Psychosocial factors and major epidemiological risks are well-known to be significant contributors to the pathogenesis and progression of multifactorial diseases. Psychoemotional stress is markedly exacerbated under conditions of social and economic instability. Anxiety, irritability, and vital exhaustion may modulate physiological processes via neurohumoral regulation, thereby increasing the susceptibility to the development and progression of cardiovascular diseases, asthenic syndrome, and cognitive decline. The neuropsychological examination facilitates not only comprehensive evaluation of cognitive and emotional status pre- and post-therapy, but the formulation of individualized strategies for stress management and prevention of its adverse consequences. The neuropsychological assessment data of 120 patients with asthenia before and after the administration of metabolic therapy were comprehensively analyzed to build a statistical model. Elevated levels of stress and vital exhaustion demonstrate significant correlation with the gastrointestinal pathologies and smoking more than 10 cigarettes per day. Prolonged completion of cognitive tasks in patients with arterial hypertension and diabetes mellitus may indicate the disturbances in cerebral tissue perfusion. Psychoemotional status improvement and attenuation of asthenic symptoms appeared to depend on both the baseline severity of dysfunction and the presence of comorbidities. The described model supports the design of personalized therapeutic strategies with consideration for individual risk factors.

Pericoronary adipose tissue (PCAT) attenuation is a novel imaging biomarker of coronary inflammation associated with an increased risk of coronary artery disease (CAD). However, no studies have examined the relationship between chronic stress and PCAT. This study aimed to evaluate the intersection between chronic stress, inflammatory biomarkers, coronary plaque features, and PCAT attenuation. A total of 98 participants without known CAD were included. PCAT attenuation, total plaque volume (TPV) quantification, and vulnerable plaque features were assessed by coronary CT angiography and chronic stress was measured by hair cortisol concentration (HCC) and vital exhaustion questionnaire. Regression models were used to analyse associations of PCAT with the inflammatory biomarkers interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α), TPV, vulnerable plaque features, and coronary stenosis. Moderating analyses were performed to test whether chronic stress modulated the association between inflammatory biomarkers and PCAT attenuation. PCAT attenuation was significantly associated with IL-6 (mean difference 1.05, 95% CI 0.21-1.89, P = 0.014), TNF-α (mean difference 0.60, 95% CI 0.06-1.13, P = 0.027), and a greater TPV (mean difference 3.51, 95% CI 0.02-7.00, P = 0.048), but not vulnerable plaque features or coronary stenosis. HCC (interaction term -0.12, 95% CI -0.22 to -0.02, P = 0.019) and vital exhaustion (interaction term 0.13, 95% CI 0.01-0.25, P = 0.024) moderated the relationship between IL-6, but not TNF-α, and PCAT attenuation. This study suggests that circulating inflammatory biomarkers are associated with PCAT attenuation, which was further correlated with TPV. Chronic stress may moderate the relationship between inflammatory cytokines and PCAT attenuation.

The global trends towards a decrease in cardiovascular mortality in the second decade of the 21st century, demonstrated in many studies, highlight the phenomenon of an increase in the prevalence of psychosocial risk factors for cardiovascular diseases (CVD), and in particular, such factors of psycho-emotional stress as depression and vital exhaustion. Analysis of large epidemiological studies has shown that decreased sleep quality is associated with a higher risk of stroke and an overall risk of CVD. Objective. To determine the gender-related features of associations of a high level of psychosocial risk factors for cardiovascular diseases (depression and vital exhaustion) and sleep quality in an open urban population. Materials and methods. A cross-sectional study was conducted using a single protocol among males and females in the 25-64 age group for four decades of life in an open urban population (Tyumen). The indicators of sleep quality, depression, and vital exhaustion (VE) were studied according to the algorithms of the World Health Organization’s MONICA-MOPSY program. Results. In the open urban population, the frequency of detection of high levels of depression prevailed in young women of the third and fourth decades of life and high levels of VE in women of the third and men of the sixth decades of life. Regarding gender, good sleep quality in the open urban population is significantly more common in men, mainly in the third and fifth decades of life. In the presence of depression and VE, both men and women of the open urban population had adverse changes in sleep quality, more pronounced in those with a high level of VE. Conclusion. The results of the sleep quality analysis in males and females in the age range, as well as the gender aspects of sleep quality associations with high levels of psychosocial risk factors, should be used in developing a preventive program to reduce high cardiovascular risk in an open urban population. The preventive program should focus primarily on the timely psychotherapeutic diagnosis of these conditions and their subsequent treatment.

