Sleep-related Problems Research Articles

Assessing Bedtime Procrastination in Iran: Psychometric Properties and Predictive Value for Insomnia

ABSTRACT Objectives Bedtime procrastination has been identified as an important factor associated with insufficient sleep and health and well-being problems. This study aims to investigate factor structure and psychometric properties of Bedtime procrastination Scale (BPS) in the Persian-speaking community. Additionally, this research aims to examine the role of bedtime procrastination in predicting sleep-related problems. Method Four hundred and thirty-three participants (average age 23 years, 55.7% female) took part in this study. All participants completed the BPS, the Insomnia Severity Index (ISI), and the Tuckman Procrastination Scale (TPS). Confirmatory factor analysis and hierarchical regression analysis were used to examine the factor structure and predict sleep-related problems. Results Confirmatory factor analysis showed that, unlike other language versions, the two-factor model without item 3 was the most suitable structure. This scale demonstrated acceptable reliability and validity. Additionally, the results of hierarchical regression analysis indicated that the procrastination factor, especially bedtime procrastination, was the best predictor of insomnia severity. Conclusion In this study, the Persian version of BPS showed strong validity and reliability. These findings suggest that the Persian BPS can serve as a valuable and comprehensive research tool for assessing bedtime procrastination.

Development and preliminary psychometric properties of the Scale of Health Belief Model for Sleep

Abstract Background Sleep-related problems are a serious risk to physical and emotional health, academic success, and safety in adolescents. A measurement tool is needed to comprehensively evaluate adolescents’ sleep and plan the steps necessary for behavioral change. This study aimed to develop a scale based on the Health Belief Model that can reliably and validly evaluate adolescent individuals’ beliefs towards sleep. Methods This methodological study was conducted with 494 adolescents between September and October 2022 in Antalya, Turkey. Initially, 81 items about sleep were created according to the Health Belief Model. Validity was assessed as content and construct validity and reliability was assessed as internal consistency. Content validity was evaluated with ten expert views The scale was tested for construct validity with Exploratory Factor Analysis (EFA), after which the scale’s reliability was evaluated for item-total correlations using Pearson’s correlation analysis and for internal consistency with Cronbach’s Alpha. Results In the first EFA, sixteen factors with eigenvalues greater than 1 explained 63.80% of the total variance. Items with factor loadings of less than .30 and those that appeared in more than one factor with differences of less than %10 were removed from the scale one by one and the analysis was repeated. In the last EFA of the 46-item scale, six factors were found with an eigenvalue greater than 1 that explained 57.7 % of the total variance. The scale’s item-total correlations ranged between .26 - .79. Cronbach’s coefficient alpha of subscales was found .92 for perceived susceptibility, .90 for perceived severity, .90 for perceived benefits, .81 for self-efficacy, .79 for motivation and .69 for perceived barriers. Conclusions The validity and reliability properties of the scale of Health Belief Model for sleep have been found good levels in Adolescents. Its intercultural adaptation for use with adolescents in other countries is recommended. Key messages • The newly developed the scale of Health Belief Model for sleep was found to be valid and reliable. • It can be used to assess adolescents’ beliefs about sleep.

The impact of sleep problems on cerebral aneurysm risk is mediated by hypertension: a mediated Mendelian randomization study.

Cerebral aneurysm (CA) is a common vascular disease. The risk factors of CA include hypertension, smoking, and a family history of genetic predisposition. Although sleep-related problems have been found to have a strong association with cardiovascular disease, there is a lack of research regarding the causal relationship with cerebral aneurysms. In this study, we investigated the causal relationship between four sleep-related problems, including snoring, insomnia, narcolepsy, and napping during the day, and CA using a two-sample Mendelian randomization (MR) analysis. Moreover, the potential confounders before sleep problems and CA were further analyzed by multivariate MR (MVMR). The causal relationship between insomnia and CA was obtained analytically by means of sixMR analyses. There was a strong causal effect relationship between insomnia and CA, which suggests this as a potential risk factor [odds ratio (OR) = 8.35, 95% confidence interval (CI) = 2.422-28.791, p = 7.772e-04]. On this basis, hypertension was identified as a mediator between insomnia and CA by MVMR, with a mediating effect of 52.538% (OR = 3.05, 95% CI = 1.549-4.55, p = 0.015). The causal relationship between insomnia and CA was predicted using genetic variance data, and insomnia was found to be a potential risk factor. Furthermore, hypertension is a mediator between insomnia and CA. Therefore, focusing on sleep problems and improving sleep quality may be an active and effective strategy to prevent CA.

