Severe Psychological Distress Research Articles

Psychological Distress and Cannabis Vaping Among U.S. Adolescents

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

Parent psychological distress and parent-child relationships two years into the COVID-19 pandemic: Results from a Canadian cross-sectional study.

Mental health impacts of the COVID-19 pandemic have not been felt equally within populations. Parents with children living at home were early on identified as a population at heightened mental health risk, with concerns about the potential long-term impacts of the pandemic on parents' mental health, family functioning, and children's well-being. This study investigates impacts of the pandemic on parents' psychological distress, contextual sources of distress, and associations with family functioning nearly two years into the pandemic. Data were drawn from a national cross-sectional survey of adults living in Canada in November and December 2021 that was representative by age, gender, household income, and region. Parents with children < 18 years old living at home (N = 553) reported their experiences of psychological distress, pandemic-related stressors, coping mechanisms, and family functioning (changes in parent-child interactions, children's anxiety). Chi-square tests, logistic regression, and linear regression analyses examined sociodemographic inequities in parents' levels of psychological distress, sources and mitigating mechanisms of distress, and associations between psychological distress and family functioning. Nearly two years into the pandemic, parents with children at home reported nearly double pre-pandemic population estimates of moderate to severe psychological distress. Psychological distress was more frequently reported among parents with pre-existing mental health conditions, disabilities, and financial stressors. Parents with greater psychological distress reported increases in negative parent-child interactions due to the pandemic and higher anxiety among their children. This study identifies sustained negative impacts of the pandemic on parents' mental health and family functioning in Canada nearly two years into the pandemic, despite high vaccine uptake and declining infection rates. Disparities in financial stress, social support structures, and pre-existing mental health were identified as underlying sources of psychological distress. These results highlight that meaningful responses to promote mental health among parents and families must address social and structural inequities.

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

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

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

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

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

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

The association between emotion malleability beliefs and severe psychological distress stratified by sex, age, and presence of any psychiatric disorders.

Recent studies have shown an association between psychological distress and emotion malleability beliefs, meaning mindsets about whether one's emotions are fixed or changeable. However, most studies have not examined the association between these beliefs and sociodemographic factors. A nationwide cross-sectional Internet survey of residents of Japan aged 15-79 years was conducted using sampling weights for national estimates to investigate the association between emotion malleability beliefs and sociodemographic factors and between fixed beliefs and severe psychological distress (SPD). SPD was defined as a Kessler 6 Scale score of ≥13. Adjusted odds ratios for SPD were calculated considering potential confounders. Further analyses were stratified by sex, age and presence of any psychiatric disorder. The analysis included 23,142 participants (female, 48.64%). Fixed beliefs were associated with female sex, age < 45 years, and presence of psychiatric disorders. These beliefs were associated with SPD, and additional analysis showed stronger associations with SPD among female respondents, respondents aged 45-59 years, and those aged ≥60 years. Results indicate that female sex, age < 45 years, and current mental disorders were associated with fixed emotion malleability beliefs. Associations between fixed emotion malleability beliefs and SPD were particularly strong among female respondents and people aged ≥45 years compared with the general population. Our study extends the association between emotion malleability beliefs and psychological health to the general population. Future studies should explore mechanisms underlying individual differences in emotion beliefs.

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

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

The Impact of Gender Affirming Medical Care During Adolescence on Adult Health Outcomes Among Transgender and Gender Diverse Individuals in the United States: The Role of State-Level Policy Stigma.

Purpose: Gender affirming medical care (GAMC) aims to alleviate gender dysphoria by helping people align their physical body more closely with their gender identity. Bills seeking to limit or prohibit GAMC for trans children and adolescents have become a controversial topic. This study aimed to examine whether exposures to GAMC during adolescence are associated with adult psychological and general health outcomes, and to demonstrate the mechanism through which state-level legislation may work to moderate the association. Methods: We conducted analyses using data from the 2015 U.S. Transgender Survey, which surveyed 27,715 transgender and gender diverse (TGD) adults between August and September of 2015. The study compared the health outcomes of those who had GAMC exposures during adolescence with those who did not. Moderation analysis with propensity score matching was used to adjust for potential confounding factors. The general and psychological health outcomes measured were past-month severe psychological distress, past-year suicidal ideation, participant's general health, and past-year health care avoidance due to possible mistreatment. Results: GAMC during adolescence was negatively associated with severe psychological distress in adulthood. When examining past-year health care avoidance due to possible mistreatment, the effect sizes differed significantly between those in a trans-supportive state and those in a trans-unsupportive state. Conclusion: Our work highlights the importance of state-level policy stigma in understanding the association between GAMC and health outcomes. Findings point to the importance of enacting long-term legislative safeguards against TGD discrimination and removing barriers to access the full spectrum of care for adolescents who identify as TGD.