ABSTRACTIntroductionTransplantation with a kidney from a living donor has superior long‐term patient and graft survival compared to a kidney from a deceased donor. For a kidney donor, feelings of stress may exist at different stages of the donation process. The aim of the study was to evaluate living kidney donors’ perceived and measured stress levels before and after donation.MethodsIn this prospective observational cohort study with longitudinal follow‐up, kidney donors were invited to answer three self‐rating questionnaires targeting stress, vital exhaustion, and depressive symptoms the day before and two and six months after kidney donation. At the same time points, blood and saliva samples of insulin, glucose, and cortisol were collected.ResultsAnalyses were based on data from seventy‐five individuals, with a mean age 46.5 (11) years, 60% women. The kidney donors scored low in self‐rating stress, exhaustion and depression both pre‐ and two and six months post‐donation, and no correlations were established between self‐reported measures and metabolic stress biomarkers. Post‐donation, however, a gender difference emerged, with women reporting decreased vitality scores 32.1 (9.3) and 30.7 (11.6) at two and six months versus men reporting increased scores 35.8 (6.9) and 36.9 (7.1). Six months post‐donation, women also reported more symptoms of depression than men, 12.2 (12.5) versus 6.4 (8.2) (p = 0.058).ConclusionsKidney donors’ self‐reported and measured stress levels and depressive symptoms were low and did not change from pre‐donation up to six months after donation. The low levels of subjective and objective stress reported by the donors support the limited risks associated with living kidney donation. However, six months post‐donation, women reported more feelings of exhaustion and depression than did men. Practitioner points: (1) The low levels of subjective and objective stress reported by kidney donors support the limited risks associated with living kidney donation. (2) Because most kidney donors are women, the gender difference in perceived stress levels presented in this study is of clinical relevance. (3) A more structured psychosocial follow‐up could enable the identification of individuals in need of more psychological follow‐up post‐donation.

This systematic review and meta-analysis aims to investigate the association of burnout and vital exhaustion (VE) symptoms with (measures of) the metabolic syndrome (MetS). PubMed, Embase, and PsycINFO were systematically searched until April 26, 2024. Studies investigating adult populations, burnout, or VE as exposures and (measures of) MetS as outcomes were included. Data extraction and quality assessment were performed independently by two observers. If at least three independent effect measures (in at least two studies) were available per association, meta-analyses were performed using random-effects models. We included 101 studies (71% cross-sectional, 11% case-control, 13% prospective, 5% alternative) comprising 22 strong, 55 moderate, and 24 weak quality studies. Meta-analyses showed relevant but statistically nonsignificant associations of burnout and VE symptoms with higher incident (odds ratio [OR] = 1.53 [0.82, 2.87], I² = 0%) and prevalent MetS (OR = 1.28 [0.99, 1.64], I² = 85%), incident obesity (OR = 1.88 [0.81, 4.36], I² = 0%), waist-to-hip ratio (standardized mean difference = 0.62 [-0.65, 1.90], I2 = 95%), prevalent high waist circumference (OR = 1.14 [0.80, 1.62], I² = 28%), high triglycerides (OR = 1.49 [0.82, 2.71], I² = 40%), and a significantly higher prevalent hypertension (OR = 1.63 [1.44, 1.84], I2 = 51%). We found no clinically relevant associations with remaining MetS measures. Burnout and VE symptoms might be associated with a higher odds of prevalent and incident MetS, however, not statistically significant. These results should be interpreted with caution due to the cross-sectional design of most studies, use of unadjusted baseline data, and substantial heterogeneity in some analyses. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Supplemental Material for The Association of Burnout and Vital Exhaustion With (Measures of) the Metabolic Syndrome: A Systematic Review and Meta-Analysis