The Association Between Lifestyle Factors and Mental Well-being among Dental Students

Dentistry can be considered a challenging field, with dental students often experiencing high levels of stress and poor mental health. Hence, maintaining mental well-being is important so that dental students can cope with their stressors effectively. Lifestyle factors like physical activity, sleep problems, and addictions impact the levels of mental well-being. This paper aimed to identify the association between dental students’ lifestyle factors and mental well-being. This cross-sectional descriptive study was conducted among all the undergraduate dental students at a university in Malaysia. Data were collected by using a self-administered questionnaire [which included questions on demographic background, lifestyle factors, and the Warwick-Edinburgh Mental Well-being Scale (WEMWBS)] and analysed using SPSS (version 26.0). Out of the surveyed students, 83.2% responded. The mean WEMWBS score for this study population was 46.09 ± 7.93. The results showed that engagement in physical activity positively affected mental well-being scores, while the presence of sleep-related problems was associated with lower mental well-being scores. Encouraging the adoption of healthier lifestyle factors, such as regular physical activity and practising good sleep hygiene along with the intervention of sleep-related problems, could improve mental well-being levels among dental students significantly.

Structural Equation Modeling of Musculoskeletal Pains, Work–Family Conflict, and Sleep-Related Problems on Well-Being of Food Manufacturing Workers

The objective of this study is to investigate the causal relationships between musculoskeletal pains, work–family conflict, sleep-related problems, and the well-being of food manufacturing workers using structural equation modeling. This study analyzed 523 food manufacturing workers extracted from the Sixth Korea Working Conditions Survey. We formulated six hypotheses based on literature reviews and examined the structural causal relationship between work–family conflict, musculoskeletal pains, sleep-related problems, and well-being. According to the results of structural equation modeling, work–family conflict has a significant impact on musculoskeletal pains (standardized path coefficient of 0.113). Furthermore, both musculoskeletal pains (standardized path coefficient of 0.350) and work–family conflict (standardized path coefficient of 0.212) have been found to affect sleep-related problems. It has also been established that musculoskeletal pains have a direct influence on well-being (standardized path coefficient of 0.115). The association and structural causality between musculoskeletal pain and psychological factors in food manufacturing workers can be used for customized measures to improve the well-being of food manufacturing workers. This study is also meaningful in that musculoskeletal pain and psychological factors should be managed in an integrated manner.

Socioeconomic Status, Stress, and Cancer-related Fatigue among Chinese American Breast Cancer Survivors: The Mediating Roles of Sleep.

Sleep-related issues may be one significant pathway through which socioeconomic disadvantages are associated with worse self-reported states in cancer. The present study examined the relationships between SES (income and education level) and two important biobehavioral factors (cancer-related fatigue and perceived stress), as well as mediation through sleep-related problems (sleep medication use, daytime dysfunction, and sleep quality) among a sample of Chinese American breast cancer survivors. 136 Chinese American breast cancer survivors completed a self-reported questionnaire. We found that relative to those with the lowest annual household income, those with the highest income have lower perceived stress. This relationship was mediated by lower sleep quality. Relative to those with a high school degree or less, those with graduate degrees have lower daytime dysfunction, and in turn lower cancer-related fatigue. Our findings point to the importance of addressing sleep-related issues, perceived stress, and cancer-related fatigue among Chinese American breast cancer survivors with low SES backgrounds.

Food Manufacturing Workers and Structural Causality among Work Environment, Work–Family Conflict, Musculoskeletal Pain, Sleep-Related Problems, and Burnout

This study analyzes the association and structural causality among work environment, work–family conflict, musculoskeletal pain, sleep-related problems, and burnout in the food manufacturing industry. This study used the 6th Korean Working Environment Survey data, and 523 food production workers were selected as research subjects. Structural equation modeling showed that work environment and work–family conflict significantly affected musculoskeletal pain. In addition, work–family conflict and musculoskeletal pain affected sleep-related problems, and musculoskeletal pain and sleep-related problems impacted burnout. Furthermore, this research provides practical strategies to deal with musculoskeletal pain, sleep-related issues, and burnout. Burnout is more affected by sleep-related problems than by musculoskeletal pain. Additionally, sleep-related problems seem to be more affected by musculoskeletal pain than by work–family conflict. Meanwhile, musculoskeletal pain is influenced by the work environment rather than by work–family conflict. This result can be used to establish preventive policies for the safety and health of food manufacturing production workers.