Social isolation, social media use, and poor mental health among older adults, California Health Interview Survey 2019–2020

BackgroundOlder adults’ engagement on social media may be a resource to reduce loneliness and improve mental health. Purpose: This study aimed to examine loneliness and social media use and its association with severe psychological distress among older adults and whether social media use moderated the association of loneliness on severe psychological distress among older adults.MethodsThis study is a secondary analysis of the 2019–2020 California Health Interview Survey. The Kessler 6-item Psychological Distress Scale (K6) assessed symptoms of psychological distress, with a K6 score ≥ 13 associated with severe mental illness. Loneliness was measured using a revised Three Item Loneliness Scale (TILS) score. Multiple regression analyses were conducted to examine associations between loneliness and severe psychological distress.ResultsLoneliness, health status, and identification as Asian, remained strong predictors of severe psychological distress among older adults when adjusting for other factors. In bivariate analysis, high-frequent social media users, but did not remain significant when accounting for covariates. Social media use did not moderate the association between loneliness and severe psychological distress.ConclusionThis study underscores the significant impact of loneliness on poor mental health among older adults, emphasizing that while frequent social media use correlates with severe psychological distress, it may not alleviate the association of loneliness on poor mental health, thus highlighting the urgent need to address social isolation and promote genuine social connectedness, particularly among Asian older adults.

Access to palliative care in patients with advanced cancer of the uterine cervix in the low- and middle-income countries: a systematic review

BackgroundWomen with advanced uterine cervical cancer suffer from a combination of moderate to severe physical, psychological, social, and spiritual distress due to their disease and are in need of palliative care to improve their quality of life. Approximately 85% of the women live in the low- and middle-income countries. Whether these women and their families access palliative care is not known.ObjectivesTo understand the geographic accessibility, availability, financial accessibility, and acceptability of palliative care by patients with advanced cervical cancer and their families.MethodsWe conducted a Systematic review following PRISMA guidelines in CINAHL, Cochrane Central Register of Controlled Trials, MEDLINE, PsychINFO, PubMed and Scopus for the core concepts: palliative care, access, advanced uterine cervical cancer. Eligible articles were published in English, contained original data on experiences of patients and/or caregivers including symptoms management, and discussed available resources, communication, satisfaction, and healthcare utilization.ResultsOverall there was limited access to palliative care with the few available facilities located in cities, far from the rural areas where most women lived. Pervasive poverty was common with poor affordability of healthcare, travelling, accommodation, and subsistence expenses. Misconceptions and poor knowledge of the disease, cultural beliefs and attitudes, and other health system insufficiencies also presented challenges for access.ConclusionConcerted effort should be made to improve availability of palliative care facilities. Health education to address misconceptions and other cognitive barriers that limit access among cervical cancer patients and their families should be urgently undertaken in the LMICs.

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

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

Knowledge, Concerns, and Psychological Distress Among Caregivers of Patients Seeking Emergency Medical Care for Non-COVID-19-Related Illness During the COVID-19 Pandemic: A Cross-Sectional Study.