This study aimed to compare the prevalence of psychosocial risk factors for cardiovascular disease (CVD) among adults aged 25–64 in the largest metropolis (Novosibirsk) and a large city (Tyumen) in Western Siberia. Material and methods Representative samples of adults aged 25–64 from Novosibirsk (metropolis) and Tyumen (large city) were examined between 2010–2013 and 2015–2017. Psychosocial factors, including personal anxiety (PA), vital exhaustion (VE), and depression (D), were assessed using standardized methods from the WHO MONICA-psychosocial program protocol. Results. In the Siberian metropolis, higher prevalence rates of elevated PA and D were observed compared to the large city: in men in younger age groups (25–34 years for D; 35–44 years for PA and D); in women in extreme age groups (25–34 and 55–64 years for D). Conversely, the large city showed higher prevalence rates for certain psychosocial factors: in men in older age group (55–64 years for D). and in women in younger (25–34 years for VE) and middle-aged (45–54 years for PA) groups. Conclusions. Significant differences in the prevalence of psychosocial CVD risk factors were identified across age categories in urban populations of Western Siberia. These findings underscore the importance of tailoring preventive programs to address age- and location-specific risk profiles in Siberian cities.

A multitude of studies have supported that vital exhaustion is an important predictor of physical and psychological well-being, especially in the aftermath of adverse medical events; however, some authors have expressed that vital exhaustion may be repetitive with other popular constructs, namely burnout, fatigue, and depression. We resolve this tension by performing a meta-analysis of 74 sources on the immediate nomological network of vital exhaustion. Our results support that the relations of vital exhaustion with emotional exhaustion ( = 0.71, = 0.82, k = 4, n = 1152) and depression ( = 0.70, = 0.83, k = 59, n = 30,963) approached the magnitude of its convergent validity correlation ( = 0.75, = 0.88, k = 4, n = 1445), suggesting that these constructs share most of their variance. Researchers should reinvestigate whether vital exhaustion relates to outcomes when accounting for these two constructs.

Purpose of the study: based on a longitudinal study, to assess the contribution of psychosocial factors to survival and the risk of developing cardiovascular diseases (CVD) among people 25–64 years old in Siberia (Novosibirsk, Tyumen, Tomsk). Materials and methods. On the basis of Research Institute of Therapy and Preventive Medicine – branch of the Federal State Budgetary Scientific Institution «Federal Research Center Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences», Tyumen Cardiology Research Center – branch of the Federal State Budgetary Scientific Institution «Tomsk National Research Medical Center of the Russian Academy of Sciences», Research Institute of Cardiology – branch of the Federal State Budgetary Scientific Institution «Tomsk National Research Medical Center of the Russian Academy of Sciences» using the standard protocol for cardiac screening programs: «Study of the prevalence of coronary artery disease, risk factors for coronary artery disease in various regions of the country»; WHO «MONICA», which did not differ significantly, as well as the «MONICA-psychosocial» subprogram to identify psychosocial risk factors for cardiovascular diseases, cross-sectional studies were conducted on random representative samples of people 25-64 years old: Tomsk – 1981–1982 (n = 738 men); 1985–1986 (n = 1148 men); 1994–1995 (n = 637 men – postal survey and n = 450 men – cardiac screening); Tyumen – 1996 (795 men and 813 women); Novosibirsk – 1994 (657 men and 870 women). The cohort in Tyumen was observed for 12 years, in Tomsk for 19 years, and in Novosibirsk for 16 years. The following «end points» were recorded: death from ischemic heart disease (IHD), CVD, new-onset acute myocardial infarction (AMI) using the WHO program «Acute Myocardial Infarction Registry». Results. Among men and women 25-64 years old in Tyumen, a high 12-year relative risk of cardiovascular death was established in persons with a low level of education, in the professional group of heavy physical labor; in the male cohort – among single, widowed and divorced men. An assessment of the attributable risk of the social gradient in the male cohort showed the greatest contribution to cardiovascular death from the group of widows – 69.2 %, in the female cohort – from the group of people with a low level of education – 84.0 %. For men 25–64 years old in Tomsk, prognostically significant parameters of the social gradient of attributable risk are ranked as follows: 1) for mortality from IHD – working professions, lack of a permanent life partner, low level of education; 2) for mortality from CVD – working professions, average level of education, lack of a permanent life partner, low level of education. Among men and women aged 25–64 years in Novosibirsk, high levels of anxiety, depression and low levels of social support became prognostically significant risk factors for AMI for men and women; among men there is a high level of vital exhaustion. Conclusions. It was established that in the high: 12-year relative risk, 19-year attributable risk of cardiovascular death, the social gradient is prognostically significant. Anxiety, depression, vital exhaustion, social support play a leading role in predicting CVD in the Siberian region among the active working population.