Acute sleep deprivation-induced hepatotoxicity and dyslipidemia in middle-aged female rats and its amelioration by butanol extract of Tinospora cordifolia

BackgroundSleep deprivation (SD) due to an unhealthy lifestyle poses an oxidative challenge and is closely associated with an increased risk and prevalence of different metabolic disorders. Although the negative consequences of SD are well reported on mental health little is known about its detrimental effects on liver function and lipid metabolism. Tinospora cordifolia is reported for its hepatoprotective activity in different pre-clinical model systems. The current study was designed to elucidate the cumulative effects of aging and acute SD on liver functions, oxidative stress, and lipid metabolism, and their management by butanol extract of T. cordifolia (B-TCE) using middle-aged female acyclic rats as the model system.ResultsRats were divided into 4 groups: (1) Vehicle-undisturbed (VUD) (2) Vehicle-sleep deprived (VSD) (3) B-TCE pre-treated sleep-deprived (TSD) (4) B-TCE pre-treated undisturbed sleep (TUD). TSD and TUD groups were given 35 mg/kg of B-TCE once daily for 15 days followed by 12 h of sleep deprivation (6 a.m.–6 p.m.) of VSD and TSD group animals using the gentle-handling method while VUD and TUD group animals were left undisturbed. SD of VSD group animals increased oxidative stress, liver function disruption, and dyslipidemia which were ameliorated by B-TCE pre-treatment. Further, B-TCE was observed to target AMPK and its downstream lipid metabolism pathways as well as the p-Akt/cyclinD1/p-bad pathway of cell survival as possible underlying mechanisms of its hepatoprotective activity.ConclusionsThese findings suggest that B-TCE being a multi-component extract may be a potential agent in curtailing sleep-related problems and preventing SD-associated hepatotoxicity and dyslipidemia in postmenopausal women.Graphical abstractGraphical abstract to depict mechanism of action of B-TCE on liver function and lipid metabolism.

Burnout and quality of life among healthcare workers in central Uganda.

The widespread problem of burnout among healthcare workers is not only common but also a significant concern that impacts the entire healthcare system in Uganda. It is essential to understand the connection between burnout and quality of life among healthcare workers in the specific context of central Uganda, where healthcare professionals face high patient volumes, limited resources, exposure to infectious diseases, and socioeconomic challenges. This study examined the relationship between burnout and quality of life among healthcare workers in central Uganda. This research utilized a cross-sectional study conducted across various healthcare settings in central Uganda. The data were analyzed at descriptive, bivariate, and multivariate levels. The relationship between dependent and independent variables was evaluated using an independent t-test for binary variables and a one-way analysis of variance (ANOVA) for categorical variables. Significance was determined with a reported p-value, with relationships deemed significant at p < 0.2. For multivariable analysis, multiple linear regression was employed using a forward selection method, with significance set at 5% (p < 0.05). Our findings indicate that nearly 40% of healthcare workers reported experiencing high levels of burnout. The average score for overall quality of life was 10.71 (±4.89), with variations observed across different domains. The study reveals a significant connection between socio-demographic factors, burnout, and overall quality of life, emphasizing the impact of job category, supervisory support, sleep quality, and burnout on the well-being of healthcare workers. Predictive analysis illustrates how these factors influence both overall quality of life scores and scores in specific domains. Particularly noteworthy is that nurses and technicians tend to have a lower quality of life compared to physicians. The results underscore the relationship between socio-demographic factors, burnout, and particular aspects of quality of life. Notably, job category, supervisory support, sleep quality, and burnout stand out as significant factors shaping the well-being of healthcare workers. Nurses and technicians encounter distinct challenges, suggesting the need for interventions tailored to their needs. Addressing issues such as inadequate supervisory support, burnout, and sleep-related problems is recognized as a potential approach to improving the overall quality of life among healthcare workers.