Introduction During the active phase of the COVID-19 pandemic, the global healthcare system failed to meet the increased demand for healthcare resources,infrastructures, and facilities. The brunt of the healthcare crisis was faced not only by COVID-19 victims; a large majority of non-COVID patientswere deprived of routine and emergency care. Factors that possibly affected resource utilization, healthcare-seeking behavior, service delivery patterns, and national health systems' priority during the pandemic were the knowledge and attitudinal concerns related to the COVID-19 disease and its control measures. Here, we evaluated the knowledge, concern, and psychological distress among the caregiversof the patients attending the emergency department at a tertiary healthcare center inIndia.​ Methodology We conducted a survey-based study using a pre-validated questionnaire on the caregivers of the patients visiting the emergency department (ED) from June to September 2020 (during the first wave of the COVID-19 pandemic). The demographic details and responses of the participants were documented in the semi-structured proforma. A pre-validated COVID-19 Peritraumatic Distress Index (CPDI) questionnaire was used to assess psychological stress. Results Out of 1014 participantsinterviewed, the majority weremale attendants (72%), aged 18-45 (82%), and seeking medical attention for patients with chronic illnesses (76%). Acute onset emergencies like stroke, myocardial infarction, trauma, etc. were the ED presentation in only one-fifth of patients. COVID-19-related knowledge wasadequate for questions related to age groups at risk for the viral infection (97% agreed that all age groups were at risk), mode of transmission (75-90% were aware of the commonmodes of transmission), and >65% knew the common symptoms of COVID-19 infection. However, only 38.5% knew about frequent handwashingas a protective measure. More than half of the participants considered the COVID-19vaccine as the sole ray of hope and disregarded the effectiveness of alternative medicines such as Ayurvedic/homeopathic/allopathic medicines as preventive options. One-third were first-time visitors to the hospital, while two-thirds of all participants were afraid to visit any hospital during the COVID-19 pandemic. The majority (84%) faced difficulty in accessing the index tertiary care center due to transport, socioeconomic support, or lockdown-related restrictions. In comparison, 60% reported some form of discrimination at almost all levels of healthcare settings due to COVID-19-related priority changes. Nearly half (48%) of all enrolled caregivers reported experiencing mild-to-moderate distress (CPDI score=28-51), and 15.7% felt severe distress (CPDI score >51) while seeking treatment for the non-COVID-19 illness of their patient. Age and socioeconomic status were significantly associated with COVID-19-related psychological distress levels (p<0.001 in logistic regression), while gender, education, and residence showed no significant associations. Conclusion Most of the patient caregivers visiting the emergency department during the COVID-19 pandemic had an adequate understanding of risk factors and preventive measures. The major barriers to accessing healthcare facilities were transport, financial issues, and lockdown-related restrictions. Almost two-thirds of the caregivers revealed mild-to-moderate to severe psychological distress due to the pandemic and lockdown-related concerns.

Married women’s decision to delay childbearing, and loneliness, severe psychological distress, and suicidal ideation under crisis: online survey data analysis from 2020 to 2021

BackgroundThe COVID-19 pandemic has affected every aspect of our lives, including the decision to become pregnant. Existing literature suggests that infertility and the decision to delay childbearing at a younger age are associated with a lower level of well-being and regrets when women start to desire a baby. Thus, the decision to delay childbearing due to the pandemic could negatively affect the well-being of women. This study focuses on how pregnancy decisions affect the well-being of women during the COVID-19 pandemic.MethodsFrom the Japan COVID-19 and Society Internet Survey, a nationally representative web-based survey, 768 observations of married women aged 18 to 50 years who had the intention of getting pregnant during the pre-pandemic period (conducted in 2020 and 2021) were used. Loneliness, severe psychological distress, and suicidal ideation were used as well-being indicators. For pooled data, a generalised estimated equation (GEE) model was used to estimate how pregnancy decision related to well-being indicators. For a sub-analysis, the sample was divided by the survey year and a Poisson regression model was used.ResultsThe GEE analysis showed an association between delaying childbearing and severe psychological distress, with the prevalence ratio (PR) being 2.06 [95% CI (1.40–3.03)]. Furthermore, loneliness and suicidal ideation that occurred after the beginning of the pandemic were significantly related to the decision to delay childbearing—1.55 [95% CI (1.03,2.34)] and 2.55 [95% CI (1.45–4.51)], respectively. Moreover, these PRs were larger for 2021 compared to 2020.ConclusionDuring the COVID-19 pandemic, approximately one-fifth of married women who had childbearing intentions before the pandemic decided to postpone pregnancy. They exhibited a deteriorated mental health state. Furthermore, the negative associations were larger in 2021 compared to 2020. Loneliness has negative consequences for both mental and physical health, as well as elevated severe psychological distress and suicidal ideation among those who decided to postpone pregnancy. Therefore, the current results should not be overlooked by society.