Teaching is a genuinely social and highly demanding task. Drawing on Porges' phylogenetic polyvagal theory with three evolved systems and three associated behavioral responses (social engagement, mobilization, and immobilization), we investigated teachers' heart rate and heart rate variability in social interactions using ambulatory assessments. We continuously measured heart rate and heart rate variability of 42 apparently healthy teachers on a work and leisure day with ambulatory electrocardiogram. We videotaped four consecutive, same-day lectures of each teacher. We trained observers to code student aggression and frontal teaching behaviors in an event sampling procedure with the behavior observation system for analyzing aggressive behavior in school settings. Additionally, perceived teacher-student relationship, social support from other teachers / school management, occupational complaints, and vital exhaustion were assessed by teacher self-reports. Teachers showed an increased heart rate and a decreased heart rate variability on a workday compared to a leisure day, anticipatory stress before classes, as well as insufficient recovery during lunchtime. Observed student aggression and high proportion of frontal teaching were associated with lower heart rate variability, while better perceived teacher-student relationship was correlated with higher heart rate variability. Differently, teachers' psychological strain and heart rate variability were unrelated to each other. Corresponding to polyvagal theory, results suggest that successful social interactions are fundamental for teachers' favorable cardiological reactions.

How stressful is firm insolvency? Self-reported, biological, and physiological indicators of entrepreneurs’ well-being

Data are accumulating on the direct influence of psychoemotional and psychosocial factors on the inexorable growth of obesity prevalence, and therefore the concept of an interdisciplinary approach is needed, including dietary, physical activity and mental state modifications.Aim. To determine the effectiveness of cognitive-behavioral group the­ra­py (CBGT) in combination with nutritional modifications for body mass (BM) management in women with obesity.Material and methods. The study involved 20 women (mean age 46,6±12,3 years) with a BMI ≥30 kg/m2, rigid to diet therapy. A medical psychologist and a nutritionist conducted CBGT sessions with the participants. Initially, BM, BM index, and eating behavior were assessed (DEBQ, Stunkard, CARDIA questionnaires). In addition, the following were used to study the mental status: Toronto Alexithymia Scale ­(TAS-20), vital exhaustion test, University of California, Los Angeles (UCLA) Loneliness Scale, Test of Self-Conscious Affect (TOSCA), Reeder Stress Inventory, and Psychological Stress Measure (PSM-25). The changes were studied 8 weeks after the start CBGT.Results. After 2 months, the BMI dynamics was -4,33 kg (p<0,001). A decrease in the severity of emotional eating behavior by an average of 0,77 (p<0,001), external eating behavior by 1,05 (p<0,001) points was noted, no significant changes in restrained eating behavior were obtained (p=0,43). According to the CARDIA test, after 2 months of CBGT, the detection rate of pathological significance of BM decreased by 50% (p<0,001); as well as episodes of loss of control over food intake (initially in 5 (25%) (p<0,001)), distress due to loss of control over food intake (initially in 6 (30%) (p<0,001). CBGT in combination with dietary intervention showed a decrease in the severity of chronic stress, which corresponded to an increase in the total score from 1,8±0,75 to 2,0±0,60 (p<0,05), a decrease in vital exhaustion from 5,6±3,89 to 4,1±2,66 (p=0,001) and loneliness from 34,9±12,61 to 29,9±7,57 (p=0,007), a decrease in guilt-proneness from 53,0±8,42 to 42,8±11,18 (p<0,001) and shame-proneness from 38,3±10,99 to 31,6±10,07 points (p=0,014).Conclusion. The mental state of a person has a significant impact on eating behavior and on the regulation of BM, which emphasizes the need for complex interventions to provide effective assistance to people with obesity.