Physical activity and social anxiety symptoms among Chinese college students: a serial mediation model of psychological resilience and sleep problems

BackgroundSocial anxiety symptoms are common and harmful psychological illness in college students. Although some studies have illustrated that physical activity could reduce social anxiety symptoms, the specific mechanism is still unclear. Based on theoretical studies on resilience and sleep, this study constructed a serial mediation model to explore whether they mediate between physical activity and social anxiety symptoms among college students.MethodsThis study surveyed 9,530 college students from three colleges in China to explore the mediating effect of physical activity and sleep problems between physical activity and social anxiety symptoms. Participants were investigated with the International Physical Activity Questionnaire, Connor-Davidson Resilience Scale, Sleep-related problems, and the Social Interaction Anxiety Scale and the Social Phobia Scale. Correlations between variables were analysed using Pearson correlation analysis and mediation analyses were performed using SPSS PROCESS macro 3.3 software.ResultThe study found that physical activity was negatively associated with social anxiety symptoms and sleep problems, but positively with psychological resilience. After controlling for sociodemographic variables, physical activity can not only indirectly alleviate social anxiety symptoms through the separate mediation of psychological resilience and sleep problems, but also through the serial mediation of psychological resilience and sleep problems.ConclusionThese results suggest that improving physical activity levels could reduce social anxiety scores by increasing psychological resilience and sleep quality. This is of great reference significance for the prevention and intervention of college students’ mental health.

Sleep-related impairment among people who use opioids: The critical role of structural vulnerability

ObjectivePeople who use opioids are vulnerable to sleep disturbances due to a range of factors, including the substances they use and the various structural vulnerabilities they face. We aimed to understand the burden of sleep-related impairment and problems pertaining to sleep context and schedule among people who use opioids. MethodsWe explored sleep quality and problems among a suburban sample of people who use opioids experiencing extensive structural vulnerabilities (N = 170). Participants reported their most urgent concern in the past week (e.g., sleep, drug use, housing), their sleep context, sleep problems, sleep schedules, and scores on the PROMIS Sleep-Related Impairment measure. We then quantified associations between Sleep-Related Impairment scores and sociodemographics and substance use. ResultsParticipants were primarily men (66%) and non-Hispanic Black (67%) with a mean age of 42 (SD: 12.1). Many experienced hunger (44%) and literal homelessness (40%). One-quarter (28%) reported that sleep was their most urgent concern in the past week. The most common problems when falling or staying asleep were mental health-related symptoms (81%) and pain/discomfort (32%). Literal homelessness (β = 2.2, 95% CI: 0.6, 3.7), hunger (β = 2.3, 95% CI: 1.0, 3.6), and frequent alcohol use (β = 1.5, 95% CI: 0.2, 2.7) were significantly associated with Sleep-Related Impairment scores. ConclusionsHomelessness and hunger are associated with sleep-related impairment in people who use opioids. Poor sleep quality, substance use, structural vulnerability, and mental health problems are all interrelated sources of functional impairment in this population. Interventions that address poverty as an underlying cause of sleep-related impairment and provide safe sleeping environments are needed.

Daytime Sleep Problems Are Related to Fine Motor Function in Persons with Down Syndrome

ABSTRACT Given the high prevalence of sleep problems and fine motor deficits that have been reported in persons with Down syndrome (DS), this study was to investigate the effect of sleep-related problems occurring during the day on fine motor function (i.e. manual dexterity and handgrip strength) in persons with DS. We also tested the moderating role of obstructive sleep apnoea (OSA) in the link between sleep-related problems occurring during the day and fine motor function. It was hypothesised that subtle sleep-related problems occurring during the day would significantly predict fine motor performance. Fifty-two persons with DS, aged 13–54, participated and caregivers completed a sleep questionnaire for their children with DS. Hierarchical multiple regression analyses indicated a greater frequency of sleep-related problems occurring during the day significantly predicted greater manual dexterity deficits. Results also suggested that OSA was the moderator for the association between sleep-related problems occurring during the day and manual dexterity. This study has highlighted the importance of exploring sleep problems that might impair fine motor performance for the DS population in their everyday lives. Additional studies are needed to develop effective interventions to promote sleep hygiene and fine motor development in this population.

Prevalence of Internet Gaming Disorder and Its Impact on Routine Activities Among Dental Students in Belagavi, India: A Cross-Sectional Study.