Examination of Behavioural Patterns of Psychological Distress and Evaluation of Related Factors: A latent class regression.

This study aimed to identify the behavioural pattern of psychological distress (PD) in the population of 18 to 65 years old people in Mashhad, Iran, using latent class regression and evaluate the related factors. PD is a unique emotional state with suffering in response to a stressor or specific need that leads to temporary or permanent impacts. Due to its negative effects on several features of life like the quality of life, health, performance and productivity of individuals, PD and its consequences are considered a public health priority. A cross-sectional study was performed on 425,286 individuals aged 18 to 65, who were referred to health centres in Mashhad, northeastern Iran in the first half of 2018. The information required for this study, including a checklist of demographic information and the six-item Kessler Psychological Distress Scale (K-6), was obtained from the Sina System. Latent class regression identified three latent patterns of PD in answering the questions of the K-6 questionnaire, including severe PD (14%), low PD distress (40%) and no PD (46%). Statistical variables of this study due to the results are considered as the following: women, illiterate people, unemployed and divorced people, individuals aged between 50 and 59 years and people with low weight were more likely to be in the severe PD class than in the no PD class. Although a small percentage of people were classified as severely disturbed, the findings showed a high rate of symptoms of distress and sadness even in the no PD class.

Evaluating the Agreement between k-median and Latent Class Analysis for Clustering of Psychological Distress Prevalence

Introduction: Psychological distress (PD) is one of the most common mental disorders in the general population. Psychological distress is considered a public health priority due to its adverse effects on quality of life, health, performance, and productivity. It can also predict several serious mental illnesses, such as depressive disorder and anxiety. In this study, we intend to identify the behavioral pattern of PD in the population of 18 to 65 years old in Mashhad using two methods, K-median and Latent Class Analysis (LCA), and evaluate the agreement between the two methods.&#x0D; Methods: This cross-sectional study was performed on 38058 individuals referred to community health care centers in Mashhad of Iran in 2019. The information used in this study was extracted from Sina Electronic Health Record System (SinaEHR) database. A demographic information checklist and a 6-item Kessler psychological distress scale (K-6) were used for data collection. K-median and LCA were used for data analysis.&#x0D; Results: Out of 38058 participants, 49.3% were women, 86.1% were married, and 63.6% had a diploma and under diploma education. The LCA identified three patterns of PD in answering the items of the K-6 questionnaire, including severe PD (19.7%), low PD (36.7%), and no PD (43.5%). Three clusters were identified by the K-Median method: 1) severe PD (22.0%), 2) low PD (31.1%), and 3) and no PD (46.9%). The agreement between K-Median and LCA was kappa = 0.862.&#x0D; Conclusion: About 20% of people were classified as having severe PD. Both LCA and k-median methods can reasonably identify the latent pattern of PD with significant entropy, and there was almost complete agreement between the two methods in data clustering. Considering the advantages of the LCA, this method is recommended to identify the latent pattern of PD based on the k-6 questionnaire.

Psychological stressors and needs among essential workers at a Singapore hospital during the COVID-19 pandemic

Background Hospital workers have borne a large burden of the COVID-19 pandemic, exposed to risks of infection, while enduring elevated workloads, increased workplace stress, prolonged hours in uncomfortable working conditions, and public stigmatisation. Objectives In this cross-sectional study, we examined the psychological stressors of COVID-19 on hospital essential services workers and their needs at a tertiary hospital in Singapore. Methods: We conducted a study of 246 outsourced essential workers comprising housekeeping, maintenance staff, and porting staff. Psychological distress was measured by the Kessler-6 scale. We also surveyed respondents through a questionnaire on the main concerns that worried them, supportive resources available, and additional resources that would most help them. Results Among the survey respondents, concerns related to employment, finances, accommodation, transportation, and likelihood of receiving medical attention for COVID-19 were significantly associated with moderate to severe psychological distress ( p&lt;0.05). Stress from isolation and fear of COVID-19 infection constituted the greatest psychosocial burdens. Respondents felt that main supportive resources came from their employers and social circles. They also listed enhanced individual ability to cope, and additional financial aid from their employers and the government would help them the most. Conclusions Financial and accommodation-related stressors reflect structural factors that exacerbated the psychosocial burdens faced by non-medical hospital workers. Most respondents tended to individualise their coping strategies, which point towards the need for stronger social protections and mental health provisions for hospital essential services workers.