BackgroundDue to poorer exercise tolerance, it may be challenging for frail older adults to engage in moderate- or vigorous-intensity exercise. While low-intensity exercise interventions may be more feasible, its effectiveness for such population group remains unclear. We examined the effectiveness and implementation of community-based Baduanjin Qigong, a low-intensity exercise program in older adults with varying frailty status.MethodsA two-arm, multicenter assessor-blind parallel group randomized controlled trial was conducted at three local senior activity centers. Fifty-six community-dwelling older adults with low handgrip strength were randomly allocated to either the intervention (IG) or wait-list control (CG) group. The IG underwent a supervised 16-week Baduanjin exercise program at a frequency of 2–3 × 60 min sessions/week. The CG was instructed to maintain their usual activity and received a monthly health education talk. The primary outcome measures were knee extension strength, vital exhaustion, and fear of falling. Secondary outcome measures include physiological falls risk, handgrip strength, gait speed, timed up and go test, 30-second sit-to-stand, quality of life, depression, and frailty. All outcome measures were assessed at baseline and 4-month follow-up.ResultsOverall, there were no statistically significant differences in all outcome measures between CG and IG at 4-month follow-up. However, in exploratory compliance analysis, a statistically significant group x time interaction was found for vital exhaustion (B = -3.65, 95% CI [-7.13, -0.16], p = .047) among participants with at least 75% attendance. In post-hoc within-group comparisons, IG showed improved vital exhaustion by 4.31 points (95% CI [1.41, 7.20], d = 0.60). The average participant attendance rate was 81.3%. No major adverse events occurred, and all participants reported positive experiences with the exercise intervention.ConclusionsOur study demonstrated that Baduanjin is a safe, feasible, and acceptable exercise program that can be successfully implemented in community settings for older adults with varying frailty status. With good adherence, Baduanjin exercise could potentially be effective in alleviating vital exhaustion. However, the effectiveness of Baduanjin on physical performance, psychological measures and frailty in community-dwelling older adults remains equivocal.Trial registrationClinicalTrials.gov NCT04549103. Registered September 16, 2020.

Purpose of the study: to determine associations of the prevalence of coronary heart disease and some psychosocial risk factors (negative affective states) among men 25–64 years old in the open population of a mid-urban city in Western Siberia.Material and methods. A cross-sectional study with a response rate of 85.0 % was conducted on a representative sample of men 25–64 years old in the city of Tyumen (n = 1000). To determine the levels of personal anxiety, depression, hostility, vital exhaustion, and sleep quality, the standard WHO MONICA-MOPSY questionnaire was used.Results. In the open population of a mid-urban city in Western Siberia, psychosocial risk factors for CVD are significantly common in men aged 25–64 years: personal anxiety (92.4 %), depression (23.6 %), sleep disturbance (50.9 %), hostility (70.0 %), vital exhaustion (54.5 %). Frequency of detection of high gradations of psychosocial risk factors for CVD – personal anxiety (36.6 %), depression (4.6 %), sleep disorders (9.5 %), hostility (46.4 %), vital exhaustion (15.9 %) – increases with age, reaching a maximum in the sixth decade of life. In men 25–64 years old in a mid-urban city in Western Siberia with the presence of IHD, high levels of PSF are more common than in persons without IHD – personal anxiety (OR 4.07), depression (OR 21.07), sleep disorders (OR 5.05) , hostility (OR 2.71), vital exhaustion (OR 6.02); with the presence of «definite» IHD – significantly more often – personal anxiety (OR 9.51), depression (OR 39.84), sleep disturbance (OR 5.28), hostility (OR 4.65), vital exhaustion (OR 14. eleven).Conclusions. Thus, analysis of the definition of psychosocial risk factors associated with the prevalence of coronary heart disease in men 25–64 years old seems necessary to use when developing a preventive program to reduce high cardiovascular risk in the open population of a mid-urban city in Western Siberia, focused primarily on regulation of psychological parameters.

