 %CI): 2.0 (1.1–3.3), p=0.044]. ConclusionsCapacity should be built in terms of implementing community-based peer-facilitated support groups in local organizations providing care to adolescents living with HIV.