Association between residential greenness and severe psychological distress and the moderating role of ‘stay-at-home’ status: a population-based cross-sectional study during the COVID-19 pandemic in Japan

ObjectiveThere is a need for public health strategies to address the negative psychological consequences of the COVID-19 pandemic, and the role of residential green exposure has gained prominence, particularly in...

Social media and mental health of undergraduate medical students of Mysuru: cross sectional study

Background: Social media is a form of electronic communication, through which people can share ideas and information. With the advent of internet and social networking sites, humans have become social more virtually than in person. This has led to people living more isolated lives affecting one’s health. Hence the objective is to assess the effects of social media on students and factors associated. Methods: It was a Cross sectional study among 367 undergraduates from a medical college in Mysuru, over a duration of 2 months. A self-administered questionnaire with socio- demographic variables and a standard GHQ-12 (general health questionnaire) was used for the scoring of their distress levels. Descriptive statistics were taken and Chi-square test was done for statistical significance. Results: Out of 367 students, the mean age of students were 21.5 years. The prevalence suggestive of distress was found to be 72.4% (265), and severe psychological distress was found to be 3.27%. Among usage of apps, people using 1 app had 48.5% distress, 2 apps had 75.6% distress, 3 apps had 63.3% distress and 4 apps 74.2% distress. There was no significant association between factors and severity of distress. Conclusions: From the above study, we have shown that social media with all its influence has a negative impact on the students’ behavior. With this the youth need to be educated on its use and its limitations counselled regarding its ill effects and necessary tolls for seeking help be made available at their disposal.

Perceived Workplace Health Support and Severe Psychological Distress Among Japanese Workers: A Prospective Cohort Study.

This study aimed to assess the extent to which the intensity of perceived workplace health support (PWHS) affected the incidence of psychological distress. At the baseline, data from 4540 eligible participants throughout Japan were obtained using an Internet survey. Among them, 2362 participants who could be followed up 1 year after the initial study were included in the analysis. The intensity of PWHS was determined using an original questionnaire. Psychological distress was assessed using the Kessler Psychological Distress Scale. Participants with high PWHS were less likely to experience severe psychological distress than those with low PWHS even after adjusting for confounding factors including work-related factors. The incidence of severe psychological distress decreased as the intensity of PWHS increased. Enhanced PWHS reduced psychological distress and positively affected workers' mental health.

Perspectives of people living with HIV on barriers to timely ART initiation following referral for antiretroviral therapy: A qualitative study at an urban HIV clinic in Kampala, Uganda.

Early initiation of antiretroviral therapy (ART) after HIV diagnosis prevents HIV transmission, progression of HIV to AIDS and improves quality of life. However, little is known about the barriers to timely ART initiation among patients who test HIV positive in settings different from where they will receive HIV treatment, hence are referred in the routine setting. Therefore, we explored the perspectives of people living with HIV on barriers faced to initiate ART following HIV testing and referral for treatment. In this qualitative study, we purposively sampled and enrolled 17 patients attending the Mulago ISS clinic. We selected patients (≥18 years) who previously were received as referrals for HIV treatment and had delayed ART initiation, as ascertained from their records. We conducted in-depth interviews, which were audio recorded, transcribed and translated. We used Atlas.ti version 9 software for data management. Data analysis followed thematic and framework analysis techniques and we adopted the socio-ecological model to categorize final themes. Key themes were found at organizational level including; negative experiences at the place of HIV diagnosis attributed to inadequate counselling and support, unclear communication of HIV-positive results and ambiguous referral procedures; and, long waiting time when patients reached the HIV clinic. At individual level, the themes identified were; immediate denial with late acceptance of HIV-positive results attributed to severe emotional and psychological distress at receiving results, fear of perceived side effects and long duration on ART. At interpersonal level, we found that anticipated and enacted stigma after HIV diagnosis resulted in non-disclosure, discrimination and lack of social support. We found that challenges at entry (during HIV test) and navigation of the HIV care system in addition to individual and interpersonal factors contributed to delayed ART initiation. Interventions during HIV testing would facilitate early ART initiation among patients referred for HIV care.