Internet gaming has gained popularity since the millennium, greatly expanding both the game industry and the player base. Moreover, internet gaming disorder (IGD)is a condition included in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) for further study. To assess the prevalence of IGD and its association with physical symptoms among dental students in Belagavi, India. A cross-sectional study was conducted among 385 dental students, chosen through simple random sampling. Data were gathered using a pre-validated, closed-ended questionnaire, incorporating the 9-item DSM-5 short version. The questionnaire was administered to undergraduate students during theory classes and collected after 10 minutes, while postgraduate students received it in their respective departments. To identify significant differences, Chi-square and analysis of variance(ANOVA) tests were applied, with statistical significance established at p ≤ 0.05. A total of 385 responses were collected, comprising 86 males (22.3%) and 299 females (77.7%). Among the respondents, 28 (7.2%) were diagnosed with IGD, while 123 (31.8%) were identified as risky gamers. Significant differences were found between disordered, risky, and normal gamers concerning sleep-related problems (p ≤ 0.05). The prevalence of IGD and risky gamers was 7.2% and 31.8% respectively. There was a significant association between disordered, risky, and normal gamers with daily routine activities.

Problematic smartphone use and mental health outcomes among Singapore residents: The health and lifestyle survey

BackgroundThe excessive use of smartphones and its association with adverse outcomes has been widely reported, with several studies showing an association between smartphone overuse, depression, anxiety, and sleep-related problems. MethodsThe study used data from the Health and Lifestyle Survey, a nationwide population survey. It examined the prevalence of Problematic Smartphone Use (PSU) and its association with mental health outcomes among Singapore residents aged 15–65 years. ParticipantsParticipants were assessed for PSU using the Smartphone Addiction Scale-Short Version, psychological distress with the Patient Health Questionnaire-9, and Generalised Anxiety Disorder −7 questionnaire, sleep problems using the Insomnia Severity Index, and positive mental health with Rapid Positive Mental Health Instrument. ResultsIn all, 6509 participants completed the survey, giving a survey response rate of 73.2 %. The prevalence of PSU was 30.2 % in the population. Individuals with PSU were more likely to have symptoms of moderate or severe depression (OR: 3.2, 95 % CI: 2.4–4.4), anxiety (OR: 3.4, 95 % CI: 2.4–4.8), insomnia (OR: 3.4, 95 % CI: 2.8–4.2), and poorer positive mental health (β: −0.3, 95 % CI: −0.4 to −0.2). ConclusionsThe study is the first to examine PSU in a national sample of Singaporeans across a wide age range. It provides valuable insights into mental health comorbidities among those with PSU, which is useful for practitioners.

Food Insecurity and Sleep-Related Problems in Adolescents: Findings from the EHDLA Study.

The current research aimed to investigate the connection between food insecurity and sleep issues among Spanish adolescents aged from 12 to 17 years from the Valle de Ricote (Region of Murcia, Spain). Data from the Eating Healthy and Daily Life Activities Study, which included a sample of 836 adolescents (55.3% girls), were analyzed. Food insecurity was evaluated using the Child Food Security Survey Module in Spanish (CFSSM-S), while sleep-related problems were evaluated using the Bedtime problems, Excessive daytime sleepiness, Awakenings during the night, Regularity and duration of sleep, and Sleep-disordered breathing (BEARS) sleep screening tool. Generalized linear models were employed to explore the association between food insecurity and sleep-related issues. Compared with their counterparts with food security, adolescents with food insecurity had greater probabilities of bedtime problems (24.1%, 95% confidence interval (CI) 16.9% to 33.0%, p = 0.003), excessive daytime sleepiness (36.4%, 95% CI 27.5% to 46.3%, p < 0.001), awakenings during the night (16.7%, 95% CI 10.8% to 25.1%, p = 0.004), and any sleep-related problems (68.1%, 95% CI 57.5% to 77.1%, p < 0.001). This study suggests that food insecurity is related to greater sleep-related problems among adolescents. Implementing strategies to mitigate food insecurity may contribute to improved sleep health among adolescents, highlighting the importance of integrated public health interventions.