Aggressive student behavior is considered one of the main risk factors for teacher stress. The present study investigated teachers' physiological and behavioral reactions when facing aggressive student behavior and examined which resources favor adaptive teacher reactions. The sample included 42 teachers. We assessed (a) teacher self-reports (i.e., resources, risk factors, and vital exhaustion) (b) classroom observations, (c) ambulatory assessments of teachers' heart rate and heart rate variability, and (d) teachers' progesterone concentrations in the hair. The present study focused on a subsample of ten teachers (9 females, Mage = 34.70, SD = 11.32) managing classes which were potentially very stressful as they had a high density of aggressive behavior. High levels of work satisfaction, hair progesterone, and a low level of work overload fostered social integrative teacher responses. Moreover, in 75% of the cases, teachers succeeded in downregulating their physiological reaction. Our results support the notion that teachers evaluate stressors in light of their resources. When they perceive their resources as insufficient for coping with a challenging situation, stress arises, and subsequently, they react inefficiently to aggressive behavior. Thus, teacher education could benefit from strengthening teacher resources and strategies for coping with aggressive student behavior.

Aim of the study was to analyze the associations of vital exhaustion (VE) with smoking and physical activity among people 25–44 years old in the city of Novosibirsk. Material and methods. A study was carried out on a random representative sample of people aged 25–44 years from the database of the Territorial Compulsory Health Insurance Fund in one of the districts of Novosibirsk in 2013–2016. 975 individuals were examined, including 427 men (age 34.0 ± 0.4 years) and 548 women (age 35.0 ± 0.4 years). The response rate was 50 %. To assess the level of vital exhaustion (VE), the MOPSY scale for VE was proposed; attitudes towards smoking and physical activity were studied using the “Knowledge and attitude towards one’s health” scale, previously tested and validated for the study population in the WHO program “MONICA-psychosocial (MOPSY)”. The materials were processed in accordance with the algorithms presented by the WHO program “MONICA” and the results were obtained on the scales. Results. VE was observed in 48.6 % of participants. 58.9 % of respondents smoked (p < 0.001). Among individuals with a high level of VE (HVE), 10.5 % attempted to change smoking, but were unsuccessful (p < 0.05). Respondents were asked the question: “Do you do physical exercises at home?”, among persons with HVE of both sexes, the answer “I should have done exercises, but I don’t” prevailed in 53.2 % cases (p < 0.01). To the question: “How do you spend your leisure time?” among people with HVE, the answer “physically passive” was more common – 38 % (p < 0.001). Conclusions. Individuals with HVE have a greater dependence on smoking and a lower level of physical activity.

Background – The Indonesian version of the Maastricht Vital Exhaustion Questionnaire (MQ) is an instrument for assessing vital exhaustion in CHD patients. However, the psychometric results of this instrument have yet to be identified in the population of CHD patients in Indonesia. This study aims to evaluate the psychometric properties of the Indonesian version of the MQ instrument using Rasch analysis. Methods – The population of this study was all CHD patients undergoing outpatient treatment at a hospital in West Java. There were 97 respondents using convenience sampling. The instrument used is the Indonesian version of MQ. The reliability and validity of the instrument were analyzed using Rasch analysis and the Winsteps application by considering the Cronbach's Alpha value, Mean square fit statistic (MNSQ), Standardized fit statistics (ZSTD), separation of strata (Separation), and unidimensionality. Findings – α-Cronbach 0.78 with item reliability 0.95 indicates very good reliability; person and item strata separation >2.4 and >5.9, indicating the instrument can identify respondent groups well; MNSQ item infit-outfit 1-0.94 is close to ideal (1) as is ZSTD infit-outfit 0.11 – 0.03 (close to 0); Unidimensionality measurements show a total raw variance of 32.4% with unexplained eigenvalues all <10% indicating good validity. Conclusions - The internal consistency of the instrument is reliable. The data fits the model because the items can measure, have logical predictions, and functionally show unidimensionality. Based on the results, the Indonesian version of the MQ was proven valid and reliable for identifying vital exhaustion in CHD patients in Indonesia.

Vital Exhaustion (VE) refers to a physical and mental state of excessive fatigue, feelings of demoralization, hopelessness, and increased irritability. The short form of the Maastricht Vital Exhaustion Questionnaire (MVEQ) is a widely used measure to assess VE. Despite its utility is broadly recognized, the validity and reliability of the scale have yet to be examined in the Italian context. The present study aimed to evaluate the psychometric properties of the shortened MVEQ in a community sample of Italian older adults. A total of 722 older adults (Mage = 72.97, SD = 7.71; 60.4% females) completed the MVEQ, as well as other self-report questionnaires assessing anxiety, depression and stress in order to evaluate the criterion-related validity of the scale. A confirmatory factor analysis (CFA) was conducted to examine the original MVEQ latent structure. Internal consistency was assessed through model-based omega coefficient. Test-retest reliability was examined by re-administering the MVEQ after three months to a subsample of 568 participants. Factorial invariance tests across gender were conducted by means of multi-group CFAs. The one-factor model showed an acceptable fit to the data. The MVEQ yielded a reliable total score (ω = 0.822) and showed moderate-to-large correlations with measures of anxiety, depression, and stress (r range 0.30 to 0.75, ps < 0.001). Test-retest reliability was supported by an Intraclass Correlation Coefficient (ICC) of 0.661. Lastly, the scale was factorially invariant across gender. Overall, the MVEQ provided evidence of reliability and criterion-related validity in a sample of Italian older adults and may be useful for both clinical and research practices.

Aim. To analyze the associations of exhaustion, as a marker of chronic social stress, with smoking in a random representative sample of people aged 25-44 years in Novosibirsk.Material and methods. In Research Institute of Internal and Preventive Medicine — branch of the Institute of Cytology and Genetics, in 2013-2016, a study of a random representative sample of people aged 25-44 years in one of the Novosibirsk districts was conducted (registration № FWNR-2024-0002). A total of 975 individuals were examined, of which 427 men and 548 women. The response rate was &gt;70%. Assessment of exhaustion level and attitude towards smoking was carried out according to standard methods of the World Health Organization's MONICA-psychosocial (MOPSY) program protocol.Results. Among people aged 25-44 years, 38,3% of men and 56,1% of women had exhaustion (χ2=40,744; df=2, p&lt;0,001). Among people of both sexes aged 25-44 years, 58,9% were smokers, of which 27,1% stopped smoking, while 31,8% continued to smoke. Among men, 72,7% smoked, 29% stopped smoking and 43,7% continued smoking. Among women, 48,4% smoked, 25,6% stopped smoking, and 22,8% continued smoking (χ2=72,374; df=5, p&lt;0,001). Among people of both sexes aged 25-44 years with a high exhaustion, 10,5% tried to change their smoking status, but unsuccessfully (χ2=20,708; df=10, p&lt;0,05), and among women — 7,2% (χ2=27,117; df=10, p&lt;0,05). Among those who tried unsuccessfully to change their smoking status (10,1%), "some events annoyed more now than before" (χ2=20,053; df=10, p&lt;0,05). Women who smoke (33%), as well as women who smoke but quit for a while (21,2%) "wanted to die at times" (χ2=20,040; df=10, p&lt;0,05). Among those who smoke, but quit for some time, both among people of both sexes 25-44 years old (14,7%) (χ2=22,783; df=10, p&lt;0,05) and among men (16,1%) (χ2=19,593; df=10, p&lt;0,05) and women (14%) (χ2=20,734; df=10, p&lt;0,05) individually, more often "there was a feeling that recently life requires more strength than is left." Men who tried unsuccessfully to change their smoking status were (13,8%) more often "woke up feeling exhausted and tired" (χ2=19,713; df=10, p&lt;0,05).Conclusion. We found that people with a high exhaustion have greater dependence on smoking.

Baseline Characteristics From a New Longitudinal Cohort of Patients With Noncancer Pain and Chronic Opioid Use in the United States