Out of their control: College students’ beliefs in sleep myths, sleep problems, and psychological flexibility

ObjectivesCollege students suffer from deficient sleep, and the pernicious factors that support this phenomenon are diverse. The aim of the current study was to better understand the role of sleep-related myths in college students’ sleep disturbance. A second aim was to examine if college students’ levels of sleep disturbance were similarly associated with their belief in sleep-related myths or if their capacity to be psychologically flexible might moderate this process. MethodsThe online sample consisted of 638 undergraduates (82.4% female; Mage=21.3, SD=1.6years), who reported on their level of belief in sleep-related myths, sleep disturbance, sleep environment, sleep hygiene, and psychological flexibility. ResultsControlling for critical sleep-related correlates, including melatonin usage, work hours and perceived sleep-related self-efficacy, we found that for students with below-average (−1 SD) psychological flexibility, the greater their belief in the myth that their sleep schedules were out of their control was associated with greater levels of sleep disturbance. ConclusionsThese results not only highlight another important source of college students’ sleep problems, but they also speak to the widespread belief that college students have little control over their sleep. Findings from the current study raise the possibility that by developing students’ capacities to be more psychologically flexible and by empowering students to prioritize their sleep, they will be able to decrease the likelihood of experiencing sleep and sleep-related problems.

Abnormal sleep patterns are associated with depressive symptoms in Chinese community-dwelling older adults

ObjectiveDepression is an important public health issue among older adults, often associated with their sleep-related problems. We aimed to investigate the association between sleep-related problems and depressive symptoms among Chinese community-dwelling older adults. MethodsThis cross-sectional study utilized self-reported data from 2896 participants (aged ≥60 years) from Shanghai, China. Nocturnal sleep duration and difficulty initiating sleep (DIS) symptoms were obtained through face-to-face questionnaires. Nocturnal sleep duration was categorized as ‘short’ (<7 h), ‘normal’ (7–8 h), and ‘long’ (>8 h). Subsequently, the 3 groups were further divided into 6 groups based on the presence of DIS, and the combined sleep behaviors were termed ‘sleep patterns'. Logistic regression was conducted to assess the association of sleep variables and sleep patterns with the risk of depressive symptoms. ResultsCompared to the reference group, ‘short sleep duration’ and DIS symptoms were associated with depressive symptoms (with odds ratios (OR) of 1.50 and 1.79, respectively, with 95% confidence intervals (CI) of 1.14–1.97 and 1.39–2.31). When compared to ‘normal sleep duration without DIS', both ‘short sleep duration with DIS' (OR = 2.60, 95% CI: 1.81–3.72) and ‘normal sleep duration with DIS' (OR = 1.60, 95% CI: 1.03–2.49) were statistically associated with depressive symptoms in adjusted regression models. ConclusionShort sleep duration and DIS symptoms were found to be associated with depressive symptoms. Combining DIS symptoms with sleep duration, DIS was identified as a risk factor for elevated depressive symptoms in individuals with short and normal sleep durations. In managing depressive symptoms, it is imperative to thoroughly evaluate insomnia and nighttime sleep, which can provide valuable insights for nursing and medical policy.

Sleep Quality and Quality of Life in Remitted Bipolar Disorder Patients: A Cross-sectional Comparative Study

Background: Patients diagnosed with bipolar disorder often have sleep-related problems, even when not in an episode. Poor sleep quality may be related to poor quality of life. The objective of this study was to evaluate sleep quality in remitted bipolar patients and compare it to controls, as well as to study the relationship between quality of sleep and quality of life in euthymic bipolar individuals. Methods: We studied sleep quality and quality of life in 86 remitted bipolar disorder patients and 86 matched healthy controls using the Pittsburgh Sleep Quality Index (PSQI) and World Health Organization Quality of Life Assessment (WHOQOL-BREF). Results: There was significantly poorer sleep quality in euthymic bipolar patients compared to controls, especially in subjective sleep quality and sleep duration. WHOQOL-BREF domain scores were lower among patients than controls, with a large effect size. All domains on the PSQI correlated negatively with the domains on the WHOQOL-BREF, with the physical health domain being affected the most. Lack of generalizability of the results and the cross-sectional design that cannot determine causality are the limitations of our study. Conclusions: Poor sleep quality persists in bipolar patients even in the euthymic phase and correlates with a poor quality of life.

Suicidal ideation in people with multiple sclerosis and its association with coping self-efficacy

BackgroundChronic neurological disease such as multiple sclerosis (MS), is a significant risk factor for psychological distress, which can result in suicidal behaviour. Suicidal ideation (SI) is considered a harbinger of suicide-related mortality. However, so far, little is known about the role of protective factors against SI in MS. ObjectiveThis study aims to assess the association between coping self-efficacy and SI when controlled for sociodemographic variables, clinical variables, sleep-related problems, and depression. MethodsThe study sample consisted of 162 people with MS, was predominantly female (75.9 %), the mean age was 40.9 ± 11.4 years, the mean disease duration was 11.7 ± 7.1 years, and the mean functional disability score was 3.55 ± 1.1. We used the Coping Self-Efficacy scale (CSE), the General Health Questionnaire-28 (GHQ-28), the Expanded Disability Status Scale (EDSS), the Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI), and the Multidimensional Fatigue Inventory (MFI). Multiple linear regressions were utilized to statistically analyse the data. ResultsAll assessed coping self-efficacy dimensions were significantly associated with SI in MS when controlled for sociodemographic variables, clinical variables, sleep-related problems, and depression. Furthermore, all assessed coping self-efficacy dimensions were able to alleviate the negative association between income, depression and SI. ConclusionPeople with MS may significantly benefit from psychological support aimed at promoting coping self-efficacy and utilization of various coping strategies. Problem-focused coping, coping focused on getting support, and coping focused on stopping unpleasant thoughts and feelings seem to have comparable associations with SI, and thus interventions aimed at empowering any of these dimensions may be beneficial in diminishing the severity of SI.

A cross-sectional mental-health survey of Chinese postgraduate students majoring in stomatology post COVID-19 restrictions.

The psychological status of Chinese postgraduate students majoring in stomatology after the COVID-19 restrictions still remains unclear. The objective of this study is to evaluate the mental status through a cross-sectional survey and gather related theoretical evidence for psychological intervention on postgraduate students majoring in stomatology. An online survey was administered, and subjective well-being, anxiety, stress and depression symptoms were assessed using the 5-item World Health Organization Well-Being Index (WHO-5), item Generalized Anxiety Disorder Scale (GAD-7), 10-item Perceived Stress Scale (PSS-10), and Patient Health Questionnaire-9 (PHQ-9), respectively, wherein suicidal ideation and sleep-related problems were measured with PHQ-9 and Insomnia Severity Index (ISI). A total of 208 participants who completed one questionnaire were considered as valid. It was found that female respondents generally exhibited significantly higher levels of PSS-10, PHQ-9, and GAD-7 scores and shorter physical activity hours than male students. Students from rural areas demonstrated significantly higher levels of PHQ-9, suicidal ideation, and less portion of good or fair family economic support. Additionally, individuals from only-child families reported increased levels of activity hours (1.78 ± 2.07, p = 0.045) and a higher portion (55.10%, p = 0.007) of having clear future plan as compared with multiple-child families. The risk factors for anxiety symptoms (GAD-7 score) were higher scores of PSS-10 (OR = 1.15, 95% CI = 1.09-1.22), PHQ-9 (OR = 1.35, 95% CI = 1.22-1.49), and ISI-7 (OR = 1.14, 95% CI = 1.06-1.23), while owning a clear graduation plan was the protective factor (OR = 0.55, 95% CI = 0.31-0.98). Moreover, the risk factors for depressive symptoms (PHQ-9) included PSS-10 (OR = 1.10, 95% CI = 1.04-1.16), GAD-7 (OR = 1.38, 95% CI = 1.25-1.52), suicidal ideation (OR = 5.66, 95% CI = 3.37-9.51), and ISI-7 (OR = 1.17, 95% CI = 1.09-1.25). Approximately 98.08% of Chinese postgraduates studying stomatology reported experiencing at least moderate stress after the COVID-19 restrictions. Within the limitations of this study, senior students were more inclined to stress, while anxiety symptoms were related to severer levels of stress, depression, and insomnia. Depressive symptoms were associated with higher levels of stress, anxiety, insomnia, suicidal ideation, and lower levels of self-reported well-being. Thus, psychological interventions for postgraduates should be timely and appropriately implemented by strengthening well-being, reasonably planning for the future, and good physique, thereby mitigating the psychological issues after COVID-19 restrictions.